Dynamic impacts of a financial reform of the CAP on regional land use, income and overall growth

In this paper we investigate the impacts of abolishing the Common Agricultural Policy (CAP) for the post-2013 European Union (EU) financial perspective and the impacts of re-investing the released funds on research and development (R&D). We apply a linked system of models to analyze the impacts for the EU member states. The linked system consists of five land-use sector models (agriculture, forestry, urban area, tourism and transport infrastructure), which are connected to a macro-econometric model. Additionally, a land cover model is used to disaggregate land use countries to a 1 km² grid. Three scenarios are analysed. In the “baseline” currently decided policies are assumed to be continued until 2025. In the “tax rebate” scenario agricultural support (first pillar) is removed, and the member states’ contributions to EU lowered. In the “R&D investments” scenario agricultural support is also removed, and the released funds are used to increase general R&D efforts in the EU. We find that in both liberalization scenarios, agricultural producer prices drop compared to the baseline. Agricultural production drops too, but less so in the “R&D investment” scenario due to productivity gains resulting from the increased R&D spending. In some countries, the productivity gains totally offset the negative impact of liberalisation on agricultural production. Smaller agricultural production implies less agricultural land use, and the more so in the “R&D Investment” scenario where productivity increases. The fall in agricultural production and prices negatively affects economic activity and households’ purchasing power, but the reduced direct taxation compensates this effect and results in a GDP gain of 0.53% and 0.8 million additional jobs. In “R&D investment” GDP gain reaches 2.57% and yields 2.95 million additional jobs in EU in 2025. The GDP, consumption and employment gains in the “R&D Investment” scenario widely exceed the losses in the agriculture sectors. The analysis indicates that if no external effects of agriculture are considered, then the CAP is an inefficient use of tax money, and that a considerable contribution to reaching the goals of the Lisbon agenda would be achieved if the same amount of money was instead invested in R&D.CAP reform, economical growth, land use, Agricultural and Food Policy, Land Economics/Use,

Reducing use of antimicrobials — Experiences from an intervention study in organic dairy herds in Denmark

With the aim of phasing out the use of antimicrobials 23 Danish organic dairy producers from the same organic dairy company participated in Stable School farmer groups from February 2004 to March 2005 in order to go through a common learning and development process towards their common goal. Data on production and herd health were evaluated from two years before to three years after the start of the Stable Schools. For comparison, data was collected from the remaining 35 herds delivering to the same dairy company, 118 organic dairy herds delivering to other dairies and 115 conventional herds. On average, the project herds were smaller with lower production and had half the incidence rate of mastitis treatment than the organic herds from other dairies before the start of the project. The incidence rate of mastitis treatments was reduced considerably from 20 treatments per 100 cow years to 10 treatments per 100 cow years after the project period. Somatic cell count (SCC) and scores for acute and chronic intramammary infections did not change significantly during the study period, and milk production increased at the same rate as in the other herd groups. The incidence rate of mastitis treatments or the reduction of the incidence rate could be related to the herd SCC or the prevalence of blind quarters. The incidence rates of locomotive disorders and reproductive disorders were lower in the project herds compared with herds from other dairies before the project start, and the differences increased during the project period though the reduction of the incidence rates in the project herds was not statistically significant. It is concluded that the farmers participating in the Stable Schools managed to reduce the use of antimicrobials in their herds also after the project period without apparent negative effects on production and udder and herd health

Contextual determinants associated with children's and adolescents' mental health care utilization:a systematic review

Determinants at the contextual level are important for children's and adolescents' mental health care utilization, as this is the level where policy makers and care providers can intervene to improve access to and provision of care. The objective of this review was to summarize the evidence on contextual determinants associated with mental health care utilization in children and adolescents. A systematic literature search in five electronic databases was conducted in August 2021 and retrieved 6439 unique records. Based on eight inclusion criteria, 74 studies were included. Most studies were rated as high quality (79.7%) and adjusted for mental health problems (66.2%). The determinants that were identified were categorized into four levels: organizational, community, public policy or macro-environmental. There was evidence of a positive association between mental health care utilization and having access to a school-based health center, region of residence, living in an urban area, living in an area with high accessibility of mental health care, living in an area with high socio-economic status, having a mental health parity law, a mental health screening program, fee-for-service plan (compared to managed care plan), extension of health insurance coverage and collaboration between organizations providing care. For the other 35 determinants, only limited evidence was available. To conclude, this systematic review identifies ten contextual determinants of children's and adolescents' mental health care utilization, which can be influenced by policymakers and care providers. Implications and future directions for research are discussed PROSPERO ID: CRD42021276033.</p

Contralateral breast cancer risk is influenced by the age at onset in BRCA1-associated breast cancer

BRCA1/2 mutation carriers diagnosed with breast cancer have a strongly elevated life-time risk of developing a contralateral tumour. We studied the contralateral breast cancer risk in 164 patients from 83 families with a proven BRCA1 mutation in relation to the age at diagnosis of the first primary breast cancer. In the actuarial outcomes after 10 years’ follow-up, 40% of the 124 BRCA1-patients diagnosed with breast cancer < 50 years had developed contralateral breast cancer, vs 12% of the 40 patients > 50 years at first diagnosis (Plogrank= 0.02). These data suggest that age at diagnosis of the first tumour should be taken into account when prophylactic mastectomy in BRCA1-patients is considered. © 2000 Cancer Research Campaig

The injectable-only contraceptive medroxyprogesterone acetate, unlike norethisterone acetate and progesterone, regulates inflammatory genes in endocervical cells via the glucocorticoid receptor

Clinical studies suggest that the injectable contraceptive medroxyprogesterone acetate (MPA) increases susceptibility to infections such as HIV-1, unlike the injectable contraceptive norethisterone enanthate (NET-EN). We investigated the differential effects, molecular mechanism of action and steroid receptor involvement in gene expression by MPA as compared to NET and progesterone (P4) in the End1/E6E7 cell line model for the endocervical epithelium, a key point of entry for pathogens in the female genital mucosa. MPA, unlike NET-acetate (NET-A) and P4, increases mRNA expression of the anti-inflammatory GILZ and IκBα genes. Similarly, MPA unlike NET-A, decreases mRNA expression of the pro-inflammatory IL-6, IL-8 and RANTES genes, and IL-6 and IL-8 protein levels. The predominant steroid receptor expressed in the End1/E6E7 and primary endocervical epithelial cells is the glucocorticoid receptor (GR), and GR knockdown experiments show that the anti-inflammatory effects of MPA are mediated by the GR. Chromatin-immunoprecipitation results suggest that MPA, unlike NET-A and P4, represses pro-inflammatory cytokine gene expression in cervical epithelial cells via a mechanism involving recruitment of the GR to cytokine gene promoters, like the GR agonist dexamethasone. This is at least in part consistent with direct effects on transcription, without a requirement for new protein synthesis. Dose response analysis shows that MPA has a potency of ∼24 nM for transactivation of the anti-inflammatory GILZ gene and ∼4-20 nM for repression of the pro-inflammatory genes, suggesting that these effects are likely to be relevant at injectable contraceptive doses of MPA. These findings suggest that in the context of the genital mucosa, these GR-mediated glucocorticoid-like effects of MPA in cervical epithelial cells are likely to play a critical role in discriminating between the effects on inflammation caused by different progestins and P4 and hence susceptibility to genital infections, given the predominant expression of the GR in primary endocervical epithelial cells

Are BRCA1- and BRCA2-related breast cancers associated with increased mortality?

There has been contradictory evidence as to whether BRCA1 associated breast cancers have a poorer prognosis than non-BRCA1 cancers. In this issue of Breast Cancer Research Robson and colleagues provide further evidence for poorer survival in BRCA1 carriers and show that it could be attributed to failure to treat small node-negative grade 3 breast cancers with chemotherapy. There still remains little evidence for a survival difference for BRCA2 related breast cancers. Although the high contralateral breast cancer risk is confirmed by this study there is no real evidence for an increase in ipsilateral recurrence or new primary breast cancers in mutation carriers up to the 10-year point

BRCA1 and BRCA2 mutations in a population-based study of male breast cancer

Background: The contribution of BRCA1 and BRCA2 to the incidence of male breast cancer (MBC) in the United Kingdom is not known, and the importance of these genes in the increased risk of female breast cancer associated with a family history of breast cancer in a male first-degree relative is unclear. Methods: We have carried out a population-based study of 94 MBC cases collected in the UK. We screened genomic DNA for mutations in BRCA1 and BRCA2 and used family history data from these cases to calculate the risk of breast cancer to female relatives of MBC cases. We also estimated the contribution of BRCA1 and BRCA2 to this risk. Results: Nineteen cases (20%) reported a first-degree relative with breast cancer, of whom seven also had an affected second-degree relative. The breast cancer risk in female first-degree relatives was 2.4 times (95% confidence interval [CI] = 1.4–4.0) the risk in the general population. No BRCA1 mutation carriers were identified and five cases were found to carry a mutation in BRCA2. Allowing for a mutation detection sensitivity frequency of 70%, the carrier frequency for BRCA2 mutations was 8% (95% CI = 3–19). All the mutation carriers had a family history of breast, ovarian, prostate or pancreatic cancer. However, BRCA2 accounted for only 15% of the excess familial risk of breast cancer in female first-degree relatives. Conclusion: These data suggest that other genes that confer an increased risk for both female and male breast cancer have yet to be found

Prophylactic Mastectomy in BRCA1/2 Mutation Carriers and Women at Risk of Hereditary Breast Cancer: Long-Term Experiences at the Rotterdam Family Cancer Clinic

Background BRCA1/2 mutation carriers and women from a hereditary breast(/ovarian) cancer family have a highly increased risk of developing breast cancer (BC). Prophylactic mastectomy (PM) results in the greatest BC risk reduction. Long-term data on the efficacy and sequels of PM are scarce. Methods From 358 high-risk women (including 236 BRCA1/2 carriers) undergoing PM between 1994 and 2004, relevant data on the occurrence of BC in relation to PM, complications in relation to breast reconstruction (BR), mutation status, age at PM and preoperative imaging examination results were extracted from the medical records, and analyzed separately for women without (unaffected, n = 177) and with a BC history (affected, n = 181). Results No primary BCs occurred after PM (median follow-up 4.5 years). In one previously unaffected woman, metastatic BC was detected almost 4 years after PM (primary BC not found). Median age at PM was younger in unaffected women (P < .001), affected women more frequently were 50% risk carriers (P < .001). Unexpected (pre)malignant changes at PM were found in 3% of the patients (in 5 affected, and 5 unaffected women, respectively). In 49.6% of the women opting for BR one or more complications were registered, totaling 215 complications, leading to 153 surgical interventions (71%). Complications were mainly related to cosmetic outcome (36%) and capsular formation (24%). Conclusions The risk of developing a primary BC after PM remains low after longer follow-up. Preoperative imaging and careful histological examination is warranted because of potential unexpected (pre)malignant findings. The high complication rate after breast reconstruction mainly concerns cosmetic issues