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Iedereen heeft het over de vergroeningsopgave. Architecten en stedenbouwkundigen weten er wel raad mee, getuige de prachtige artist impressions van groene steden als moderne Hof van Eden. Maar wie gaat al dat groen beheren? We spraken hierover met diverse experts.

De glastuinbouw wil laten zien wat de sector in de periode 2004-2016 heeft gepresteerd op het gebied van reductie van het gewasbeschermingsmiddelengebruik. LTO Glaskracht Nederland en de Stichting Programmafonds Glastuinbouw hebben daarom aan Wageningen Economic Research opdracht gegeven om de gebruiksgegevens van chemische gewasbeschermingsmiddelen in het Bedrijveninformatienet in de jaren 2004, 2008, 2012 en 2016 samen te vatten in gemiddelden per deelsector en per hoofdgewas. In deze factsheet worden deze gemiddelden gepresenteerd. De factsheet geeft een tussenresultaat. In een volgende factsheet wordt het middelengebruik gecombineerd met milieubelastingpunten voor spuiwater (substraat) en uitspoeling (grondteelt) voor berekening van de milieubelasting op waterleven en bodemleven als gevolg van de emissie van gewasbeschermingsmiddelen vanuit de glastuinbouw.

© 2017 Lynden Roberts et al. Objectives. To observe the choices of conventional disease modifying antirheumatic drugs (cDMARDs) and biologic DMARDs (bDMARDs) in the management of rheumatoid arthritis (RA) in Australian routine clinical practice, to assess treatment survival and determine the effect of cDMARDs/bDMARDs on disease activity. Methods. Routinely collected, deidentified clinical data was sourced from 20 Australian rheumatology practices. RA patients aged ≥18 years, who had received cDMARDs/bDMARDs and a recorded subsequent visit, were included. A linear mixed model was used to determine the change over time and the percentage reduction in disease activity was summarized. Results. 12,526 RA patients were included: 72% females, mean age 62 years. cDMARDs and bDMARDs were used in 92% and 30% of patients, respectively. The most commonly prescribed cDMARD was methotrexate (76% patients); median time to stopping treatment was 337 months [95% CI: 279-ND]. Etanercept was the most commonly prescribed bDMARD (12% patients); median time to stopping treatment was 79 months [95% CI: 57-93]. Of 5,341 patients with a first change in medication (cDMARD or bDMARD), 87% had therapy escalation and 13% deescalation. Reduction in DAS28-ESR, 6-month post-DMARDs initiation ranged from 3%, adalimumab, to 14%, leflunomide and tocilizumab. Conclusions. In this large Australian cohort of unselected community RA patients, the choices of cDMARDs/bDMARDs are aligned with current international guidelines.

Aim: To assess the association between baseline clinical prognostic factors and subsequent Disease Activity Score of 28 joints (DAS28) remission in early rheumatoid arthritis (RA). Method(s): Data were collected using point of care clinical software from participating rheumatology centres. Patients aged 18 years or over whose date of clinical onset of RA was within the previous 12-24 months, who had at least 6 months of follow-up data and a DAS28-ESR (erythrocyte sedimentation rate) score recorded between 12 and 24 months from first being seen for RA were included. Data collected included baseline demographics, mode of disease onset, pattern of joint involvement at onset, smoking status, DAS28, rheumatoid factor (RF), anti-citrullinated peptide antibodies (ACPA), time from symptom onset to presentation and disease activity at baseline. Univariate and multivariate logistic regression of DAS28-ESR remission between 12 and 24 months after first assessment were performed. Result(s): Data from 1017 patients were analyzed: 70% female; mean age 60 years (SD: 14.7); 70% RF-positive, 58% ACPA-positive. The strongest age and sex adjusted baseline predictors of DAS28-ESR remission at 12-24 months were remission at baseline (odds ratio [OR]: 4.49, 95% CI: 2.17-9.29, P < 0.001), being male (OR: 2.42, 95% CI: 1.46-4.01, P < 0.001), abstaining from alcohol (P < 0.001) and being lower weight (OR: 0.98, 95% CI: 0.97-1.00, P = 0.015). There was no statistically significant association between joint onset patterns, mode of onset, RF, ACPA or smoking status. Conclusion(s): In this observational study, patients with early RA at risk of not achieving remission include those with high disease activity at baseline, women, those who drink alcohol and those with higher body weight.Copyright © 2017 Asia Pacific League of Associations for Rheumatology and John Wiley & Sons Australia, Ltd

Aim: To evaluate the demographic features and clinical pattern of patients treated with confirmed CASPAR criteria with Psoriatic Arthritis in Australia (PARA). Method(s): This was a retrospective non-interventional multi-centre study using the Audit4 clinical audit program, with de-identified and routinely collected clinical data sourced from participating rheumatology practices in the OPAL consortium (Optimising Patient outcomes in Australian rheumatoLogy) across Australia during November 2015. Patients were included if they fulfilled the Classification Criteria for Psoriatic Arthritis (CASPAR) as determined by the treating physician. Data available included patient demographics (age and sex), duration of illness (from date of physician diagnosis), subtype of psoriatic arthritis (PsA) as classified by Moll and Wright and CASPAR scores. Result(s): In total, 1097 patients diagnosed with CASPAR-validated PsA were included in the study; 56% female, 44% male (0.7% missing/unassigned). The mean age (+/- standard deviation (SD)]) was 54.5 years (+/-13.1), and the median duration of disease (+/- SD) was 11.6 years (+/-10.0). Among those patients with PsA subtype recorded (n = 662), asymmetric oligoarthritis was the most prevalent at 48% and arthritis mutilans was the least prevalent at 1.1%. Across the total patient cohort, the mean CASPAR total score (+/- SD) was 3.8 (+/-0.9). Of those patients with CASPAR component scores recorded for dactylitis (n = 833), psoriasis (n = 1082) and nail dystrophy (n = 889), 62.5%, 82.2% and 88.9% of patients were currently symptomatic for these criteria respectively. Conclusion(s): Cross-sectional assessment of this Australian cohort of patients with CASPAR-validated PsA demonstrates a demographic profile and clinical pattern aligned with the known epidemiology of PsA. This study underscores the prevalence of the extra-articular manifestations of PsA. Further understanding of PsA in Australia will benefit from continued characterisation o

Since the sinking of the Titanic, many researchers have investigated in greater detail who survived the disaster and who did not. The exceptional high rate of survival of women and children on board of the Titanic, in contrast to other maritime disasters, is explained by the strong adherence to the ‘Women and Children first’ norm (Frey, Savage & Torgler, 2010a, 2010b, 2011; Elinder & Erixson, 2012). However, male passengers did not receive this preference treatment and were thus allocated to their own resources in order to survive the disaster. Many research has already focused on the role of passenger class and the chance of survival (Frey et al., 2010a, 2010b, 2011; Elinder & Erixson, 2012). This thesis seeks to examine the role of the resources of male passengers on the chances of survival in greater detail. These resources are investigated by means of occupation. Three hypotheses are derived; one about the level of prestige, the level of physical abilities, and the level of caring traits someone has in their occupation. Both quantitative and qualitative data with information about passengers of the Titanic is used. Regression analyses are conducted to examine the relations between different occupational resources and the chance of survival. Results show that both prestigious occupations, physical occupations, and caring occupations do not significantly influence the chance of survival of a male passenger on board of the Titanic. Implications of these findings are discussed.

Since the sinking of the Titanic, many researchers have investigated in greater detail who survived the disaster and who did not. The exceptional high rate of survival of women and children on board of the Titanic, in contrast to other maritime disasters, is explained by the strong adherence to the ‘Women and Children first’ norm (Frey, Savage & Torgler, 2010a, 2010b, 2011; Elinder & Erixson, 2012). However, male passengers did not receive this preference treatment and were thus allocated to their own resources in order to survive the disaster. Many research has already focused on the role of passenger class and the chance of survival (Frey et al., 2010a, 2010b, 2011; Elinder & Erixson, 2012). This thesis seeks to examine the role of the resources of male passengers on the chances of survival in greater detail. These resources are investigated by means of occupation. Three hypotheses are derived; one about the level of prestige, the level of physical abilities, and the level of caring traits someone has in their occupation. Both quantitative and qualitative data with information about passengers of the Titanic is used. Regression analyses are conducted to examine the relations between different occupational resources and the chance of survival. Results show that both prestigious occupations, physical occupations, and caring occupations do not significantly influence the chance of survival of a male passenger on board of the Titanic. Implications of these findings are discussed.

Waarde kaasexport in 2016 licht gestegen De export, inclusief wederuitvoer, van kaas is met € 68 mln. gestegen naar een totaal van € 3,2 mld. in 2016. Dit is een stijging van ruim 2%. Duitsland is de belangrijkste exportbestemming. Van alle kaas die in Duitsland wordt geïmporteerd is 26% afkomstig uit Nederland.

Patients with diabetes type 2 benefit from continuing the metformin treatment when the moment has come that insulin administering becomes necessary. This is shown by this research that studied the long-term (4.3 years) effects of metformin on among others cardiovascular diseases. The metformin induced improvement in cardiovascular diseases was partly explained by weight loss and improvement in endothelial function in the metformin group, but not by lower insulin levels. Finally, long-term metformin treatment turned out to considerably decrease the risk of developing a vitamin B12 deficiency. The present guidelines, however, don’t make recommendations for the prevention and detection of vitamin B12 deficiencies during the metformin treatment. This research presents strong arguments for the routine determination of vitamin B12 during the metformin treatment.

Background: Psoriatic arthritis (PsA) is a spondyloarthritis spectrum disease with prominent involvement of skin and joints. The management of PsA patients is often complex and there is no uniformity across the medical profession. The majority of PsA studies have been prospective clinical trials involving a homogenous and restricted patient population. This may not reflect real clinical practice where patients have co-morbidities and other clinical characteristics that preclude them from participating in clinical trials. Objective(s): To provide a cross sectional analysis of disease activity and management of PsA patients in the Australian population. Method(s): This was a retrospective non-interventional multi-centre study using the Audit4 clinical audit program, with de-identified and routinely collected clinical data sourced from participating rheumatology practices in the OPAL consortium (Optimising Patient outcomes in Australian rheumatoLogy) across Australia during November 20151. Data collected included baseline characteristics, prevalence and duration of cDMARD and bDMARD treatments, DAS28-CRP results, and reasons for stopping therapy. Result(s): A total of 3422 clinician diagnosed PsA patients were included in this study: 60% were female, mean age 54 years (+/-14) and mean disease duration 10 years (+/-9). Of patients with a valid treatment record (n=2948), 46% were on cDMARD monotherapy, 19% on bDMARD monotherapy, 13% on combination bDMARD and cDMARD therapy, 11% on combination cDMARD therapy and 10% were on no DMARDs. Of those with DAS28 CRP results (n=494), the highest mean DAS 28 CRP was 3.32 (+/-1.57) on combination cDMARD therapy, and the lowest DAS 28 CRP was 2.19 (+/-0.89) on bDMARD monotherapy. The most common reasons for cessation of cDMARD monotherapy was adverse reactions (41%), for bDMARD monotherapy lack of efficacy (26%) and combination bDMARD and cDMARD therapy either completed treatment or drug no longer required (37%). Conclusion(s): Cross

Many small towns in South Africa are burdened with a legacy of poverty and unemployment. As a response to these social and urban issues this research project argues for an approach towards town planning in such a way as to promote sustainable pro-poor tourism . The research project aims to explore how a themed integrated resort development can be used as a tool to restructure the economy of Hazyview X44 and other similar small towns in South Africa. The research project presents a Site Development Plan for Hazyview X44, which includes an International Convention Centre ICC, Casino, Pre-Colonial Heritage museum, restaurants, hotel precinct, playpark and greenstone museum, which will potentially pave the way for future similar integrated resort developments in small towns in South-Africa. Hopefully these development nodes can act as a catalyst for economic revival not only in the tourism industry but also in its respective communities all over South-Africa. The intended outcome is that this Integrated Resort Development will be economically viable, socially just and ecologically sustainable.

Het stationsgebied Breda is de afgelopen jaren compleet veranderd. Er kwam een nieuw station inclusief een compleet vernieuwde buitenruimte. In die buitenruimte speelt kwalitatief hoogstaand groen een prominente rol. Lanen met zomerlindes, Japanse honingbomen en 68 tijdelijke fruitbomen bepalen het straatbeeld en geven kleur aan het gebied.