An LP-Model to Analyse Economic and Ecological Sustainability in Dutch Dairy Farming

Since the enactment of the Economic Growth and Tax Relief Reconciliation Act of 2001, owners and operators of farms and ranches have opportunities to evaluate new estate planning strategies for the transfer of farm businesses to subsequent generations. However, with provisions of the Act to be phased in over several years, consideration must be given to having a "staged" estate plan. Under provisions of the current law, estate tax is repealed in the year 2010, but if Congress does not act, the legislation sunsets and returns to prior law January 1, 2011. This fact provides planning challenges for owners and operators of farms and ranches as the phase-in of provisions, the repeal in 2010, and the return to prior law relative to estate planning and business inter-generational transfer of property. This paper investigates the planning process and options available as they relate to a family-owned property in North Carolina, USA. Plans made must take into consideration the dynamics of a changing legislative environment, special-use valuation of land, opportunity cost of alternative uses for land, and off-farm heirs.Environmental Economics and Policy, Livestock Production/Industries,

General practice cooperatives: long waiting times for home visits due to long distances?

BACKGROUND: The introduction of large-scale out-of-hours GP cooperatives has led to questions about increased distances between the GP cooperatives and the homes of patients and the increasing waiting times for home visits in urgent cases. We studied the relationship between the patient's waiting time for a home visit and the distance to the GP cooperative. Further, we investigated if other factors (traffic intensity, home visit intensity, time of day, and degree of urgency) influenced waiting times. METHODS: Cross-sectional study at four GP cooperatives. We used variance analysis to calculate waiting times for various categories of traffic intensity, home visit intensity, time of day, and degree of urgency. We used multiple logistic regression analysis to calculate to what degree these factors affected the ability to meet targets in urgent cases. RESULTS: The average waiting time for 5827 consultations was 30.5 min. Traffic intensity, home visit intensity, time of day and urgency of the complaint all seemed to affect waiting times significantly. A total of 88.7% of all patients were seen within 1 hour. In the case of life-threatening complaints (U1), 68.8% of the patients were seen within 15 min, and 95.6% of those with acute complaints (U2) were seen within 1 hour. For patients with life-threatening complaints (U1) the percentage of visits that met the time target of 15 minuts decreased from 86.5% (less than 2.5 km) to 16.7% (equals or more than 20 km). DISCUSSION AND CONCLUSION: Although home visits waiting times increase with increasing distance from the GP cooperative, it appears that traffic intensity, home visit intensity, and urgency also influence waiting times. For patients with life-threatening complaints waiting times increase sharply with the distance

Molecular epidemiology and disease severity of influenza virus infection in patients with haematological disorders

nfluenza virus infection is a common cause of self‐limiting respiratory tract infection(RTI), however immunocompromised patients are at an increased risk for a severecourse of disease or fatal outcome. We therefore aimed to gain a betterunderstanding of the molecular epidemiology of influenza viruses from patientswith haematological disorders and their impact on the clinical course of disease.Molecular analysis using polymerase chain reaction (PCR) of nasopharyngeal swabswas performed for influenza virus in haematological patients at the HeidelbergUniversity Hospital. Clinical data was evaluated to identify associated risk factors.For phylogenetic analysis, the hemagglutinin (HA) gene was sequenced. Out of 159influenza positive patients, 117 patients developed upper RTI (influenza A:n= 73;influenza B:n= 44). Lower RTI was observed inn= 42 patients (26%),n= 22/42patients developed severe disease andn= 16/159 (10.1%) patients died. Risk factorsfor lower RTI were nosocomial infection (p= 0.02), viral shedding for≥14 days(p= 0.018), IgG levels <6 g/dL (p= 0.046), bacterial/fungal co‐infections (p< 0.001).Risk factors for fatal outcome were age≥65 years (p= 0.032), bacterial/fungal(p≤0.001) co‐infections and high viral load (p= 0.026). Sequencing of the HA gene(n= 115) revealed subtype A(H3N2) (n= 46), A(H1N1)pdm09 (n= 24), B/Victoria(n= 34), B/Yamagata (n= 11). There was no correlation between influenza (sub)typeand lower RTI. Influenza infection in haematological patients is associated withsignificant morbidity and mortality, the risk for aggravating co‐infections, prolongedviral shedding and nosocomial transmission emphasizing the need for infectioncontrol.Peer Reviewe

GPs views on transfer of information about terminally ill patients to the out-of-hours co-operative

<p>Abstract</p> <p>Background</p> <p>In the Netherlands, the increase in of out-of-hours care that is provided by GP co-operatives is challenging the continuity of care for the terminally ill in general practice. Aim of this study is to investigate the views of general practitioners (GPs) on the transfer of information about terminally ill patients to the GP co-operatives. GPs were asked to give their view from two different perspectives: as a GP in their daily practice and as a locum in the GP co-operative.</p> <p>Methods</p> <p>Retrospective web based questionnaire sent to all 424 GPs in the Amsterdam region.</p> <p>Results</p> <p>With a response rate of 42%, 177 physicians completed the questionnaire. Transfer of information to the GP co-operative about most of their terminally ill patients was reported by 82% of the GPs and 5% did not do so for any of their patients. A faster than foreseen deterioration of the patient's situation was the most frequently reported reason for not transferring information.</p> <p>Of those who transferred information to the GP co-operative, more than 95% reported that they provided information about the diagnosis and terminally ill status of the patient. Information about medication, patient wishes regarding treatment, and prognosis was reported by respectively 90%, 87%, and 74% of the GPs. Less than 50% of the GPs reported that they transferred information about the patient's awareness of both the diagnosis and the prognosis, about the psychosocial context, and intolerances.</p> <p>In their role as locum, over 90% of the GPs wanted to receive information about the diagnosis, the terminally ill status of the patient, the medication and the patient's wishes regarding treatment.</p> <p>Conclusions</p> <p>Although most GPs reported that they transferred information about their terminally ill patients to the GP co-operative, the content of this information varies considerably. Only 21% of the GPs, working out of hours as a locum, were satisfied with the quality of the information transferred.</p

Out-of-hours care in western countries: assessment of different organizational models

Contains fulltext : 81655.pdf (publisher's version ) (Open Access)BACKGROUND: Internationally, different organizational models are used for providing out-of-hours care. The aim of this study was to assess prevailing models in order to identify their potential strengths and weaknesses. METHODS: An international web-based survey was done in 2007 in a sample of purposefully selected key informants from 25 western countries. The questions concerned prevailing organizational models for out-of-hours care, the most dominant model in each country, perceived weaknesses, and national plans for changes in out-of-hours care. RESULTS: A total of 71 key informants from 25 countries provided answers. In most countries several different models existed alongside each other. The Accident and Emergency department was the organizational model most frequently used. Perceived weaknesses of this model concerned the coordination and continuity of care, its efficiency and accessibility. In about a third of the countries, the rota group was the most dominant organizational model for out-of-hours care. A perceived weakness of this model was lowered job satisfaction of physicians. The GP cooperative existed in a majority of the participating countries; no weaknesses were mentioned with respect to this model. Most of the countries had plans to change the out-of-hours care, mainly toward large scale organizations. CONCLUSION: GP cooperatives combine size of scale advantages with organizational features of strong primary care, such as high accessibility, continuity and coordination of care. While specific patients require other organizational models, the co-existence of different organizational models for out-of-hours care in a country may be less efficient for health systems

Roles of fire history and rewetting in peatland restoration and vegetation recovery on the Merang peat dome, South Sumatra, Indonesia

In the restoration of drained and degraded tropical peat swamp forest (PSF) it is not well understood whether fire suppression on its own is sufficient to facilitate regeneration, or if rewetting plays a key role. We attempt to answer this question in the Merang area, a 23,000-ha peatland located in South Sumatra province, Indonesia. As with more than 90 % of PSF in Southeast Asia, the area has been largely degraded by logging and drainage canals, along with multiple fires. It has been designated and managed as an ecosystem restoration area since 2016, by which time only a single 254 ha patch of original PSF habitat remained. However, scattered remnant PSF trees ( 4 fires), while Macaranga pruinosa, Melicope glabra and Melicope lunu-ankenda dominate in regenerating areas that have experienced 12 fires. While fire suppression is essential to prevent further loss of vegetation, effective rewetting is required before woody vegetation can recover

Carbon chemistry in Galactic Bulge Planetary Nebulae

Galactic Bulge Planetary Nebulae show evidence of mixed chemistry with emission from both silicate dust and PAHs. This mixed chemistry is unlikely to be related to carbon dredge up, as third dredge-up is not expected to occur in the low mass Bulge stars. We show that the phenomenon is widespread, and is seen in 30 nebulae out of 40 of our sample, selected on the basis of their infrared flux. HST images and UVES spectra show that the mixed chemistry is not related to the presence of emission-line stars, as it is in the Galactic disk population. We also rule out interaction with the ISM as origin of the PAHs. Instead, a strong correlation is found with morphology, and the presence of a dense torus. A chemical model is presented which shows that hydrocarbon chains can form within oxygen-rich gas through gas-phase chemical reactions. The model predicts two layers, one at $A_V\sim 1.5$ where small hydrocarbons form from reactions with C$^+$, and one at $A_V\sim 4$, where larger chains (and by implication, PAHs) form from reactions with neutral, atomic carbon. These reactions take place in a mini-PDR. We conclude that the mixed chemistry phenomenon occurring in the Galactic Bulge Planetary Nebulae is best explained through hydrocarbon chemistry in an UV-irradiated, dense torus.Comment: 13 pages, 10 figue

Diagnostic Potential of Imaging Flow Cytometry

Imaging flow cytometry (IFC) captures multichannel images of hundreds of thousands of single cells within minutes. IFC is seeing a paradigm shift from low- to high-information-content analysis, driven partly by deep learning algorithms. We predict a wealth of applications with potential translation into clinical practice

The Lamb shift in muonic hydrogen and the proton radius

By means of pulsed laser spectroscopy applied to muonic hydrogen (μ− p) we have measured the 2S F = 1 1/2 − 2PF = 2 3/2 transition frequency to be 49881.88(76) GHz. By comparing this measurement with its theoretical prediction based on bound-state QED we have determined a proton radius value of rp = 0.84184 (67) fm. This new value is an order of magnitude preciser than previous results but disagrees by 5 standard deviations from the CODATA and the electronproton scattering values. An overview of the present effort attempting to solve the observed discrepancy is given. Using the measured isotope shift of the 1S-2S transition in regular hydrogen and deuterium also the rms charge radius of the deuteron rd = 2.12809 (31) fm has been determined. Moreover we present here the motivations for the measurements of the μ 4He + and μ 3He + 2S-2P splittings. The alpha and triton charge radii are extracted from these measurements with relative accuracies of few 10 − 4. Measurements could help to solve the observed discrepancy, lead to the best test of hydrogen-like energy levels and provide crucial tests for few-nucleon ab-initio theories and potentials