Vestigingssteun voor bedrijfsopvolgers in de agrarische sector : een analyse van drie mogelijke varianten

In dit rapport is voor drie varianten van vestigingssteun het effect op de financiële positie na de bedrijfsovername onderzocht. De financiële positie na bedrijfsovername is zeer verschillend tussen bedrijven. Deze uitgangssituatie na overname is van essentieel belang voor de levensvatbaarheid. Voor de analyse van de drie varianten is een rekenmodel gemaakt. Van de drie varianten komt de variant zoals die door het Nederlands Agrarisch Jongeren Kontakt is voorgesteld het beste naar voren: het 'Next Generation Fund'. De opvolger ontvangt bij bedrijfsovername 50.000 gulden, die na 10 jaar moet worden terugbetaald. Dit is met name gunstig voor de liquiditeitspositie van de opvolger. Het effect van vestigingssteun op de levensvatbaarheid valt in het niet vergeleken met de effecten van de verschillen in uitgangssituatie

Landschappelijke effecten van veranderingen in de landbouw

Inkomens in de landbouw lopen duidelijk achterop in Nationale Landschappen met kernkwaliteiten die gerelateerd zijn aan behoud van karakteristieke watersystemen zoals kreekrestanten en vrij meanderende beken. Het LEI ontdekte regionale patronen in de productieomstandighede

The prognostic value of blood lactate levels relative to that of vital signs in the pre-hospital setting: a pilot study

Introduction: A limitation of pre-hospital monitoring is that vital signs often do not change until a patient is in a critical stage. Blood lactate levels are suggested as a more sensitive parameter to evaluate a patient's condition. The aim of this pilot study was to find presumptive evidence for a relation between pre-hospital lactate levels and in-hospital mortality, corrected for vital sign abnormalities. Methods: In this prospective observational study (n = 124), patients who required urgent ambulance dispatching and had a systolic blood pressure below 100 mmHg, a respiratory rate less than 10 or more than 29 breaths/ minute, or a Glasgow Coma Scale (GCS) below 14 were enrolled. Nurses from Emergency Medical Services measured capillary or venous lactate levels using a hand-held device on arrival at the scene (T1) and just before or on arrival at the emergency department (T2). The primary outcome measured was in-hospital mortality. Results: The average (standard deviation) time from T1 to T2 was 27 (10) minutes. Non-survivors (n = 32, 26%) had significantly higher lactate levels than survivors at T1 (5.3 vs 3.7 mmol/L) and at T2 (5.4 vs 3.2 mmol/L). Mortality was significantly higher in patients with lactate levels of 3.5 mmol/L or higher compared with those with lactate levels below 3.5 mmol/L (T1: 41 vs 12% and T2: 47 vs 15%). Also in the absence of hypotension, mortality was higher in those with higher lactate levels. In a multivariable Cox proportional hazard analysis including systolic blood pressure, heart rate, GCS (all at T1) and delta lactate level (from T1 to T2), only delta lactate level (hazard ratio (HR) = 0.20, 95% confidence interval (CI) = 0.05 to 0.76, p = 0.018) and GCS (HR = 0.93, 95% CI = 0.88 to 0.99, p = 0.022) were significant independent predictors of in-hospital mortality. Conclusions: In a cohort of patients that required urgent ambulance dispatching, pre-hospital blood lactate levels were associated with in-hospital mortality and provided prognostic information superior to that provided by the patient's vital signs. There is potential for early detection of occult shock and pre-hospital resuscitation guided by lactate measurement. However, external validation is required before widespread implementation of lactate measurement in the out-of-hospital setting

Retroperitoneal fibrosis and β-blocking agents:Is there an association?

AIM: Retroperitoneal fibrosis (RPF) is a rare chronic fibro-inflammatory disorder which may be secondary to certain drugs, including beta-blocking agents (BBAs). However, their causative role is unclear. We aimed to investigate this association. METHODS: Disproportionality analysis was carried out on cases from 1985 to October 4, 2020 in VigiBase®, the WHO pharmacovigilance database. The Bayesian-based IC025 metric and reporting odds ratio were used in order to assess the adverse event signal. We also analysed all published case reports from the literature regarding BBA-associated RPF to assess the value of suggested supportive clinical evidence. RESULTS: 1.599 individual case safety reports (ICSRs) of RPF were reported to VigiBase®, of which 132 (32%) concerned 16 different single BBA. For 12 of these agents (75%), reporting of RPF was disproportionate, indicating a potential safety signal. Line listing analysis of ICSRs showed no consistent time interval from start of BBA to RPF diagnosis (range 0,7-264 mo). Dechallenge was negative or unknown in the majority of cases (74%). In 18 published cases from the literature, time from start of BBA to RPF diagnosis varied widely (range 3-156 mo). BBA were discontinued 6 mo before (n=1) or at the time of RPF diagnosis (n=17). Most patients (84%) also received RPF specific treatment. Follow-up (FU) duration was short (median 5 mo [range 1-24 mo]) and in most cases (83%) relevant FU data were lacking. CONCLUSION: Although disproportionality analysis indicated a potential safety signal for RPF associated with BBAs, clinical evidence did not support a cause and effect relationship

Reproducing reality. Recreating bonding defects observed in transparent poly(methyl methacrylate) museum objects and assessing defect formation

The most common method chosen by artists, designers, and craftsmen to realize artworks and objects with transparent poly(methyl methacrylate) (PMMA) is to bond pieces from premanufactured sheets using solvents or adhesives. This method is considered relatively easy to use, however achieving bonds that are both transparent and strong can be difficult. Artifacts from museum collections made by bonding transparent PMMA often exhibit a variety of bonding defects and failures not yet addressed in depth in the conservation literature. Therefore, an international project started with the aims of classifying these bonding issues and understand their causes. This paper presents the results of the first part of this project which included the following research activities: surveys of bonding defects in PMMA artworks and design objects in museum collections, a literature review of the most recommended materials and methods used to bond PMMA over time, the preparation of bonded PMMA mock-ups based on literature review, chemical characterization of the bonding materials, thermal ageing of mock-ups, and finally technical examinations of the PMMA bonded mock-ups. The main defects observed in the museum objects surveyed were successfully recreated in the lab and the causes of their formation were assessed