Session E8: Fish Migration Possibilities in the Netherlands; State of the Art (Barriers, Solutions, Monitoring)

Abstract: Measures to restore fish migration is gaining a major boost in the Netherlands since the Water Framework Directive, Benelux Regulation and Eel Directive are operational. Water managers, responsible for a good ecological status, are working hard to reach free fish migration in their waters. Currently, 1.124 measures are realized at barriers like weirs, pumping stations, sluices and culverts. 2.745 barriers are identified. Since 2000, there is a strong development of measures and new techniques. These results are based on a study “The Netherlands living with Fish Migration”, that was started in 2008. Target of this study was the evaluation of the progress in approach of measures and to gather information on improvement of fish migration in the Netherlands. Within this project a database was created with the prioritized barriers and measures for fish migration. This data is supplied by the water managers. Every four years water managers are asked for an update and an evaluation is carried out. In this presentation the results are discussed, with focus on type of barrier, solutions and intensity of monitoring carried out by the water managers. Also an overview of planning, with respect to WFD targets, is given. A map is created of for migratory fish accessible inland waters in up- and downstream direction. Database and maps are good medium for exchanging knowledge between water managers and other stakeholders

Een snelle kosten-effectiviteitsanalyse voor het Deltaprogramma IJsselmeergebied: wat zijn de kosten en veiligheidsbaten van wel of niet meestijgen met de zeespiegel en extra zoetwaterbuffer?

Changes in the climate will have a major impact on the Dutch economy and environment. According to official Dutch climate scenario’s, at the end of the century the sea level will have increased by between 35 and 85 cm. This paper investigates major policy options for the IJsselmeer-area to ensure safety against flooding and various options to increase the freshwater stock. It is concluded that the costs to ensure safety and to protect the citizens, economy and the environment are substantial, that installing massive pumps results in major savings and that in the short run the fresh water stock can be tripled at very low costs (25 million euro). In contrast to the suggestion by the second Dutch Delta Commission, the water level in the IJsselmeer need not rise in line with the sea level The costs of raising dikes and safety benefits were calculated using the model Diqe-Opt. In addition, also all kinds of secondary costs and benefits were investigated, like the effects of changing the water level for the environment, shipping, agriculture and historic monuments built on long wooden piles. The effects on the environment were incorporated in several different ways. One approach was to estimate the costs to prevent environmental damage. For biodiversity, the shallow parts of the IJsselmeer are the most important. These can be protected against a rising water level by constructing a sand barrier. An alternative option is to purchase agricultural land and to use this for environmental purposes. In addition to these cost estimates, also the effects on biodiversity without any additional policy measures were investigated. This was measured in two different ways: the extent to which legal environmental protection standards were met and the score in biodiversity points. According to this cost-effectiveness analysis le 5.5), the option to install giant pumps at the Afsluitdijk is billions of euro cheaper than letting the water level rise with the sea level. This holds also when the differences in fresh water buffer are taken into account. Another conclusion of this analysis was that with limited investments (about 25 million euro), the fresh water buffer in the IJsselmeer-region could be tripled in about a decade

Een snelle kosten-effectiviteitsanalyse voor het Deltaprogramma IJsselmeergebied: wat zijn de kosten en veiligheidsbaten van wel of niet meestijgen met de zeespiegel en extra zoetwaterbuffer?

Changes in the climate will have a major impact on the Dutch economy and environment. According to official Dutch climate scenario’s, at the end of the century the sea level will have increased by between 35 and 85 cm. This paper investigates major policy options for the IJsselmeer-area to ensure safety against flooding and various options to increase the freshwater stock. It is concluded that the costs to ensure safety and to protect the citizens, economy and the environment are substantial, that installing massive pumps results in major savings and that in the short run the fresh water stock can be tripled at very low costs (25 million euro). In contrast to the suggestion by the second Dutch Delta Commission, the water level in the IJsselmeer need not rise in line with the sea level The costs of raising dikes and safety benefits were calculated using the model Diqe-Opt. In addition, also all kinds of secondary costs and benefits were investigated, like the effects of changing the water level for the environment, shipping, agriculture and historic monuments built on long wooden piles. The effects on the environment were incorporated in several different ways. One approach was to estimate the costs to prevent environmental damage. For biodiversity, the shallow parts of the IJsselmeer are the most important. These can be protected against a rising water level by constructing a sand barrier. An alternative option is to purchase agricultural land and to use this for environmental purposes. In addition to these cost estimates, also the effects on biodiversity without any additional policy measures were investigated. This was measured in two different ways: the extent to which legal environmental protection standards were met and the score in biodiversity points. According to this cost-effectiveness analysis le 5.5), the option to install giant pumps at the Afsluitdijk is billions of euro cheaper than letting the water level rise with the sea level. This holds also when the differences in fresh water buffer are taken into account. Another conclusion of this analysis was that with limited investments (about 25 million euro), the fresh water buffer in the IJsselmeer-region could be tripled in about a decade

Sex Differences in Adverse Drug Reactions of Metformin:A Longitudinal Survey Study

Introduction: In general, women more often experience metformin-associated adverse drug reactions (ADRs) than men. Objectives: We aimed to assess whether sex differences in reported ADRs for metformin are observed at different times after initiation, and to explore their concurrence with sex differences in the dose of metformin over time. This may guide future studies in assessing the involved mechanisms of sex differences in metformin-associated ADRs and may guide sex-specific management of ADRs in clinical practice. Methods: This study has a longitudinal design using data about patients initiating metformin collected by the Dutch National Pharmacovigilance Center Lareb through their Intensive Monitoring program. Patients were asked to complete a web-based questionnaire six times after initiation (i.e., at 2 weeks, 6 weeks and at 3, 6, 9, and 12 months). The outcome variables were the proportion of patients reporting any ADR (primary) and the dose of metformin (secondary). Sex differences in the proportions of ADRs and in the dose were tested at each assessment using Pearson Chi-Squared tests and Wilcoxon rank-sum tests, respectively. Using Bonferroni adjustment for multiple testing, a p value < 0.01 was considered statistically significant. Results: The number of included patients was 1712 (40.9% women). Women reported an ADR more often than men, which was statistically significant at the assessment at 2 weeks (34% vs 25%, p < 0.001), and 6 weeks (37% vs 28%, p = 0.001) after initiation. In general, women were reported to be prescribed a lower dose than men, which became statistically significant at the 9-month assessment (p < 0.01). Conclusions: Sex differences in reported ADRs were seen in the first weeks after metformin initiation, whereas statistically significant differences in self-reported prescribed dosing were observed after several months. Patients, in particular women, might benefit from being prescribed lower metformin doses at treatment initiation

Neuropsychiatric adverse drug reactions associated with low dose methotrexate in rheumatoid arthritis patients

BACKGROUND: Neuropsychiatric adverse drug reactions (NPADRs) are not commonly associated with low dose methotrexate (LDMTX) in patients with rheumatoid arthritis (RA). RESEARCH DESIGN AND METHODS: In this case series assessment, we described the nature and frequency of NPADRs with LDMTX in the Dutch DREAM-RA registry, including causality of NPADRs, the impact on further LDMTX treatment and the impact on patient reported Health Related Quality of Life (HRQoL). RESULTS: A total of 71 NPADRs (frequency 6.8%) associated with LDMTX were captured in the DREAM-RA registry. NPADRs were registered for 62 (5.9%) out of 1048 patients with 10.9 NPADRs per 1000 patient years. Headache, dizziness and depression were most frequently reported. The causality was considered probable for 67 NPADRs (94.4%) and definite for 1 NPADR (1.4%). NPADRs led to LDMTX withdrawal in 34 cases (47.9%) and was not restarted in 16 cases (47.1%). Median mental HRQoL was significantly decreased around the occurrence of the NPADR and remained significantly lower after the event. Median physical HRQoL was not significantly affected. CONCLUSIONS: Knowledge on the nature, frequency and impact of the demonstrated NPADRs during LDMTX therapy will enhance attention toward these potential ADRs allowing better risk assessment and communication to patients

Door de dam heen : Soort- en rivier specifieke effecten van dammen op Europese trekvissen

Dammen vormen wereldwijd de grootste bedreiging voor rivierecosystemen, wat vooral tot uitdrukking komt in de afname van de aantallen trekvissen. De mate waarin vissoorten worden beperkt in hun migratie verschilt echter van rivier tot rivier en van soort tot soort. Recent zijn de effecten van rivierfragmentatie op trekvissen door barrières op Europese schaal onderzocht

Exploring wastewater nitrogen and phosphorus flows in urban and rural areas in China for the period 1970 to 2015

China has experienced rapid population growth and increasing human N and P discharge from point sources. This paper presents a new spatial and temporal model-based, province-scale inventory of N and P in wastewater using detailed information on the location and functioning of 4436 WWTPs covering China for the period 1970–2015. China's nutrient discharge to surface water increased 22-fold from 177 to 3908 Gg N yr−1 and 29-fold from 20 to 577 Gg P yr−1 in urban areas between 1970 and 2015. The ten strongly urbanized and industrialized provinces along the Eastern coast contributed 43 % of China's total N and P discharge to surface water in 2015. At present, the contribution of rural areas to total wastewater discharge (2082 Gg N yr−1 and 434 Gg P yr−1) is 35 % for N and 43 % for P. The model approach and sensitivity analysis of this study indicate that policies aiming at improving water quality need to consider these regional differences, i.e., improvement of the wastewater treatment technology level in Eastern regions and increasing both the sewage connection and wastewater treatment in Central and Western regions

Gastrointestinal adverse drug reaction profile of etanercept:Real world data from patients and healthcare professionals

Objective. We aimed to describe the nature and frequency of gastrointestinal adverse drug reactions (GI-ADRs) of etanercept (ETN) using patient-reported and healthcare professional (HCP)-registered data and compared this frequency with the GI-ADR frequency of the widely used tumor necrosis factor-α inhibitor adalimumab (ADA). Methods. Reported GI-ADRs of ETN for rheumatic diseases were collected from the Dutch Biologic Monitor and DREAM registries. We described the clinical course of GI-ADRs and compared the frequency with ADA in both data sources using Fisher exact test. Results. Out of 416 patients using ETN for inflammatory rheumatic diseases in the Dutch Biologic Monitor, 25 (6%) patients reported 36 GI-ADRs. In the DREAM registries 11 GI-ADRs were registered for 9 patients (2.3%), out of 399 patients using ETN, with an incidence of 7.1 per 1000 patient-years. Most GI-ADRs consisted of diarrhea, nausea, and abdominal pain. GI-ADRs led to ETN discontinuation in 1 patient (4%) and dose adjustment in 4 (16%) in the Dutch Biologic Monitor. Eight GI-ADRs (73%) led to ETN discontinuation in the DREAM registries. The frequency of GI-ADRs of ETN did not significantly differ from GI-ADRs of ADA in both data sources (Dutch Biologic Monitor: ETN 8.7% vs ADA 5.3%, P = 0.07; DREAM: ETN 2.8% vs ADA 4.7%, P = 0.16). Conclusion. Most GI-ADRs associated with ETN concerned gastrointestinal symptoms. These ADRs may lead to dose adjustment or ETN discontinuation. The frequency of ETN-associated GI-ADRs was comparable to the frequency of ADA-associated GI-ADRs. Knowledge about these previously unknown ADRs can facilitate early recognition and improve patient communication