Public Health Foresight Report 2018 - A healthy prospect

Het gaat goed met de volksgezondheid in Nederland. We worden steeds ouder, en de meeste mensen voelen zich gezond en niet beperkt. Toch staan we voor een paar grote toekomstige opgaven. In deze synthese van de zevende Volksgezondheid Toekomst Verkenning (VTV) staat beschreven wat er op ons afkomt en hoe we daarmee om kunnen gaan. De VTV-2018 laat zien hoe onze volksgezondheid en zorg zich de komende 25 jaar ontwikkelen als we als maatschappij niets extra's zouden doen. Door de vergrijzing neemt het aantal ouderen toe. Ook wonen zij vaker alleen en zelfstandig. Er zijn straks meer mensen met chronische aandoeningen als dementie, kanker en hart- en vaatziekten, en deze aandoeningen komen vaker tegelijkertijd voor. Daardoor wordt de zorg complexer. De zorg verandert ook door technologische ontwikkelingen en omdat patiënten steeds meer zelf doen. Er komt meer druk op mantelzorgers. Daarnaast hebben we last van de drukke stad en flexibel werk. Jongeren ervaren steeds meer prestatiedruk. Dit zijn een aantal van de belangrijke opgaven waar we voor staan. Deze opgaven vragen om een nieuwe manier van werken. We zullen meer moeten samenwerken: beleidsmakers, burgers, patiënten, zorgverleners, onderzoekers én maatschappelijke organisaties. Daarbij staat de persoonlijke situatie van mensen centraal. Dit betekent ook over de grenzen van volksgezondheid en zorg heen kijken: voor een gezonde toekomst zijn een gezonde omgeving, school en werkplek van groot belang. Er gebeurt al veel in de maatschappij voor de volksgezondheid en zorg om beter voorbereid te zijn op de toekomst. Hier kunnen we van leren en verder op bouwen. De VTV verschijnt elke vier jaar, in opdracht van het ministerie van VWS. Hiermee draagt het RIVM bij aan het volksgezondheidsbeleid in Nederland. De volledige VTV-2018 is te vinden op www.vtv2018.nl.The prospects for future public health in the Netherlands are good. Our life expectancy is steadily increasing, and most people feel healthy and do not experience activity limitations. Nevertheless, we face some major future challenges. The seventh Public Health Foresight study describes the societal challenges we will be facing and how we can deal with them. The Public Health Foresight study 2018 shows how our public health and health care sector will develop over the coming 25 years if we, as a society, do not take any extra measures. Our ageing population results in an increase in the number of older persons. These persons also live alone and independently more frequently. More people will suffer from chronic diseases such as dementia, cancer, and cardiovascular diseases, and these diseases will also occur more often in combination with each other. As a result, health care will become more complex. Care is also changing as a result of technological developments and because patients are increasingly doing more themselves. More pressure is being put on informal caregivers. In addition, we are faced with increasingly busy cities and flexible contracts, and young people are feeling increasing levels of pressure to perform. The above are some of the major challenges we are facing. These challenges demand a new way of working. We will have to collaborate more; this applies to policymakers, citizens, patients, caregivers, researchers, and social organisations. While doing so, the focus should be on the personal situation of each individual. This also means that we need to look beyond the scope of the public health sector and care sector as such. A healthy environment, school, and workplace are essential for a healthy future. Much is already being done within society in relation to public health and care to be better prepared for the future. We can learn from this and use it as a base to build on further. The Public Health Foresight study is published once every four years at the request of the Ministry of Health, Welfare and Sport. Through this study, RIVM contributes to public health policy in the Netherlands. The complete Public Health Foresight study 2018 can be accessed at www.vtv2018.nl

A Radical Shift for the Future of Environmental Law: the Potential and Risks of the Use of Technology for the Benefit of the Environment

The rate of environmental decline over the past few decades has been alarming, reflecting the relative ineffectiveness of the expanding body of environmental law that has been enacted since the early 1970s. Scholars have analysed the causes for the sub-optimal performance of environmental regulation, and put forward a plethora of explanations. Our scientific understanding of how ecologies interrelate and what critical thresholds exist remains sketchy at best, which hinders the articulation of appropriate regulatory goals. It is also hard to channel the behaviour of citizens for as long as the costs of environmental harm are borne by future generations that are not represented in political and legal processes. Last but not least, disequilibrium exists between those having an interest in pursuing a certain (industrial) activity and the environment, which cannot fend for itself, yet is not easily represented in the law. The search is on for new regulatory approaches that radically improve on the environmental performance of the current regulatory regime. As environmental threats, such as climate change, are becoming ever more acute and serious, and public funds simultaneously increasingly scarce, technology is becoming part of the standard toolbox of environmental regulators. This being so, we can no longer postpone thinking about the implications of the use of technology for environmental law. First and foremost, this is because changes in one mode of regulation will reverberate across the regulatory landscape. Norms that would be challenged by the employment of technologies are in particular those pertaining to access to environmental information, public participation in environmental decision-making and access to justice in environmental cases. These norms not so much regard the effectiveness of environmental regulation, but seek to safeguard its legitimacy. Legitimacy, in this context, implies that both the goals pursued by regulation are proper (or, put more specifically, that regulation responds to major environmental needs) and that regulators pursue those goals in the right way (respecting fundamental rights, proportionality, taking account of principles of environmental law, such as polluter pays, precaution etc.). In general terms, the paper hence revolves around questions concerning (a) the environmental potential of the employment of technology and (b) the compatibility of the use of technology with the existing regulatory landscape. We will look into these issues by focussing on one area where technological innovation may profoundly impact on environmental law: geo-engineering. Geo-engineering is defined as deliberate large-scale manipulation of the planetary environment to counteract anthropogenic climate change. (International) legislation explicitly aimed at regulating the various forms of geo-engineering is still absent. We will analyse how international law should react on the emergence of these innovative technologies. A twofold response seems in order. First, the development and deployment of these technologies needs to be regulated in such a way as to avoid unwanted negative impacts on the environment. Second, legislation may be required to embed geo-engineering within the existing regulation. We will show the various ways in which this can be done. This case, thus, offers an interesting opportunity to explore both the potential and risks that arise when using new technologies to combat environmental degradation

Tailor-made directional emission in nanoimprinted plasmonic-based light-emitting devices

We demonstrate an enhanced and tailor-made directional emission of light-emitting devices using nanoimprinted hexagonal arrays of aluminum nanoparticles. Fourier microscopy reveals that the luminescence of the device is not only determined by the material properties of the organic dye molecules but is also strongly influenced by the coherent scattering resulting from periodically arranged metal nanoparticles. Emitters can couple to lattice-induced hybrid plasmonic–photonic modes sustained by plasmonic arrays. Such modes enhance the spatial coherence of an emitting layer, allowing the efficient beaming of the emission along narrow angular and spectral ranges. We show that tailoring the separation of the nanoparticles in the array yields an accurate angular distribution of the emission. This combination of large-area metal nanostructures fabricated by nanoimprint lithography and light-emitting devices is beneficial for the design and optimization of solid-state lighting systems

Thermalization and Cooling of Plasmon-Exciton Polaritons: Towards Quantum Condensation

We present indications of thermalization and cooling of quasi-particles, a precursor for quantum condensation, in a plasmonic nanoparticle array. We investigate a periodic array of metallic nanorods covered by a polymer layer doped with an organic dye at room temperature. Surface lattice resonances of the array---hybridized plasmonic/photonic modes---couple strongly to excitons in the dye, and bosonic quasi-particles which we call plasmon-exciton-polaritons (PEPs) are formed. By increasing the PEP density through optical pumping, we observe thermalization and cooling of the strongly coupled PEP band in the light emission dispersion diagram. For increased pumping, we observe saturation of the strong coupling and emission in a new weakly coupled band, which again shows signatures of thermalization and cooling.Comment: 8 pages, 5 figures including supplemental material. The newest version includes new measurements and corrections to the interpretation of the result

From weak to strong coupling of localized surface plasmons to guided modes in a luminescent slab

We investigate a periodic array of aluminum nanoantennas embedded in a light-emitting slab waveguide. By varying the waveguide thickness we demonstrate the transition from weak to strong coupling between localized surface plasmons in the nanoantennas and refractive index guided modes in the waveguide. We experimentally observe a non-trivial relationship between extinction and emission dispersion diagrams across the weak to strong coupling transition. These results have implications for a broad class of photonic structures where sources are embedded within coupled resonators. For nanoantenna arrays, strong vs. weak coupling leads to drastic modifications of radiation patterns without modifying the nanoantennas themselves, thereby representing an unprecedented design strategy for nanoscale light sources

Modified emission of extended light emitting layers by selective coupling to collective lattice resonances

We demonstrate that the coupling between light emitters in extended polymer layers and modes supported by arrays of plasmonic particles can be selectively enhanced by accurate positioning of the emitters in regions where the electric field intensity of a given mode is maximized. The enhancement, which we measure to reach up to 70%, is due to the improved spatial overlap and coupling between the optical mode and emitters. This improvement of the coupling leads to a modification of the emission spectrum and the luminous efficacy of the sample.Peer Reviewe

Improved red-response in thin film a-Si:H solar cells with soft-imprinted plasmonic back reflectors

The impact of controlled nanopatterning on the Ag back contact of an n-i-p a-Si:H solar cell was investigated experimentally and through electromagnetic simulation. Compared to a similar reference cell with a flat back contact, we demonstrate an efficiency increase from 4.5% to 6.2%, with a 26% increase in short circuit current density. Spectral response measurements show the majority of the improvement between 600 and 800 nm, with no reduction in photocurrent at wavelengths shorter than 600 nm. Optimization of the pattern aspect ratio using electromagnetic simulation predicts absorption enhancements over 50% at 660 nm

Quantum Rod Emission Coupled to Plasmonic Lattice Resonances: A Collective Directional Source of Polarized Light

We demonstrate that an array of optical antennas may render a thin layer of randomly oriented semiconductor nanocrystals into an enhanced and highly directional source of polarized light. The array sustains collective plasmonic lattice resonances which are in spectral overlap with the emission of the nanocrystals over narrow angular regions. Consequently, different photon energies of visible light are enhanced and beamed into definite directions.Comment: 4 pages, 3 figure

Substrate conformal imprint fabrication process of synthetic antiferromagnetic nanoplatelets

Methods to fabricate and characterize monodisperse magnetic nanoplatelets for fluid/bio-based applications based on spintronic thin-film principles are a challenge. This is due to the required top-down approach where the transfer of optimized blanket films to free particles in a fluid while preserving the magnetic properties is an uncharted field. Here, we explore the use of substrate conformal imprint lithography (SCIL) as a fast and cost-effective fabrication route. We analyze the size distribution of nominal 1.8 um and 120 nm diameter platelets and show the effect of the fabrication steps on the magnetic properties which we explain through changes in the dominant magnetization reversal mechanism as the size decreases. We show that SCIL allows for efficient large-scale platelet fabrication and discuss how application-specific requirements can be solved via process and material engineering

In silico synchronization reveals regulators of nuclear ruptures in lamin A/C deficient model cells

The nuclear lamina is a critical regulator of nuclear structure and function. Nuclei from laminopathy patient cells experience repetitive disruptions of the nuclear envelope, causing transient intermingling of nuclear and cytoplasmic components. The exact causes and consequences of these events are not fully understood, but their stochastic occurrence complicates in-depth analyses. To resolve this, we have established a method that enables quantitative investigation of spontaneous nuclear ruptures, based on co-expression of a rmly bound nuclear reference marker and a uorescent protein that shuttles between the nucleus and cytoplasm during ruptures. Minimally invasive imaging of both reporters, combined with automated tracking and in silico synchronization of individual rupture events, allowed extracting information on rupture frequency and recovery kinetics. Using this approach, we found that rupture frequency correlates inversely with lamin A/C levels, and can be reduced in genome- edited LMNA knockout cells by blocking actomyosin contractility or inhibiting the acetyl-transferase protein NAT10. Nuclear signal recovery followed a kinetic that is co-determined by the severity of the rupture event, and could be prolonged by knockdown of the ESCRT-III complex component CHMP4B. In conclusion, our approach reveals regulators of nuclear rupture induction and repair, which may have critical roles in disease development