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Bespreking van: Michiel de Ronde (2019). Leven in verhalen. Begeleiden met mythen, sprookjes en gedichten rond vragen op de levensweg. Utrecht: Eburon. ISBN 9789463012751
Although many countries have shown a distinct drop in crime over the last decades, the criminological literature suggests that fear of crime in those countries remained relatively stable. Research on this issue is sparse however, mostly confined to a single country, a few indicators and/or a relatively short timeframe. For this chapter 1,100 data series on fear of crime related items from (supra)national surveys were collected, covering 121 countries and more than 25 years (1989-2015). Using these data, a first prototype for an International Fear of Crime Trend Index was developed. Used on the five UN-regions with the highest average amount of data series per country, the index shows a pronounced fear drop in four of the five regions: all of them in Europe and the Anglo-Saxon countries. Explanations for these fear drops are hypothesized and directions for further research are formulated.
I was somewhat surprized with the fog in Groningen upon my arrival. This is notthe fog that covers the beautiful landscapes of the northern Netherlands in theevening and in the early morning. No… It is the fog that obscures the real aspectsof the earthquake problem in the region and is crystallised in the phrase “Groningen earthquakes are different”, which I have encountered numerous times whenever I raised a question of the type “But why..?”. A sentence taken out of the quiver as the absolute technical argument which mysteriously overshadows the whole earthquake discussion.Q: Why do we not use Eurocode 8 for seismic design, instead of NPR?A: Because the Groningen earthquakes are different!Q: Why do we not monitor our structures like the rest of the world does?A: Because the Groningen earthquakes are different!Q: Why does NPR, the Dutch seismic guidelines, dictate some unusual rules?A: Because the Groningen earthquakes are different!Q: Why are the hazard levels incredibly high, even higher than most Europeanseismic countries?A: Because the Groningen earthquakes are different!and so it keeps going…This statement is very common, but on the contrary, I have not seen a single piece of research that proves it or even discusses it. In essence, it would be a difficult task to prove that the Groningen earthquakes are different. In any case it barricades a healthy technical discussion because most of the times the arguments converge to one single statement, independent of the content of the discussion. This is the reason why our first research activities were dedicated to study if the Groningen earthquakes are really different. Up until today, we have not found any major differences between the Groningen induced seismicity events and natural seismic events with similar conditions (magnitude, distance, depth, soil etc…) that would affect the structures significantly in a different way.Since my arrival in Groningen, I have been amazed to learn how differently theearthquake issue has been treated in this part of the world. There will always bedifferences among different cultures, that is understandable. I have been exposed to several earthquake engineers from different countries, and I can expect a natural variation in opinions, approaches and definitions. But the feeling in Groningen is different. I soon realized that, due to several factors, a parallel path, which I call “an augmented reality” below, was created. What I mean by an augmented reality is a view of the real-world, whose elements are augmented and modified. In our example, I refer to the engineering concepts used for solving the earthquake problem, but in an augmented and modified way. This augmented reality is covered in the fog I described above. The whole thing is made so complicated that one is often tempted to rewind the tape to the hot August days of 2012, right after the Huizinge Earthquake, and replay it to today but this time by making the correct steps. We would wake up to a different Groningen today. I was instructed to keep the text as well as the inauguration speech as simple aspossible, and preferably, as non-technical as it goes. I thus listed the most common myths and fallacies I have faced since I arrived in Groningen. In this book and in the presentation, I may seem to take a critical view. This is because I try to tell a different part of the story, without repeating things that have already been said several times before. I think this is the very reason why my research group would like to make an effort in helping to solve the problem by providing different views. This book is one of such efforts.The quote given at the beginning of this book reads “How quick are we to learn: that is, to imitate what others have done or thought before. And how slow are we to understand: that is, to see the deeper connections.” is from Frits Zernike, the Nobel winning professor from the University of Groningen, who gave his name to the campus I work at. Applying this quotation to our problem would mean that we should learn from the seismic countries by imitating them, by using the existing state-of-the-art earthquake engineering knowledge, and by forgetting the dogma of “the Groningen earthquakes are different” at least for a while. We should then pass to the next level of looking deeperinto the Groningen earthquake problem for a better understanding, and alsodiscover the potential differences.
Marnix Eysink Smeets constateert dat de veiligheidsbeleving van het publiek al langer hoog op de politieke agenda staat. Criminologisch onderzoek op dit terrein heeft veel inzichten opgeleverd in operationalisering, meetmethoden en determinanten van angst voor criminaliteit. Maar over mechanismen, trends, effecten en beïnvloedbaarheid is veel minder bekend. Daarnaast valt op dat veel onderzoekers eenzijdig gericht zijn op de ‘traditionele’ angst voor criminaliteit, terwijl zich inmiddels nieuwe misdrijven en dreigingen hebben gemanifesteerd.
Als moderne mensen van (na) de Verlichting is het ons onmogelijk om nog één te zijn met de natuur, zoals onze voorouders dat ooit waren. Diezelfde voorouders hebben ons echter in hun sprookjes en mythen een schat aan symbolische vertellingen nagelaten, die ons aanspreken in de taal van zintuigelijke beelden, aan de natuur ontleende metaforen en van gevoelens gevulde fantasieën. De werkvorm van het dwalen in het sprookjesbos laat zien dat het ons in de verbinding van het wandelen in de natuur en het opgaan in het verhaal, wel lukt om te komen in een staat van tweede primitiviteit. Daarin maken de cognitieve controle en de reflectieve beschouwing even plaats voor een gevoelsmatige ontvankelijkheid en een daaraan verbonden symboolgevoeligheid. In de heen-en-weerbeweging tussen de symbolische vertelling en het eigen verhaal, tussen het opgaan in het sprookje en het verwoorden van eigen ervaringen, tussen het dwalen in het bos en het dwalen in het eigen gemoed, blijkt een speelruimte te ontstaan, waarin nieuwe inzichten oplichten en een diepere vorm van aanvaarding zich aandient.
Openbare pleinen hebben een enorme impact op de levenskwaliteit van stadsbewoners, vooral in kwetsbare wijken. Ze kunnen lichaamsbeweging, gemeenschapsinteracties, spel en klimaatadaptatie vergemakkelijken, die allemaal de gezondheid van de lokale bevolking beïnvloeden. Er zijn echter vaak veel vragen over hoe de percepties en ervaringen van lokale gemeenschappen kunnen worden vastgelegd bij de (her)ontwikkeling van deze pleinen, waarbij het risico bestaat dat gemarginaliseerde groepen worden uitgesloten. Hoe kunnen openbare pleinen deze verschillende functies en percepties integreren en inclusieve plekken voor iedereen worden? Ontdek het in de korte documentaire 'Eyes on the Square'. Door algemene principes van experts, ervaringen uit best practices door heel Nederland en perspectieven van omwonenden te combineren, pleiten de makers voor meer inclusieve ontwikkelingen voor gezonde steden.
MULTIFILE
The critical care community still has mixed feelings when considering the optimal nutrition of intensive care unit (ICU) patients, which is understandable as randomized controlled trials have not been very helpful in improving clinical practice. There have been no randomized controlled trials (RCTs) to contribute to the discussion, especially concerning the role of enterally fed protein in optimal critical care. Recent studies on the route of feeding have shown that enteral nutrition (EN) is not necessarily superior to parenteral nutrition (PN) [1, 2]. There appears to be a strong consensus, with backup from a meta-analysis, on the preferential use of EN over PN [3]. The infection rate was especially used as an argument; however, this is not substantiated in recent trials [1, 2]. We have to consider how applicable this current knowledge is to all ICU patients. Early EN is still the preferred way of feeding [3]. Starting feeding early may improve the outcome of ICU patients. RCTs have all investigated (supplemental parenteral) energy delivery [4]. Only two trials have ‘considered’ protein: the PERMIT trial [5] (protein supplemented, equal level) and EAT-ICU trial [6] (protein supplemented, higher level). Early energy delivery should be applied cautiously since it appears to be related to worse outcome in ICU patients [7, 8, 9]. Therefore, and from the perspective of clinical practice, the Swiss Supplemental PN (SPN) trial appears to provide the most logical design [10]—start with early EN and evaluate on day 3 what the level of energy delivery is; when delivery levels are low (< 60%) start supplementation PN. In clinical practice in our ICU the enteral feeding levels are high enough to avoid PN supplementation, which therefore restricts the specific indication to use PN. The focus of this research has been caloric delivery. There are more than enough observational data to support that higher protein delivery is associated with improved outcome in ICU patients [7, 8, 9]. These observational studies clearly show the benefit of higher protein delivery. However, they are considered relatively weak evidence since illness is considered a confounding factor in the relationship between delivery and outcome for which we cannot completely adjust. Randomized trials have not been conducted, although two trials with randomized high(er) amino acid infusion are available and somewhat contradicting [11, 12]. As with the studies on caloric delivery, the studies on protein have been hampered by insufficient knowledge on energy and protein metabolism under these (patho)physiological circumstances in the ICU patient [7, 8, 9]. Therefore, mechanistic studies on the protein physiology in ICU patients is an essential and current development. The Swedish group of Wernerman and Rooyackers has provided crucial information on the topic. They showed that it was possible to change protein balance during the early phase of admission to the ICU from negative to positive by a short-term (3-h) high-level (1 g/kg/day) amino acid (AA) infusion [13]. This observation was very important to help understand the physiology since it showed that, under these circumstances of critical illness, some basic principles of nutrition still perform well. In the December 2017 issue of Critical Care, Sundstrom et al. showed that the effect of supplemental AA infusion at 3 h is still present at 24 h [14]. Why is this so important to know? We know from extensive studies in sports and the elderly that protein synthesis can be stimulated by bolus protein feeding; however, we know relatively little about the effects of continuous (low dose per time unit) feeding. While the absolute levels of protein balance still have to be considered with caution (e.g., choice of tracer), and we are not completely sure where the protein is going, we now know this positive effect on protein balance is lasting. The next challenge is to reconnect this physiological information with the outcome of ICU patients. We have shown that muscle (protein) mass at admission to the ICU is relevant for the outcome of ICU patients [15]. We do not know if we can change muscle mass and outcome of ICU patients with protein nutrition. The study by Sundstrom et al. [14] is very promising for protein balance, but will that be enough to change outcome? And, if so, is that true for all patients—does one size fit all? The ICU patient group is heterogeneous. Earlier, we found high protein delivery to be associated with lower mortality, except for sepsis patients and patients with early caloric overfeeding [7]. The EAT-ICU trial did not find an effect of early goal-directed feeding on physical component score at 6 months or on mortality [6]. Goal-directed feeding included feeding energy based on indirect calorimetry and protein up to 1.5 g/kg/day from day 1. Feeding calories up to the measured caloric target from day 1 may be equal to caloric overfeeding [7]. The 47% of patients with sepsis in the EAT-ICU trial might also not benefit from the higher protein feeding [7]. Therefore, the effects of protein and energy cannot be assessed individually from this trial. Ferrie et al. showed interesting differences in muscle mass and function between an AA infusion rate of 0.8 and 1.2 g/kg/day [12], but not all patients are equal—one size does not fit all! Those patients with a low protein reserve (low muscle mass) may be at highest risk in the ICU and may benefit more from intervention with early protein nutrition. We have to await further studies, including randomized studies and post-hoc observational studies, to further develop this area of interest. The studies trying to understand the mechanism behind the physiological effect are important as well; we might come nearer to the truth of what works and what does not work in ICU nutrition.
