Narcolepsy is a chronic sleep disorder characterised by symptoms of excessive daytime sleepiness and cataplexy. The aim of this study was to describe the health‐related quality of life of people with narcolepsy residing in the UK. The study comprised a postal survey of 500 members of the UK narcolepsy patient association, which included amongst other questions the UK Short Form 36 (SF‐36), the Beck Depression Inventory (BDI), and the Ullanlinna Narcolepsy Scale (UNS). A total of 305 questionnaires were included in the final analysis. The results showed that the subjects had significantly lower median scores on all eight domains of the SF‐36 than normative data, and scored particularly poorly for the domains of role physical, energy/vitality, and social functioning. The BDI indicated that 56.9% of subjects had some degree of depression. In addition, many individuals described limitations on their education, home, work and social life caused by their symptoms. There was little difference between the groups receiving different types of medication. This study is the largest of its type in the UK, although the limitations of using a sample from a patient association have been recognised. The results are consistent with studies of narcolepsy in other countries in demonstrating the extensive impact of this disorder on health‐related quality of life.

Significant increases in precipitation have been observed in The Netherlands over the last century. At the same time persistent spatial variations are apparent. The objective of this study is to analyse and explain these spatial patterns, focussing on changes in means and extremes for the period 1951-2009. To investigate different possibilities for the causes of spatial variations, a distinction was made between six regions based on mean precipitation, soil type and elevation, and four zones at different distances to the coast. Spatial maxima in mean precipitation inland and over elevated areas are mainly formed in winter and spring, while maxima along the coast are generated in autumn. Daily precipitation maxima are found in the central West coast and over elevated areas. Upward trends in daily precipitation are highest from February to April and lowest from July to September. The strongest and most significant increases are found along the coast. For several seasonal and climatological periods diverging behaviour between coastal and inland zones is observed. We find that distance to the coast gives a more consistent picture for the seasonal precipitation changes than a classification based on surface characteristics. Therefore, from the investigated surface factors, we consider sea surface temperature to have the largest influence on precipitation in The Netherlands.

Expansion of urban areas has profound effects on land surface characteristics. As such, the land surface can exert influence on atmospheric parameters that might alter precipitation amounts or patterns. In this study, precipitation observations near urban areas along the West coast of the Netherlands are investigated throughout the 1951-2010 period. An innovative analysis methodology is used to deal with the small and fragmented urban areas in the Netherlands. The results show that daily precipitation totals downwind of urban areas are, on average, about 7% higher than precipitation in the rest of the Dutch West coast. Precipitation enhancements up to 20% are found depending on wind direction and time period. These results are comparable with studies from around the globe and show that the influence of relatively small fragmented urban areas, as are present in the Netherlands, can be similar to the influence of large metropolitan areas on precipitation.

In this paper, the Weather Research and Forecasting (WRF) Model is used to investigate the sensitivity of precipitation to soil moisture and urban areas in the Netherlands. The average output of a 4-day event during 10-13 May 1999 for which the individual days had similar synoptical forcing is analyzed. Four simulations are conducted to test the impact of soil moisture changes on precipitation. A positive soil moistureprecipitation feedback is found, that is, wet (dry) soils increase (decrease) the amount of precipitation. Three additional experiments are executed, two in which urban areas in the Netherlands are expanded and one where urban areas are completely removed. Expansion of urban areas results in an increase of the sensible heat flux and a deeper planetary boundary layer, similar to reducing soil moisture. Expanding urban areas reduces precipitation over the Netherlands as a whole, but the local response is not clear. Within existing urban areas, mean and maximum temperature increases of 0.4 and 2 K, respectively, are found under an urban coverage scenario for 2040. The ratio of evapotranspiration to precipitation (a measure of the soil moistureprecipitation feedback) in the urbanization experiments is only about one-third (23%) of that in the soil moisture experiments (67%). Triggering of precipitation, on the other hand, is relatively high in the urban expansion experiments. The effects of reduced moisture availability and enhanced triggering in the urban expansion experiments compensate each other, leading to the moderate reduction in precipitation.

Abstract. The effects of historic and future land use on precipitation in the Netherlands are investigated on 18 summer days with similar meteorological conditions. The days are selected with a circulation type classification and a clustering procedure to obtain a homogenous set of days that is expected to favor land impacts. Changes in precipitation are investigated in relation to the present-day climate and land use, and from the perspective of future climate and land use. To that end, the weather research and forecasting (WRF) model is used with land use maps for 1900, 2000, and 2040. In addition, a temperature perturbation of +1 • C assuming constant relative humidity is imposed as a surrogate climate change scenario. Decreases in precipitation of, respectively, 3-5 and 2-5 % are simulated following conversion of historic to present, and present to future, land use. The temperature perturbation under present land use conditions increases precipitation amounts by on average 7-8 % and amplifies precipitation intensity. However, when also considering future land use, the increase is reduced to 2-6 % on average, and no intensification of extreme precipitation is simulated. In all, the simulated effects of land use changes on precipitation in summer are smaller than the effects of climate change, but are not negligible.