Nem-konvencionális gyógymódok a háziorvos szemszögéből

INTRODUCTION: The patients initiate the use of complementary and alternative medicine and this often remains hidden from their primary care physician. AIM: To explore general practitioners' knowledge and attitude towards complementary and alternative medicine, and study the need and appropriate forms of education, as well as ask their opinion on integration of alternative medicine into mainstream medicine. METHOD: A voluntary anonymous questionnaire was used on two conferences for general practitioners organized by the Family Medicine Department of Semmelweis University. Complementary and alternative medicine was defined by the definition of the Hungarian Academy of Sciences and certified modalities were all listed. RESULTS: 194 general practitioners answered the questionnaire (39.8% response rate). 14% of the responders had licence in at least one complementary and alternative medicine modalities, 45% used complementary and alternative medicine in their family in case of illnesses. It was the opinion of the majority (91.8%) that it was necessary to be familiar with every method used by their patients, however, 82.5% claimed not to have enough knowledge in complementary medicine. Graduate and postgraduate education in the field was thought to be necessary by 86% of the responders; increased odds for commitment in personal education was found among female general practitioners, less than 20 years professional experience and personal experience of alternative medicine. CONCLUSIONS: These data suggest that general practitioners would like to know more about complementary and alternative medicine modalities used by their patients. They consider education of medical professionals necessary and a special group is willing to undergo further education in the field. Orv. Hetil., 2015, 156(28), 1133-1139

Developing a nationally appropriate mitigation measure from the greenhouse gas abatement potential from livestock production in the Brazilian Cerrado.

Brazil is one of the first major developing countries to commit to a national greenhouse gas (GHG) emissions target that requires a reduction of between 36.1% and 38.9% relative to baseline emissions by 2020. The country intends to submit to agricultural emissions reductions as part of this target with livestock production identified as offering significant abatement potentia

Existing and near-to-market methane reducing feed additives and technologies:Evidence of Efficacy, Regulatory Pathways to Market and Mechanisms to Incentivise Adoption

The aim of this work was to (i) review the scientific evidence for a defined range of close-to-market products (five feed supplements and one technology) in relation to the diverse farm circumstances in which they may be used; (ii) evaluate the evidential requirements of relevant regulatory processes and assess the position of these products on their path to regulatory approval; and (iii) considerthe role of evidence in the various public and private mechanisms that are emerging to incentivise use of these products on far

Identification of hypertensive patients with dominant affective temperaments might improve the psychopathological and cardiovascular risk stratification: a pilot, case-control study.

BACKGROUND: Although mood disorders and cardiovascular diseases have widely studied psychosomatic connections, data concerning the influence of the psychopathologically important affective temperaments in hypertension are scarce. To define a possibly higher cardiovascular risk subpopulation we investigated in well-treated hypertensive patients with dominant affective temperaments (DOM) and in well-treated hypertensive patients without dominant temperaments the level of depression and anxiety, arterial stiffness and serum Brain-derived Neurotrophic Factor (seBDNF). METHODS: 175 hypertensive patients, free of the history of psychiatric diseases, completed the TEMPS-A, Beck Depression Inventory and Hamilton Anxiety Scale questionnaires in two primary care practices. Of those 175 patients, 24 DOM patients and 24 hypertensive controls (matched in age, sex and the presence of diabetes) were selected for measurements of arterial stiffness and seBDNF level. RESULTS: Beck and Hamilton scores in DOM patients were higher compared with controls. Pulse wave velocity and augmentation index did not differ between the groups while in the DOM patients decreased brachial systolic and diastolic and central diastolic blood pressures were found compared with controls. SeBDNF was lower in the DOM group than in the controls (22.4 +/- 7.2 vs. 27.3 +/- 7.8 ng/mL, p < 0.05). CONCLUSIONS: Although similar arterial stiffness parameters were found in DOM patients, their increased depression and anxiety scores, the decreased brachial and central diastolic blood pressures as well as the decreased seBDNF might refer to their higher vulnerability regarding the development not only of major mood disorders, but also of cardiovascular complications. These data suggest that the evaluation of affective temperaments should get more attention both with regard to psychopathology and cardiovascular health management

Hyperthymic affective temperament and hypertension are independent determinants of serum brain-derived neurotrophic factor level

BACKGROUND: Brain-derived neurotrophic factor (BDNF) has neuroprotective, proangiogenic and myogenic effects and, therefore, possibly acts as a psychosomatic mediator. Here, we measured serum BDNF (seBDNF) level in hypertensive patients (HT) and healthy controls (CONT) and its relation to affective temperaments, depression and anxiety scales, and arterial stiffness parameters. METHODS: In this cross-sectional study, affective temperaments, anxiety, and depression were studied with questionnaires (TEMPS-A, HAM-A, and BDI, respectively). SeBDNF level and routine laboratory parameters were measured as well. Arterial stiffness was evaluated with a tonometric method. RESULTS: Allover, 151 HT, and 32 CONT subjects were involved in the study. SeBDNF level was significantly higher in HT compared to CONT (24880 +/- 8279 vs 21202.6 +/- 6045.5 pg/mL, p < 0.05). In the final model of regression analysis, hyperthymic temperament score (Beta = 405.8, p = 0.004) and the presence of hypertension (Beta = 6121.2, p = 0.001) were independent determinants of seBDNF. In interaction analysis, it was found that in HT, a unit increase in hyperthymic score was associated with a 533.3 (95 %CI 241.3-825.3) pg/mL higher seBDNF. This interaction was missing in CONT. CONCLUSIONS: Our results suggest a complex psychosomatic involvement of BDNF in the pathophysiology of hypertension, where hyperthymic affective temperament may have a protective role. BDNF is not likely to have an effect on large arteries

The landscape model: a model for exploring trade-offs between agricultural production and the environment

We describe a model framework that simulates spatial and temporal interactions in agricultural landscapes and that can be used to explore trade-offs between production and environment so helping to determine solutions to the problems of sustainable food production. Here we focus on models of agricultural production, water movement and nutrient flow in a landscape. We validate these models against data from two long-term experiments, (the first a continuous wheat experiment and the other a permanent grass-land experiment) and an experiment where water and nutrient flow are measured from isolated catchments. The model simulated wheat yield (RMSE 20.3–28.6%), grain N (RMSE 21.3–42.5%) and P (RMSE 20.2–29% excluding the nil N plots), and total soil organic carbon particularly well (RMSE 3.1 − 13.8 %), the simulations of water flow were also reasonable (RMSE 180.36 and 226.02%). We illustrate the use of our model framework to explore trade-offs between production and nutrient losses

Wider implications of greenhouse gas mitigation measures in English agriculture

nder the guidance of the Committee for Climate Change (CCC), the UK has identified a range of greenhouse gas mitigation actions that can be implemented cost-effectively within different sectors of the economy. UK agriculture and land use change make a relatively small (around 8% of total) but significant contribution to emissions and the sector is expected to make a contribution to overall targets.In response to initial government GHG budgets, the agricultural industry has responded with its own route map for reducing sector emissions, initially by concentrating on measures that reduce emissions by raising production efficiency. Many of the measures identified by the industry have already been identified in Marginal Abatement costs curves (MACCs) developed for the CCC.In developing the MACCs there was a recognition that the cost-effectiveness of measures could be altered by the inclusion of wider ancillary impacts (or co-benefits and costs) and the additional life-cycle and displacement impacts implied by some measures. For example, some measures implemented on farms can impact on biodiversity and water quality. Other measures could entail activities beyond the farm gate that give rise to pollution. Other measures implemented in the UK could reduce productivity and therefore be offset by production overseas, with no net effect on emissions.This project attempts to provide a more systematic review of the nature and size of these impacts. It will focus on the measures covered by the industry route map as applicable to agriculture in England. The identification and quantification of these external and ancillary impacts will help government understand the full costs of implementing both the industry route map and alternative mitigation actions indicated by CCC analysis.An initial qualitative review will summarise how relevant mitigation measures can be associated with the aforementioned ancillary impacts, and a scoring system will be developed to grade these additional impacts. A further quantitative analysis will develop and implement a methodology for quantifying and valuing (in monetary terms) the relevant costs and benefits associated with the same measures.Both stages will draw on a range of published data to define a baseline for the analysis and the range of non-market external costs and benefit estimates that are available for the agricultural sector.The outputs of this project are inception, interim and final reports, and a set of accompanying spreadsheets that will link mitigation measure scenarios to their relevant external costs. This information will provide Defra with a better evidence base on the full economic impacts (and therefore cost-effectiveness) of measures. Cost-effective mitigation reduces the overall burden of mitigation on society (i.e. farmers and tax payers).This project will be delivered by a multi disciplinary team including crop and animal scientists, ecologists and economists. The team has previously collaborated on the development of MACCs for the agricultural sector and has considerable experience in the quantification of ancillary impacts and their monetary valuationObjectiveThe tender specification sets out a clear set of qualitative and quantitative objectives, which we use as the structure of this section (numbered 1 – 8). We also spell out discrete deliverables as reports that can be used as intermediate milestones and deliverables if necessary. More normally, these sections will be consolidated into one final report at the end of the project. We recognize the overall objective of this project is to gain a better understanding of the wider consequences of accomplishing the mitigation targets set out in the industry route map. A subsidiary objective is to investigate methods to offset these impacts. These objectives are expanded in the section on Approaches and Methodology section below.Qualitative1. Inventory of relevant impacts for each mitigation measure (stand alone report, Month 1)2. Baseline impacts and traffic light scoring (Stand alone report, End Month 2)3. A qualitative commentary on the interaction between measures and productivity potential and potential to offset elsewhere (stand alone report Month 2)4. Summarise/synthesise relevant agriculture externality values for categories relevant to measures (stand alone report or report section, Month 2)Relevant categories to be considered :- Food production (and quality)- Production outside the farm gate- Social impacts (jobs, built environment, farm sizes, landscape)- LUC (and its environmental effects)- Genetic and systemic diversity (and resilience implications)- Pests and diseases- Biodiversity- Animal health and welfareQuantitative5. Establish a monetary value baseline without reference to any mitigation scenario (report section Month 3)6. Gap analysis on external impacts and monetary values – including wider LCA impacts and values ( report section Month 3)7. Derive a social value of each measure in the route map (overlaid on baseline) (report section Month 5)8. Developing user-friendly spreadsheet for future use (Month 5)The main milestones are an inception meeting (with a written report), a final report (consolidating all sections above) and at least three further meetings or knowledge exchange events.<br/