Inside the black box of Agricultural Innovation Projects: Exploring the interactions between farmers, greenhouses, scientists, pigs & neighbours

Bunders-Aelen, J.G.F. [Promotor]Zweekhorst, M.B.M. [Copromotor]Regeer, B.J. [Copromotor

Maatschappelijk vertrouwen in de varkenshouderij: Deel 1: managementsamenvatting en conclusies

De aanleiding voor het project met de ‘officiële’ titel ‘Maatschappelijk vertrouwen in de veehouderij, in het bijzonder in de varkenshouderij’ is het topsectordocument Agro & Food: De Nederlandse groeidiamant (2011). Hierin wordt gesteld dat maatschappelijk draagvlak van wezenlijk belang is voor de Agro & Foodsector. Het idee is dat technische oplossingen, zoals nieuwe stalsystemen, kunnen bijdragen aan het creëren van een positief beeld van de sector, maar waarschijnlijk niet voldoende zijn voor het herstel van maatschappelijk vertrouwen in de Agro & Foodsector in het algemeen en de varkenshouderij in het bijzonder. Maatschappelijk ver- en wantrouwen in voedsel en voedselproductie is vandaag de dag onverminderd actueel. De paardenvleesaffaire en de doorgaande stroom van berichten in de media dat er met voedsel wordt gefraudeerd, illustreren dit. Dat de Onderzoekraad voor Veiligheid momenteel onderzoek doet naar voedselveiligheidrisico’s in de vleesverwerkende industrie is eveneens tekenend. Maar het vraagstuk van maatschappelijk vertrouwen is niet nieuw. Het is een issue dat al langere tijd speelt. Mede met het oog hierop is veel geïnvesteerd in betere stalsystemen en regelgeving en zijn er diverse commissies en dialogen geweest. Toch is en blijft maatschappelijk vertrouwen en draagvlak delicaat en gebrekkig. Dit wordt door de sector als problematisch ervaren. Aan Wageningen UR is gevraagd een onderzoek te doen naar het maatschappelijk vertrouwen van de veehouderij, met de toespitsing op de varkenshouderij. Het onderzoek is tweeledig van karakter. Enerzijds gaat het om diagnose die tot doel heeft meer te begrijpen van maatschappelijk vertrouwen en van de mechanismen die tot wantouwen of tot vertrouwen leiden. Op basis hiervan heeft dit onderzoek, anderzijds, tot doel voorstellen te doen over (het ontwikkelen van) interventies die bijdragen aan verbetering van maatschappelijk vertrouwen

Determinants of first prescription of hormone replacement therapy. A follow-up study among 1689 women aged 45-60 years

The aim of the present study was to ascertain the cumulative incidence of first hormone replacement therapy (HRT) and the factors that predict its prescription. In a general population 1689 women were followed for 9 months in order to trace first HRT prescriptions. Determinants (well-being, attitude towards menopause, menopausal status and another 9 variables) were measured by means of a questionnaire. Data analyses were performed for all women and for women with or without typical climacteric complaints. The cumulative 9 month incidence of HRT was 6.2%. For women without typical complaints a lower level of well-being (odds ratio 5.5; 95% Cl 1.9–15.5) and the former use of the contraceptive pill (odds ratio 4.6; 95% CI 1.0–20.5) were independently associated with HRT prescription. For women with typical complaints a positive attitude towards ‘menopause should be treated' (odds ratio 3.8; 95% Cl 1.8–8.0) was a determinant of HRT prescription. The cumulative incidence of HRT prescription is high, but from additional data it is apparent that within a period of 1 year and 9 months the majority of women stop taking HRT. For women without typical complaints, physicians prescribe HRT five times more often to those with a lower level of well-being. For women with typical complaints the physician's prescription is primarily related to the woman's attitude towards (medical) treatment of the menopause

Vasomotor symptoms and well-being in the climacteric years

Objectives: To determine more closely the relationship between vasomotor symptoms, well-being and climacteric status according to the last menstrual bleeding and according to the women themselves. Methods: A population-based cross-sectional study was executed using a postal questionnaire. Well-being of women with and without vasomotor symptoms was compared, for the different menopausal statuses. All 2729 women living in a commuter suburb of Rotterdam aged 45-60 years were approached of whom 1947 (71.3%) responded. Well-being was measured by the Inventory of Subjective Health (ISH) and three subscales of the Sickness Impact Profile (SIP). Results: The results showed that the relationship between vasomotor symptoms and well-being was dependent on climacteric status. Pre- and (middle and late) postmenopausal women with vasomotor symptoms more often experienced a relatively lower level of well- being compared to women without these symptoms. However, when the prevalence of vasomotor symptoms is as its peak, i.e. in late perimenopause, a difference in the level of well-being between women with and without vasomotor symptoms was absent. Conclusions: It is concluded that well-being and vasomotor symptoms were inversely related in all menopausal statuses except for the (late) perimenopausal phase. For this no somatic explanation seems plausible. A more social scientific explanation is suggested

Duration of hormonal replacement therapy in general practice; a follow- up study

Objectives: To assess the mean duration of use of HRT in general practice and to identify determinants of the duration of HRT use. Methods: A general population of 1689 women aged 45-60 years and enlisted in five group practices of general practitioners were followed for 9 months to trace first HRT prescriptions. All 103 women who were prescribed HRT were followed for a period of 2.25 years. Duration of HRT was assessed by using the data provided on the dispensing of HRT. Possible determinants of duration of use, such as attitude towards menopause, menopausal status and another six variables were measured by means of a questionnaire. Results: None of the 103 women received HRT for a preventive purpose; the main indication was menopausal complaints. More than 60% of the women stopped their HRT within 6 months and only 8% of the women remained on HRT for more than 2 years. The mean duration of use was 7 months. Determinants that significantly predicted the duration of HRT use were age, attitude towards treatment of the menopause and the group practice. Conclusions: The mean duration of HRT use is very short, despite the fact that the most prevalent indication is the alleviation of menopausal symptoms. Apparently, Dutch women are presently unwilling to take HRT for longer periods

Number of Patients Studied Prior to Approval of New Medicines: A Database Analysis

Background: At the time of approval of a new medicine, there are few long-term data on the medicine's benefit-risk balance. Clinical trials are designed to demonstrate efficacy, but have major limitations with regard to safety in terms of patient exposure and length of follow-up. This study of the number of patients who had been administered medicines at the time of medicine approval by the European Medicines Agency aimed to determine the total number of patients studied, as well as the number of patients studied long term for chronic medication use, compared with the International Conference on Harmonisation's E1 guideline recommendations. Methods and Findings: All medicines containing new molecular entities approved between 2000 and 2010 were included in the study, including orphan medicines as a separate category. The total number of patients studied before approval was extracted (main outcome). In addition, the number of patients with long-term use (6 or 12 mo) was determined for chronic medication. 200 unique new medicines were identified: 161 standard and 39 orphan medicines. The median total number of patients studied before approval was 1,708 (interquartile range [IQR] 968-3,195) for standard medicines and 438 (IQR 132-915) for orphan medicines. On average, chronic medication was studied in a larger number of patients (median 2,338, IQR 1,462-4,135) than medication for intermediate (878, IQR 513-1,559) or short-term use (1,315, IQR 609-2,420). Safety and efficacy of chronic use was studied in fewer than 1,000 patients for at least 6 and 12 mo in 46.4% and 58.3% of new medicines, respectively. Among t

Melkveehouders over verduurzaming in de zuivelketen

De Nederlandse Zuivel Organisatie (NZO) en LTO Nederland hebben hun krachten gebundeld in de Duurzame Zuivelketen. Het streven is om samen met de betrokken zuivelondernemingen en de melkveehouders, die bij hen aangesloten zijn, de Nederlandse zuivelsector wereldwijd koploper te maken op het gebied van duurzaamheid. Om die reden heeft de Duurzame Zuivelketen een aantal doelen geformuleerd, die gerelateerd zijn aan klimaat en energie, diergezondheid en dierenwelzijn, weidegang en biodiversiteit en milieu. Door middel van een enquête in het najaar van 2012 onder 150 gangbare en 23 biologische melkveehouders is onderzocht hoe melkveehouders tegen over de (haalbaarheid van de) door de Duurzame Zuivelketen geformuleerde doelen staan en tegenover de activiteiten van de betrokken zuivelondernemingen. Ook is gevraagd naar de maatregelen die melkveehouders al nemen of van plan zijn te gaan nemen om duurzaamheidsdoelen te realiseren en naar de invloed van de omgeving daarop

Adviseurs over verduurzaming in de zuivelketen

By means of the Sustainable Dairy Chain initiative, dairy businesses and dairy farmers are together pursuing a future-proof and responsible dairy sector and, as a result, are supporting the market and society at large. In order to do this, the goals of the Sustainable Dairy Chain initiative have been formulated along four sustainability themes. This report describes how advisers see sustainability and the aims of the Sustainable Dairy Chain initiative, and how they raise the matter in discussions with dairy farmers