Pain and psychological health status in chronic pain patients with migration background—the Zurich study

The objective of this paper is to investigate whether there were differences in pain and psychological health status in chronic pain patients with and without migration background before and after an 8-week interdisciplinary outpatient pain programme (IOPP). One hundred eighteen consecutively assessed patients were included. Pain and psychological health were recorded prior to and after the intervention, and at the 3-, 6- and 12-month follow-up. The migrant group experienced a statistically significant and clinically relevant higher amount of pain and worse psychological functioning than the non-migrant group at all time points. Statistically significant differences between the groups for the variables depression, anxiety, kinesiophobia and passive coping, in particular catastrophizing, were observed in the short and long term. The non-migrant group improved continuously on all outcome measurements at all time points. The results show differences in outcome for chronic pain patients with and without migration background. High pain intensity, high levels of depression, anxiety and catastrophizing at baseline appear to be major barriers for improvement in a sample of migrant patients when participating in an IOPP. Treatments may have to be tailored to the specific needs of this patient group to better address their poor psychological health status and to improve the course of the pain disorde

A922 Sequential measurement of 1 hour creatinine clearance (1-CRCL) in critically ill patients at risk of acute kidney injury (AKI)

Meeting abstrac

Precipitation or water capacity indices? An analysis of the benefits of alternative underlyings for index insurance

Eastern Germany is often hit by drought causing income risk for crop farmers. Index-based risk management instruments could help crop farmers to reduce their farm income risk. Such instruments have some important advantages over damage-based insurance, like e.g. less moral hazard and adverse selection. At the same time they typically have a high level of basis risk. Up to now, mainly precipitation-based weather derivatives have been discussed as an appropriate risk management instrument for farmers in Germany. As a potentially more effective alternative, we propose water capacity-based index insurance. In order to show the benefits of a precipitation-based and water capacity-based index insurance, several contract designs are compared. Using a whole farm risk program planning approach, we show that for an average agricultural producer in Eastern Germany water capacity-based index insurance offers greater benefits than precipitation-based index insurance.Index insurance Whole farm risk program planning approach Water capacity

How location decisions influence the transport cost of processed and unprocessed bioenergy digestates: the impact of plant size and location on profitability of biogas plants in Germany

The production of bioenergy is considered to be a promising energy source for a sustainable energy mix and it is politically promoted in many countries. With the exception of Brazilian ethanol, bioenergy not competitive to fossil energy sources, and therefore needs to be subsidised. Several types of bioenergy are based on bulky raw biomass with high per unit transport costs, importantly impacting on the plant’s production costs and profitability. In addition, considerable quantities of digestates are released, causing disposal costs. Various studies in the past aimed primarily at analysing transport costs of inputs. In this paper we focus on disposal costs of fermentation digestates from biogas production in Germany and analyse different processing techniques and their impact on profitability for three plant size in three case study areas. Our results show that especially in regions with only a small amount of agricultural land and a large heterogeneity in its agricultural area, processing of digestates increases the profitability of biogas production. The same accounts for regions with high livestock density, where the area needed for disposal is comparatively large. The cost efficiency is enforced by a high share of animal excrements on input and the biogas plant sizetransport costs, biogas profitability, digestates processing, choice of location

Investments in Kazakhstani Dairy Farming: A Comparison of Classical Investment Theory and the Real Options Approach

This study analyzes the explanatory potential of the real options approach (ROA) regarding the reluctance of Kazakhstani farmers to invest in modern dairy farming. More precisely, it compares the valuation of the ROA with those of the classical investment criterion such as the net present value (NPV). A further objective is to analyze the sensitivity of investment triggers with respect to assumed stochastic processes. To do so, an option-pricing model, which combines the stochastic simulation and the parameterization of investment triggers, is suggested. The results reveal that the investment trigger given by the ROA is considerably higher than the one given by the NPV criterion. This verifies that the ROA has an explanatory potential for the reluctance of farmers to invest in modern dairy farming. In addition, it was found that the option-pricing results indicate a high sensitivity regarding different stochastic processes as well as risk attitudes

Die ökonomische Bewertung der Feldberegnung unter Berücksichtigung von Risiko und veränderter Wasserentnahmeerlaubnisse

Mit der Wasserrahmenrichtlinie hat die EU einen juristischen Rahmen geschaffen, alle aquatischen Ökosysteme zu schützen. Diese vornehmlich auf den Grundwasserschutz abzielende Maßnahme kann zu wirtschaftlichen Nachteilen für Landwirte führen. So wird die Feldberegnung als Möglichkeit genutzt, den ökonomischen Erfolg landwirtschaftlicher Betriebe zu verbessern. Gleichzeitig wird ihr eine wichtige Rolle als Risikomanagementinstrument zugestanden. In diesem Beitrag werden unter Anwendung eines erweiterten gesamtbetrieblichen Risikoprogrammierungsansatzes die Auswirkungen einer Reduzierung der Wasserentnahmeerlaubnisse unter Berücksichtigung der Risikoakzeptanz des Entscheiders analysiert. Dabei wird ein typischer Betrieb in Nordost-Niedersachsen betrachtet. Die Ergebnisse zeigen, dass die ökonomischen Nachteile der Beschränkung der Wasserentnahmeerlaubnisse für den untersuchten Betrieb überproportional mit der Reglementierung ansteigen und bislang vielfach verwendete deterministische Bewertungsansätze diese Nachteile systematisch unterschätzen. The European Union has established the Water Framework Directive (WFD) as a legal framework to protect all aquatic ecological systems including groundwater. This directive is primarily aiming at water protection and may have advantages for the water regime in sensitive areas. Nevertheless, it may also involve economic disadvantages for agricultural enterprises. In this paper we analyze the economic implications of the WFD for farmers using irrigation, i.e., the negative economic consequences for farms resulting from a reduction of water withdrawal permits in the north-east of Lower Saxony. In a whole farm risk programming approach we show how much benefit farmers loose if the amount of water withdrawal permits is reduced. To avoid solutions that would possibly exceed the farmers’ risk tolerance, the apparently accepted standard deviation of the program’s total gross margin is used as an upper bound in the optimization. This should represent an observable reflection of the individual risk attitude of the farmers. The results demonstrate that deterministic approaches do not consider all economic impacts caused by the reduction of water withdrawal permits as well as that risk has to be considered

Pain and psychological health status in chronic pain patients with migration background-the Zurich study

The objective of this paper is to investigate whether there were differences in pain and psychological health status in chronic pain patients with and without migration background before and after an 8-week interdisciplinary outpatient pain programme (IOPP). One hundred eighteen consecutively assessed patients were included. Pain and psychological health were recorded prior to and after the intervention, and at the 3-, 6- and 12-month follow-up. The migrant group experienced a statistically significant and clinically relevant higher amount of pain and worse psychological functioning than the non-migrant group at all time points. Statistically significant differences between the groups for the variables depression, anxiety, kinesiophobia and passive coping, in particular catastrophizing, were observed in the short and long term. The non-migrant group improved continuously on all outcome measurements at all time points. The results show differences in outcome for chronic pain patients with and without migration background. High pain intensity, high levels of depression, anxiety and catastrophizing at baseline appear to be major barriers for improvement in a sample of migrant patients when participating in an IOPP. Treatments may have to be tailored to the specific needs of this patient group to better address their poor psychological health status and to improve the course of the pain disorder

The SECURE study: long-term safety of ranibizumab 0.5 mg in neovascular age-related macular degeneration

Item does not contain fulltextOBJECTIVE: To evaluate long-term safety of intravitreal ranibizumab 0.5-mg injections in neovascular age-related macular degeneration (nAMD). DESIGN: Twenty-four-month, open-label, multicenter, phase IV extension study. PARTICIPANTS: Two hundred thirty-four patients previously treated with ranibizumab for 12 months in the EXCITE/SUSTAIN study. METHODS: Ranibizumab 0.5 mg administered at the investigator's discretion as per the European summary of product characteristics 2007 (SmPC, i.e., ranibizumab was administered if a patient experienced a best-corrected visual acuity [BCVA] loss of >5 Early Treatment Diabetic Retinopathy Study letters measured against the highest visual acuity [VA] value obtained in SECURE or previous studies [EXCITE and SUSTAIN], attributable to the presence or progression of active nAMD in the investigator's opinion). MAIN OUTCOME MEASURES: Incidence of ocular or nonocular adverse events (AEs) and serious AEs, mean change in BCVA from baseline over time, and the number of injections. RESULTS: Of 234 enrolled patients, 210 (89.7%) completed the study. Patients received 6.1 (mean) ranibizumab injections over 24 months. Approximately 42% of patients had 7 or more visits at which ranibizumab was not administered, although they had experienced a VA loss of more than 5 letters, indicating either an undertreatment or that factors other than VA loss were considered for retreatment decision by the investigator. The most frequent ocular AEs (study eye) were retinal hemorrhage (12.8%; 1 event related to study drug), cataract (11.5%; 1 event related to treatment procedure), and increased intraocular pressure (6.4%; 1 event related to study drug). Cataract reported as serious due to hospitalization for cataract surgery occurred in 2.6% of patients; none was suspected to be related to study drug or procedure. Main nonocular AEs were hypertension and nasopharyngitis (9.0% each). Arterial thromboembolic events were reported in 5.6% of the patients. Five (2.1%) deaths occurred during the study, none related to the study drug or procedure. At month 24, mean BCVA declined by 4.3 letters from the SECURE baseline. CONCLUSIONS: The SECURE study showed that ranibizumab administered as per a VA-guided flexible dosing regimen recommended in the European ranibizumab SmPC at the investigator's discretion was well tolerated over 2 years. No new safety signals were identified in patients who received ranibizumab for a total of 3 years. On average, patients lost BCVA from the SECURE study baseline, which may be the result of disease progression or possible undertreatment. FINANCIAL DISCLOSURE(S): Proprietary or commercial disclosure may be found after the references