Knowledge and perceptions in participatory policy processes: lessons from the delta-region in the Netherlands

Water resources management issues tend to affect a variety of uses and users. Therefore, they often exhibit complex and unstructured problems. The complex, unstructured nature of these problems originates from uncertain knowledge and from the existence of divergent perceptions among various actors. Consequently, dealing with these problems is not just a knowledge problem; it is a problem of ambiguity too. This paper focuses on a complex, unstructured water resources management issue, the sustainable development—for ecology, economy and society—of the Delta-region of the Netherlands. In several areas in this region the ecological quality decreased due to hydraulic constructions for storm water safety, the Delta Works. To improve the ecological quality, the Dutch government regards the re-establishment of estuarine dynamics in the area as the most important solution. However, re-establishment of estuarine dynamics will affect other uses and other users. Among the affected users are farmers in the surrounding areas, who use freshwater from a lake for agricultural purposes. This problem has been addressed in a participatory decision-making process, which is used as a case study in this paper. We investigate how the dynamics in actors’ perceptions and the knowledge base contribute to the development of agreed upon and valid knowledge about the problem–solution combination, using our conceptual framework for problem structuring. We found that different knowledge sources—expert and practical knowledge—should be integrated to create a context-specific knowledge base, which is scientifically valid and socially robust. Furthermore, we conclude that for the convergence of actors’ perceptions, it is essential that actors learn about the content of the process (cognitive learning) and about the network in which they are involved (strategic learning). Our findings form a plea for practitioners in water resources management to adopt a problem structuring approach in order to deal explicitly with uncertainty and ambiguity

Young Children's Sugar-Sweetened Beverage Consumption and 5-Year Change in BMI:Lessons Learned from the Timing of Consumption

Sugar-sweetened beverages (SSBs) are an already known risk factor for weight gain in childhood. To identify windows of opportunity for public health interventions, insight into the consumption behavior of SSBs is needed. We investigated whether total SSB consumption was related to body mass index (BMI) change and overweight and compared whether the timing of consumption over the day differed between low and high consumers. In the Dutch GECKO Drenthe birth cohort, a cohort embedded within the Groningen Expert Center for Kids with Obesity (GECKO), height and weight were measured by trained nurses at age 5/6 years (y) and 10/11 y (N = 1257). BMI was standardized for age and sex (BMI-z). In the food pattern questionnaire completed by parents at age 5/6 y, beverages were assessed for seven time segments (breakfast, morning, lunch at school, lunch at home, afternoon, dinner, and evening). Linear and logistic regression analyses were adjusted for potential confounders (sex, baseline BMI-z, parental BMI, parental education level, maternal age at birth, maternal smoking during pregnancy). The median daily SSB consumption frequency ranged from 1.9 times per day (1.5-2.0, 25th-75th percentile) in the lowest quartile to 4.9 times per day (4.6-5.5) in the highest quartile. In the highest compared to the lowest quartile of SSB consumption frequency, the confounder-adjusted odds ratio for overweight incidence was 3.12 (95% CI, 1.60-6.07). The difference in consumption between quartile 1 and quartile 4 occurred mainly during main meals and in the evening, e.g., at breakfast (31% vs. 98%, p < 0.001), lunch at home (32% vs. 98%, p < 0.001), and dinner (17% vs. 72%, p < 0.001). These drinking occasions characterizing high SSB consumers mostly occurred in the home environment, where parental influence on dietary behaviors is profound. Therefore, these results exposed a window of opportunity, leading to the advice for parents to offer their children sugar-free drinks to quench thirst with main meals

Home lands: island and archipelagic states’ policymaking for human mobility in the context of climate change

Climate change related migration and displacement are already a reality for many people around the world. A growing body of research suggests that the number of people affected will rise over the coming decades, which will create additional risks for the achievement of the Sustainable Development Goals. This trend and the related issues are an increasing topic of discussion at international policy fora. The Task Force on Displacement under the United Nations Framework Convention on Climate Change (UNFCCC) and the Platform on Disaster Displacement (PDD) are addressing these policy challenges. The Global Compact for Safe, Orderly and Regular Migration (GCM) is calling for the development of “coherent approaches to address the challenges of migration movements in the context of sudden-onset and slow-onset natural disasters”. This report reflects what is currently known about the impacts of climate change on people living in island nations and highlights the necessity to develop policies that address human mobility dynamics resulting from adaptation to these changes. By looking at island and archipelagic states as diverse as Kiribati, Saint Lucia and the Philippines, the various political frameworks within which they operate and the different response mechanisms they have adopted can be examined. First-hand interviews with experts from across the regions show the multiplicity of challenges governments are facing: from difficulties in distribution of relief goods to land scarcity, aid dependency, insufficient data and personnel capacities. Yet the key interviewees underline ways in which governments can capitalise on the strengths inherent to island and coastal communities to further build resilience using existing and innovative practices

Cortical gyrification in relation to age and cognition in older adults

Gyrification of the cerebral cortex changes with aging and relates to development of cognitive function during early life and midlife. Little is known about how gyrification relates to age and cognitive function later in life. We investigated this in 4397 individuals (mean age: 63.5 years, range: 45.7 to 97.9) from the Rotterdam Study, a population-based cohort. Global and local gyrification were assessed from T1-weighted images. A measure for global cognition, the g-factor, was calculated from five cognitive tests. Older age was associated with lower gyrification (mean difference per year ​= ​−0.0021; 95% confidence interval ​= ​−0.0025; −0.0017). Non-linear terms did not improve the models. Age related to lower gyrification in the parietal, frontal, temporal and occipital regions, and higher gyrification in the medial prefrontal cortex. Higher levels of the g-factor were associated with higher global gyrification (mean difference per g-factor unit ​= ​0.0044; 95% confidence interval ​= ​0.0015; 0.0073). Age and the g-factor did not interact in relation to gyrification (p ​> ​0.05). The g-factor bilaterally associated with gyrification in three distinct clusters. The first cluster encompassed the superior temporal gyrus, the insular cortex and the postcentral gyrus, the second cluster the lingual gyrus and the precuneus, and the third cluster the orbitofrontal cortex. These clusters largely remained statistically significant after correction for cortical surface area. Overall, the results support the notion that gyrification varies with aging and cognition during and after midlife, and suggest that gyrification is a potential marker for age-related brain and co

Nutrition beyond the first 1000 days:diet quality and 7-year change in BMI and overweight in 3-year old children from the Dutch GECKO Drenthe birth cohort

The identification of early-life determinants of overweight is crucial to start early prevention. As weight gain accelerates between 2 and 6 years, we studied the association between diet quality in children aged 3 years and the change in BMI and overweight incidence in the following 7 years. From the Dutch GECKO Drenthe birth cohort, 1001 children born in 2006 or 2007 with complete data on diet (food frequency questionnaire at the age of 3 years) and growth at the age of 3 and 10 years were included. Diet quality was estimated with the evidence-based Lifelines Diet Score (LLDS). Measured height and weight at the age of 3 and 10 years were used to calculate BMI z-scores standardized for age and sex. The associations of the LLDS (in quintiles) with BMI-z change and overweight incidence were studied with linear and logistic regression analyses. Overweight prevalence in the total study population increased from 8.3% at the age of 3 years to 16.7% at the age of 10 years. The increase in overweight prevalence ranged from 14.7% in Q1 to 3.5% in Q5. Children with a better diet quality (higher quintiles of LLDS) increased significantly less in BMI-z (confounder adjusted βLLDS = -0.064 (-0.101; -0.026)). Children with a poor diet quality at the age of 3 years had a considerably higher risk for overweight at the age of 10 years (confounder adjusted OR for Q1 vs. Q5 was 2.86 (95% CI 1.34-6.13). These results show the importance of diet in healthy development in the early life following the first 1000 days when new habits for a mature diet composed of food groups with lifelong importance are developed, providing a relevant window for overweight prevention early in life

Trajectories of imaging markers in brain aging: the Rotterdam Study

With aging, the brain undergoes several structural changes. These changes reflect the normal aging process and are therefore not necessarily pathologic. In fact, better understanding of these normal changes is an important cornerstone to also disentangle pathologic changes. Several studies have investigated normal brain aging, both cross-sectional and longitudinal, and focused on a broad range of magnetic resonance imaging (MRI) markers. This study aims to comprise the different aspects in brain aging, by performing

Sensor-supported measurement of adaptability of dogs (Canis familiaris) to a shelter environment: Nocturnal activity and behavior

Every shelter dog is faced with the challenge to adapt to a kennel environment. To monitor the welfare of individual shelter dogs, evaluating behavioural and physiological parameters, potentially useful as indicators for adaptability of individual dogs is crucial. Nocturnal activity, i.e. resting patterns, has already been identified as a candidate indicator of adaptability and can be easily measured remotely with the help of sensors. We investigated the usefulness of a 3-axial accelerometer (Actigraph®) to monitor nocturnal activity in shelter dogs every night during the full first two weeks in-shelter starting directly at shelter intake, as a measure of welfare. Additionally, urinary cortisol/creatinine ratio (UCCR), body weight and behaviour data were collected to evaluate stress responses. A control group of pet dogs in homes, matched to the shelter dog group, was also monitored. Shelter dogs had higher nocturnal activity and UCCRs than pet dogs, especially during the first days in the shelter. Nocturnal activity, both accelerometer measures and activity behaviour, and UCCRs decreased over nights in the shelter. Smaller dogs had higher nocturnal activity and UCCRs than larger dogs and showed less autogrooming during the first nights. Dogs with no previous kennel experience had higher nocturnal activity and UCCRs, and showed less body shaking, than dogs with previous kennel experience. Overall, sheltered dogs also showed less body shaking during the first night. The number of dogs showing paw lifting decreased over days. Age class and sex effected only few activity behaviours. Shelter dogs significantly lost body weight after 12 days in the shelter compared to the moment of intake. Shelter dogs had disrupted nocturnal resting patterns and UCCRs compared to pet dogs and seem to partly adapt to the shelter environment after two weeks. Sensor-supported identification of nocturnal activity can be a useful additional tool for welfare assessments in animal shelters

A case report of a blueberry muffin baby caused by congenital self-healing indeterminate cell histiocytosis

Background: Blueberry muffin is a descriptive term for a neonate with multiple purpuric skin lesions. Many causes are known, amongst them life-threatening diseases like congenital infections or leukemia. Indeterminate cell histiocytosis (ICH) is an exceptionally rare cause of blueberry muffin rash. ICH is a histiocytic disorder which can be limited to the skin or can present with systemic involvement. A mutation that has been described in histiocytic disorders is a MAP2K1 mutation. In ICH, this mutation has previously been described in merely one case. Case presentation: A term male neonate was admitted to the neonatology ward directly after birth because of a blueberry muffin rash. ICH was diagnosed on skin biopsy. The lesions resolved spontaneously. The patient is currently 3 years old and has had no cutaneous lesions or systemic involvement so far. This disease course is similar to that of the Hashimoto-Pritzker variant of LCH. Conclusions: ICH can manifest in neonates as resolving skin lesions. It is limited to the skin in most cases, but systemic development is possible. Therefore, it is essential to confirm the diagnosis with a biopsy before the lesions resolve and to monitor these patients closely with routine follow-up.</p

Comparative studies on water governance: a systematic review

Governance is key to tackle water challenges and transform water management under the increasing pressures of competing water uses and climate change. Diverse water governance regimes have evolved in different countries and regions to regulate the development and management of water resources and the provision of water services. Scholars and policy analysts have been comparing these water governance regimes to analyze elements and processes, to assess performance, or to draw lessons. While the number of such studies has increased over the past decades, no comprehensive synthesis exists. This paper aims to present such a synthesis through conducting a systematic review of the emerging field of comparative water governance studies, and critically reflecting on how water governance is defined, conceptualized and assessed in different contexts. Based on the insights that this review brings about, we identify four areas for future research: 1) improving the balance between small-N, medium-N and large-N studies that are applied for comparative studies on water governance, 2) conducting longitudinal comparisons of water governance in order to identify temporal governance trends and patterns 3) expanding the geographical coverage of the comparisons to include underrepresented countries and regions, focusing more broadly on the Global South 4) addressing the issues of justice, equity and power, which are becoming increasingly important in tackling the water governance challenges that are exacerbated by the impacts of climate change, industrialization and urbanization

Hearing loss and cognitive decline in the general population: a prospective cohort study

Background: Previous studies identifying hearing loss as a promising modifiable risk factor for cognitive decline mostly adjusted for baseline age solely. As such a faster cognitive decline at a higher age, which is expected considering the non-linear relationship between cognition and age, may have been overlooked. Therefore it remains uncertain whether effects of hearing loss on cognitive decline extend beyond age-related declines of cognitive function. Methods: 3,590 non-demented participants were eligible for analysis at baseline, and a maximum of 837 participants were eligible for the longitudinal analysis. Hearing loss was defined at baseline. Cognitive function was measured at baseline and at follow-up (4.4 years [SD: 0.2]). Multivariable linear regression analysis was used for the cross-sectional analysis. Linear mixed models were used to assess the longitudinal association between hearing loss and cognitive decline over time while adjusting for confounders and the interaction of age and follow-up time. Results: Hearing loss was associated with lower cognitive function at baseline. Moreover, hearing loss was associated with accelerated cognitive decline over time on a memory test. After additionally adjusting for the interaction between age and follow-up time, we found that hearing loss did not accelerate cognitive decline anymore. Conclusions: Hearing loss was associated with lowe