Communicatie en maatschappelijke acceptatie van milieubeleid : een onderzoek naar de houding ten aanzien van de 'dure afvalzak' in Barendrecht

Most environmental problems require solutions both at a technological level and behavioural level. An important question is how to stimulate ecological or proenvironmental behaviour. The present thesis focuses on the communicative aspects of influencing environmental behaviour. To what extent and under what circumstances are public information campaigns and other forms of communication adequate policy instruments to influence environmental behaviour of consumers and producers?Chapter 1 defines and explains some of central concepts of the present thesis. One of the forms of communication as a policy instrument is public information campaigns. Public information campaigns are defined as a form of goal-oriented communication aimed at enhancing knowledge in order to affect behavioural changes in the interest of an individual or a collective. However, public information campaigns encompass a broad range of activities. Therefore, a distinction is made between providing information on demand and persuasion. In the case of information on demand, the target group feels a problem and is in search of some kind of solution. This solution can be a specific advice. In the case of persuasion, the target group doesn't feel a problem. The aim is to convince the public of the seriousness of a particular issue and the necessity to change its behaviour.Besides public information campaigns, other forms of communication are discussed that stress the interaction between a sender and a receiver. Because of the popularity of the network approach in policy processes, the emphasis is more and more on communication between relevant actors during the development of policy measures by means of discussion, mediation and negotiation.Under environmental (or environmentally relevant) behaviour, we classify all kinds of behaviour that directly or indirectly influences the quality of the physical environment.Chapter 2 investigates how pro-environmental behaviour can be stimulated by communication. This question will be considered in relation to determinants of environmental behaviour. Is environmental behaviour easy or difficult to change? Because most public information campaigns aim at increasing knowledge, a relevant question is whether environmental behaviour is influenced by knowledge.A common distinction used to explain environmental behaviour is one between reasoned and non-reasoned behaviour. Models of reasoned action argue that people consider different consequences of different alternatives at the same time and that their considerations are based on knowledge and arguments. The aim of public service campaigns (increasing knowledge ) fits well into the assumptions of models of reasoned action.Perceived behavioural control, attitude, social norm and personal norm are central concepts in the explanation for reasoned (environmental) behaviour. Perceived behavioural control is a rather broad concept and refers to different aspects. The first aspect consists of the availability of products and services (opportunities). The second aspects is concerned with personal factors such as time and money whereas the third aspect refers to the cognitive and physical abilities of an individual.Social influence on behaviour is not limited to the perceived regulations about how one ought to behave and the motivation to comply to these regulations (subjective norm). Social norms can also be internalised into personal norms about how one personally feels about how or how not to behave. Social influence can also manifest itself in the type of attitudes a person holds: knowledge about behavioural consequences and the evaluation of these consequences is often based on interactions of an individual with his or her social environment.Environmental consciousness is a general attitude and that influences environmental behaviour in an indirect manner.The individual consequences of pro-environmental behaviour are often disadvantageous: it is more expensive, more time-consuming, andlor less convenient. Therefore the choice between pro-environmental and anti-environmental behavioural is often described as a social dilemma. If people choose to behave in the interest of a collective, their behaviour may conflict with their own, personal interests. Also, in order to reach a certain collective goal or good, one depends on the behaviour of other individuals. In such a situation, people may opt for egoistic behaviour. A person may attach high value to a healthy and clean environment, but not as much as to personal, negative consequences. Or one might be willing to accept personal, aversive consequences, but has little confidence in the co-operation of other actors. In the latter case, people may follow a 'wait-and-see policy'.In general, detrimental environmental behaviour is difficult to change. An 'egocentric' choice is highly likely, because the environmental issue is a complex social dilemma: environmental problems are large-scale, may manifest themselves on a longer term, and the consequences are often uncertain. More knowledge about environmental problems or the environmental consequences of behaviour does not automatically lead to pro- environmental behaviour. Because of the complex nature of the environmental dilemma a discrepancy exists between people's knowledge and their actual behaviour.Thus, more knowledge about environmental problems and solutions does not lead to behavioural change. Moreover, in some situations increasing knowledge is a too ambitious goal. People are not always perceptive to new information. Some behaviours are habits, in which case one acts without considering possible alternatives or actively processing new information. Or people process information only to a certain extent because they wish to consider only a limited number of alternatives. They do not continue looking for the best alternative, but are satisfied with the first, acceptable alternative. Or people limit themselves in the number of consequences of a behavioural choice. If the motivation and/or ability to process information is limited, decisions are made on the bases of affective associations or heuristics. Many enviromnental behaviours are not guided by knowledge or arguments. In this case, trying to increase knowledge is an inadequate strategy for change.Chapter 3 concerns the influence of communication on pro-environmental behaviour in relation to the policy context. Is communication the only policy instrument or is communication part of a larger package of policy instruments to realise pro- environmental behaviour?The choice for a policy instrument should be based on a situational analysis. A policy situation can be analysed globally with regard to the urgency of the desired behaviour, the measurability of the undesired behaviour, the size of the target group and the perceived costs of behavioural change. Such a global analysis could lead to a first selection of relevant policy instruments. In order to specify the content and the possible effect of policy instruments a more detailed social psychological analysis is required. Questions for such a analysis can be derived from the determinants of (environmental) behaviour (see chapter 2).Communication as a sole instrument of change is effective under exceptional circumstances: if the pro-environmental behaviour is advantageous at an individual level; if the pro-environmental alternative is relatively easy and people think that most other people will opt for the pro-enviromnental alternative; if the situation is relatively small scale and group norms can be communicated directly and personally; and if the target group is highly motivated and prepared to make high sacrifices. In other circumstances a moral appeal on individuals will result in little success because of the highly complex nature of the social dilemma. In order to influence environmental behaviour there is often a need for policy measures, such as regulation and taxation, because they have effect on the costs ans benefits of different alternatives. Communication can support these instruments.Chapter 4 focuses on increasing the public acceptance of new policy measures. A central question of the research presented in this thesis is to what extent communication can promote the public acceptance of restrictive policy measures to protect the environment. Acceptance of a policy measure is defined by means of the attitude concept. Acceptance refers to the attitude towards a particular measure of those concerned. The relation between the attitude towards a measure and behaviour will be investigated. An individual accepts a measure if he or she has a neutral or positive attitude towards the measure. Public acceptance of policy measures and regulations is important because restrictive measures are difficult to realise and to control if a major part of those concerned do not agree with the measure. The possibilities of a government to force compliance are limited because of the numerous ways to dodge a regulation. If people accept a regulation, chances are that the regulation will be observed. The attitude towards a policy measure can be based on a judgement of the characteristics of the policy measure itself or on perceptions of the government in general. The amount of effort people expend to form a judgement of a policymeasure may vary widely. Some people expend relatively little effort and rely on, relatively simple, heuristic cues whereas others carefully scrutinise the arguments pro and con a measure. In the latter case, attitude formation is reasoned.Different factors may influence the perception and evaluation of environmental regulations. The following factors are relevant to the perception and evaluation of advantages:1. Awareness of the seriousness of a problem2. Perceived effectiveness of a promoted behavioural change as compared toits alternatives3. Awareness of the necessity of governmental intervention(trust in the participation of other actors)4. Perceived effectiveness of a measure as compared to alternative measures(perceived likelihood of non compliance)The following factors are relevant to the perception and evaluation of disadvan-tages:5. Perceived possibilities of legal, alternative behaviours6. Amount of sources of the target group (income, time)7. Perceived efficiency of a measure as compared to alternative measures8. Extent to which the target group is confronted with other restrictions9. Expectations of future regulations and restrictions10. Extent to which the target group is confronted with simultaneous liberali-sation11. Perceived fairness of sacrifice requesteda. Awareness of responsibilityb. Perceived contribution of other target groupsc. Perceived possibilities of non compliance12. Extent to which the target group has been involved in the decision makingof the regulating measuresIf the conditions under which people accept restrictive policy measures are sufficiently clear, we can examine how to promote acceptation and the role of communication in acceptation processes. This issue will be addressed to in chapter 5.Communication should not only be used to gain support from those who are against restrictive policy measures. If communication is used in such limited way, the contents of a policy measure are not an issue of discussion. A more broad perspective on gaining public support, indicates that promoting acceptation of policy measures means designing an acceptable policy. A measure should be 'communicable', that is, should be in accordance with the perceptions and preferences of a target group. Tuning in to the perceptions and preferences of a target group can take shape by means of research, by maintaining various (informal) contacts by which 'accidental developments' can be taken along and the organisation of a process of interactive policy making.Policy can be developed according to two different strategies: a closed or open process. In a relatively closed-door policy making process (a decideannounce-defend strategy) plans are formulated, possibly based on a pilot study, and subsequently communicated. This strategy stems from a hierarchical perspective on policy making processes, in which a government has a superior position to the actors to be guided. In this perspective, it is assumed that a government is well-informed about the perceptions and preferences of a target group or can be informed by means of research. A more open process of policy making, starts with communication and is followed by plan making in consultation with those concerned. This strategy evolved out of network model of policy making. In this perspective, the process of policy making is viewed as an interactive process between various, interdependent actors, such as a government, other governments, interest groups, environmental groups, political parties, the media, research institutions and the target group. In order to create public support, the nature of measures is adjusted to the perceptions and preferences of a target group. In this approach to policy making, the focus is on co-operation and consensus building.Wolsink (1990) rejected the use of a decide-announce-defend strategy as a way to promote public acceptance. An essential condition for public support for restrictive measures is mutual communication during the policy making process between a government and the target group. For environmental policies to be effective and legitimate, it is important to involve the people who are or will be affected bij the outcomes of these policies. An open process of policy making seems to have three important advantages. First, it may result in policy measures tailored to the perceptions and preferences of the public. Second, the target group feels less 'overtaken' by the introduction of measures. Finally, the target group has more time to engage in a learning process vis-a-vis a particular environmental problem.The role of communication in the process of policy making should not be limited to convincing the target group of the necessity of the measures to be taken. Communication during the process of policy making, implementation and evaluation can be used in a number of, one-sided and two-sided, ways.Chapter 6 describes the design of the empirical study of this thesis which took place in the community of Barendrecht. The local government of Barendrecht introduced on May 3rd 1993 a 'differentiated tax system' for household waste. The differentiated tax system consists of a fixed and a variable contribution. The variable contribution is related to the number of refuse bags used by a household. Households are compelled to present their waste in a special community refuse bag (the 'blue bag') that costs Hfl. 2.50 each. At the same time, the fixed contribution has been decreased by Hfl. 14.50 per household of two persons or more.The local government of Barendrecht followed a closed-door strategy of policy making. After the phase in which the policy measures were planned and designed, several communication activities took place in order to promote acceptation. A review of literature showed (see chapter 5) the importance of communication during the phase of policy- making (consultation of and negotiation with - a representation of - the target group). A closed-door strategy of policy making, such as a decide-announce-defend strategy, often leads to rejection instead of acceptance and other aversive effects. However, in the case of Barendrecht, we presumed a relatively favourable starting-situation. Because of public information campaigns of the national government and media coverage of the issue of waste reduction, to a certain extent, public support is already created. Therefore we formulated the central problem question of our research as follows: are in a relatively uncomplicated situation, communication activities aimed at justifying restrictive policy measures sufficient to effectuate public support for such measures? If it turns out that in a relatively uncomplicated situation, communication after the process of policy making is not sufficient, we can conclude that a decide-announce-defend strategy may also fail in a more complicated situation.Our research focused on three central questions of which the last question is the most comprehensive:1. To which extent is the communication strategy of the local government of Barendrecht effective: To which extent do the citizens of Barendrecht accept the differentiated tax system on household waste?2. What is the relation between acceptance of the differentiated tax system and non compliance or evading behaviour?3. What factors explain acceptance of the implementation the differentiated tax system?In order to answer these questions, 399 households of the community of Barendrecht were interviewed about half a year after implementation of the differentiated tax system.Chapter 7 described the operationalisation of the research questions, chapter 8 presents the results and in chapter 9 the results are discussed.Results confirm the starting position of Barendrecht is relatively uncomplicated : a basis for implementation of policy measures seems to be present. Nevertheless, forty- eight percent of the respondents has a negative attitude towards the expensive refuse bag. This means that the communication strategy of the local government to promote the expensive refuse bag resulted in limited success.Results also show a relation between acceptance and compliance. The less respondents indicate an acceptance of the expensive bag, the more they report evading behaviour. A total of 15 percent of respondents indicated they dodge the tax. By contrast, none of the respondents with a positive or extremely positive attitude towards the expensive bag, reports evading behaviour. About a quarter of the respondents with a negative attitude and about half of the respondents With an extremely negative attitude regularly avoids the use of the expensive bag by depositing their waste in ordinary (and less expensive) bags in a neighbouring town.It was argued that the attitude towards a policy measures can be based on a judgement of the characteristics of a particular measure or on perceptions of the government in general. Also, some people expend relatively little effort and rely on simple affective or heuristic cues whereas other carefully scrutinise the arguments pro and con a measure and consider the individual advantages and disadvantages.In the present research, a negative attitude towards the expensive refuse bag is mainly explained by the extent to which one agrees with negative affective reactions. The attitude towards the local government does not add to the explanation of a negative attitude. A small contribution was found of the attitude score which was composed of respondents' perception of the most important advantages and disadvantages. This suggests that the judgement of the policy measure is based on the characteristics of this particular measure and not on the attitude towards the local government. Furthermore, it seems that affective judgements (that can be legitimate in their own right) are more important than processing arguments pro and con. This conclusion is supported by the finding that almost 70 percent of the respondents has little knowledge about the waste issue in general and the implementation of a differentiated tax system for household waste in particular.A potential danger of a closed-door policy making strategy is that the target group feels 'taken over' if policy measures are implemented. This seems to have been the case in Barendrecht. Results show that the perceived involvement in decision making contributes to the acceptance of the differentiated tax system. On the basis of these results the theoretical model of acceptance of policy measures was adjusted. Another potential danger of a closed-door strategy is that policy measures do not connect with the perceptions and preferences of a target group. This was exactly the case in Barendrecht. Respondents against the implementation of the expensive bag (almost half of the respondents) judged the measure as unpleasant and unsympathetic. They made various critical remarks.The results of the research on the implementation of the expensive bag in Barendrecht can be interpreted as a plea for more interaction in early phases of policy making. The closed-door process of policy-making as used by the local government of Barendrecht - making plans first, and communicating later - did not result in public support. Public support for policy measures cannot be created afterwards but is a consequence of a mutual learning process.However, the idea of interactive policy making, which focuses on consensus, should not be embraced to easily and without criticism. Chapter 10 provides a critical review of consensus approaches. The neglect of power relations, the role of government, the undemocratic character and the effectiveness o4consensus approaches are discussed. Consensus approaches should not be viewed as a panacea. They can be effective, but only under certain conditions. A government should connect with the existing activities and initiatives of a community. However, because the awareness of some environmental problems is relatively low, starting points for change are sometimes absent. In this situation the government should take the initiative. In this case challenging policy proposals and persuasive comm

Diagnosing von Willebrand disease: genetic analysis

Investigation of a patient with possible von Willebrand disease (VWD) includes a range of phenotypic analyses. Often, this is sufficient to discern disease type, and this will suggest relevant treatment. However, for some patients, phenotypic analysis does not sufficiently explain the patient's disorder, and for this group, genetic analysis can aid diagnosis of disease type. Polymerase chain reaction and Sanger sequencing have been mainstays of genetic analysis for several years. More recently, next-generation sequencing has become available, with the advantage that several genes can be simultaneously analyzed where necessary, eg, for discrimination of possible type 2N VWD or mild hemophilia A. Additionally, several techniques can now identify deletions/duplications of an exon or more that result in VWD including multiplex ligation-dependent probe amplification and microarray analysis. Algorithms based on next-generation sequencing data can also identify missing or duplicated regions. These newer techniques enable causative von Willebrand factor defects to be identified in more patients than previously, aiding in a specific VWD diagnosis. Genetic analysis can also be helpful in the discrimination between type 2B and platelet-type VWD and in prenatal diagnosis for families with type 3

Authorities' Coercive and Legitimate Power:The Impact on Cognitions Underlying Cooperation

The execution of coercive and legitimate power by an authority assures cooperation and prohibits free-riding. While coercive power can be comprised of severe punishment and strict monitoring, legitimate power covers expert, and informative procedures. The perception of these powers wielded by authorities stimulates specific cognitions: trust, relational climates, and motives. With four experiments, the single and combined impact of coercive and legitimate power on these processes and on intended cooperation of n1 = 120, n2 = 130, n3 = 368, and n4 = 102 student participants is investigated within two exemplary contexts (tax contributions, insurance claims). Findings reveal that coercive power increases an antagonistic climate and enforced compliance, whereas legitimate power increases reason-based trust, a service climate, and voluntary cooperation. Unexpectedly, legitimate power is additionally having a negative effect on an antagonistic climate and a positive effect on enforced compliance; these findings lead to a modification of theoretical assumptions. However, solely reason-based trust, but not climate perceptions and motives, mediates the relationship between power and intended cooperation. Implications for theory and practice are discussed.© 2017 Hofmann, Hartl, Gangl, Hartner-Tiefenthaler and Kirchle

Blood-induced joint damage: novel targets for therapy

-induced joint damage can occur due to a trauma but also during surgery when blood leaks into the joint cavity. Besides that, it is one of the major causes of morbidity amongst haemophilia patients. The aims of this thesis were to further unravel the pathogenesis of blood-induced joint damage and to develop new strategies to prevent or treat this joint damage. To achieve these aims several in vitro and in vivo models were used. This thesis shows in an in vivo model that, in contrast to intermittent exposure, a 4-day continuous blood exposure twice in 4 weeks leads to prolonged cartilage damage. This prolonged damage is independent of the level of synovial inflammation. It appears that there is a threshold to induce irreversible joint damage, which is only reached by a more intensive continuous blood load. Furthermore, coagulating blood causes more cartilage damage and synovial inflammation than anticoagulated blood. This aggravation of joint damage by coagulation is also seen in vitro where coagulated blood results in more cartilage damage compared to anticoagulated blood. If the consequences of blood-exposure could be visualized very shortly after a joint bleed, instead of after years, it would allow prevention or treatment at a more individual patient level. One way to monitor joint damage is by measuring biochemical markers. It is demonstrated that on average a single joint bleed increases biochemical markers of joint tissue damage (CTXII, COMP, C1,2C, and CS846) in a small group of patients. Blood-induced damage to the cartilage matrix is limited by IL-4 as well as IL-10. Adding IL-4 to IL-10 leads to a more pronounced protective effect than IL-10 alone, suggesting that a combination of the two cytokines might have additional value. Besides the effects on proteoglycan turnover also IL-4, and to a lesser extent IL-10, limits production of proinflammatory cytokines by blood monocytes and limits apoptosis of chondrocytes. However, there is only a short time window of 4-8 hours after onset of the joint bleed in which IL-4 plus IL-10 can still limit blood-induced cartilage damage. The damage can be almost fully prevented by shortening the time span of blood exposure by aspirating the blood within 24 hours. In an in vivo haemophilia mouse model, a single intra-articular injection directly after a joint bleed ameliorates cartilage degeneration, but does not diminish synovial inflammation when analysed after 30 days. The reason for a partial effect on cartilage damage and the absence of an effect on inflammation could be due to low bioavailability of the cytokines. A fusion protein combining IL-4 and IL-10, called the ‘IL4-10 synerkine’ and having the same effects on blood-induced cartilage damage, might tackle this problem. For patients with heavily damaged joints, joint distraction can be used as an alternative to surgical treatments like ankle arthrodesis or total joint replacement. In the haemophilia patients treated, joint distraction improves their functional health and participation in society and autonomy, diminishes their pain, and results in evident structural improvement of the joint