Specialisation through co-operation between farms in organic farming

Co-operation in organic production provides the potential for production specialisation with the help of co-operation in machinery use, input integration, crop rotation, shared buildings and marketing. Co-operation models provide the opportunity to optimise production between different lines of production from environmental, economic and functional perspectives

Subfreezing air as a cough trigger and multiple triggers are strongly associated with the presence of asthma in chronic cough

Background: Management of chronic cough relies on the recognition of cough background disorders. It is not known whether certain cough triggers are associated with specific background disorders. Methods: This was an e-mail study to public service employees of two towns in Finland. The questionnaire included twelve triggers. Current asthma was defined as doctor's diagnosis of asthma and current wheezing. Chronic rhinosinusitis was defined as either nasal blockage or nasal discharge and either facial pain/pressure or reduction/loss of smell for more than three months. Gastroesophageal reflux disease was defined as heartburn and/or regurgitation on at least one day a week during the last three months. Idiopathic cough was defined as absence of any of them. Results: There were 421 subjects with current cough that had lasted at least eight weeks. Subfreezing air as a cough trigger was associated with an adjusted odds ratio (aOR) of 7.27 (4.09-12.9), (p <0.001), for current asthma. The number of cough triggers was largest in asthma, followed by chronic rhinosinusitis, gastro-esophageal reflux, and idiopathic cough (7.05 (6.14-7.96), 4.94 (4.35-5.54), 4.60 (3.77-5.43), and 3.44 (3.02-3.86), respectively, p <0.001). Presence of five or more triggers was associated with an aOR of 7.49 (3.96-14.2), (p <0.001) for current asthma. Absence of any cough triggers increased the probability of idiopathic cough (aOR 2.71 (1.54-4.77), p= 0.001). Conclusions: Subfreezing air as a cough trigger and multiple triggers are strongly associated with the presence of current asthma in chronic cough. Absence of any cough triggers increases the probability of idiopathic cough.Peer reviewe

Persistence of chronic cough in a community-based population

Chronic cough causes significant impairment in the quality of life and is often immune to treatment. Previous studies about its persistence have focused on patients managed in special cough clinics. Little is known about the persistence of chronic cough in unselected populations. In this prospective follow-up study, we investigated factors that predict the persistence of cough at 12-month follow-up in a community-based study of subjects with chronic cough. The first e-mail survey in 2017 included a questionnaire about current cough and its risk factors. The 264 subjects who reported chronic cough were sent a follow-up questionnaire 12 months later. The response rate was 77.7% (205 subjects), of whom 165 subjects (80.5%) still had cough in 2018. In multivariate analysis, the following baseline factors predicted the persistence of cough at 12 months; gastro-oesophageal reflux disease (adjusted OR (aOR) 5.02 (95% CI 1.10-22.83)), presence of a chemical trigger (aOR 2.88 (95% CI (1.20-7.00)), duration of cough more than 1 year (aOR 2.80 (95% CI 1.27-6.22)), frequent somatic symptoms (aOR 1.31 (95% CI 1.07-1.59)), and low number of family members (aOR 0.71 (95% CI 0.52-0.98)). In conclusion, most patients with chronic cough still suffer from cough 1 year later. The presence of gastro-oesophageal reflux disease is the main predictor for the persistence of cough.Peer reviewe

Defining the risk factors for acute, subacute and chronic cough: a cross-sectional study in a Finnish adult employee population

Objectives Chronic cough is linked to various long-standing risk factors like asthma, chronic rhinitis and oesophageal reflux disease. On the contrary, acute and subacute cough are usually considered to be caused by acute respiratory infections. Little is known about the possible long-standing risk factors for acute and subacute cough. In this study, we have identified the long-standing risk factors for acute, subacute and chronic cough in order to identify the risk factors specifically associated with chronic cough.Design A comprehensive 80-item questionnaire was sent via email to the participants.Setting A community-based study to all public service employees of two towns in central Finland.Participants There were 13 980 employees, of them 3697 responded (26.4%). Among the responders, there were 199 subjects with current daily acute cough (duration &lt;3 weeks, prevalence 5.4%), 126 subjects with current daily subacute cough (duration 3–8 weeks, prevalence 3.4%) and 267 subjects with current daily chronic cough (duration &gt;8 weeks, prevalence 7.2%).Primary outcome measures The risk factors that associated with each cough subtype. The subjects without any cough formed the reference group.Results Several risk factors were associated with both short and long cough subtypes namely family history of chronic cough, moisture damage exposure and number of reported somatic symptoms. Furthermore, allergy was associated with acute and subacute cough. Current asthma and chronic rhinitis were associated with subacute and chronic cough. Oesophageal reflux disease and advanced age were associated with chronic cough.Conclusions The specific risk factors for chronic cough were oesophageal reflux disease and advanced age. Acute and subacute cough should not be regarded merely as symptoms of acute respiratory infections but possible manifestations of long-standing risk factors. A new risk factor for all cough types was family history of chronic cough.Peer reviewe

Predictors of prolongation in recent-onset cough

Chronic cough greatly decreases the quality of life and is often refractory to treatment. Interventions at an early stage could prevent cough from becoming chronic. To this end, the patients at high risk of cough prolongation would need to be identified. In this study, we investigated the factors that predicted cough at 12 months among subjects with a recent-onset cough. This was a prospective, observational follow-up study in a community-based population consisting of working-age subjects. The first e-mail survey in 2017 included a comprehensive questionnaire about current cough and its risk factors. The 259 subjects who reported a recent-onset ( The response rate was 72.6% (188 subjects). There were 99 subjects (52.7%) with cough in 2018. The following baseline factors predicted the presence of any cough at 12 months in the multivariable analysis: wheezing (adjusted odds ratio (aOR 2.80, 95% CI 1.3-5.27), dog ownership (aOR 2.56, 95% CI 1.21-5.44), cough duration >3 weeks (aOR 2.29, 95% CI 1.11-4.76), family history of chronic cough (aOR 2.20, 95% CI 1.13-4.30), body mass index >25 kg.m(-2) (aOR 2.06, 95% CI 1.02-4.15) and frequent somatic symptoms (aOR 1.36, 95% CI 1.13--1.64). There were 29 subjects (15.4%) with continuous cough and 66 subjects (35.1%) with recurrent cough. The risk factors were completely different between recurrent and continuous cough. It may be possible to identify the risk factors of cough prolongation among subjects with recent-onset cough. Early interventions should be targeted to these kinds of patients.Peer reviewe

The impacts of cough : a cross-sectional study in a Finnish adult employee population

Given the very high prevalence of cough, little is known about its impacts. A questionnaire was sent via e-mail to all public service employees in two towns in Finland. There were 373 subjects with acute cough, 174 with subacute cough and 421 with chronic cough. Cough-related quality of life was assessed with the Leicester Cough Questionnaire (LCQ) and depressive symptoms with Patient Health Questionnaire-2. In addition, data on doctor's visits and sick leave days were collected. Mean LCQ (95% CI) total scores were 16.2 (15.9–16.5), 14.5 (14.1–15.0) and 14.6 (14.3–14.9) among subjects with acute, subacute and chronic cough, respectively (p<0.001). The prevalence of depressive symptoms was 5.4%, 7.5% and 4.8%, respectively, and 5.0% among subjects without current cough (p=0.50). The respective proportions of subjects with at least one doctor's visit due to cough during the previous year were 27.6%, 44.8%, 49.6% and 16.1% (p<0.001). The respective proportions of subjects with at least one sick leave day due to cough during the previous year were 28.9%, 39.1%, 36.3% and 15.3% (p<0.001). Any current cough was associated with an increased the risk of several (three or more) yearly doctor's visit due to any reason (adjusted odds ratio (aOR) 1.49, 95% CI 1.27–1.76) and several (seven or more) yearly sick leave days due to any reason (aOR 1.43, 95% CI 1.22–1.68). Cough decreases quality of life, and has a large socioeconomic impact by increasing doctor's visits and sick leave days. However, it is not associated with depressive symptoms. The impacts of subacute and chronic cough are comparable, and larger than those of acute cough

Long-term prognosis of chronic cough: a prospective, observational cohort study

Abstract Background The long-term prognosis of chronic cough and its determinants need to be clarified. Methods This is a prospective, observational cohort study. Eighty-nine unselected subjects with chronic (> 8 weeks’ duration) cough were carefully investigated: Clinical examination, symptom questionnaire, Leicester Cough Questionnaire (LCQ), skin prick tests, ambulatory peak expiratory flow monitoring, spirometry before and after 0.4 mgs of salbutamol, exhaled nitric oxide concentration measurement, hypertonic saline cough provocation test, and histamine bronchial provocation test. After five years, a letter was sent to the subjects containing questions about continuation of cough, smoking, indoor exposures, presence of co-morbidities, and current medication. It also contained LCQ and Cough Clinic diagnostic questionnaire. Sixty-eight subjects (76%) responded. Results At five years, continuing regular cough was present in 31 (46%) of the subjects and continuing impairment in cough-related quality of life (less than 1.3 points’ improvement in LCQ) in 32 (47%). Continuing regular cough was associated with presence of chronic rhinitis or esophageal reflux disease, baseline mild airway responsiveness to histamine, and baseline strong cough responsiveness to hypertonic saline. Continuing impairment in cough-related quality of life was associated with high body mass index, absence of atopy, absence of pets, and high number of background disorders (esophageal reflux disease, asthma, or chronic rhinitis). Conclusions Almost half of subjects with chronic cough suffered of the disorder at five years from initial assessment. Several possible determinants of poor prognosis could be identified

Specialisation through co-operation between farms in organic farming

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Luomutilojen erikoistuminen yhteistyön avulla

Sisältö: CD-ROM sisältää artikkelit Maatalouspäivien 2006 esitelmistä ja postereista kokonaisuudessaan.vo