Doormelkproef is gestart

Veel aandoeningen, zoals melkziekte, zijn gerelateerd aan het op gang komen van de melkproductie. Na een uitvoerige studie naar de fysiologische achtergronden van droogzetten en het op gang komen van de melkproductie is een proefplan gemaakt voor de doormelkproef. Achtergronden en opzet van dit nieuwe onderzoek worden in dit artikel beschreven

A method to study the effect of bronchodilators on smoke retention in COPD patients: study protocol for a randomized controlled trial

<p>Abstract</p> <p>Background</p> <p>Chronic obstructive pulmonary disease (COPD) is a common disease, associated with cardiovascular disease. Many patients use (long-acting) bronchodilators, whilst they continue smoking alongside. We hypothesised an interaction between bronchodilators and smoking that enhances smoke exposure, and hence cardiovascular disease. In this paper, we report our study protocol that explores the fundamental interaction, i.e. smoke retention.</p> <p>Method</p> <p>The design consists of a double-blinded, placebo-controlled, randomised crossover trial, in which 40 COPD patients smoke cigarettes during both undilated and maximal bronchodilated conditions. Our primary outcome is the retention of cigarette smoke, expressed as tar and nicotine weight. The inhaled tar weights are calculated from the correlated extracted nicotine weights in cigarette filters, whereas the exhaled weights are collected on Cambridge filters. We established the inhaled weight calculations by a pilot study, that included paired measurements from several smoking regimes. Our study protocol is approved by the local accredited medical review ethics committee.</p> <p>Discussion</p> <p>Our study is currently in progress. The pilot study revealed valid equations for inhaled tar and nicotine, with an R²of 0.82 and 0.74 (p < 0.01), respectively. We developed a method to study pulmonary smoke retentions in COPD patients under the influence of bronchodilation which may affect smoking-related disease. This trial will provide fundamental knowledge about the (cardiovascular) safety of bronchodilators in patients with COPD who persist in their habit of cigarette smoking.</p> <p>Trial registration</p> <p>ClinicalTrials.gov: <a href="http://www.clinicaltrials.gov/ct2/show/NCT00981851">NCT00981851</a></p

A framework for integrated environmental health impact assessment of systemic risks

Traditional methods of risk assessment have provided good service in support of policy, mainly in relation to standard setting and regulation of hazardous chemicals or practices. In recent years, however, it has become apparent that many of the risks facing society are systemic in nature – complex risks, set within wider social, economic and environmental contexts. Reflecting this, policy-making too has become more wide-ranging in scope, more collaborative and more precautionary in approach. In order to inform such policies, more integrated methods of assessment are needed. Based on work undertaken in two large EU-funded projects (INTARESE and HEIMTSA), this paper reviews the range of approaches to assessment now in used, proposes a framework for integrated environmental health impact assessment (both as a basis for bringing together and choosing between different methods of assessment, and extending these to more complex problems), and discusses some of the challenges involved in conducting integrated assessments to support policy

Doormelkproef is gestart

Veel aandoeningen, zoals melkziekte, zijn gerelateerd aan het op gang komen van de melkproductie. Na een uitvoerige studie naar de fysiologische achtergronden van droogzetten en het op gang komen van de melkproductie is een proefplan gemaakt voor de doormelkproef. Achtergronden en opzet van dit nieuwe onderzoek worden in dit artikel beschreven

Towards a resilient food supply chain in the context of food safety

Global food supply chains have been constantly challenged by various food safety incidents or crisis. Traditional approaches on enhancing robustness of the food supply chain are not sufficient to ensure a safe food supply to the society, while building resilience as a more comprehensive approach has shown to be a good alternative option. With a resilience thinking, the food supply chain is not targeting to achieve a state of zero food safety risks, but rather to pursue the capacity to adapt and manage food safety shocks. A resilient food supply chain can still be vulnerable under the constant pressure of food safety hazards and the changing food chain environment, but has the capacity to adapt to and recover from the shocks. This study aimed to1) provide a clear definition for resilient food supply chains in the context of food safety; 2) provide a procedure to assess food safety resilience; 3) specify how a resilient food supply chain can be quantified and improved by providing a numerical example in a case study. Three dimensions of resilience factors, being time, degree of impacts caused by the food safety shocks, and degree of recovery, are suggested for assessing supply chain resilience. Results of a case study on Salmonella spp. in the pork supply chain show that the proposed framework and modelling allow for selecting the most effective strategies (having alternative suppliers, enhancing animal resilience as examples for the considered case) for improving the resilience of the supply chain for food safety

Application of Cigarette Smoke Characterisation Based on Optical Aerosol Spectrometry. Dynamics and Comparisons with Tar Values

Item does not contain fulltextIntroduction: Cigarette smoking causes devastating disease worldwide. Current cigarette classification is based on standardised tar mass values obtained from smoking-machines. However, their ability to predict disease is poor, and these mass values are primarily determined by larger particles. The aim of our study is to investigate in how far claimed tar values also reflect smaller tar particles in cigarette smoke. Methods: We developed a method to measure size-resolved particle distributions based on experimentally selecting conditions that revealed the least variety within different smoking regimes, puff numbers, diluted and undiluted ageing times, and filter taping. Next, we analysed three cigarettes types with different tar values. Cigarettes were smoked by a Cerulean SM-450 smoking machine, and subsequently smoke samples were diluted and collected in Tedlar (R) bags and measured for size-resolved particle distributions by a universal optical aerosol spectrometer. Results: Our method involved a smoking regime according to ISO 3308, the sixth puff, and no delayed ageing. We attained valid size-resolved particle distributions between 250 and 1,000 nm. The results revealed similar total particle counts across different cigarette types, though with different size-resolved particle distributions. In particular, smaller particles in lower tar cigarettes were underestimated. Conclusion: We developed a method to investigate submicron size-resolved particle distributions in cigarette smoke in order to compare cigarettes with different tar values. Our study suggests that mass-based tar values are a poor reflection of smaller particles in mainstream cigarette smoke, and hence supports the opinion that current tar values are a poor predictor of disease-risk and therefore that they are deceptive to smokers

Clinimetric properties of sacroiliac joint mobility tests: A systematic review

Background: Previous systematic reviews revealed poor reliability and validity for sacroiliac joint (SIJ) mobility tests. However, these reviews were published nearly 20 years ago and recent evidence has not yet been summarised. Objectives: To conduct an up-to-date systematic review to verify whether recommendations regarding the clinical use of SIJ mobility tests should be revised. Study design: Systematic review. Method: The literature was searched for relevant articles via 5 electronic databases. The review was conducted according to the PRISMA guidelines. COSMIN checklists were used to appraise the methodological quality. Studies were included if they had at least fair methodology and reported clinimetric properties of SIJ mobility tests performed in adult patients with non-specific low back pain, pelvic (girdle) pain and/or SIJ pain. Only tests that can be performed in a clinical setting were considered. Results: Twelve relevant articles were identified, of which three were of sufficient methodological quality. These three studies evaluated the reliability of eight SIJ mobility tests and one test cluster. For the majority of individual tests, the intertester reliability showed slight to fair agreement. Although some tests and one test cluster had higher reliability, the confidence intervals around most reliability estimates were large. Furthermore, there were no validity studies of sufficient methodological quality. Conclusion: Considering the low and/or imprecise reliability estimates, the absence of high-quality diagnostic accuracy studies, and the uncertainty regarding the construct these tests aim to measure, this review supports the previous recommendations that the use of SIJ mobility tests in clinical practice is problematic