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This paper investigates the influence of multi-decadal climatic variability on the temporal evolution of root zone storage capacities (Sr,max) and its implications for streamflow predictions in the Meuse basin. Through a comprehensive analysis of 286 catchments across Europe and the US that are hydro-climatically comparable to the Meuse basin, we construct inter-decadal distributions of past deviations in evaporative ratios (IE) from expected values based on catchment aridity (IA). These distributions of ΔIE were then used to estimate inter-decadal changes in Sr,max and to quantify the associated consequences for streamflow predictions in the Meuse basin. Our findings reveal that, while catchments do not strictly adhere to their specific parametric Budyko curves over time, the deviations in IE are generally very minor, with an average ΔIE=0.01 and an interquartile range (IQR) of −0.01 to 0.03. Consequently, these minor deviations lead to limited inter-decadal changes in Sr,max, mostly ranging between −10 and +21 mm (−5 % to +10 %). When these changes (ΔSr,max) are accounted for in hydrological models, the impact on streamflow predictions in the Meuse basin is found to be marginal, with the most significant shifts in monthly evaporation and streamflow not exceeding 4 % and 12 %, respectively. Our study underscores the utility of parametric Budyko-style equations for first-order estimates of future Sr,max in hydrological models, even in the face of climate change and variability. This research contributes to a more nuanced understanding of hydrological responses to changing climatic conditions and offers valuable insights for future climate impact studies in hydrology.

The wflow_sbm hydrological model, recently released by Deltares, as part of the Wflow.jl (v0.7.3) modelling framework, is being used to better understand and potentially address multiple operational and water resource planning challenges from a catchment scale to national scale to continental and global scale. Wflow.jl is a free and open-source distributed hydrological modelling framework written in the Julia programming language. The development of wflow_sbm, the model structure, equations and functionalities are described in detail, including example applications of wflow_sbm. The wflow_sbm model aims to strike a balance between low-resolution, low-complexity and high-resolution, high-complexity hydrological models. Most wflow_sbm parameters are based on physical characteristics or processes, and at the same time wflow_sbm has a runtime performance well suited for large-scale high-resolution model applications. Wflow_sbm models can be set a priori for any catchment with the Python tool HydroMT-Wflow based on globally available datasets and through the use of point-scale (pedo)transfer functions and suitable upscaling rules and generally result in a satisfactory (0.4 ≥ Kling–Gupta efficiency (KGE) < 0.7) to good (KGE ≥ 0.7) performance for discharge a priori (without further tuning). Wflow_sbm includes relevant hydrological processes such as glacier and snow processes, evapotranspiration processes, unsaturated zone dynamics, (shallow) groundwater, and surface flow routing including lakes and reservoirs. Further planned developments include improvements on the computational efficiency and flexibility of the routing scheme, implementation of a water demand and allocation module for water resource modelling, the addition of a deep groundwater concept, and computational efficiency improvements through for example distributed computing and graphics processing unit (GPU) acceleration.

Objective: Breast cancer screening decision aids (DAs) are designed to help women decide whether or not to participate in mammography-based programmes. We aimed to explore women's and healthcare professionals' expectations of a breast cancer screening DA, as part of the French DEDICACES study., Methods: This French qualitative study was based on semistructured, individual interviews with women from the general population, general practitioners (GPs), midwives, gynaecologists, radiologists and screening centre managers. Sampling was purposive and used diversification criteria. The inductive analysis was based on grounded theory., Results: Between April 2018 and May 2019, we interviewed 40 people: 13 women, 14 GPs, 4 gynaecologists, 3 midwives, 3 radiologists and 3 screening centre managers. The women and the healthcare professionals considered that a DA could help to improve levels of knowledge, harmonise medical practice and provide reliable, comprehensive information. Overall, the interviewees wanted an easy-to-use, intuitive, graphic-rich, interactive, computer-based, patient-centred DA. Use of the DA might be limited by a lack of familiarity with shared decision-making (SDM), the risk of misuse and a preference for asymmetric positive information., Conclusion: The present results are likely to facilitate the development of the first validated tool for SDM support in French breast cancer screening programmes., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)