Betesmarker i Mjölkkrisens Sverige : Mjölkbönder och betesmarken, landskapet och framtiden

The situation for Swedish dairy farmers has been difficult since 2014. Many are choosing to close down their businesses. At the same time, Sweden has experienced a reduction of important habitats consisting of grazing lands, a trend that is still ongoing. This study explores how dairy farmers look at grasslands, their values, management, and future. Through interviews with dairy farmers it investigates how farmers look at the systems of environmental compensation awarded for the management of pastures and grassland habitats. The study concludes that is primarily an aesthetic landscape value that is the main reason behind the desire to preserve pastures amongst farmers. This can be linked to a personal relationship between the farmers and the landscape he/she grew up in and help create through with their work. Any reduction in grasslands has not been observed by a majority of the interviewed farmers, despite the fact that such a reduction is occurring in their counties as a whole. This suggests that the situation can vary widely at a local level. The opinions concerning the environmental compensations vary among the interviewees, but overall there is a wish for a less bureaucratic system that provides more flexibility for the farmer. This wish for less bureaucracy is also found concerning the system around the law demanding that all cows should be allowed to graze during a period of the year. In the end, it seems important for the future of grazinglands and the habitats they create that profitability returns to the dairy farmers, since without farmers grazing will be further reduced. Today’s difficult situation for the farmers increases the risk of it being difficult to find the workforce of future farmers who are willing and able to perform the work that is done today

Decompression of the greater occipital nerve improves outcome in patients with chronic headache and neck pain - a retrospective cohort study

Background: Compression of the greater occipital nerve (GON) may contribute to chronic headache, neck pain, and migraine in a subset of patients. We aimed to evaluate whether GON decompression could reduce pain and improve quality of life in patients with occipital neuralgia and chronic headache and neck pain. Methods: In this retrospective cohort study, selected patients with neck pain and headache referred to a single neurosurgical center were analyzed. Patients (n = 22) with suspected GON neuralgia based on nerve block or clinical criteria were included. All patients presented with occipital pain spreading frontally and to the neck in various degree. Surgical decompression was performed under local anesthesia. Follow-up was made by an assessor not involved in the treatment of the patients, by telephone 2-5 years after the surgical procedure and an interview protocol was used to collect information. The data from the follow-up protocols were then analyzed and reported. Results: When analyzing the follow-up protocols, decreased headache/migraine was reported in 77% and neck pain was reduced in 55% of the patients. Conclusions: Decompression of GON(s) may reduce neck pain and headache in selected patients with persistent headache, neck pain, and clinical signs of GON neuralgia. Based on the limitations of the present retrospective study, the results should be considered with caution

Can diabetes medication be reduced in elderly patients? : An observational study of diabetes drug withdrawal in nursing home patients with tight glycaemic control

Aim: To explore the feasibility of withdrawal of diabetes medication in elderly patients with HbA1c £ 6.0%. Methods: HbA1c was measured in 98 patients with known diabetes in 17 nursing homes in Sweden. 32 subjects with HbA1c £ 6.0% participated in the drug withdrawal study. After measuring plasma glucose on three consecutive days, diabetes drugs were reduced, i.e. complete withdrawal of oral anti-diabetic drugs (OADs), complete insulin withdrawal when doses were £ 20 units/day and reduced by half in patients on more than 20 units/day. Results: We identified 31 episodes of plasma glucose £ 4.4 mmol/l, most of them nocturnal (n=17). Mean HbA1c was 5.2 % ± 0.4 compared to 7.1 % ± 1.6 in the non-intervention group. Three months after the diabetes drug discontinuation, 24 patients (75%) remained in the intervention group and mean HbA1c was then 5.8 %. ± 0.9. Six months after baseline investigation mean HbA1c in the intervention group was 5.8 % ± 1.1 compared with 6.6 % ± 1.4 in the non-intervention group. Conclusions: Hypoglycaemic events are common among elderly patients with type 2 diabetes. The withdrawal of diabetes medication in elderly with tight glycaemic control is safe and may decrease the risk for hypoglycaemia.Original Publication: Peter Sjöblom, Anders Tengblad, Ulla-Britt Löfgren, Christina Lannering, Niklas Anderberg, Ulf Rosenqvist, Sigvard Mölstad and Carl J Östgren, Can diabetes medication be reduced in elderly patients?: An observational study of diabetes drug withdrawal in nursing home patients with tight glycaemic control, 2008, Diabetes Research and Clinical Practice, (82), 2, 197-202. http://dx.doi.org/10.1016/j.diabres.2008.08.014 Copyright: Elsevier Science B.V., Amsterdam. http://www.elsevier.com/</p