Green knowledge exchange Turkey-The Netherlands : priority issues identified for cooperation in the field of biodiversity protection and conservation : interviews with experts from Governmental and Non-Governmental Organisations based in Turkey and based in The Netherlands

As a consequence of its geographical location Turkey is very rich in biodiversity; its flora is richest, both in terms of overall plant diversity and level of endemism compared to Europe, North Africa, or countries in the Middle East. This report gives an overview of important biodiversity issues in Turkey and priorities for cooperation selected by Turkish and Dutch parties. The project aimed to facilitate the set up of a long-term cooperation between Turkey and The Netherlands in a structural ‘Green Knowledge Exchange’ between officials and experts of the two countries. Reports of interviews with (non)governmental organizations (Netherlands and Turkey) form the backbone of this publication. It also provides a SWOT analysis and comparison of the information obtained from Turkish side and the information provided by organisations based in The Netherlands

Immunological and Physiological Differences Between Layer- and Broiler Chickens after Concurrent Intratracheal Administration of Lipopolysaccharide and Human Serum Albumin

Layers and broilers were concurrently intratracheally challenged with 0.5 mg Lipopolysaccharide (LPS) and 0.1 mg Human Serum Albumin (HuSA) at 3 weeks of age. Specific total and isotype-specific (IgM, IgG, IgA) Antibody (Ab) responses to HuSA during 3 weeks following immunization, cellular in vitro mitogen responses to Concanavalin A (Con A) and specific cellular responses in vitro to different dosages of HuSA, blood serotonin (5-HT) levels, plasma Corticosterone (CORT) levels at 6 weeks of age and ex vivo nitric oxide (NO) production in the presence of LPS, respectively, were measured in all birds. Higher in vitro cellular responses to HuSA, but not Con A, were found in the broilers than in the layers. Also higher total, IgM and IgG antibody responses to HuSA were found in the broilers. Higher ex vivo NO production was found in the layers. A heavier spleen weight was found in the broilers, but relative spleen weight was higher in the layers. The broilers grew much heavier and also maintained a higher growth during the first 24 and 48 h after i.t. challenge with LPS and HuSA. No breed effect was found for body temperature responses after i.t. challenge. Blood 5-HT levels and plasma CORT levels were significantly higher in the layers. Number and type of significant correlations between 5-HT levels, cachectin response to LPS, antibody levels and cellular immunity differed between breeds. Our data suggest comparable immune responses to i.t. HuSA challenge in broilers and layers of similar age and confirm the earlier reported higher humoral immune response in broilers. On the other hand, the cachectin response to LPS differed between broilers and layers. Our results do not confirm the earlier reported higher cellular immune response of layers. Different significant relationships between physiological parameters in broilers and layers were found. Our results suggest that selection for enhanced growth does not necessarily affect specific immune competence of poultr

Towards a new approach for estimating indirect costs of disease

__Abstract__ Many researchers in the field of evaluation of health care doubt the usefulness of estimates of indirect costs of disease in setting priorities in health care. This paper attempts to meet part of the criticism on the concept of indirect costs, which are defined as the value of production lost to society due to disease. Thus far in cost of illness studies and cost-effectiveness analyses the potential indirect costs of disease were calculated. In the following a first step will be taken towards a new method for estimating indirect costs which are expected to be effectuated in reality: the friction cost method. This method explicitly takes into account short and long run processes in the economy which reduce the production losses substantially as compared with the potential losses. According to this method production losses will be confined to the period needed to replace a sick worker: the so called friction period. The length of this period and the resulting indirect costs depend on the situation on the labour market. Some preliminary results are presented for the indirect costs of the incidence of cardiovascular disease in the Netherlands for 1988, both for the friction costs and the potential costs. The proposed methodology for estimating indirect costs is promising, but needs further development. The consequences of illness in people without a paid job need to be incorporated in the analysis. Also the relation between internal labour reserves and costs of disease should be further investigated. Next to this, more refined labour market assumptions, allowing for diverging situations on different segments of the labour market are necessary

Cost-effectiveness of a pressure ulcer quality collaborative

ABSTRACT. BACKGROUND: A quality improvement collaborative (QIC) in the Dutch long-term care sector (nursing homes, assisted living facilities, home care) used evidence-based prevention methods to reduce the incidence and prevalence of pressure ulcers (PUs). The collaborative consisted of a core team of experts and 25 organizational project teams. Our aim was to determine its cost-effectiveness from a healthcare perspective. METHODS: We used a non-controlled pre-post design to establish the change in incidence and prevalence of PUs in 88 patients over the course of a year. Staff indexed data and prevention methods (activities, materials). Quality of life (Qol) weights were assigned to the PU states. We assessed the costs of activities and materials in the project. A Markov model was built based on effectiveness and cost data, complemented with a probabilistic sensitivity analysis. To illustrate the results of longer term, three scenarios were created in which change in incidence and prevalence measures were (1) not sust

The management of cervical intra-epithelial neoplasia (CIN): Extensiveness and costs in The Netherlands

In order to provide greater insight into both the extensiveness and the medical costs of the diagnosis and treatment of screen-detected cervical intra-epithelial neoplasia (CIN) in general medical practice in The Netherlands, data from national registries and gynaecology departments were retrieved, and experts were interviewed. Of the 5060 women diagnosed with CIN in 1988, more than 50% were treated in hospital with conisation or hysterectomy, which on average took 5.5 days stay per admission. The assessed average duration of the total pre- and post-treatment period is 4.6 years. The average total medical costs in women with detected CIN III are Dfl 3700 per woman. The diagnosis of CIN I and II involves more medical procedures and time than CIN III, but fewer women have conisation or hysterectomy, resulting in lower total medical costs (Dfl 2572). The overall extent and costs of the management of CIN should be accounted for when balancing the benefits, unfavourable effects and costs of cervical cancer screening