Update welzijnsprestaties biologische veehouderij

Dit rapport geeft een actuele weergave van de werkelijke welzijnsprestaties van de biologische veehouderijsectoren, en welke ontwikkelingen er gaande zijn. Aan de hand van verbeteragenda's wordt aangegeven waar en hoe nog welzijnswinst te behalen is. De biologische veehouderij wil laten zien dat ze staat voor een maatschappelijk verantwoorde en duurzame productie, met aandacht voor milieu, klimaat, natuur en landschap, voedselkwaliteit, inkomen en dierenwelzijn. Dierenwelzijn als één van de thema’s van duurzaamheid staat centraal in deze rapportage. De bestaande kennis over dit onderwerp is geïnventariseerd voor de melkvee-, varkens-, pluimvee-, schapen- en geitensectoren. De welzijnsprestaties zijn gebaseerd op dierkenmerken en zijn ingedeeld in vier welzijnsklassen: gedrag, gezondheid, comfort en voeding (Welfare Quality®, 2009). Omdat geen algemeen geaccepteerde en geldende manier bestaat om welzijnscriteria tegen elkaar af te wegen, zijn voor de uiteenzetting van welzijnsprestaties alleen individuele welzijnscriteria gehanteerd

Beleidsinstrumenten voor energie-neutrale en klimaatvriendelijke agrosectoren : zoektocht naar de optimale instrumentenmix

Greenhouse horticulture, dairy farming and intensive livestock farming have access to policy and otherinstruments that help these sectors move closer to their energy and climate objectives. However, whilesome objectives for 2020 are close to being achieved, others are more remote. This applies in particularto the production of renewable energy and the reduction of greenhouse-gas emissions in the dairysector, as well as the production of renewable energy using co-fermentation and the reduction of CO2emissions in intensive livestock farming. Education, economic incentives and regulations and legislationrepresent the major instruments used. Horticulture uses more specific instruments tailored to the natureof the sector, while livestock farming largely favours generic instruments. Regular reviews are carriedout to assess whether the instruments still incentivise the appropriate behaviour and do not fundinnovations that are already out of date or do not contribute to long-term objectives. A point forattention, however, is the limited number of tools – or limited support – for business owners to movecloser to their climate and energy objectives. This is in spite of the need for business owners to have aperspective for action. Alongside this, current communication and knowledge transfer appear toconcentrate on business owners who are actively working toward these objectives, even though more‘passive’ business owners should also be involved in developments---In de glastuinbouw, melkveehouderij en intensieve veehouderij zijn beleids- en andere instrumenteningezet om energie- en klimaatdoelstellingen te halen. De doelen voor 2020 zijn nog niet allemaalgehaald en zijn soms ook niet binnen handbereik. Dit geldt met name voor productie van duurzameenergie en reductie van broeikasgassen in de melkveehouderij en voor productie van duurzameenergie door co-vergisting en reductie van CO2-emissie in de intensieve veehouderij. Educatie,economische incentives en wet- en regelgeving zijn de belangrijkste instrumenten. De glastuinbouwgebruikt meer specifieke tuinbouwgerichte instrumenten, terwijl de veehouderij vooral generiekeinstrumenten inzet. Regelmatig wordt herzien of de instrumenten nog wel het juiste gedragondersteunen en niet inzetten op innovaties die al achterhaald zijn of niet bijdragen aan lange termijndoelen. Een aandachtspunt is dat het aantal tools of handvatten om ondernemers te helpen klimaatenenergiedoelstellingen na te streven nog beperkt is terwijl juist handelingsperspectief belangrijk isvoor ondernemers. Daarnaast lijkt communicatie en kennisoverdracht nu nog vooral gericht te zijn opondernemers die actief een bijdrage willen leveren, terwijl ook andere, meer passieve ondernemersmeegenomen moeten worden in de ontwikkelingen

Ondernemers en de actoren in hun omgeving in beweging: Zoektocht naar rode draden in agrarische transitieprocessen

With the aid of a theoretically-based analysis of four historical and four current change processes - or transition case studies - in agriculture, we have made a study of how farmers and their associated actors move towards a sustainable agriculture. The change processes always appear to need the same 'conditions' in order to be successful and also appear always to encounter the same types of obstacles. It may be concluded from this that better advance anticipation of obstacles' hanging above the heads' of people involved in change needs to be possible, so that the envisaged change processes can proceed more easily. It remains a fact, however, that every change process also encounters unmanageable, unpredictable obstacles.Farm Management,

Verdienmodellen natuurinclusieve landbouw

Deze brochure richt zich op agrarische ondernemers en hun adviseurs. Wilt u nieuwe ideeën opdoen voor verdienmodellen gericht op de combinatie van landbouw met natuur? Wilt u voorbeelden van wat natuur voor u kan betekenen en hoe u hierin stappen kunt zetten? Laat u dan inspireren door deze brochure. En ga samen met verschillende partijen om de tafel om een natuurinclusief verdienmodel samen te stellen

Predniso(lo)ne Dosage and Chance of Remission in Patients With Autoimmune Hepatitis

Background & Aims Patients with autoimmune hepatitis (AIH) commonly receive induction therapy with predniso(lo)ne followed by maintenance therapy with azathioprine. European Association for Study of the Liver clinical practice guidelines advise a predniso(lo)ne dose range of 0.50–1 mg/kg/day, which leaves room for practice variation. We performed a multicenter study to determine the efficacy of different dose ranges of predniso(lo)ne induction therapy in a large European cohort of patients with AIH. Methods We performed a retrospective cohort study using a comparative effectiveness design. We collected data from 451 adults with AIH who began treatment from 1978 through 2017 at 9 centers in 5 European countries. We assigned patients to a high-dose group (initial predniso(lo)ne dose ≥0.50 mg/kg/day; n=281) or a low-dose group (<0.50 mg/kg/day; n=170). Logistic regression was performed to determine difference in outcomes between the groups. The primary outcome was normal serum levels of transaminases at 6 months after initiation of therapy. Results There was no significant difference in rates of normalization of transaminases between the high-dose predniso(lo)ne group and the low-dose group (70.5% vs 64.7%; P =.20). After multivariable logistic regression with correction for confounders, there was no difference in the likelihood of normalization of transaminases between the groups (odds ratio, 1.21; 95% CI, 0.78 – 1.87; P =.38). Patients given an initial high dose of predniso(lo)ne received more predniso(lo)ne over time than patients started on a lower dose (median doses over 6 months: 3780 mg vs 2573 mg) ( P <.01). Conclusions In a retrospective study of patients with AIH in Europe, we found that the dose of predniso(lo)ne to induce remission in patients with AIH is less relevant than assumed. An initial predniso(lo)ne dose below 0.50 mg/kg/day substantially decreases unnecessary exposure to predniso(lo)ne in patients with AIH

High discontinuation rate of azathioprine in autoimmune hepatitis, independent of time of treatment initiation

Contains fulltext : 225262.pdf (Publisher’s version ) (Open Access)BACKGROUND: Guidelines regarding treatment for autoimmune hepatitis (AIH) favour two strategies for azathioprine (AZA) introduction: concurrent with steroids at induction or delayed by 2-4 weeks. The safety and efficacy of both strategies have been unexplored. METHODS: We established a cohort of 900 AIH patients from 12 centres in 7 European countries. There were 631 patients who used AZA as part of the therapeutic regimen. We distinguished two groups: patients with early AZA (<2 weeks) or delayed AZA initiation (≥2 weeks). Primary outcome was discontinuation of AZA in the first year of treatment. Cox regression and propensity score matching was performed to determine difference in outcomes between groups. RESULTS: Patients with early AZA initiation had significantly lower transaminases and bilirubin at baseline. Discontinuation rates of AZA did not differ between early and delayed starters (16.6% vs 14.2%), which did not reach statistical significance (hazard ratio 0.97, 95% confidence interval 0.61-1.55, P = .90). Stratification according to baseline disease activity or propensity score matching did not alter the results. Main reason for AZA discontinuation was intolerance to treatment (14.0% vs 13.2%, P = .78) with nausea and vomiting as main side effects. AIH remission rates were comparable among groups. CONCLUSION: The discontinuation rate of AZA in AIH treatment is ~15% in the first year of treatment. Early or delayed AZA initiation does not differ in remission and discontinuation rates in AIH induction therapy. Our data suggest that either strategy may be used as part of AIH treatment

The relation between plasma tyrosine concentration and fatigue in primary biliary cirrhosis and primary sclerosing cholangitis

BACKGROUND: In primary biliary cirrhosis (PBC) and primary sclerosing cholangitis (PSC) fatigue is a major clinical problem. Abnormal amino acid (AA) patterns have been implicated in the development of fatigue in several non-hepatological conditions but for PBC and PSC no data are available. This study aimed to identify abnormalities in AA patterns and to define their relation with fatigue. METHODS: Plasma concentrations of tyrosine, tryptophan, phenylalanine, valine, leucine and isoleucine were determined in plasma of patients with PBC (n = 45), PSC (n = 27), chronic hepatitis C (n = 22) and healthy controls (n = 73). Fatigue and quality of life were quantified using the Fisk fatigue severity scale, a visual analogue scale and the SF-36. RESULTS: Valine, isoleucine, leucine were significantly decreased in PBC and PSC. Tyrosine and phenylalanine were increased (p < 0.0002) and tryptophan decreased (p < 0.0001) in PBC. In PBC, but not in PSC, a significant inverse relation between tyrosine concentrations and fatigue and quality of life was found. Patients without fatigue and with good quality of life had increased tyrosine concentrations compared to fatigued patients. Multivariate analysis indicated that this relation was independent from disease activity or severity or presence of cirrhosis. CONCLUSION: In patients with PBC and PSC, marked abnormalities in plasma AA patterns occur. Normal tyrosine concentrations, compared to increased concentrations, may be associated with fatigue and diminished quality of life

Rapid Response to Treatment of Autoimmune Hepatitis Associated With Remission at 6 and 12 Months

BACKGROUND & AIMS Changes in serum levels of transaminases immediately after initiation of treatment for autoimmune hepatitis (AIH) might be associated with biochemical markers of remission and liver-related events. We assessed the outcomes of patients with vs without rapid responses to treatment of AIH in a large international cohort. METHODS We performed a retrospective cohort study, collecting data from 2 independent cohorts of adults with AIH from 12 centers in 7 countries in Europe. We collected information on patient demographics; serologic, histologic, and biochemical analyses; and treatment. We used a receiver operating characteristic curve and Youden index to calculate the optimal percentage decrease in level of aspartate aminotransferase (AST) after 8 weeks of treatment that associated with normalization of transaminase levels after 26 weeks of treatment with predniso(lo)ne (primary outcome) in the first (discovery) cohort (n = 370). We evaluated the results in the second (validation) cohort (n = 370). Secondary outcomes were liver-related death or transplantation. We performed univariate and multivariable logistic and Cox regression with correction for confounders. RESULTS A significant decrease in level of AST after 8 weeks of treatment was significantly associated with normalization of transaminase levels at 26 and 52 weeks (P < .001); a decrease of more than 80% in level of AST was associated with optimal normalization. In both cohorts, rapid responders (≥80% decrease in level of AST after 8 weeks) were more likely to achieve normalization of transaminases at 26 and 52 weeks when compared to non-rapid responders. Rapid responders in the discovery cohort had lower risk of liver-related death or transplantation (adjusted hazard ratio 0.18; 95% CI 0.05-0.63; P = .007), although this was not confirmed in the validation cohort. Results from measurement of alanine aminotransferase did not differ significantly from those of AST for the primary outcome. Slow responders (without normalization of transaminases after 1 year) had the highest risk of liver transplantation or liver-related death. CONCLUSIONS In a retrospective study of patients with AIH, we found that a rapid response to treatment, based on level of AST after 8 weeks, associates with normalization of transaminase levels in the following year. Patients with a rapid response also have a lower risk of liver-related death or transplantation than patients without this rapid response