Final project report: EEC 2092/91 (ORGANIC) Revision

This report summarises the findings of the project that have been presented in a number of separate reports and publications. In the Chapters 2 to 5 the approach, results and conclusions of the project are summarised, following the structure of the different work packages. Chapter 2 summarises the work on ethical values of organic agriculture. Chapter 3 looks at the differences in the implementation of Regulation (EEC) 2092/91 across Europe and compares the European Regulation with international standards. Chapters 4 and 5 summarise the findings that relate to reducing the dependency on non-organic inputs in the case of feed and seed. The final Chapter 6 consolidates the recommendations of the whole project arising from the various different work packages in one place. Recommendations are aimed in particular at the second stage of the ongoing revision process of the European Regulation, the transfer of the detailed rules from the Annexes of the Regulation (EEC) 2092/91 that is expected to start after the completion of the project. Further recommendations for standard setting bodies, regulators and research recommendations are also presented. The overall objective of the project was to provide recommendations for the revision and further development of the Regulation (EEC) 2092/91 and other standards for organic agriculture, broken down into a number of specific objectives that resulted in 12 seperate reports. The basic ethical values and value differences of organic agriculture in Europe was identified through stakeholder consultation (D 2.1) and through literature as part of developing a procedure for balancing and integrating the basic values in developments of EU regulation (D 2.3). Organic standards from national and private organisations in Europe were compared with the EU regulation with help of database (www.organicrules.org) and differences were analysed to give recommendations on further harmonisation of the EU regulation (D 3.2). The knowledge on how to achieve 100 % organic rations in diets for livestock was expanded through a meta-analysis of literature and an overview of the current situation to characterise the availability of protein sources for 100% organic diets for pigs and poultry was produced (D 4.1 part 1 and 2). Criteria for use of organic inputs, evaluation criteria for Annex II C: Feed materials and Annex II D: Dietary supplements of Regulation (EEC) 2092/91 were developed (D. 4.2). A guide for operators was developed (D 4.3). The knowledge on how to reduce the use of non-organic seed and vegetative propagation materials was improved through reports on seed borne diseases in organic seed and propagation material (D 5.1), on the importance of quality characterising in organic seed and propagation material (D 5.2) and analysis of national derogation regimes (D 5.3). The project produced 12 reports, 7 scientific publications in peer-reviewed journals, and a project web-page at www.organic-revision.org where all reports and further documents are available. It organised 3 workshops with stakeholders and had ongoing communication with the Unit on Organic Farming in DG Agriculture responsible for the Organic Regulation. Members of the team produced in total more than 250 dissemination items

The transformation of community hospitals through the transition to value-based care: Lessons from Massachusetts

Enabling community hospitals to provide efficient and effective care and maintain competition on par with their academic medical center (AMC) counterparts remain challenges for most states. Advancing accountable care readiness adds to the complexity of these challenges. Community hospitals experience narrower operating margins and more limited access to large populations than their AMC counterparts, making the shift to value-based care difficult. Massachusetts has taken legislative action to ensure a statewide focus on reducing healthcare costs, which includes a nearly $120-million grant program supporting community hospital and system transformation toward a value-based environment. The Massachusetts Health Policy Commission’s Community Hospital Acceleration, Revitalization and Transformation (CHART) investment program is the state’s largest effort to date aimed at readying community hospitals for value-based care. In doing so, Massachusetts has created the largest state-driven, all-payer (payer-blind) readmission reduction initiative in the country. n this paper, we examine the design and evolution of CHART Phases 1 and 2 and offer insights for other states contemplating innovative approaches to bolstering community hospital participation in value-based care models

Extraction of level density and gamma strength function from primary gamma spectra

We present a new iterative procedure to extract the level density and the gamma strength function from primary gamma spectra for energies close up to the neutron binding energy. The procedure is tested on simulated spectra and on data from the Yb-173(He-3,alpha)Yb-172 reaction.Comment: 23 pages including 1 table and 7 figure

SYNOVIAL FLUID AND SERUM ANTIBODIES AGAINST CHLAMYDIA IN DIFFERENT FORMS OF ARTHRITIS: INTRA-ARTICULAR IgA PRODUCTION IN CHLAMYDIA SEXUALLY ACQUIRED REACTIVE ARTHRITIS

SUMMARY Since the presence of Chlamydia has been shown in synovial fluid (SF) from some patients with Chlamydia reactive arthritis, we investigated whether anti-Chlamydia antibodies present in the joint are derived from the circulation or are locally produced. We compared titres of IgG, IgM and IgA antibodies against Chlamydia, and against a control antigen (tetanus toxoid), by an enzyme-linked immunosorbent assay (ELISA), in paired samples of serum and SF from Chlamydia trachomatis sexually acquired reactive arthritis (CT-SARA) patients and from patients with other forms of arthritis. The ratio of serum/SF IgA anti-Chlamydia antibodies was significantly decreased in CT-SARA patients. It is concluded that, in our experimental conditions, we found evidence for intra-articular production of IgA anti-Chlamydia antibodie

Level densities and γ\gamma-strength functions in 148,149^{148,149}Sm

The level densities and $\gamma$-strength functions of the weakly deformed $^{148}$Sm and $^{149}$Sm nuclei have been extracted. The temperature versus excitation energy curve, derived within the framework of the micro canonical ensemble, shows structures, which we associate with the break up of Cooper pairs. The nuclear heat capacity is deduced within the framework of both the micro canonical and the canonical ensemble. We observe negative heat capacity in the micro canonical ensemble whereas the canonical heat capacity exhibits an S-shape as function of temperature, both signals of a phase transition. The structures in the $\gamma$-strength functions are discussed in terms of the pygmy resonance and the scissors mode built on exited states. The samarium results are compared with data for the well deformed $^{161,162}$Dy, $^{166,167}$Er and $^{171,172}$Yb isotopes and with data from (n,$\gamma$)-experiments and giant dipole resonance studies.Comment: 12 figure

THE VALUE OF ISOTYPE DETERMINATION OF SERUM ANTIBODIES AGAINST CHLAMYDIA FOR THE DIAGNOSIS OF CHLAMYDIA REACTIVE ARTHRITIS

SUMMARY In clinical rheumatology, the diagnosis of Chlamydia reactive arthritis is difficult because an incomplete form of the disease can closely resemble an undifferentiated seronegative mono/oligoarthritis. We investigated whether measuring specific isotypes of anti-Chlamydia antibodies in serum can improve the diagnosis, by comparing such antibody concentrations in the serum of patients with well-defined disease, i.e. Chlamydia trachomatis sexually acquired reactive arthritis (CT-SARA), with other arthritides. Antibody levels were determined by enzyme-linked immunosorbent assay (ELISA). When considering two different isotypes and their combination, the best sensitivity (63%) was obtained for IgM and/or IgA results with a specificity of 81%. The patients with CT-SARA and SARA had the highest levels of antibodies of all isotypes tested. It is concluded that, in our experimental conditions, only very high values of specific isotypes could indicate a diagnosis of Chlamydia reactive arthriti

Discharge planning, self-management, and community support: Strategies to avoid psychiatric rehospitalisation from a service user perspective

Abstract Objective Psychiatric rehospitalisation is often seen as a negative outcome in terms of healthcare quality and cost, as well as potentially hindering the process of recovery. The purpose of our study was to explore psychiatric rehospitalisation from a service-user perspective, paying attention to how rehospitalisation can be avoided. Method Eight focus groups, including a total of 55 mental health service users, were conducted in six European countries (Austria, Finland, Italy, Norway, Romania, and Slovenia). The results were analysed using systematic text condensation. Results All participants had been in touch with mental health services for at least one year, and had experienced more than one psychiatric hospitalisation. Participants emphasised the importance of discharge planning and psychoeducation both during and after the hospital stay, as well as the benefits of structured plans, coping strategies, self-monitoring techniques, and close contact with local community services.Social contacts and meaningful activities were also considered to be critical, as was support from peers and family members. Conclusion Efforts to avoid psychiatric rehospitalisation should include actions that support a functional day-to-day life, improve coping strategies, and build on cross-sectoral collaboration. Practice implications The study emphasises the need for psychoeducational and psychosocial interventions, starting already during the inpatient stay

Effect of Omega-3 Fatty Acids on Lipoprotein Profile and Particle Size in Hispanic Women

The effect of increased Ω3 fatty acids on lipoprotein sub-fractions has not been well studied in Hispanic women, a group with a high prevalence of dyslipidemia and metabolic syndrome. The purpose of this randomized, placebo-controlled trial was to examine the effect of a 90-day (90D) combined EPA+DHA supplementation on lipoprotein profiles of Hispanic women. Twenty-seven non-diabetic women were randomly assigned to the Ω3 group (n=17, 1.9 g/day EPA+DHA) or the placebo group (n=10, 2 g/day oleic acid). At baseline (0D) and 90D a fasting blood sample was drawn for determination of lipoprotein profile and lipoprotein particle sub-fractions. For the Ω3 group, total cholesterol increased 6.5%, triglycerides were reduced 14.8%, LDL concentration increased 5.6%, and total LDL particle size concentration increased 8.2% (P \u3c 0.05). Large LDL particle size concentration increased 16% from 0D to 90D, this change was not significant (P = 0.051). At 90D, total cholesterol, LDLs, and LDL particle concentration were higher in the Ω3 group compared to placebo (P \u3c 0.05). Omega-3 supplementation resulted in reduced plasma TGs and an increase in large LDL particle size concentration, yet had no effect on HDL particle size or concentration. Further research is necessary to examine the effects of increased Ω3 fatty acid intake in Hispanic women on dyslipidemia and related co-morbidities

Critical temperature for quenching of pair correlations

The level density at low spin in the 161,162-Dy and 171,172-Yb nuclei has been extracted from primary gamma rays. The nuclear heat capacity is deduced within the framework of the canonical ensemble. The heat capacity exhibits an S-formed shape as a function of temperature, which is interpreted as a fingerprint of the phase transition from a strongly correlated to an uncorrelated phase. The critical temperature for the quenching of pair correlations is found at Tc=0.50(4) MeV.Comment: 8 pages including 4 figures, different method to extract Tc, different figures, text partly rewritte