Building Capabilities for Multi-Stakeholder Interactions at Global and Local Levels: An Executive Interview with Jan Kees Vis, Berton Torn and Anniek Mauser

Managers of Unilever discuss the processes that led the company to develop and implement a corporate sustainability strategy working with multiple stakeholders. Major learning points include: 1) interactions with stakeholders are crucial to secure strategic resources in developing countries; 2) developing multi-stakeholder platforms must be rooted in the corporate culture and based on principles of innovation; 3) the overarching sustainability strategy, Sustainable Living Plan, launched in 2010, set broad objectives, while empowering local and regional managers—and even individual employees—to start and scale bottom-up initiatives if they find consensus within the organization. The discussions promise to fuel the debate on how organizations can effectively manage “wicked problems” through multi-stakeholder engagement

Association of 1800 cGy cranial irradiation with intellectual function in children with acute lymphoblastic leukaemia

Cranial radiation therapy in childhood acute lymphoblastic leukaemia has been associated with adverse neuropsychological effects, such as low intelligence. However, records show that these associations usually occur when the dose of radiation used is 2400 cGy. We investigated whether a lower dose of 1800 cGy had the same adverse effects on long-term survivors and whether high doses of methotrexate but no radiation therapy would have a more beneficial effect. We evaluated 203 children for six years in a multi-centre European study. The patients were divided into two groups: 129 children treated with 1800 cGy of cranial radiation therapy and 74 children who received high-dose methotrexate but no radiation therapy. We used full scale intelligence quotient, verbal, and performance IQ tests to assess the patient's intelligence. We found a significant decline in full scale intelligence quotient in the irradiated group that increased with the length of time from diagnosis. Younger age at diagnosis was associated with lower full scale intelligence quotient in the radiated group. Our results indicate that a radiation dose of 1800 cGy can have negative effects on neurocognitive function and we continue to question the benefit of low-dose cranial radiation therapy

Recovery of dialysis patients with COVID-19 : health outcomes 3 months after diagnosis in ERACODA

Background. Coronavirus disease 2019 (COVID-19)-related short-term mortality is high in dialysis patients, but longer-term outcomes are largely unknown. We therefore assessed patient recovery in a large cohort of dialysis patients 3 months after their COVID-19 diagnosis. Methods. We analyzed data on dialysis patients diagnosed with COVID-19 from 1 February 2020 to 31 March 2021 from the European Renal Association COVID-19 Database (ERACODA). The outcomes studied were patient survival, residence and functional and mental health status (estimated by their treating physician) 3 months after COVID-19 diagnosis. Complete follow-up data were available for 854 surviving patients. Patient characteristics associated with recovery were analyzed using logistic regression. Results. In 2449 hemodialysis patients (mean ± SD age 67.5 ± 14.4 years, 62% male), survival probabilities at 3 months after COVID-19 diagnosis were 90% for nonhospitalized patients (n = 1087), 73% for patients admitted to the hospital but not to an intensive care unit (ICU) (n = 1165) and 40% for those admitted to an ICU (n = 197). Patient survival hardly decreased between 28 days and 3 months after COVID-19 diagnosis. At 3 months, 87% functioned at their pre-existent functional and 94% at their pre-existent mental level. Only few of the surviving patients were still admitted to the hospital (0.8-6.3%) or a nursing home (∼5%). A higher age and frailty score at presentation and ICU admission were associated with worse functional outcome. Conclusions. Mortality between 28 days and 3 months after COVID-19 diagnosis was low and the majority of patients who survived COVID-19 recovered to their pre-existent functional and mental health level at 3 months after diagnosis

More than smell - COVID-19 is associated with severe impairment of smell, taste, and chemesthesis

Recent anecdotal and scientific reports have provided evidence of a link between COVID-19 and chemosensory impairments, such as anosmia. However, these reports have downplayed or failed to distinguish potential effects on taste, ignored chemesthesis, and generally lacked quantitative measurements. Here, we report the development, implementation, and initial results of a multilingual, international questionnaire to assess self-reported quantity and quality of perception in 3 distinct chemosensory modalities (smell, taste, and chemesthesis) before and during COVID-19. In the first 11 days after questionnaire launch, 4039 participants (2913 women, 1118 men, and 8 others, aged 19-79) reported a COVID-19 diagnosis either via laboratory tests or clinical assessment. Importantly, smell, taste, and chemesthetic function were each significantly reduced compared to their status before the disease. Difference scores (maximum possible change ±100) revealed a mean reduction of smell (-79.7 ± 28.7, mean ± standard deviation), taste (-69.0 ± 32.6), and chemesthetic (-37.3 ± 36.2) function during COVID-19. Qualitative changes in olfactory ability (parosmia and phantosmia) were relatively rare and correlated with smell loss. Importantly, perceived nasal obstruction did not account for smell loss. Furthermore, chemosensory impairments were similar between participants in the laboratory test and clinical assessment groups. These results show that COVID-19-associated chemosensory impairment is not limited to smell but also affects taste and chemesthesis. The multimodal impact of COVID-19 and the lack of perceived nasal obstruction suggest that severe acute respiratory syndrome coronavirus strain 2 (SARS-CoV-2) infection may disrupt sensory-neural mechanisms. © 2020 The Author(s) 2020. Published by Oxford University Press. All rights reserved

Subjective intensity and pleasantness in taste

This thesis contains studies on intensity and pleasantness in taste perception. There is a formal relationship between intensity and hedonic value of stimuli, which can be expressed in an inverted U. The fact that pleasantness depends partially on stimulus intensity poses a problem when one wants to study them independently. We attempted to dissociate intensity and pleasantness by manipulation of stimulus dimensions. Mixtures of two taste substances were used, one pleasant and the other unpleasant. Based on preceding subjective intensity matching, different proportional combinations of both substances could be composed in such a way as to keep stimulus intensity constant. Depending on the proportions of the components, the iso-intense stimuli had a different hedonic value. Manipulating stimulus dimensions may be characterized as a bottom-up approach. We also used a top-down approach to dissociate intensity and pleasantness. This part of the thesis involves several experiments dealing with timing differences between attention to and judgment of either pleasantness or intensity of taste stimuli. In one paper it is shown that the response time required to judge intensity is considerably shorter than the time needed to respond to pleasantness. In a related paper changes in intensity and pleasantness over time were studied. The results from these papers suggest that intensity can be judged much faster than pleasantness, since the latter is conceptually more fuzzy and complex. In another paper, subjects were required to switch their judgment of a taste stimulus from intensity to pleasantness or vice versa. The switch from pleasantness to intensity was much faster than from intensity to pleasantness. However, our observations show that pleasantness judgements become faster as pleasantness becomes a more clearly defined concept, for example in very unpleasant taste stimuli. Still another top-down way to affect taste judgments is by providing information on the stimulus and then studying the judgment of that stimulus. This approach was chosen in two experiments. When a preceding verbal prime is negative and hedonically congruent with the following stimulus (a bitter unpleasant taste), this stimulus is detected faster than when prime and stimulus are congruent and both positive. A finding like this supports the idea of preferential facilitation of the processing of negative stimuli under time constraints. A well-known effect is the synergism caused by adding the widely used taste-enhancer monosodium glutamate to food. We studied this phenomenon in a model bouillon solution and found that it is due primarily to pleasantness change rather than intensity change. The results of some of the tasks mentioned above were interpreted in the framework of attention. How people attend to a taste in terms of brain mechanisms is as yet unclear. So a study was carried out to find out whether increased attention to a taste stimulus is accompanied by enhanced activity in the gustatory cortex. This turned out to be true; however, even in the case of stimulus absence (tasteless solution) the mere instruction to attend to a taste already led to increased activity in the gustatory cortex as evidenced by fMRI measurements

Comparison times are longer for hedonic than for intensity judgements of taste stimuli

Response times of intensity and hedonic comparisons were determined in a within-subjects experimental design. Forced-choice paired comparisons of orange lemonades with various concentrations of added quinine sulfate were made by 48 subjects. Depending on experimental condition, the subjects had to focus either on intensity or on pleasantness and give their responses as fast as possible. The data showed shorter response times for intensity comparisons than for pleasantness comparisons. Although taste processing may be partially serial and partially parallel, the larger part of the response times and the differences between them may be due to cognitive processin

Temporal aspects of intensity and hedonic responses

The present study investigated temporal aspects of hedonic responses. The focus was on the hedonic response in itself and on the time-course of the hedonic response as compared to the intensity response. Analogously to time-intensity (TI) scaling, we used temporal scaling for intensity and pleasantness aspects of taste. Twenty four subjects were instructed to focus on and continually rate either the intensity or the pleasantness of three different concentrations of an orange lemonade stimulus in a within-participants design. As was expected, the latency and the time to maximum of the intensity response were shorter than the latency and time to maximum of the hedonic response. Unforeseen, the intensity response lasted longer than the pleasantness response. These results suggest that initially the processing of the intensity and pleasantness aspects is in serial and later on may be in parallel. Our study confirms that, as was suggested by Taylor and Pangborn [Journal of Sensory Studies 4 (1990) 241-247], time-hedonic scaling can be performe