Acute Neck Pain in General Practice

We performed a prospective cohort study with one-year follow-up of patients with acute neck pain in general practice. Patients above 18 years of age consulting their GP for non-specific acute neck pain lasting no longer than six weeks were invited to participate. Self-administered questionnaires were collected from patients at baseline and after 6, 12, 26 and 52 weeks. 187 patients were included and we have follow-up data of 138 patients (74%). After one-year 47% still reported neck pain. Regression analysis showed that the highest association with "recovery" was the advice of the GP "to wait and see" and for "sick leave" referral by the GP We described of patients with acute neck pain. At baseline the management by the GP consisted of prescribing medication for 42% of patients and 51% was referred to a physiotherapist. Advices given by the GP were: to "wait and see", to "improve posture" and "stay active". In a subgroup analysis of patients after a Motor Vehicle Accident (MVA) the subgroup (n=42) was significantly younger, reported more sick leave and higher levels of headache. At baseline we asked the GP's to give an assessment of the risk for chronic neck pain and the GP showed to be able to make an adequate assessment of that. In a test-retest study the NDI has shown to be a reliable and responsive instrument. We evaluated the reliability of the Acute Low Back Pain Screenings Questionnaire (ALBPSQ) and determined a cut-off point for predicting future sick leave

Stochastic modelling of Salmonella monitoring in finishing pigs

Results of serological monitoring for Salmonella in finishing pigs are used to classify herds and target control measures at herds with high prevalence. The outcome of monitoring depends on three factors: (a) the optical density percentage (OD%) used to declare a sample positive, (b) the herd classification scheme, and (c) the number of samples. The goal of this study was to analyse the impact of these three factors on the reliability and cost of Salmonella monitoring in finishing pigs. A stochastic simulation model was constructed to evaluate 12 monitoring scenarios based on: (a) four cut-off values for the OD% and (b) three herd classification schemes. Furthermore, eight different sampling schemes were evaluated. The main outputs of the model are (a) the percentage of herds changing classification as a reliability criterion and (b) the total number of samples taken as a cost criterion. Results indicated that monitoring scenarios based on cut-off OD% 10 are most reliable. Moreover, inclusion of a zero-prevalence class decreased the reliability of monitoring. The economically optimal sampling scheme depended on the monitoring scenario used

Inventarisatie zoönosen bij het paard in Nederland

Het ministerie van EZ heeft laten onderzoeken of het paard in Nederland een rol speelt bij het ontstaan van infectieziekten die kunnen worden overgedragen van dieren op mensen (zoönosen)