Abstract: Climate change is related with weather extremes, which may cause damages to infrastructure used by freight transport services. Heavy rainfall may lead to flooding and damage to railway lines, roads and inland waterways. Extreme drought may lead to extremely low water levels, which prevent safe navigation by inland barges. Wet and dry periods may alternate, leaving little time to repair damages. In some Western and Middle-European countries, barges have a large share in freight transport. If a main waterway is out of service, then alternatives are called for. Volume- and price-wise, trucking is not a viable alternative. Could railways be that alternative? The paper was written after the unusually long dry summer period in Europe in 2022. It deals with the question: If the Rhine, a major European waterway becomes locally inaccessible, could railways (temporarily) play a larger role in freight transport? It is a continuation of our earlier research. It contains a case study, the data of which was fed into a simulation model. The model deals with technical details like service specification route length, energy consumption and emissions. The study points to interesting rail services to keep Europe’s freight on the move. Their realization may be complex especially in terms of logistics and infrastructure, but is there an alternative?
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The aim of this systematic review was to examine the association between malnutrition and oral health in older people (≥ 60 years of age). A comprehensive systematic literature search was performed in four databases (PubMed, CINAHL, Dentistry and Oral Sciences Source, and Embase) for literature from January 2000 to May 2020. Both observational and intervention studies were screened for eligibility. Two reviewers independently screened the search results to identify potential eligible studies, and assessed the methodological quality of the full-text studies. A total of 3240 potential studies were identified. After judgement for relevance, 10 studies (cross-sectional (n = 9), prospective cohort (n = 1)) met the inclusion criteria. Three studies described malnourished participants as having fewer teeth, or functional (tooth) units (FTUs), compared to well-nourished participants. Four studies reported soft tissue problems in malnourished participants, including red tongue with blisters, and dry or cracked lips. Subjective oral health was the topic in six studies, with poorer oral health and negative self-perception of oral health in malnourished elderly participants. There are associations between (at risk of) malnutrition and oral health in older people, categorized in hard and soft tissue conditions of the mouth, and subjective oral health. Future research should be focused on longitudinal cohort studies with proper determination of malnutrition and oral health assessments, in order to evaluate the actual association between malnutrition and oral health in older people.
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Recent years have seen a global rise in the failure of tailings dams. Studies investigating the causes of slope failure often recognise high intensity rainfall events to significantly contribute to liquefaction, erosion and overtopping. This study aims to investigate the influence of alternative physical and geohydrological processes that, under tension saturation conditions, contribute to slope instability in tailings dams. It has been suggested that the generation of transient pressure wave mechanisms by high intensity rainfall events, surface ponding and wetting front advancement result in the formation of an induced pressure head that triggers the mobilization of pre-event water. In order to quantify these physical processes, this study included the analysis of rapid transmission conditions in a silica fines mix, with similar physical and hydraulic characteristics as platinum tailings. A tall leak-proof soil column, containing the soil sample compacted to in-situ dry bulk density, was fitted with seven observation ports. Each port consisted of a pore air pressure probe, a mini tensiometer and a time domain reflectometry probe. After set-up and initial stabilisation, three separate artificial high intensity rainfall events were applied to the surface. Monitoring of hydraulic state variables was recorded at thirty second intervals by automatic logging, thereby enabling the analysis of measured outcomes. Observations showed instant spikes in pore air pressure ahead of the wetting front, as well as a number of delayed responses. The interpretation of lab results led to the conclusion that pressure diffusion mechanisms throughout the porous medium, could result in the rapid release and mobilisation of previously stagnant antecedent moisture, thereby enabling phreatic levels to rising rapidly and in excess to the amount of surface infiltration. Also, since an increase in pore water pressure is likely to cause a reduction in shear strength, it is suggested that these physical and geohydrological processes could have an adverse impact on the stability of tailings dams.
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Older people are often over-represented in morbidity and mortality statistics associated with hot and cold weather, despite remaining mostly indoors. The study “Improving thermal environment of housing for older Australians” focused on assessing the relationships between the indoor environment, building characteristics, thermal comfort and perceived health/wellbeing of older South Australians over a study period that included the warmest summer on record. Our findings showed that indoor temperatures in some of the houses reached above 35 °C. With concerns about energy costs, occupants often use adaptive behaviours to achieve thermal comfort instead of using cooling (or heating), although feeling less satisfied with the thermal environment and perceiving health/wellbeing to worsen at above 28 °C (and below 15 °C). Symptoms experienced during hot weather included tiredness, shortness of breath, sleeplessness and dizziness, with coughs and colds, painful joints, shortness of breath and influenza experienced during cold weather. To express the influence of temperature and humidity on perceived health/wellbeing, a Temperature Humidity Health Index (THHI) was developed for this cohort. A health/wellbeing perception of “very good” is achieved between an 18.4 °C and 24.3 °C indoor operative temperature and a 55% relative humidity. The evidence from this research is used to inform guidelines about maintaining home environments to be conducive to the health/wellbeing of older people. Original publication at MDPI: https://doi.org/10.3390/atmos13010096 © 2022 by the authors. Licensee MDPI.
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Ageing brings about physiological changes that affect people’s thermal sensitivity and thermoregulation. The majority of older Australians prefer to age in place and modifications to the home environment are often required to accommodate the occupants as they age and possibly become frail. However, modifications to aid thermal comfort are not always considered. Using a qualitative approach this study aims to understand the thermal qualities of the existing living environment of older South Australians, their strategies for keeping cool in hot weather and warm in cold weather and to identify existing problems related to planning and house design, and the use of heating and cooling. Data were gathered via seven focus group sessions with 49 older people living in three climate zones in South Australia. The sessions yielded four main themes, namely ‘personal factors’, ‘feeling’, ‘knowing’ and ‘doing’. These themes can be used as a basis to develop information and guidelines for older people in dealing with hot and cold weather. Original publication at MDPI: https://doi.org/10.3390/ijerph16060935 © 2018 by the authors. Licensee MDPI.
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This chapter reports on the findings of a research project aimed at investigating the actual thermal environment of the housing of older occupants (aged 65 or over) in South Australia. The study documented their thermal preferences and behaviours during hot and cold weather and relationships to their well-being and health. Information was collected in three phases, a telephone survey, focus group discussions and detailed house environmental monitoring that employed an innovative data acquisition system to measure indoor conditions and record occupant perceptions and behaviours. The research covered three climate zones and extended over a nine-month period. The detailed monitoring involved a total of 71 participants in 57 houses. More than 10,000 comfort/well-being questionnaire responses were collected with more than 1,000,000 records of indoor environmental conditions. Analysis of the data shows the relationships between thermal sensation and self-reported well-being/health and the various adaptive strategies the occupants employ to maintain their preferred conditions. Findings from the research were used to develop targeted recommendations and design guidelines intended for older people with specific thermal comfort requirements and more broadly advice for architects, building designers and policymakers. Original publication at: Routledge Handbook of Resilient Thermal Comfort Chapter 7: https://doi.org/10.4324/9781003244929-10
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Analyse the results from a representative selection of the supply chain studies for school feeding programmes in Kenya, Ghana and Mali, and make specific suggestions for interventions that can efficiently include SHF in the supply chains.
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Honger is nog steeds een wereldwijd probleem, terwijl iedereen genoeg te eten zou hebben als we het beschikbare voedsel goed zouden verdelen en benutten, en het niet zouden verspillen. Maar alleen al in Nederland gooien we ruim 33 kilo voedsel per persoon per jaar weg. Dat moet anders! Door voedsel slimmer te verpakken, kunnen we voedselverspilling én onnodig verpakkingsafval voorkomen. Binnen het project Goed Verpakt hebben we verschillende partijen samengebracht om integraal aan dit onderwerp te werken. Het breed samengestelde consortium bestond uit kennisinstellingen, producenten van aardappels, groente en fruit, producenten van maaltijden en portieverpakkingen, producenten van verpakkingsmaterialen en een brancheorganisatie. Onze centrale onderzoeksvraag was: Hoe kunnen bedrijven in de voedingssector op een meer duurzame manier in de behoefte van de eindgebruiker voorzien, waarbij de gekozen totaaloplossing van de product-verpakkingscombinatie past binnen en circulaire economie en aansluit bij de vereisten van de hele keten? Samen hebben we naar slimme product-verpakkingscombinaties gezocht, waarbij we hebben geanalyseerd welke duurzaamheidsdilemma’s partijen in de keten ervaren en hoe we die kunnen oplossen of wegnemen. Daarbij hebben we ook in beeld gebracht wat de betrokken partijen zelf kunnen doen en wat zij voor elkaar kunnen krijgen door een nauwere samenwerking binnen de keten. Voor slimme product-verpakkingscombinaties is ook de overheid een onmisbare partner. Onduidelijkheid, een gebrek aan daadkracht en te eenzijdige wet- en regelgeving werken averechts en ondermijnen het streven naar meer duurzaamheid binnen de sector. Beleidsmakers onderschatten de expertise die nodig is om dit goed te regelen. Maar verduurzaming is dus vooral een kwestie van nauwer samenwerken. Met partners binnen de branche, met interessante partijen buiten de branche én met de overheid. We formuleren in dit document alvast onze negen gouden regels van integraal duurzaam verpakken. Daarnaast blijven de betrokken kennisinstellingen onderzoek doen naar dit onderwerp. Bijvoorbeeld naar consumentengedrag en – intenties en naar de inzet van de Rethink-methode voor het herontwerpen van product-verpakkingscombinaties. Zo zorgen alle betrokken partners voor een circulaire toekomst waarin voedsel steeds slimmer verpakt wordt en we met een minimum aan afval zo veel mogelijk voedsel beschikbaar maken voor iedereen.
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Oncology healthcare professionals (HCPs) and cancer patients often have difficulties in navigating conversations about sexual changes and concerns due to cancer and its treatments. The present study draws on Discursive Psychology to analyze how the topic of sexuality is raised and managed in Dutch oncological consultations. Our corpus consists of 28 audio recordings. We analyzed the discursive practices used by cancer patients and oncology HCPs and to what effect. Patients, on the one hand, employ vagueness, pronouns, and ellipses, while HCPs attribute talk to others and use generalizations, and speech perturbations. Through these practices they collectively keep the topic of sexuality at a distance, thereby constructing it as a delicate topic. Moreover, we explicate the norms related to sexual behavior that cancer patients and oncology HCPs orient to in their talk. Finally, we address ways in which oncology HCPs can open the door on discussing sexual changes with their patients.
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Introduction: Besides dyspnoea and cough, patients with idiopathic pulmonary fibrosis (IPF) or sarcoidosis may experience distressing non-respiratory symptoms, such as fatigue or muscle weakness. However, whether and to what extent symptom burden differs between patients with IPF or sarcoidosis and individuals without respiratory disease remains currently unknown. Objectives: To study the respiratory and non-respiratory burden of multiple symptoms in patients with IPF or sarcoidosis and to compare the symptom burden with individuals without impaired spirometric values, FVC and FEV1 (controls). Methods: Demographics and symptoms were assessed in 59 patients with IPF, 60 patients with sarcoidosis and 118 controls (age ≥18 years). Patients with either condition were matched to controls by sex and age. Severity of 14 symptoms was assessed using a Visual Analogue Scale. Results: 44 patients with IPF (77.3% male; age 70.6±5.5 years) and 44 matched controls, and 45 patients with sarcoidosis (48.9% male; age 58.1±8.6 year) and 45 matched controls were analyzed. Patients with IPF scored higher on 11 symptoms compared to controls (p<0.05), with the largest differences for dyspnoea, cough, fatigue, muscle weakness and insomnia. Patients with sarcoidosis scored higher on all 14 symptoms (p<0.05), with the largest differences for dyspnoea, fatigue, cough, muscle weakness, insomnia, pain, itch, thirst, micturition (night, day). Conclusions: Generally, respiratory and non-respiratory symptom burden is significantly higher in patients with IPF or sarcoidosis compared to controls. This emphasizes the importance of awareness for respiratory and non-respiratory symptom burden in IPF or sarcoidosis and the need for additional research to study the underlying mechanisms and subsequent interventions.
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