Two key air pollutants that affect asthma are ozone and particle pollution. Studies show a direct relationship between the number of deaths and hospitalizations for asthma and increases of particulate matter in the air, including dust, soot, fly ash, diesel exhaust particles, smoke, and sulfate aerosols. Cars are found to be a primary contributor to this problem. However, patient awareness of the link is limited. This chapter begins with a general discussion of vehicular dependency or ‘car culture’, and then focuses on the discussion of the effects of air pollution on asthma in the Netherlands. I argue that international organizations and patient organizations have not tended to put pressure on air-control, pollution-control or environmental standards agencies, or the actual polluters. While changes in air quality and the release of greenhouse gases are tied to practices like the massive corporate support for the ongoing use of motor vehicles and the increased prominence of ‘car culture’ globally, patient organizations seem more focused on treating the symptoms rather than addressing the ultimate causes of the disease. Consequently, I argue that to fully address the issue of asthma the international health organizations as well as national health ministries, patient organizations, and the general public must recognize the direct link between vehicular dependency and asthma. The chapter concludes with a recommendation for raising environmental health awareness by explicitly linking the vehicular dependency to the state of poor respiratory health. Strategic policy in the Netherlands then should explicitly link the present pattern of auto mobility to public health. https://onlinelibrary.wiley.com/doi/book/10.1002/9781118786949 LinkedIn: https://www.linkedin.com/in/helenkopnina/
MULTIFILE
Background: There is still limited evidence on the effectiveness and implementation of smoking cessation interventions for people with severe mental illness (SMI) in Dutch outpatient psychiatric settings. The present study aimed to establish expert consensus on the core components and strategies to optimise practical implementation of a smoking cessation intervention for people treated by Flexible Assertive Community Treatment (FACT) teams in the Netherlands. Design: A modified Delphi method was applied to reach consensus on three core components (behavioural counselling, pharmacological treatment and peer support) of the intervention. The Delphi panel comprised five experts with different professional backgrounds. We proposed a first intervention concept. The panel critically examined the evolving concept in three iterative rounds of 90 min each. Responses were recorded, transcribed verbatim and thematically analysed. Results: Overall, results yielded that behavioural counselling should focus on preparation for smoking cessation, guidance, relapse prevention and normalisation. Pharmacological treatment consisting of nicotine replacement therapy (NRT), Varenicline or Bupropion, under supervision of a psychiatrist, was recommended. The panel agreed on integrating peer support as a regular part of the intervention, thus fostering emotional and practical support among patients. Treatment of a co-morbid cannabis use disorder needs to be integrated into the intervention if indicated. Regarding implementation, staff’s motivation to support smoking cessation was considered essential. For each ambulatory team, two mental health care professionals will have a central role in delivering the intervention. Conclusions: This study provides insight into expert consensus on the core components of a smoking cessation intervention for people with SMI. The results of this study were used for the development of a comprehensive smoking cessation program.
DOCUMENT
Pressure on natural resources, unsustainable production and consumption, inequality and a growing global population lie at the base of the big challenges that people face. This chapter investigates how businesses can take responsibility in dealing with these challenges by means of frugal business model innovation. The notion of ‘frugal innovation’ was first introduced in the context of emerging markets, giving non-affluent customers opportunities to consume affordable products and services suited to their needs. Business modelling with a frugal mindset opens up a path that provides significant value while minimizing the use of resources such as energy, capital and time. Business models require intentional design if they are to deliver aspired sustainability impacts. Diminish or simplify resources can be described as the means to remove or reduce features, resources, required activities and/or waste streams. Decompose can be described as the removal of resources from the commercial value proposition and replacing them with resources the user/consumer already can access or uses. This is an Accepted Manuscript of a book chapter published by Routledge/CRC Press in Circular Economy : Challenges and Opportunities for Ethical and Sustainable Business on 2021, available online: https://doi.org/10.4324/9780367816650
DOCUMENT
