Nationale 'good practices' voor de VWA: Studie naar drie soortgelijke autoriteiten in Nederland

In 2005 researchers from Wageningen UR and LNV DK conducted exploratory research for VWA into the good practices of three inspectorates - PD, IVW-DL and AFM - as part of the review of the financial system, subject to the financial articles, due to be implemented in EU member states on 1 January 2006. In these three cases, the main focus was on the implementation of auditing activities and the method of financing. The findings for these cases and the findings of the cases from EU member states will be used in the scenario study. In all, three reports will be published in the framework of this investigation.Financial Economics,

Assessment of hormonal parameters in long-term karate Practitioners

Introduction: Karate is a Japanese martial art which is widely practiced in the Western world as a form of self-defense, as well as a discipline to achieve physical and mental balance.However, little is known with respect to its specific psychobiological effects, particularly in relation to the influence that karate may exert on the endocrine system. Thus, in the present study we analyzed the effects of regular karate practice on several hormonal parameters. Methods: 27 healthy volunteer subjects participated in the study, of whom 15 were allocated to the experimental group, and 12 were assigned to the control group. Experimental subjects were karate players with a minimum of 3 years of practice in this discipline. Blood samples for the quantification of hormonal parameters (TSH, T3, T4, PTH, ACTH, cortisol, and DHEA) were taken in both groups. To compare the means of the control and experimental group, a t-test for independent groups was performed in each dependent variable. Results: Significant differences between the experimental and control group were found in T3, T4, and cortisol, with karate players showing lower blood levels of these hormones than control. Conclusions: These findings reveal that long-term karate practice is associated to a significant endocrine modulation, which suggests interesting psychobiological implications, and lends itself to potential clinical considerations. Further research is needed to properly assess the scope of the peculiar hormonal profile displayed by advanced karate practitioners.Universidad de Málaga, Campus de Excelencia Internacional Andalucía Tec

Immune modulation after long-term karate practice

Introduction: Karate is a Japanese martial arts system which traces its roots back to China, and is nowadays widely popular both as a method of self-defense, as well as a discipline with potential physical and psychological benefits. However, karate has been scarcely investigated from a psychobiological perspective, and its effects on the immune system remain virtually unknown. Therefore, we designed the present study with the aim of analyzing the effects of several years of regular karate practice on different immune parameters. Methods: 27 healthy volunteer subjects participated in the study, 15 being allocated to the experimental group, and 12 to the control group. Experimental subjects were all karate players who had practiced this martial art for a minimum of three years. Blood samples for the quantification of immune parameters (leukocytes, neutrophils, monocytes, eosinophils, basophils, lymphocytes, IgG, IgA, IgM, IgE) were taken in both groups. As statistical analysis, a t-test for independent groups was performed in each dependent variable. Results: Compared to the control group, karate practitioners exhibited a significantly higher number of leukocytes, monocytes, and lymphocytes, as well as greater serum concentrations of IgG and IgM. Conclusions: Our findings show that long-term karate practice is related to a broad modulation of immune parameters, including leukocytes counts as well as immunoglobulin concentrations. This peculiar immunomodulatory profile, apart from its psychobiological relevance, may have noteworthy clinical implications. Further investigation would be necessary to fully elucidate the influence that long-term karate training can exert on the immune system.Universidad de Málaga, Campus de Excelencia Internacional Andalucía Tec

Reimbursed medication adherence enhancing interventions in 12 european countries:Current state of the art and future challenges

Background: Medication non-adherence jeopardises the effectiveness of chronic therapies and negatively affects financial sustainability of healthcare systems. Available medication adherence-enhancing interventions (MAEIs) are utilised infrequently, and even more rarely reimbursed. The aim of this paper was to review reimbursed MAEIs across selected European countries. Methods: Data on reimbursed MAEIs were collected from European countries at the ENABLE Cost Action expert meeting in September 2021. The identified MAEIs were analysed and clustered according to their characteristics, direct vs. indirect relation to adherence, and the targeted adherence phase. Results: Out of 12 contributing countries, 10 reported reimbursed MAEIs, 28 in total, of which 20 were identified as MAEIs targeting adherence directly. Reimbursed MAEIs were most often performed by either doctors (n = 6), nurses (n = 6), or pharmacists (n = 3). The most common types of MAEIs were education (n = 6), medication regimen management (n = 5), and adherence monitoring feedback (n = 4). Only seven reimbursed MAEIs were technology-mediated, whereas 11 addressed two interlinked phases of medication adherence, i.e., implementation and persistence. Conclusion: Our review highlights the scarcity of reimbursed MAEIs across the selected European countries, and calls for their more frequent use and reimbursement

Doxorubicin Exposure and Breast Cancer Risk in Survivors of Adolescent and Adult Hodgkin Lymphoma

PURPOSEFemale Hodgkin lymphoma (HL) survivors treated with chest radiotherapy (RT) at a young age have a strongly increased risk of breast cancer (BC). Studies in childhood cancer survivors have shown that doxorubicin exposure may also increase BC risk. Although doxorubicin is the cornerstone of HL chemotherapy, the association between doxorubicin and BC risk has not been examined in HL survivors treated at adult ages.METHODSWe assessed BC risk in a cohort of 1,964 female 5-year HL survivors, treated at age 15-50 years in 20 Dutch hospitals between 1975 and 2008. We calculated standardized incidence ratios, absolute excess risks, and cumulative incidences. Doxorubicin exposure was analyzed using multivariable Cox regression analyses.RESULTSAfter a median follow-up of 21.6 years (IQR, 15.8-27.1 years), 252 women had developed invasive BC or ductal carcinoma in situ. The 30-year cumulative incidence was 20.8% (95% CI, 18.2 to 23.4). Survivors treated with a cumulative doxorubicin dose of &gt;200 mg/m2 had a 1.5-fold increased BC risk (95% CI, 1.08 to 2.1), compared with survivors not treated with doxorubicin. BC risk increased 1.18-fold (95% CI, 1.05 to 1.32) per additional 100 mg/m2 doxorubicin (Ptrend =.004). The risk increase associated with doxorubicin (yes v no) was not modified by age at first treatment (hazard ratio [HR]age &lt;21 years, 1.5 [95% CI, 0.9 to 2.6]; HRage ≥21 years, 1.3 [95% CI, 0.9 to 1.9) or chest RT (HRwithout mantle/axillary field RT, 1.9 [95% CI, 1.06 to 3.3]; HRwith mantle/axillary field RT, 1.2 [95% CI, 0.8 to 1.8]).CONCLUSIONThis study shows that treatment with doxorubicin is associated with increased BC risk in both adolescent and adult HL survivors. Our results have implications for BC surveillance guidelines for HL survivors and treatment strategies for patients with newly diagnosed HL.</p

Doxorubicin Exposure and Breast Cancer Risk in Survivors of Adolescent and Adult Hodgkin Lymphoma

PURPOSEFemale Hodgkin lymphoma (HL) survivors treated with chest radiotherapy (RT) at a young age have a strongly increased risk of breast cancer (BC). Studies in childhood cancer survivors have shown that doxorubicin exposure may also increase BC risk. Although doxorubicin is the cornerstone of HL chemotherapy, the association between doxorubicin and BC risk has not been examined in HL survivors treated at adult ages.METHODSWe assessed BC risk in a cohort of 1,964 female 5-year HL survivors, treated at age 15-50 years in 20 Dutch hospitals between 1975 and 2008. We calculated standardized incidence ratios, absolute excess risks, and cumulative incidences. Doxorubicin exposure was analyzed using multivariable Cox regression analyses.RESULTSAfter a median follow-up of 21.6 years (IQR, 15.8-27.1 years), 252 women had developed invasive BC or ductal carcinoma in situ. The 30-year cumulative incidence was 20.8% (95% CI, 18.2 to 23.4). Survivors treated with a cumulative doxorubicin dose of &gt;200 mg/m2 had a 1.5-fold increased BC risk (95% CI, 1.08 to 2.1), compared with survivors not treated with doxorubicin. BC risk increased 1.18-fold (95% CI, 1.05 to 1.32) per additional 100 mg/m2 doxorubicin (Ptrend =.004). The risk increase associated with doxorubicin (yes v no) was not modified by age at first treatment (hazard ratio [HR]age &lt;21 years, 1.5 [95% CI, 0.9 to 2.6]; HRage ≥21 years, 1.3 [95% CI, 0.9 to 1.9) or chest RT (HRwithout mantle/axillary field RT, 1.9 [95% CI, 1.06 to 3.3]; HRwith mantle/axillary field RT, 1.2 [95% CI, 0.8 to 1.8]).CONCLUSIONThis study shows that treatment with doxorubicin is associated with increased BC risk in both adolescent and adult HL survivors. Our results have implications for BC surveillance guidelines for HL survivors and treatment strategies for patients with newly diagnosed HL.</p

Doxorubicin Exposure and Breast Cancer Risk in Survivors of Adolescent and Adult Hodgkin Lymphoma

PURPOSEFemale Hodgkin lymphoma (HL) survivors treated with chest radiotherapy (RT) at a young age have a strongly increased risk of breast cancer (BC). Studies in childhood cancer survivors have shown that doxorubicin exposure may also increase BC risk. Although doxorubicin is the cornerstone of HL chemotherapy, the association between doxorubicin and BC risk has not been examined in HL survivors treated at adult ages.METHODSWe assessed BC risk in a cohort of 1,964 female 5-year HL survivors, treated at age 15-50 years in 20 Dutch hospitals between 1975 and 2008. We calculated standardized incidence ratios, absolute excess risks, and cumulative incidences. Doxorubicin exposure was analyzed using multivariable Cox regression analyses.RESULTSAfter a median follow-up of 21.6 years (IQR, 15.8-27.1 years), 252 women had developed invasive BC or ductal carcinoma in situ. The 30-year cumulative incidence was 20.8% (95% CI, 18.2 to 23.4). Survivors treated with a cumulative doxorubicin dose of >200 mg/m2 had a 1.5-fold increased BC risk (95% CI, 1.08 to 2.1), compared with survivors not treated with doxorubicin. BC risk increased 1.18-fold (95% CI, 1.05 to 1.32) per additional 100 mg/m2 doxorubicin (Ptrend =.004). The risk increase associated with doxorubicin (yes v no) was not modified by age at first treatment (hazard ratio [HR]age <21 years, 1.5 [95% CI, 0.9 to 2.6]; HRage ≥21 years, 1.3 [95% CI, 0.9 to 1.9) or chest RT (HRwithout mantle/axillary field RT, 1.9 [95% CI, 1.06 to 3.3]; HRwith mantle/axillary field RT, 1.2 [95% CI, 0.8 to 1.8]).CONCLUSIONThis study shows that treatment with doxorubicin is associated with increased BC risk in both adolescent and adult HL survivors. Our results have implications for BC surveillance guidelines for HL survivors and treatment strategies for patients with newly diagnosed HL

Nationale 'good practices' voor de VWA: Studie naar drie soortgelijke autoriteiten in Nederland

In 2005 researchers from Wageningen UR and LNV DK conducted exploratory research for VWA into the good practices of three inspectorates - PD, IVW-DL and AFM - as part of the review of the financial system, subject to the financial articles, due to be implemented in EU member states on 1 January 2006. In these three cases, the main focus was on the implementation of auditing activities and the method of financing. The findings for these cases and the findings of the cases from EU member states will be used in the scenario study. In all, three reports will be published in the framework of this investigation

Europese 'good practices' voor de VWA: De implementatie van EG- verordening 882/2004 in Belgie, het Verenigd Koninkrijk, Duitsland en Denemarken

This report presents the results from a study of four countries. Information was collected on Belgium, the United Kingdom, Germany and Denmark, and interviews were also held in those countries, to obtain an insight into their policies and implementation of controls on feed and food safety. The study was requested by the Ministry of Agriculture, Nature and Food Quality to prepare for the implementation of EC Regulation 882/2004 in 2006 and to provide support for the reform of the funding system for the Dutch Food and Non-Food Authority (VWA). The study focused on a search for good practices for the reform of the VWA's funding system

Europese 'good practices' voor de VWA: De implementatie van EG- verordening 882/2004 in Belgie, het Verenigd Koninkrijk, Duitsland en Denemarken

This report presents the results from a study of four countries. Information was collected on Belgium, the United Kingdom, Germany and Denmark, and interviews were also held in those countries, to obtain an insight into their policies and implementation of controls on feed and food safety. The study was requested by the Ministry of Agriculture, Nature and Food Quality to prepare for the implementation of EC Regulation 882/2004 in 2006 and to provide support for the reform of the funding system for the Dutch Food and Non-Food Authority (VWA). The study focused on a search for good practices for the reform of the VWA's funding system.Agricultural and Food Policy,