Disconnection of surface water drainage:a local authority perspective

This paper argues the case for the disconnection of surface water from combined sewer systems drawing on experience gained from the European Interreg IIIB project ‘Urban Water’. Data and examples drawn from Netherlands and Germany are applied in the Local Authority area of Renfrewshire in Scotland. Disconnection is increasingly welcomed by local authorities to meet social, environmental and safety (from flooding) criteria. Unfortunately, traditional, bolt-on or end-of-pipe solutions tend to result in a degraded and piecemeal infrastructure which is expensive and difficult to manage or improve. Further, the limited availability of funding, and the acuteness of flooding problems, means that the more sustainable opportunities provided by watercourses can be readily overlooked. Disconnection of surface water focuses on controlling the water at source thereby providing a rationale for integrated use of land for water storage and other uses.The disconnection options specifically applicable in Renfrewshire are reviewed and examined, drawing on experiences from the European case studies. The paper addresses the evaluation of disconnection options, the means of promoting disconnection and the value of disconnection targets. Results from disconnection programmes are presented, with information on methods, costs and savings. The paper concludes by presenting the disconnection targets used by the various parties involved in the project

Clinical pharmacology of cannabinoids in early phase drug development

Although cannabis is especially known for its recreational use as a __soft drug__, its potential therapeutic properties have been recognized for hundreds of years. Since the isolation of THC from Cannabis sativa L, the discovery of cannabinoid receptors and their natural ligands (endocannabinoids) the interest in the development of novel cannabinoids as medicine is accelerating. This thesis describes useful cannabis-biomarkers and the clinical pharmacology of some cannabinoid agonists and antagonists in early phase drug development. This includes a novel mode of pure intrapulmonary THC administration that can be used as a benchmark for novel CB1/CB2-agonists, or to demonstrate inhibitory activity of CB1-antagonists. In addition, the pharmacodynamics and pharmacokinetics of two novel CB1/CB2 agonists are evaluated and compared with the pharmacodynamic effect profile of THC. The clinical trials carried out for this research were performed at the Centre for Human Drug Research, Leiden, The Netherlands.The printing of this thesis was financially supported by the foundation ‘Centre for Human Drug research’, Leiden, The NetherlandsUBL - phd migration 201

Association between muscle thickness, fat-free mass and malnutrition in patients with copd: an exploratory study

Rationale: Malnutrition is a common problem in patients with Chronic Obstructive Pulmonary Disease (COPD). Whereas estimation of fat-free muscle mass index (FFMi) with bio-electrical impedance is often used, less is known about muscle thickness measured with ultrasound (US) as a parameter for malnutrition. Moreover, it has been suggested that in this population, loss of muscle mass is characterized by loss of the lower body muscles rather than of the upper body muscles.1 Therefore, we explored the association between FFMi, muscle thickness of the biceps brachii (BB) and the rectus femoris (RF), and malnutrition in patients with COPD. Methods: Patients were assessed at the start of a pulmonary rehabilitation program. Malnutrition was assessed with the Scored Patient-Generated Subjective Global Assessment (PG-SGA). Malnutrition was defined as PG-SGA Stage B or C. FFMi (kg/m²) was estimated with bio-electrical impedance analysis BIA 101® (Akern), using the Rutten equation. Muscle thickness (mm) of the BB and the RF was measured with the handheld BodyMetrix® device (Intelametrix). Univariate and multivariate logistic regression analyses were performed to analyse associations between FFMi and muscle thickness for BB and RF, and malnutrition. Multivariate analysis corrected for sex, age, and GOLD-stage. Odds ratios (OR) and 95% confidence intervals (CI) were presented. A p-level of <0.05 was considered significant. Results: In total, 27 COPD patients (age 64±8.1 years; female 60%, GOLD-stage 3, interquartile range=3-4, BMI 27±6.6 kg/m2) were included in the analyses. In the univariate analysis, FFMi (p=0.014; OR=0.70, 95%CI: -0.12—0.15), RF thickness (p=0.021; OR=0.79, 95%CI: -0.09—0.01), and BB thickness (p=0.006; OR=0.83, 95%CI: -0.06—0.01) were all significantly associated with malnutrition. In the multivariate analysis, FFMi (p=0.031; OR=0.59, 95%CI: -0.18—0.01) and BB thickness (p=0.017; OR=0.73, 95%CI:-0.09—0.01) were significantly associated with malnutrition. None of the co-variables were significantly associated with malnutrition. Conclusion: In this relatively small sample of patients with severe COPD, low FFMi and low BB muscle thickness were both robustly associated with increased odds of being malnourished. BB muscle thickness measured with US may provide added value to the toolbox for nutritional assessment. The results of this exploratory study suggest that upper body muscles may reflect nutritional status more closely than lower body muscles. Reference: 1 Shrikrishna D, Patel M, Tanner RJ, Seymour JM, Connolly BA, Puthucheary ZA, et al. Quadriceps wasting and physical inactivity in patients with COPD. Eur Respir J. 2012;40(5):1115–22.

Klimaatadaptatie evalueren met participatief leren: ClimateCafé Malmö

In de wijk Augustenborg in Malmö zijn sinds de jaren ’90 met de bewoners veel klimaatadaptie- en leefbaarheidselementen aangelegd. Maar functioneert de wijk nog naar tevredenheid en wat valt ervan te leren? In een ClimateCafé is (het functioneren van) klimaatadaptieve maatregelen vastgelegd en gepresenteerd op het eindcongres van vier internationale projecten

ClimateCafé: an interdisciplinary educational tool for sustainable climate adaptation and lessons learned

ClimateCafé is a field education concept involving dierent fields of science and practice for capacity building in climate change adaptation. This concept is applied on the eco-city of Augustenborg in Malmö, Sweden, where Nature-Based Solutions (NBS) were implemented in 1998. ClimateCafé Malmö evaluated these NBS with 20 young professionals from nine nationalities and seven disciplines with a variety of practical tools. In two days, 175 NBS were mapped and categorised in Malmö. Results show that the selected green infrastructure have a satisfactory infiltration capacity and low values of potential toxic element pollutants after 20 years in operation. The question “Is capacity building achieved by interdisciplinary field experience related to climate change adaptation?” was answered by interviews, collecting data of water quality, pollution, NBS and heat stress mapping, and measuring infiltration rates, followed by discussion. The interdisciplinary workshops with practical tools provide a tangible value to the participants and are needed to advance sustainability eorts. Long term lessons learnt from Augustenborg will help stormwater managers within planning of NBS. Lessons learned from this ClimateCafé will improve capacity building on climate change adaptation in the future. This paper oers a method and results to prove the German philosopher Friedrich Hegel wrong when he opined that “we learn from history that we do not learn from history