Farm Diversification in Relation to Landscape Properties

Current European Common Agricultural Policy (CAP) has been moving from production support subsidies to direct decoupled income support. The emergence in policy making of the concept of multifunctional agriculture leads to the recognition that a farmer produces more than food: he produces jointly both commodity and non-commodity goods. Environmental contracts were developed in order to encourage the provision of non-commodity goods such as landscape or biodiversity. Next to these contracts, other activities as for example recreation can be observed. They are the result of farm diversification. The role of location in farmers’ decision making to diversify is pointed out in literature but geographical information is generally reduced to the location within a political delimitation unit the empirical work. Objective of this paper is two-fold. Firstly, it addresses the role of location, in term of site specific natural conditions as well as neighbouring emerging dynamics in farmer’s decision making to diversify. Attention is paid to number of activities as well as the specific types of activities, notably green services, daily recreation and other farm-linked services. Secondly, this paper introduces income from agriculture explicitly allowing testing short term price sensitivity. It was found that attractive landscape is a driver for diversification as these landscape offer more opportunities. Furthermore, diversification is responsive to price. Thirdly, role of density of past multifunctional activities in the neighborhood influences farm diversification: multifunctional activities create an externality effects as new activities emerge next to already existing ones. This dynamic may lead to the emergence of ‘multifunctional hotspots’ in landscape.Farmer diversification, landscape services, location, Farm Management, Land Economics/Use,

African Land Ecology: Opportunities and Constraints for Agricultural Development

Current agriculture in Sub-Sahara Africa is undeveloped and the Green Revolution has left the continent largely untouched. Poor performance is often related to a number of socio-economic factors. In this paper we argue that there are also some specifities of natural resources, namely local homogeneity and spatial diversity of the pre-dominant Basement Complex soils, that imply that simple fertilizer strategies may not produce the yield increases obtained elsewhere. Keywords: Sub-Sahara Africa, Agro-Ecology, Land use, Land resources, Basement Complex, Green Revolution, Micronutrients, Fertilizer Policy

Survival from testicular cancer in England and Wales up to 2001

www.bjcancer.com For many years testicular cancer has been the prime example of the tumour that is chemocurable, even when metastatic. The disappointment in oncology is that these results have so far not been replicated in the more common solid tumours. Why this should be is not clear but germ-cell tumours retain sensitivity to chemotherapy in vitro and a number of mechanisms including reduced DNA repair capacity and proneness to apoptosis have been proposed (Mayer et al, 2003). Most patients with testicular cancer present after finding a lump in the testicle that may or may not be painful. A small proportion of patients present with symptoms of metastatic disease. With the exception of some patients with metastatic disease, initial treatment after first assessment is to remove the tumour by inguinal orchidectomy. Patients are staged by tumour marke

Zelfsturing kan niet zonder doelen en monitoring

De leden van de Vereniging ‘Noardlike Fryske Wâlden’, grotendeels melkveehouders, willen graag zelf sturen op milieudoelen in de Noordelijke Friese Wouden. Hierbij willen zij collectief op milieudoelstellingen worden afgerekend, in plaats van individueel te moeten voldoen aan generieke middelvoorschriften. Twee zaken zijn noodzakelijk voor deze vorm van zelfsturing. Ten eerste moeten er heldere doelen voor milieuprestaties en milieukwaliteit zijn waarop gestuurd kan worden. Ten tweede moet er een monitoringsysteem zijn om vast te stellen of de doelen worden gehaald. Dit artikel beschrijft de ontwikkeling van milieumonitoring om de gewenste zelfsturing mogelijk te make

3MG: Meervoudige Milieu Monitoring voor Gebiedssturing; Een case study voor de Noordelijke Friese Wouden

Sinds 2005 is TransForum betrokken bij een praktijkproject in de Noordelijke Friese Wouden (het project NFW) waarin samen met boeren, bestuurders, overheden en maatschappelijke groepen wordt gezocht naar mogelijkheden om de beoogde zelfsturing vorm en inhoud te geven. Om voor milieukwaliteitdoelen een onderbouwd antwoord te kunnen geven heeft TransForum naast het praktijkproject NFW een meer analytisch gericht wetenschappelijk project ondersteund waarin een operationeel meetinstrument is ontwikkeld en getoetst. In deze studie is gebruik gemaakt van gegevens van aanwezige meetnetten in combinatie met geïntegreerde modellen. Het betreft: ammoniakemissie, stikstofdepositie, grondwaterkwaliteit, oppervlaktewaterkwalitei

Liver stiffness is associated with excess mortality in the general population driven by heart failure:The Rotterdam Study

Background: Elevated liver stiffness reflects hepatic fibrosis but can also be secondary to venous congestion. We aimed to study the association between liver stiffness and mortality in the general population, stratified for heart failure and/or coronary heart disease (CHD). Methods: We analysed individuals enrolled in the ongoing prospective population-based Rotterdam Study who attended a visit between 2009–2014 that included liver stiffness measurement. Exclusion criteria for the primary analysis were incomplete data on heart failure, unreliable liver stiffness, alcohol abuse and viral hepatitis, leaving 4.153 participants (aged 67.5 ± 8.4 years, 44.2% male) for analysis with a median follow-up of 6.0 (interquartile range: 5.1–7.0) years. Secondary analysis included participants with viral hepatitis, alcohol abuse and/or unreliable measurement. The association between liver stiffness and mortality was assessed using Cox regression. Associations between heart failure, CHD, and echocardiographic characteristics and liver stiffness were quantified with linear regression. Results: Liver stiffness ≥8.0 kPa was associated with mortality (aHR: 1.37, 95%CI: 1.00–1.89). However, this was driven by participants with heart failure (aHR: 2.48, 95%CI: 1.15–5.35), since high liver stiffness was not associated with mortality in participants without heart failure and/or CHD (aHR: 1.07, 95%CI: 0.70–1.64). Results were consistent when individuals with viral hepatitis, alcohol abuse or unreliable liver stiffness measurement were not excluded. Several cardiovascular characteristics were significantly associated with higher liver stiffness, e.g. heart failure, moderate/poor diastolic dysfunction, and right atrium diameter &gt; 4.5 cm. Conclusion: In our cohort of community-dwelling elderly, high liver stiffness was associated with excess mortality, primarily explained by participants with heart failure. Moreover, heart failure and its indicators were associated with increased liver stiffness.</p

Early Relapse After Autologous Hematopoietic Cell Transplantation Remains a Poor Prognostic Factor in Multiple Myeloma but Outcomes Have Improved Over Time

Duration of initial disease response remains a strong prognostic factor in multiple myeloma (MM) particularly for upfront autologous hematopoietic cell transplant (AHCT) recipients. We hypothesized that new drug classes and combinations employed prior to AHCT as well as after post-AHCT relapse may have changed the natural history of MM in this population. We analyzed the Center for International Blood and Marrow Transplant Research database to track overall survival (OS) of MM patients receiving single AHCT within 12 months after diagnosis (N=3256) and relapsing early post-AHCT (\u3c 24 months), and to identify factors predicting for early vs late relapses (24−48 months post-AHCT). Over three periods (2001–2004, 2005–2008, 2009–2013), patient characteristics were balanced except for lower proportion of Stage III, higher likelihood of one induction therapy with novel triplets and higher rates of planned post-AHCT maintenance over time. The proportion of patients relapsing early was stable over time at 35–38%. Factors reducing risk of early relapse included lower stage, chemosensitivity, transplant after 2008 and post-AHCT maintenance. Shorter post-relapse OS was associated with early relapse, IgA MM, Karnofsky \u3c 90, stage III, \u3e 1 line of induction and lack of maintenance. Post-AHCT early relapse remains a poor prognostic factor, even though outcomes have improved over time

Effect of priming with granulocyte colony-stimulating factor on the outcome of chemotherapy for acute myeloid leukemia

BACKGROUND: Sensitization of leukemic cells with hematopoietic growth factors may enhance the cytotoxicity of chemotherapy in acute myeloid leukemia (AML). METHODS: In a multicenter randomized trial, we assigned patients (age range, 18 to 60 years) with newly diagnosed AML to receive cytarabine plus idarubicin (cycle 1) and cytarabine plus amsacrin (cycle 2) with granulocyte colony-stimulating factor (G-CSF) (321 patients) or without G-CSF (319). G-CSF was given concurrently with chemotherapy only. Idarubicin and amsacrin were given at the end of a cycle to allow the cell-cycle-dependent cytotoxicity of cytarabine in the context of G-CSF to have a greater effect. The effect of G-CSF on disease-free survival was assessed in all patients and in cytogenetically distinct prognostic subgroups. RESULTS: After induction chemotherapy, the rates of response were not significantly different in the two groups. After a median follow-up of 55 months, patients in complete remission after induction chemotherapy plus G-CSF had a higher rate of disease-free survival than patients who did not receive G-CSF (42 percent vs. 33 percent at four years, P=0.02), owing to a reduced probability of relapse (relative risk, 0.77; 95 percent confidence interval, 0.61 to 0.99; P=0.04). G-CSF did not significantly improve overall survival (P=0.16). Although G-CSF did not improve the outcome in the subgroup with an unfavorable prognosis, the 72 percent of patients with standard-risk AML benefited from G-CSF therapy (overall survival at four years, 45 percent, as compared with 35 percent in the group that did not receive G-CSF [relative risk of death, 0.75; 95 percent confidence interval, 0.59 to 0.95; P=0.02]; disease-free survival, 45 percent vs. 33 percent [relative risk, 0.70]; 95 percent confidence interval, 0.55 to 0.90; P=0.006). CONCLUSIONS: Sensitization of leukemic cells with growth factors is a clinically applicable means of enhancing the efficacy of chemotherapy in patients with AML

Sustained response and HBsAg loss after nucleo(s)tide analogue discontinuation in chronic hepatitis B patients:the prospective SNAP study

Background &amp; Aim(s): Current guidelines suggest that nucleos(t)ide analogues (NA) can be discontinued before HBsAg loss in a selected group of chronic hepatitis B (CHB) patients. We aimed to study the safety and off-treatment response after NA cessation. Methods: This is a prospective, multicentre, cohort study in which eligible patients discontinued NA therapy. Adult patients, with a CHB mono-infection, HBeAg-negative, without a (history of) liver cirrhosis, who had achieved long-term viral suppression were eligible. Follow-up visits were planned at week 2-4-8-12-24-36-48-72-96. Re-treatment criteria included severe hepatitis (ALT &gt;10x ULN), signs of imminent liver failure (bilirubin &gt;1.5x ULN or INR &gt;1.5), or at the physician's own discretion. Results: In total, 33 patients were enrolled. Patients were predominantly Caucasian (45.5%) and had genotype A/B/C/D/unknown in 3/4/6/10/10 (9.1/12.1/18.2/30.3/30.3%). At week 48, 15 patients (45.5%) achieved a sustained response (HBV DNA &lt;2,000 IU/mL). At week 96, 13 patients (39.4%) achieved a sustained response, 4 (12.1%) achieved HBsAg loss, and 12 (36.4%) were re-treated. Severe hepatitis was the main reason for re-treatment (n=7, 21.2%). One patient with severe hepatitis developed jaundice, without signs of hepatic decompensation. Re-treatment was successful in all patients.Conclusion: NA therapy can be ceased in a highly selected group of CHB patients if close follow-up can be guaranteed. Treatment cessation may increase the chance of HBsAg loss in selected patients, which is counterbalanced by a significant risk of severe hepatitis.</p