Knowledge uncertainties in nature conservation : Analysing science-policy interactions in the Dutch Wadden Sea

Knowledge uncertainties are an important challenge for nature conservation governance. Although the legitimacy of science-based decisions is questioned by knowledge uncertainties, the dominance of scientific expertise in nature conservation has not reduced. This PhD thesis explains this paradox through an analysis of knowledge uncertainties in decision-making processes around a planned powerboat race, mussel fishery and seagrass restoration in the Dutch Wadden Sea. An analytical distinction is made between three types of knowledge uncertainties: incomplete knowledge, unpredictability and ambiguity. A key factor that explains why knowledge uncertainties have not reduced the dominance of science-based expertise in nature conservation governance is the dominant perception of uncertainty as incomplete knowledge among scientists as well as decision-makers. In order to adequately respond to knowledge debates, ambiguity triggered by diverging knowledge claims as well as the politics of knowledge uncertainties should be given due consideration.</p

Knowledge uncertainties in environmental conflicts:How the mussel fishery controversy in the Dutch Wadden Sea became depoliticised

<p>Policy-makers and scientists often expect that controversies in public policy can be solved by gathering more knowledge, even though this linear model of expertise is widely criticised in social studies of science. To shed more light on this expectation, the role of scientific uncertainties in controversies on mussel fishery in the Dutch Wadden Sea (1990–2016) is investigated. The analysis shows that mussel fishery regulation decisions were primarily based on government authority, not on scientific knowledge. Expectations of policy-makers and scientists on conflict resolution by more research were not met, because the knowledge debate was politicised over ambiguous knowledge claims. The controversy was depoliticised by a political covenant between the conflicting parties. The case study confirms that science-based knowledge fails to guide policy-making as expected in the linear model, and demonstrates how science plays important strategic, procedural and instrumental roles in structuring interactions between stakeholders in nature protection conflicts.</p

Co-creation processes of nature based solutions in hydrological modelling:case studies in the UK, Belgium and the Netherlands

Climate adaptation of brook catchments is much needed in the studied regions of England, Belgium and the Netherlands. With the continuous rise of global temperatures and global change, these regions suffer from the impacts of extreme weather events such as drought and flooding. Extreme weather and climate change impacts are spatially non-uniform, uncertain and can have different strengths at local and regional level. Therefore, cities and regions need to adapt to climate change in an ambiguous way. Accordingly, there is no uniformity in the adaptive capacity of individuals, groups within society, organisations and governments or how they can respond to current and future climate change impacts. To better understand the interlinkages in nature-based climate adaptation between the socio-economic and climate change drivers, we studied these drivers in the hydrological modelling in 3 pilot studies in the UK, the Netherlands and Belgium. Focus is on how co-creation, defined as active participation is incorporated in the hydrological modelling process, (1) within each brook catchment and (2) between the professionals, as cross border knowledge transfer. Data on the co-creation process was collected with workshops on each of the semi-annual partner meetings of each catchment. Data on the modelling process was collected by semi-structured interviews of the professionals and by using assessment of professional learning in the network (field trips). Findings on co-creation processes of nature based solutions in hydrological modelling will be compared in the UK, the Netherlands and Belgium. In the end, existing co-creation processes will be joined to a framework for co-creation which can be improved and adapted based on the gathered data. This would include: identification of stakeholder groups and their needs, the level of intended participation, the identified climate problem by the stakeholders and by the policy-makers, the planned modelling approach, the NbS etc

Mixed-methods evaluation of a co-designed peer-led intervention to tackle barriers to early diagnosis of prostate cancer for Black men in North-East England and Scotland

Background: Black men are twice as likely as White men to develop, and die from, prostate cancer. Black men access prostate cancer care less than White men. Barriers to care are complex, ranging from lack of knowledge to trust issues with healthcare providers. This study aimed to evaluate acceptability of an intervention to encourage early diagnosis of prostate cancer among Black men in North-East England and Scotland. The intervention, a peer-led workshop, co-designed with Black men (n=13) and underpinned by the Integrated Screening Action Model (I-SAM), consisted of multiple components, including health education by a Black GP and videos with testimonials from survivors, women, and religious leaders. Methods: In this mixed-method pilot study, Black African and Caribbean men, aged 42-63 (n=62), were recruited through snowball sampling from community networks. The intervention was delivered twice in November 2023 (n=21), and subsequently qualitatively evaluated through two focus groups (n=14). Feedback was used to improve the intervention, delivered again twice in February 2024 (n=41) and assessed through two focus groups (n=26). Analyses were conducted thematically. Additionally, pre-and post-surveys were collected to investigate knowledge, attitudes and intention to engage in prostate cancer testing (n=41). Wilcoxon Signed Rank Tests compared pre-and post-intervention scores. Findings: Qualitative data indicated participants felt positive about the intervention and perceived it as effective. Participants reported increased knowledge of prostate cancer risks and positive attitudes to help-seeking. They particularly liked the culturally appropriate and peer-led intervention design and delivery, which helped build trust. Quantitative findings included significant increases in knowledge (Z= 4.939, p &lt; 0.001) and intention to undergo prostate cancer testing (Z = 3.975, p &lt; 0.001). Interpretation: The sample size is small and findings must be interpreted cautiously. However, the intervention shows potential to encourage help-seeking and tackle prostate cancer inequalities. Effectiveness testing is needed on a larger scale

Mixed-methods evaluation of a co-designed peer-led intervention to tackle barriers to early diagnosis of prostate cancer for Black men in North-East England and Scotland

Background: Black men are twice as likely as White men to develop, and die from, prostate cancer. Black men access prostate cancer care less than White men. Barriers to care are complex, ranging from lack of knowledge to trust issues with healthcare providers. This study aimed to evaluate acceptability of an intervention to encourage early diagnosis of prostate cancer among Black men in North-East England and Scotland. The intervention, a peer-led workshop, co-designed with Black men (n=13) and underpinned by the Integrated Screening Action Model (I-SAM), consisted of multiple components, including health education by a Black GP and videos with testimonials from survivors, women, and religious leaders. Methods: In this mixed-method pilot study, Black African and Caribbean men, aged 42-63 (n=62), were recruited through snowball sampling from community networks. The intervention was delivered twice in November 2023 (n=21), and subsequently qualitatively evaluated through two focus groups (n=14). Feedback was used to improve the intervention, delivered again twice in February 2024 (n=41) and assessed through two focus groups (n=26). Analyses were conducted thematically. Additionally, pre-and post-surveys were collected to investigate knowledge, attitudes and intention to engage in prostate cancer testing (n=41). Wilcoxon Signed Rank Tests compared pre-and post-intervention scores. Findings: Qualitative data indicated participants felt positive about the intervention and perceived it as effective. Participants reported increased knowledge of prostate cancer risks and positive attitudes to help-seeking. They particularly liked the culturally appropriate and peer-led intervention design and delivery, which helped build trust. Quantitative findings included significant increases in knowledge (Z= 4.939, p &lt; 0.001) and intention to undergo prostate cancer testing (Z = 3.975, p &lt; 0.001). Interpretation: The sample size is small and findings must be interpreted cautiously. However, the intervention shows potential to encourage help-seeking and tackle prostate cancer inequalities. Effectiveness testing is needed on a larger scale

Developing a new national MDMA policy:Results of a multi-decision multi-criterion decision analysis

BACKGROUND: Ecstasy (3,4-methylenedioxymethamphetamine (MDMA)) has a relatively low harm and low dependence liability but is scheduled on List I of the Dutch Opium Act (‘hard drugs’). Concerns surrounding increasing MDMA-related criminality coupled with the possibly inappropriate scheduling of MDMA initiated a debate to revise the current Dutch ecstasy policy. METHODS: An interdisciplinary group of 18 experts on health, social harms and drug criminality and law enforcement reformulated the science-based Dutch MDMA policy using multi-decision multi-criterion decision analysis (MD-MCDA). The experts collectively formulated policy instruments and rated their effects on 25 outcome criteria, including health, criminality, law enforcement and financial issues, thematically grouped in six clusters. RESULTS: The experts scored the effect of 22 policy instruments, each with between two and seven different mutually exclusive options, on 25 outcome criteria. The optimal policy model was defined by the set of 22 policy instrument options which gave the highest overall score on the 25 outcome criteria. Implementation of the optimal policy model, including regulated MDMA sales, decreases health harms, MDMA-related organised crime and environmental damage, as well as increases state revenues and quality of MDMA products and user information. This model was slightly modified to increase its political feasibility. Sensitivity analyses showed that the outcomes of the current MD-MCDA are robust and independent of variability in weight values. CONCLUSION: The present results provide a feasible and realistic set of policy instrument options to revise the legislation towards a rational MDMA policy that is likely to reduce both adverse (public) health risks and MDMA-related criminal burden

Early diagnosis of PROstate CANcer for Black men (PROCAN-B): identifying barriers and facilitators

Prostate cancer is the most common cancer in men in the UK with incidence rates projected to rise. Black men are at least twice as likely to develop prostate cancer as white men and the mortality rate is twice as high, evidencing substantial cancer inequalities. Although there currently is no national screening programme for prostate cancer, it is vital that black men are aware of prostate cancer and their elevated risk as this can encourage help-seeking behaviour, and in turn early diagnosis. Early diagnosis can save lives, yet black men tend to present at later stages. This study aims to investigate barriers and facilitators to early diagnosis of prostate cancer for black men in order to tackle this cancer inequality

The association of pure fruit juice, sugar-sweetened beverages and fruit consumption with asthma prevalence in adolescents growing up from 11 to 20 years: The PIAMA birth cohort study

Pure fruit juice is comparable to sugar-sweetened beverages (SSBs) with respect to its sugar and fructose content. However, it also contains favorable components like polyphenols. From this perspective, pure fruit juice is more comparable with whole fruit. SSBs have been associated with higher asthma risk, while whole fruit consumption has been associated with lower prevalence of asthma (symptoms). Associations with pure fruit juice have been rarely studied. Therefore, we studied the associations of consumption of pure fruit juice, SSBs and whole fruit with asthma prevalence in 3046 children of the Dutch Prevention and Incidence of Asthma and Mite Allergy (PIAMA) birth cohort growing up from 11 to 20 years. Consumption of pure fruit juice, SSBs and fruit was self-reported at the ages of 11, 14, 17 and 20 years. Presence of asthma was defined based on parental reports of asthma diagnosis ever, and wheezing and asthma medication in the last 12 months. Odds ratios (OR) were estimated using generalized linear mixed models accounting for correlation between repeated measurements within subjects. No associations were found between pure fruit juice, SSBs and fruit consumption and the overall prevalence of asthma from 11 to 20 years. An earlier reported association of low pure fruit juice consumption with higher asthma prevalence at the age of 11 years in the PIAMA population was confirmed, but no associations were found at the ages of 14, 17 and 20 years

Family-Centeredness in Secure Residential Treatment and Its Relationship With Parental Involvement and Adolescent Behavioural Outcomes

Various Dutch secure residential youth care (SRYC) institutions are implementing a family-centered approach aiming to increase parental involvement and improve treatment outcomes. However, it remains unclear if and how family-centeredness (FC) is related to increased parental involvement and to improved treatment outcomes of adolescents. In this study, we unravelled the relation between FC, parental involvement, and behaviour problems of adolescents in SRYC. Families of 404 adolescents admitted to one of seven participating Dutch SRYC institutions completed a survey (at the start, at the end, and at 6-months follow-up) on problem behaviour of adolescents. In addition, 411 group care workers filled out a questionnaire about their residential group's level of FC every 6 months. Moreover, the mentor of each adolescent filled out a questionnaire about the level of parental involvement. We analysed the data using multiple mediator models. Associations were found between FC and parental involvement. However, no relation was found between FC and adolescent problem behaviour, and no mediation and no moderation effects of parental involvement were found. Overall, results showed that most parents were involved during the residential stay, and, independent of FC, adolescent problem behaviour decreased over time. Implementing FC in SRYC institutions seems to be helpful in involving parents during the residential stay, but was not found to be associated with adolescent behavioural outcomes. Our results indicate that institutions could improve their level of FC by offering more informal contact moments for parents and by addressing barriers to FC among residential staff