The role of governance in realising the transition towards sustainable societies

It is widely known that governance is central to the successful implementation of sustainable development policies and measures. Yet, there is a paucity of research which explore the links between governance and sustainability. This paper attempts to address this research need by providing an analysis of the role of governance in enabling – and to some extent – fostering a transition towards sustainable societies. A set of indicators for assessing the capacity for and willingness and commitment to transition to a more sustainable society is presented, enabling identification of direction of change. This paper presents the results of a study, in the context of which sustainability governance has been comparatively investigated in a sample of European countries with, by methodological purpose, very different economic, environmental, political and social conditions (Denmark, Finland, Germany, Latvia, Lithuania and Poland). Lessons learnt and examples of good practice – which may be replicable elsewhere-are outlined. For instance, it is discussed that limited knowledge about sustainable development amongst municipal development planners and decision-makers, deficiencies in policy integration, intersectoral cooperation, municipality and stakeholder cooperation and urban management practices are major reasons for weak governance practices in sustainable development. Furthermore, some recommendations on the role of sustainability governance are made, so as to allow the integration of the principles of governance into sustainability practice and hence provide a more general basis upon which a transition towards sustainable societies may become a reality in different types of European countries and societies. The scientific value of this paper lies in identifying opportunities for integrating principles of governance into sustainability practice, as well as outlining the basis for sustainability transitions, providing a general picture of required policy measures. The paper offers a unique comparative analysis of sustainability governance in the Baltic Sea countries, outlining some of the challenges in sustainability governance in the Baltic Sea region

Explaining variation in Down's syndrome screening uptake: comparing the Netherlands with England and Denmark using documentary analysis and expert stakeholder interviews.

Background: The offer of prenatal Down’s syndrome screening is part of routine antenatal care in most of Europe; however screening uptake varies significantly across countries. Although a decision to accept or reject screening is a personal choice, it is unlikely that the widely differing uptake rates across countries can be explained by variation in individual values alone. The aim of this study was to compare Down’s syndrome screening policies and programmes in the Netherlands, where uptake is relatively low ( 90% respectively), in an attempt to explain the observed variation in national uptake rates. Methods: We used a mixed methods approach with an embedded design: a) documentary analysis and b) expert stakeholder analysis. National central statistical offices and legal documents were studied first to gain insight in demographic characteristics, cultural background, organization and structure of healthcare followed by documentary analysis of primary and secondary sources on relevant documents on DSS policies and programme. To enhance interpretation of these findings we performed in-depth interviews with relevant expert stakeholders. Results: There were many similarities in the demographics, healthcare systems, government abortion legislation and Down’s syndrome screening policy across the studied countries. However, the additional cost for Down’s syndrome screening over and above standard antenatal care in the Netherlands and an emphasis on the ‘right not to know’ about screening in this country were identified as potential explanations for the ‘low’ uptake rates of Down’s syndrome screening in the Netherlands. The social context and positive framing of the offer at the service delivery level may play a role in the relatively high uptake rates in Denmark. Conclusions: This paper makes an important contribution to understanding how macro-level demographic, social and healthcare delivery factors may have an impact on national uptake rates for Down’s syndrome screening. It has suggested a number of policy level and system characteristics that may go some way to explaining the relatively low uptake rates of Down’s syndrome screening in the Netherlands when compared to England and Denmark

Biocides in urban wastewater treatment plant influent at dry and wet weather: concentrations, mass flows and possible sources

In recent years, exterior thermal insulation systems became more and more important leading to an increasing amount of houses equipped with biocide-containing organic façade coatings or fungicide treated wood. It is known that these biocides, e.g. terbutryn, carbendazim, and diuron, as well as wood preservatives as propiconazole, leach out of the material through contact with wind driven rain. Hence, they are present in combined sewage during rain events in concentrations up to several hundred ng L(-1). The present study focused on the occurrence of these biocides in five wastewater treatment plants in Denmark and Sweden during dry and wet weather. It was discovered, that biocides are detectable not only during wet weather but also during dry weather when leaching from façade coatings can be excluded as source. In most cases, the concentrations during dry weather were in the same range as during wet weather (up to 100 ng L(-1)); however, for propiconazole noteworthy high concentrations were detected in one catchment (4.5 μg L(-1)). Time resolved sampling (12 × 2 h) enabled assessments about possible sources. The highest mass loads during wet weather were detected when the rain was heaviest (e.g. up to 116 mg h(-1) carbendazim or 73 mg h(-1) mecoprop) supporting the hypothesis that the biocides were washed off by wind driven rain. Contrary, the biocide emissions during dry weather were rather related to household activities than with emissions from buildings, i.e., emissions were highest during morning and evening hours (up to 50 mg h(-1)). Emissions during night were significantly lower than during daytime. Only for propiconazole a different emission behaviour during dry weather was observed: the mass load peaked in the late afternoon (3 g h(-1)) and declined slowly afterwards. Most likely this emission was caused by a point source, possibly from inappropriate cleaning of spray equipment for agriculture or gardening

Supportive encounters during pregnancy and the postnatal period: An ethnographic study of care experiences of parents in a vulnerable position

Background: Pregnant women and partners with psychological and/or social challenges are exposed to adverse health outcomes. It is therefore recommended that they receive targeted maternity care services. The relationship between parents and professionals is key to help parents engage with services and experience them as supportive. However, more knowledge is needed on parents’ care experiences during encounters with professionals to further understand when and how these are experienced as supportive. Objectives: This study aimed at identifying the key elements of supportive care practices by exploring how parents in vulnerable positions experience their relationship and encounters with the professionals involved in their pregnancy and postnatal care. Design: Ethnographic fieldwork was conducted in a Danish municipality, including 50 semi-structured interviews with parents and 51 field visits during parent-professional encounters, including informal interviews and participant observation. Using a purposive recruitment strategy, 26 women and 13 men were recruited, who varied in age, socioeconomic background and vulnerability factors. COREQ reporting guidelines were used. Results: The analysis identified five themes: (a) Having a voice: Feeling listened to, (b) Being met with empathy: Feeling understood, (c) Worthy of attention: Feeling taken seriously, (d) On equal terms: Feeling like a normal family and (e) Moving in the right direction: Feeling reassured. Conclusion: Positive care experiences facilitate engagement with services and professionals as this contribute to parents feeling included, respected and safe. Conversely, negative care experiences leave parents feeling excluded, judged and anxious, potentially reinforcing and adding to existing feelings of anxiety and stigma. This requires that professionals have good communication skills and are able to approach parents in an open and non-judgmental way. Relevance to clinical practice: Understanding the significance of supportive care practices is paramount for health visitors, midwives and other professionals involved in providing for parents in vulnerable positions during pregnancy and the postnatal period