985 research outputs found

    Obstetric audit in Namibia and the Netherlands

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    Roosmalen, J.J.M. van [Promotor

    Cross compliance and competitiveness of the European beef and pig sector

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    Beef and pig production are important sectors affected by the cross-compliance policy. Full compliance with SMRs and GAECs generates costs and benefits which may have an impact on the competitiveness of these sectors on the world market. Compliance with the Nitrate Directive, animal identification and registration requirements and animal welfare standards can give rise to non-negligible cost of production increases at individual farm level and at sector level. Additional costs can be relevant either due to a low degree of compliance or by significant adjustments costs at farm level. Full compliance generates a level playing field between Member States of the EU, as some countries have to face higher additional costs than others, which are be attributed to differences in degree of compliance. This paper first presents evidence of additional costs at individual farm level due to full compliance. Then for beef and pork a methodology has been developed in order to calculate sector cost impacts following an upcsaling procedure for each of the analysed directives. Simulations with the GTAP model have enabled an assessment of the trade effect of compliance with standards and the impact on the external competitiveness of the EU beef and pork production. In some policy fields covered by cross-compliance important trade partners such as Canada, USA and New Zealand have implemented policies similar to the EU. In these three countries comparable standards to those in the EU were identified and the level and cost of compliance have been assessed. The pig sector will be affected most by a unilateral compliance with standards in the EU, in particular as the Nitrate Directive is concerned. Within the EU pig production costs will rise by 0.545 %. Imports may increase by 4% and exports may fall by 3%. However full application of the Clean Water Act in the US, which contains similar obligations to the Nitrate Directive, generates a significant sector cost increase (1,08%) which may counterbalance the loss of competitiveness of EU pork production towards the US. Compliance with the mandatory animal welfare standards has only minor cost implications and has negligible effects on external competitiveness of the EU both because of a high degree of compliance and relatively low adjustment costs at farm level. Finally, in many EU member states the degree of compliance of beef farms with the animal registration and identification directives is below 100%. Additional costs for full compliance within the EU have been estimated at 0.455%, which may cause an increase of beef imports of 2.21% and a decline of exports of ¿2.12%. This loss in competitiveness of the EU will further favour the position of Brazil on the world beef market. At the other hand significant benefits are obtained in food security of EU beef

    The origin of stiffening in cross-linked semiflexible networks

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    Strain stiffening of protein networks is explored by means of a finite strain analysis of a two-dimensional network model of cross-linked semiflexible filaments. The results show that stiffening is caused by non-affine network rearrangements that govern a transition from a bending dominated response at small strains to a stretching dominated response at large strains. Thermally-induced filament undulations only have a minor effect; they merely postpone the transition.Comment: 5 pages, 5 figure

    Costs of compliance with EU regulations and competitiveness of the EU dairy sector

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    The introduction of cross-compliance mechanism in the European Union with its 2003 CAPreform might affect the costs of production and thus competitiveness of the EU. Little evidence is available to asses the costs of compliance with regulations and it implication for trade. In this study a farm level competitiveness analysis of the impacts of the Nitrate Directive and the Identification & registration Directive focuses on the dairy sector in Germany, France, Italy, Netherlands and UK (within EU), and the US and New Zealand (outside EU). The findings from this study are integrated into a trade analysis which assesses the impact of compliance costs on competitiveness of the various trading nations in global trade. Representative farm studies were used as a basis for the cost increase calculations. Best-estimates of compliance are used from the existing literature and expert judgements. The negative impact of these measures (for nitrates, and animal identification and registration) on EU imports and exports are less than 3 percent. If a smaller increase in compliance takes place, these already relatively small trade impacts will be further diminished. When the standards for nitrate pollution taken by the US and New Zealand are taken into account along with full compliance assumption in all countries analysed, this would only slightly improve the EU exports. The trade impacts obtained when no changes are assumed to happen in key competitor countries can thus be argued as providing the upper bound of the likely trade impacts

    Antenatal corticosteroid therapy for foetal maturation in women with eclampsia and severe pre-eclampsia in a rural hospital in Western Tanzania

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    Contains fulltext : 171449.pdf (publisher's version ) (Open Access)BACKGROUND: Preterm birth is a major cause of neonatal mortality, especially in low and middle income countries. Antenatal corticosteroid therapy for foetal maturation could have a significant impact and therefore is often referred to as an important strategy to reduce neonatal mortality. A recently conducted large multinational trial showed that antenatal corticosteroids can have adverse effects in low income countries, but this is likely to depend on the specific setting. In our hospital preterm birth is only recognized in patients with severe maternal disease, due to physician-initiated delivery. Spontaneous preterm births are rarely seen in the hospital and often take place in the community or while on the road to a health facility. OBJECTIVE: To investigate the effects of antenatal corticosteroid therapy in a rural hospital in Tanzania. METHODS: A secondary analysis of a retrospective medical records study of women with severe pre-eclampsia and eclampsia performed in Ndala Hospital between July 2011 and December 2012. We used data on gestational age, birth weight, Apgar score, time between admission and birth, use of corticosteroids and maternal and foetal survival. Ethical clearance was obtained from the directorate of research and publications of the University of Dodoma (ref. UDOM/DRP/346). RESULTS: Thirty-six women with forty live foetuses were analysed. Twelve women (13 neonates) were given corticosteroids and could be compared to 24 women (27 neonates) who did not get corticosteroids. The incidence of fresh stillbirths (antenatal death) was 20 %. The 13 neonates who received corticosteroids had significantly smaller birth weight, longer interval between admission and delivery and poorer outcomes (stillbirth and neonatal death). An analysis of 24 neonates with a birth weight between 1.5 and 2.5 kg showed a trend toward better outcome in neonates who did not receive antenatal corticosteroid therapy. CONCLUSION: Small retrospective studies as these have a low level of evidence, but this study helped to gain more knowledge of local conditions affecting the effectiveness of antenatal corticosteroid therapy in our setting of a small rural hospital. Reliability of estimating gestational age, epidemiology of preterm birth, exposure to infections, foetal monitoring and quality of neonatal care are likely to influence the effect of antenatal corticosteroid therapy. Further larger prospective studies should be conducted to determine the exact preconditions of antenatal corticosteroid therapy in low-income countries. Until that time, the WHO precautions seem reasonable and audits and small observational studies like ours can help in assessing whether a specific hospital is suited for antenatal corticosteroid therapy

    Association between surgical technique, adhesions and morbidity in women with repeat caesarean section:a retrospective study in a rural hospital in Western Tanzania

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    BACKGROUND: The worldwide incidence of birth by Caesarean Section (CS) is rising. Many births after a previous CS are by repeat surgery, either by an elective CS or after a failed trial of labour. Adhesion formation is associated with increased maternal morbidity in patients with repeat CSs. In spite of large-scale studies the relation between the incidence of adhesion formation and CS surgical technique is unclear. This study aims to assess maternal and neonatal morbidity and mortality after repeat CSs in a rural hospital in a low-income country (LIC) and to analyse the effect of surgical technique on the formation of adhesions. METHODS: A cross-sectional, retrospective medical records study of all women undergoing CS in Ndala Hospital in 2011 and 2012. RESULTS: Of the 3966 births, 450 were by CS (11.3%), of which 321 were 1st CS, 80 2nd CS, 36 3rd CS, 12 4th and one 5th CS (71, 18, 8, 3 and 0.2% respectively). Adhesions were considered to be severe in 56% of second CSs and 64% of third CSs. In 2nd CSs, adhesions were not associated with closure of the peritoneum at 1st CS, but were associated with the prior use of a midline skin incision. There was no increase in maternal morbidity when severe adhesions were present. Adverse neonatal outcome was more prevalent when severe adhesions were present, but this was statistically non-significant (16% vs 6%). CONCLUSIONS: Our results give insight into the practice of repeat CS in our rural hospital. Adhesions after CSs are common and occur more frequently after midline skin incision at 1st CS compared to a transverse incision. Reviewing local data is important to evaluate quality of care and to compare local outcomes to the literature

    From Golden Spirals to Constant Slope Surfaces

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    In this paper, we find all constant slope surfaces in the Euclidean 3-space, namely those surfaces for which the position vector of a point of the surface makes constant angle with the normal at the surface in that point. These surfaces could be thought as the bi-dimensional analogue of the generalized helices. Some pictures are drawn by using the parametric equations we found.Comment: 11 pages, 8 figure

    From the brain to the field: The applications of social neuroscience to economics, health, and law

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    Social neuroscience aims to understand the biological systems that underlie people’s thoughts, feelings and actions in light of the social context in which they operate. Over the past few decades, social neuroscience has captured the interest of scholars, practitioners, and experts in other disciplines, as well as the general public who more and more draw upon the insights and methods of social neuroscience to explain, predict and change behavior. With the popularity of the field growing, it has become increasingly important to consider the validity of social neuroscience findings as well as what questions it can and cannot address. In the present review article, we examine the contribution of social neuroscience to economics, health, and law, three domains with clear societal relevance. We address the concerns that the extrapolation of neuroscientific results to applied social issues raises within each of these domains, and we suggest guidelines and good practices to circumvent these concerns
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