The growing appetite of cities is one of the greatest future challenges. There is no set menu for meeting this appetite, but a trend is observed in which city authorities focus on region-based food provision. Regionalism is motivated by the importance of increased self-reliance. Besides, regional food systems, are associated with more sustainable production and reduced carbon footprints, the reconnection of consumers with production, and the increased uptake of whole foods in urban diets. However, the question remains to what extend region based food systems may become self-reliant? How may they contribute to improved sustainability and healthy lifestyles? With the Dutch city of Almere as a case in point this paper provides a food flow data-based analysis of the opportunities and limitations of regional based food system approaches. The paper sets off with defining the concepts of sustainable self-reliance and regionalism. Next, it describes the methodology of measuring and mapping the actual food flows. We combined secondary, publicly available, with primary quantitative and qualitative datasets, involving regional businesses, urban policymakers, and residents. Our study uncovers the coinciding disconnect and interconnectedness of local, regional and global food systems. The regional scale offers opportunities for tackling many food related challenges, however, sustainable urban food security demands connections beyond the regional sphere and beyond the food domain. To assess the effects of the policy options available at the local and regional level, a solid evidence base is essential. This paper advances the development of evidence-based methodologies to monitor and inform food system policies.
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Kinderen met een lage sociaaleconomische status (SES) hebben een verhoogd risico op een suboptimale start in het leven met hogere kosten voor de gezondheidszorg. Deze studie onderzoekt de effecten van SES op individueel (maandelijks huishoudinkomen) en contextuele SES (huishoudinkomen en buurtdeprivatie), en perinatale morbiditeit op de zorgkosten in het vroege leven (0-3 jaar). Conclusie: Meer buurtdeprivatie was direct gerelateerd aan hogere zorgkosten bij jonge kinderen. Bovendien was een lager huishoudinkomen consistent en onafhankelijk gerelateerd aan hogere zorgkosten. Door de omstandigheden voor lage SES-populaties te optimaliseren, kan de impact van lage SES-omstandigheden op hun zorgkosten positief worden beïnvloed.
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Peak oxygen uptake (V'O2peak) is recognised as the best expression of aerobic fitness. Therefore, it is essential that V'O2peak reference values are accurate for interpreting a cardiopulmonary exercise test (CPET). These values are country specific and influenced by underlying biological ageing processes. They are normally stratified per paediatric and adult population, resulting in a discontinuity at the transition point between prediction equations. There are currently no age-related reference values available for the lifespan of individuals in the Dutch population. The aim of this study is to determine the best-fitting regression model for V'O2peak in the healthy Dutch paediatric and adult populations in relation to age. In this retrospective study, CPET cycle ergometry results of 4477 subjects without reported somatic diseases were included (907 females, age 7.9-65.0 years). Generalised additive models were employed to determine the best-fitting regression model. Cross-validation was performed against an independent dataset consisting of 3518 subjects (170 females, age 6.8-59.0 years). An additive model was the best fitting with the largest predictive accuracy in both the primary (adjusted R2=0.57, standard error of the estimate (see)=556.50 mL·min-1) and cross-validation (adjusted R2=0.57, see=473.15 mL·min-1) dataset. This study provides a robust additive regression model for V'O2peak in the Dutch population.
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