Annual protein yield and extractable protein potentials in three legumes and two grasses.

BACKGROUND: New protein sources with low environmental and climatic impact are needed. Perennial crops show advantages as compared to annual crops and the upcoming biorefinery technology can extract proteins from the perennial biomass for protein concentrate production. The search for best-suited biomass crops needs to include harvest during the full growing season to support economic viability of biorefinery plants. Here we examined two grasses under increasing N fertilizer regime (175, 350 and 525 kg N ha-1 ) and three legumes, subject to a four-cut strategy. The well-defined Cornell Net Carbohydrate and Protein System (CNCPS) was used to estimate potential extractable protein. A key, previously presented in the literature, was applied in order to translate the CNCPS results into potential extracted protein concentrate. RESULTS: Crude protein (CP) yield per hectare was highest in red clover in 2015 (2907 kg CP ha-1 ) and the fertilized (525 kg N ha-1 ) tall fescue in 2016 (2435 kg CP ha-1 ). When translating the numbers into potential extraction of protein concentrate, the red clover had the highest protein concentrate yield per hectare in 2015 (835 kg CP ha-1 ) and lucerne in 2016 (803 kg CP ha-1 ). CONCLUSION: The results revealed that the entire season needs attention for optimization and not only the first cut, since both CP yields and quality peaks in different cuts across the five species and 2 years. Further knowledge of CP yield responses to field management and species mixtures are needed in order to advise farmers on the optimal crop for biorefining. © 2021 Society of Chemical Industry.

Robust Species Distribution Mapping of Crop Mixtures Using Color Images and Convolutional Neural Networks.

Crop mixtures are often beneficial in crop rotations to enhance resource utilization and yield stability. While targeted management, dependent on the local species composition, has the potential to increase the crop value, it comes at a higher expense in terms of field surveys. As fine-grained species distribution mapping of within-field variation is typically unfeasible, the potential of targeted management remains an open research area. In this work, we propose a new method for determining the biomass species composition from high resolution color images using a DeepLabv3+ based convolutional neural network. Data collection has been performed at four separate experimental plot trial sites over three growing seasons. The method is thoroughly evaluated by predicting the biomass composition of different grass clover mixtures using only an image of the canopy. With a relative biomass clover content prediction of R2 = 0.91, we present new state-of-the-art results across the largely varying sites. Combining the algorithm with an all terrain vehicle (ATV)-mounted image acquisition system, we demonstrate a feasible method for robust coverage and species distribution mapping of 225 ha of mixed crops at a median capacity of 17 ha per hour at 173 images per hectare.

Microbial N Transformations and N2O Emission after Simulated Grassland Cultivation: Effects of the Nitrification Inhibitor 3,4-Dimethylpyrazole Phosphate (DMPP).

Grassland cultivation can mobilize large pools of N in the soil, with the potential for N leaching and N2O emissions. Spraying with the nitrification inhibitor 3,4-dimethylpyrazole phosphate (DMPP) before cultivation was simulated by use of soil columns in which the residue distribution corresponded to plowing or rotovation to study the effects of soil-residue contact on N transformations. DMPP was sprayed on aboveground parts of ryegrass and white clover plants before incorporation. During a 42-day incubation, soil mineral N dynamics, potential ammonia oxidation (PAO), denitrifying enzyme activity (DEA), nitrifier and denitrifier populations, and N2O emissions were investigated. The soil NO3- pool was enriched with 15N to trace sources of N2O. Ammonium was rapidly released from decomposing residues, and PAO was stimulated in soil near residues. DMPP effectively reduced NH4+ transformation irrespective of residue distribution. Ammonia-oxidizing archaea (AOA) and bacteria (AOB) were both present, but only the AOB amoA transcript abundance correlated with PAO. DMPP inhibited the transcription of AOB amoA genes. Denitrifier genes and transcripts (nirK, nirS, and clades I and II of nosZ) were recovered, and a correlation was found between nirS mRNA and DEA. DMPP showed no adverse effects on the abundance or activity of denitrifiers. The 15N enrichment of N2O showed that denitrification was responsible for 80 to 90% of emissions. With support from a control experiment without NO3- amendment, it was concluded that DMPP will generally reduce the potential for leaching of residue-derived N, whereas the effect of DMPP on N2O emissions will be significant only when soil NO3- availability is limiting. IMPORTANCE: Residue incorporation following grassland cultivation can lead to mobilization of large pools of N and potentially to significant N losses via leaching and N2O emissions. This study proposed a mitigation strategy of applying 3,4-dimethylpyrazole phosphate (DMPP) prior to grassland cultivation and investigated its efficacy in a laboratory incubation study. DMPP inhibited the growth and activity of ammonia-oxidizing bacteria but had no adverse effects on ammonia-oxidizing archaea and denitrifiers. DMPP can effectively reduce the potential for leaching of NO3- derived from residue decomposition, while the effect on reducing N2O emissions will be significant only when soil NO3- availability is limiting. Our findings provide insight into how DMPP affects soil nitrifier and denitrifier populations and have direct implications for improving N use efficiency and reducing environmental impacts during grassland cultivation.

Estimation of the Botanical Composition of Clover-Grass Leys from RGB Images Using Data Simulation and Fully Convolutional Neural Networks.

Optimal fertilization of clover-grass fields relies on knowledge of the clover and grass fractions. This study shows how knowledge can be obtained by analyzing images collected in fields automatically. A fully convolutional neural network was trained to create a pixel-wise classification of clover, grass, and weeds in red, green, and blue (RGB) images of clover-grass mixtures. The estimated clover fractions of the dry matter from the images were found to be highly correlated with the real clover fractions of the dry matter, making this a cheap and non-destructive way of monitoring clover-grass fields. The network was trained solely on simulated top-down images of clover-grass fields. This enables the network to distinguish clover, grass, and weed pixels in real images. The use of simulated images for training reduces the manual labor to a few hours, as compared to more than 3000 h when all the real images are annotated for training. The network was tested on images with varied clover/grass ratios and achieved an overall pixel classification accuracy of 83.4%, while estimating the dry matter clover fraction with a standard deviation of 7.8%.

Dry matter yield, chemical composition and estimated extractable protein of legume and grass species during the spring growth.

BACKGROUND: Knowledge of the variation of extractable protein amount in legumes and grasses as affected by harvest time is important for identifying optimal combinations to enable a high protein production in a biorefinery. The extractability of protein was estimated using the Cornell Net Carbohydrate and Protein System across six harvests during the spring growth. RESULTS: The estimated extractable protein [g kg-1 dry matter (DM)] defined as the easily available fractions B1 +B2 was significantly higher in white clover and lucerne at all harvests while, if the more cell wall attached fraction B3 can be extracted, white clover had the highest extractable protein amongst all species. Total yield of B1 +B2 per ha was higher in white clover and red clover at the early growth while B1 +B2 +B3 was by far the highest for red clover through all harvests. CONCLUSION: White clover could be a good candidate for protein production purpose in a biorefinery due to its high extractable protein content per kg DM. In order to maximise the protein production capacity, harvest should take place during early growth due to a decline in protein extractability with maturity. The final economy of the concept will depend on the value of the fibre after extraction of the protein. © 2017 Society of Chemical Industry.

Effects of Acidifying Pig Diets on Emissions of Ammonia, Methane, and Sulfur from Slurry during Storage.

Ammonia (NH) volatilization from intensive livestock production is a threat to natural ecosystems. This study investigated pig diet manipulation by 1% (w/w) benzoic acid (BA) amendment and lowering of dietary electrolyte balance through substituting 1.4% (w/w) CaCO with 2.0% (w/w) CaCl. Urine and feces were collected separately from 24 pigs fed one of four diets (Control, +BA, +CaCl, +BA+CaCl) in metabolic cages and mixed as slurry. During 103 d of storage, all acidifying diets consistently reduced pH in the slurry by 0.4 to 0.6 units. There was a strong relationship between slurry pH and NH emissions, which were considerably reduced by the three acidifying diets. The +BA diet decreased NH emission by 28%, the +CaCl diet by 37%, and the combined +BA and +CaCl diet by 40%. Acidifying diets had no effect on S cycling or emission of volatile S compounds under the prevailing conditions of restricted S feeding. Methane (CH) emissions were increased by 73% in diets with CaCl. An initial delay in CH emissions was investigated in a separate experiment with manipulation of pH (5.4, 6.7, or 8.8) and inoculation with adapted pig slurry (0, 4, 11, or 19%), which showed that methanogenic potential, rather than inhibitory effects of the chemical environment, caused the delay. In conclusion, NH emissions from slurry could be reduced by addition of BA to pig diets or by controlling the dietary electrolyte balance, but there was no additive effect of combining the two strategies. However, CH emissions from slurry may increase with acidifying diets.

Effects of cattle slurry acidification on ammonia and methane evolution during storage.

Slurry acidification before storage is known to reduce NH(3) emissions, but recent observations have indicated that CH(4) emissions are also reduced. We investigated the evolution of CH(4) from fresh and aged cattle slurry during 3 mo of storage as influenced by pH adjustment to 5.5 with sulfuric acid. In a third storage experiment, cattle slurry acidified with commercial equipment on two farms was incubated. In the manipulation experiments, effects of acid and sulfate were distinguished by adding hydrochloric acid and potassium sulfate separately or in combination, rather than sulfuric acid. In one experiment sulfur was also added to slurry as the amino acid methionine in separate treatments. In each treatment 20-kg portions of slurry (n = 4) were stored for 95 d. All samples were subsampled nine to 10 times for determination of NH(3) and CH(4) evolution rates using a 2-L flow-through system. In all experiments, the pH of acidified cattle slurry increased gradually to between 6.5 and 7. Acidification of slurry reduced the evolution of CH(4) by 67 to 87%. The greatest reduction was observed with aged cattle slurry, which had a much higher potential for CH(4) production than fresh slurry. Sulfate and methionine amendment to cattle slurry without pH adjustment also significantly inhibited methanogenesis, probably as a result of sulfide production. The study suggests that complex microbial interactions involving sulfur transformations and pH determine the potential for CH(4) emission during storage of cattle slurry, and that slurry acidification may be a cost-effective greenhouse gas mitigation option.

Sulfur turnover and emissions during storage of cattle slurry: effects of acidification and sulfur addition.

Slurry acidification using sulfuric acid reduces ammonia emissions but also affects sulfur (S) cycling. Emission of sulfur is a source of malodor and reduces the sulfur fertilizer value of the slurry. We investigated the effect of sulfate and methionine amendments, alone or in combination with acidification, on sulfur transformations in slurry and emissions of volatile sulfur compounds (VSC) during storage of fresh and aged cattle slurry. When pH was lowered to 5.5 it resulted in an almost complete inhibition of sulfate reduction. There was a huge emission of hydrogen sulfide (HS) with addition of sulfate and methionine ( < 0.01). Methanethiol (MT) was emitted in treatments with addition of methionine, especially when simultaneously acidified ( < 0.01). The large HS production in the sulfate-amended slurries resulted in little accumulation of MT and dimethyl sulfide (DMS) under neutral conditions, in contrast to acidic conditions where the degradation was inhibited and both MT and DMS accumulated. Based on odor activity values, untreated slurry had little odor development from S compounds, especially the aged slurry. Acidification did not significantly increase odor contribution from any of the compounds in fresh or aged slurry. Generally, addition of a sulfate increased the contribution from HS dramatically, whereas acidification lowered the HS contribution but increased that of MT. Thus, acidification of slurry with sulfuric acid may potentially produce more odor from S compounds than untreated slurry.

Fatty acid, tocopherol and carotenoid content in herbage and milk affected by sward composition and season of grazing.

BACKGROUND: The aim of the present work was to study to what extent grazing large amounts of white clover (WCL), red clover (RCL), lucerne (LUC) or chicory (CHI) was suitable for production of bovine milk with a high milk fat content of tocopherols, carotenoids, α-linolenic acid and conjugated linoleic acid. RESULTS: WCL, RCL, LUC and CHI swards were established to investigate the influence of herbage composition on the milk quality of grazing dairy cows at three periods. Average milk fat composition showed high concentrations of linolenic acid (12 mg g⁻¹), conjugated linoleic acid (13 mg g⁻¹), carotenoids (6 µg g⁻¹) and α-tocopherol (21 µg g⁻¹ milk fat). There were minor differences between herbage types and periods, but multivariate analysis of these data showed no clear grouping. Chemical composition of herbage varied with species as well as period, but it was not possible to relate milk and feed contents of specific fatty acids, carotenoids or tocopherols. CONCLUSION: All four herbages tested were suitable for production of milk with a high content of beneficial compounds. Thus any of these herbages could be used in production of such differentiated milk based on a large proportion of grazing in the ration.

Data on growth, uptake and N2 fixation of grass-clover leys fertilized with mineral N fertilizer and cattle slurry.

This article presents the data obtained from a field experiment in which grass-clover leys were fertilized with increasing N rates applied in either mineral N fertilizer and/or cattle slurry forms. The leys were composed of a 2-species mixture of white clover (Trifolium repens L.) and ryegrass (Lolium perenne L.) and a 4-species mixture of white clover, red clover (Trifolium pratense L.), festulolium (Festulolium braunii) and ryegrass. In total, eighty fields were established at two farm sites in the western part of Denmark on sandy soils and monitored for two herbage seasons (2018-2019). Dry matter yield, botanical composition, N concentration and the proportion of N derived from the atmosphere using the 15 N dilution method were recorded in the harvestable biomass after each cut. Furthermore, the specific growth, N uptake and quantitative biological N fixation of the species were determined. The dataset can be used to establish the N balance, to calculate the optimal economic fertilization rate based on grass-clover composition and to predict N leaching and residual effect. The data presented were thoroughly used and discussed in the research article "Contrasting effects of slurry and mineral fertilizer on N2 fixation in grass-clover mixtures".

Sulfur from biogas desulfurization: Fate of S during storage in manure and after application to plants.

Residues from hydrogen sulfide (H2S) removal in biogas filters contain sulfur (S) in various forms (sulfate, sulfide, elemental S) that, if properly stored, is potentially valuable as crop fertilizer. We investigated 1) the turnover of the S compounds from filter materials during storage in untreated and digested cattle manure (CM), and 2) the S fertilizer replacement value (SFRV) of the filter materials applied in pure form or mixed manure with and without storage. The S filter materials from four H2S removal processes (biological and physical-chemical) containing mostly sulfate and/or elemental S were added to untreated CM or digested CM and stored at 10 °C for six months. Afterwards, a pot experiment was established to assess the S availability in an oil-seed rape (Brassica napus) crop. Microbial reduction of sulfate into sulfide took place rapidly after 69 days storage of untreated CM. A lower reduction rate was observed in digested CM mixtures. After six months, 68% and 32% of the initial sulfate content were still present in mixtures containing the S filter materials from biological desulfurization with digested CM and untreated CM, respectively. Sulfate reduction was inhibited for 120 days when digested CM was mixed with S saturated solution from an ash filter, probably due to high pH (≥8.2) and redox potential (>-100 mV) levels. Oppositely, elemental S was immediately and simultaneously both reduced and oxidized. Relatively low losses of total S were observed during the present storage conditions. Despite S turnover, the SFRV of CM and digested CM significantly increased from 15-19% (of total S applied) to 56-90% when S filter materials were added. The storage of S filter materials in digested manure reduced the risk of sulfide production and potential S volatilization. The S filter materials were a valuable source of plant-available S.

Linking Protein Quality in Biorefinery Output to Forage Crop Crude Protein Input via the Cornell Net Carbohydrate and Protein System.

The biorefinery technology aiming at protein extraction is rising and identification of suitable plant biomass input with valuable protein compounds for extraction is needed. Forage crops have been evaluated by the Cornell Net Carbohydrate and Protein System (CNCPS), and the result used as proxy of extractable protein in a biorefinery process. This serves as a helpful link between crop production and refinery output; however, the method has never been validated. Such validation is the main aim of this study. Five forage species-white clover, red clover, lucerne, perennial ryegrass, and tall fescue-were cut at four dates during spring and processed in a lab-scale refinery (screw press and subsequent protein precipitation from the green juice). The pulp fraction and the precipitated protein concentrate were both CNCPS analyzed to follow the initial crude protein (CP) plant input into these two fractions. Total recovery in concentrate was highest for the legumes, which points to an advantage of these species in protein extraction setups. High recovery of B1 and B2 (50% or higher for the grasses) in the pulp demonstrated a large proportion of soluble protein ending up in the fibrous pulp and shed light on the reason behind high feed quality of the pulp fraction. In conclusion, the existing tentative assumption of extractable protein being equal to CNCPS fractions of B1 and B2 and partly B3 was shown to be too simplified. The presented findings can improve crop species screening in terms of expected extractable protein yield.

Land-use and agriculture in Denmark around year 1900 and the quest for EU Water Framework Directive reference conditions in coastal waters.

The EU Water Framework Directive (WFD) aims to protect the ecological status of coastal waters. To establish acceptable boundaries between good and moderate ecological status, the WFD calls for reference conditions practically undisturbed by human impact. For Denmark, the nitrogen (N) concentrations present around year 1900 have been suggested to represent reference conditions. As the N load of coastal waters relates closely to runoff from land, any reduction in load links to agricultural activity. We challenge the current use of historical N balances to establish WFD reference conditions and initiate an alternative approach based on parish-level land-use statistics collected 1896/1900 and N concentrations in root zone percolates from experiments with year 1900-relevant management. This approach may be more widely applicable for landscapes with detailed historic information on agricultural activity. Using this approach, we find an average N concentration in root zone percolates that is close to that of current agriculture. Thus, considering Danish coastal waters to be practically unaffected by human activity around year 1900 remains futile as 75% of the land area was subject to agricultural activity with a substantial potential for N loss to the environment. It appears unlikely that the ecological state of coastal waters around year 1900 may serve as WFD reference condition.

Emissions of sulfur-containing odorants, ammonia, and methane from pig slurry: effects of dietary methionine and benzoic acid.

Supplementation of benzoic acid to pig diets reduces the pH of urine and may thereby affect emissions of ammonia and other gases from slurry, including sulfur-containing compounds that are expected to play a role in odor emission. Over a period of 112 d, we investigated hydrogen sulfide (H(2)S), methanethiol (MT), dimethyl sulfide (DMS), dimethyl disulfide (DMDS), and dimethyl trisulfide (DMTS), as well as ammonia and methane emissions from stored pig slurry. The slurry was derived from a feeding experiment with four pig diets in a factorial design with 2% (w/w) benzoic acid and 1% (w/w) methionine supplementation as treatments. Benzoic acid reduced slurry pH by 1 to 1.5 units and ammonia emissions by 60 to 70% for up to 2 mo of storage, and a considerable, but transitory reduction of methane emissions was also observed after 4 to 5 wk. All five volatile sulfur (S) compounds were identified in gas emitted from the slurry of the control treatment, which came from pigs fed according to Danish recommendations for amino acids and minerals. The emission patterns of volatile S compounds suggested an intense cycling between pools of organic S in the slurries, with urinary sulfate as the main source. Diet supplementation with methionine significantly increased all S emissions. Diet supplementation with benzoic acid reduced emissions of H(2)S and DMTS compared with the control slurry and moderately increased the concentrations of MT. Sulfur gas emissions were influenced by a strong interaction between methionine and benzoic acid treatments, which caused a significant increase in emissions of especially MT, but also of DMDS. In conclusion, addition of 2% benzoic acid to pig diets effectively reduced ammonia volatilization, but interactions with dietary S may increase odor problems.

The fate of sulfate in acidified pig slurry during storage and following application to cropped soil.

Acidification of slurry with sulfuric acid is a recent agricultural practice that may serve a double purpose: reducing ammonia emission and ensuring crop sulfur sufficiency. We investigated S transformations in untreated and acidified pig slurry stored for up to 11 mo at 2, 10, or 20 degrees C. Furthermore, the fertilizer efficiency of sulfuric acid in acidified slurry was investigated in a pot experiment with spring barley. The sulfate content from acidification with sulfuric acid was relatively stable and even after 11 mo of storage the majority was in the plant-available sulfate form. Microbial sulfate reduction during storage of acidified pig slurry was limited, presumably due to initial pH effects and a limitation in the availability of easily degradable organic matter. Sulfide accumulation was observed during storage but the sulfide levels in acidified slurry did not exceed those of the untreated slurry for several months after addition. The S fertilizer value of the acidified slurry was considerable as a result of the stable sulfate pool during storage. The high content of inorganic S in the acidified slurry may potentially lead to development of odorous volatile sulfur-containing compounds and investigations are needed into the relationship between odor development and the C and S composition of the slurry.

Species Diversity Effects on Productivity, Persistence and Quality of Multispecies Swards in a Four-Year Experiment.

Plant species diversity may benefit natural grassland productivity, but its effect in managed grassland systems is not well understood. A four-year multispecies grassland experiment was conducted to investigate the effect of species diversity-legumes and non-leguminous forbs-on productivity, persistence and sward quality under cutting or grazing regimes and with or without slurry application. Three mixtures were established- 3-mix: grass, red and white clover, 10-mix: 3-mix plus birdsfoot trefoil and six non-leguminous forbs, and 12-mix: 10-mix plus lucerne and festulolium. Species diversity increased sward production and yield persistence under cutting regime. The 12-mix had the highest yield from the second year onwards and no statistically significant yield reduction over four years, while annual yields in the 3-mix and 10-mix decreased significantly with increasing grassland age. The higher yield in the 12-mix was mainly due to the inclusion of high-yielding lucerne. The 10-mix and 12-mix had lower proportions of unsown species than the 3-mix, the difference being dependent on grassland age. Generally, the 3-mix had higher concentrations of in-vitro organic matter digestibility (IVOMD), neutral detergent fiber (NDF) and crude protein (CP), and a lower concentration of ash than the 10-mix and 12-mix. Slurry application increased annual yield production by 10% and changed the botanical composition, increasing the proportion of grass and decreasing the proportion of legumes. Compared to cutting, grazing increased forage production by 9% per cut on average and lowered legume and forb proportions in the mixtures, but yields did not differ among the three mixtures. Overall, our results suggest that species diversity increases sward productivity and persistence only under an ungrazed cutting regime. We conclude that increasing species diversity by selecting appropriate species with compatible management is key to achieving both high yields and high persistence in managed grasslands.

Forbs enhance productivity of unfertilised grass-clover leys and support low-carbon bioenergy.

Intensively managed grasslands are dominated by highly productive grass-clover mixtures. Increasing crop diversity by inclusion of competitive forbs may enhance biomass production and sustainable biofuel production. Here we examined if one or all of three forbs (chicory, Cichorium intybus L.; caraway, Carum carvi L.; plantain, Plantago lanceolata L.) included in ryegrass-red clover mixtures enhanced above- and below-ground productivity, and assessed their biofuel potentials, based on a three-year experiment with and without fertilisation as cattle slurry. We determined herbage yield, standing root biomass, and estimated methane energy output and greenhouse gas (GHG) emissions per energy unit using life cycle assessment. Results showed that plantain-containing grass-clover mixtures significantly increased herbage yield, while chicory- or caraway-containing mixtures maintained similar yields to the grass-clover mixture. Standing root biomass of the grass-clover mixture was enhanced by inclusion of caraway and plantain, with that of plantain further enhanced by fertilisation. The highest methane energy output was achieved in plantain-containing grass-clover mixtures. All unfertilised mixtures achieved the 60% reduction in GHG emissions compared to fossil fuel, whereas all fertilised mixtures did not meet the 60% reduction target. These findings suggest that including competitive forbs such as plantain in grass-clover mixtures enhances productivity, supporting low-carbon footprint bioenergy production.

Biogas potential from forbs and grass-clover mixture with the application of near infrared spectroscopy.

This study investigated the potentials of forbs; caraway, chicory, red clover and ribwort plantain as substrates for biogas production. One-, two- and four-cut systems were implemented and the influence on dry matter yields, chemical compositions and methane yields were examined. The two- and four-cut systems resulted in higher dry matter yields (kg [total solid, TS] ha(-1)) compared to the one-cut system. The effect of plant compositions on biogas potentials was not evident. Cumulative methane yields (LCH4kg(-1) [volatile solid, VS]) were varied from 279 to 321 (chicory), 279 to 323 (caraway), 273 to 296 (ribwort plantain), 263 to 328 (red clover) and 320 to 352 (grass-clover mixture), respectively. Methane yield was modelled by modified Gompertz equation for comparison of methane production rate. Near infrared spectroscopy showed potential as a tool for biogas and chemical composition prediction. The best prediction models were obtained for methane yield at 29 days (99 samples), cellulose, acid detergent fibre, neutral detergent fibre and crude protein, (R(2)>0.9).

Sociodemographic predictors of treatment outcome in chronic non-malignant pain patients. Do patients receiving or applying for disability pension benefit from multidisciplinary pain treatment?

The present study investigated the ability of sociodemographic variables to predict the short-term effect of multidisciplinary pain treatment in 286 chronic non-malignant pain patients consecutively referred to a Danish multidisciplinary pain centre. At inclusion and 3 and 6 months later the patients' pain and health related quality of life (HRQL) was assessed using self-administered questionnaires. Sociodemographic variables measured were: age, gender, educational level, civil status, employment status and disability pension (DP) status. Intensity of pain was measured using a VAS scale. HRQL was evaluated using the Medical Outcome Study-Short Form (SF-36) and the Psychological General Well-Being Scale (PGWB). Drop out was 30% after 6 months, leaving 170 patients for the study of treatment effects. Among the sociodemographic variables evaluated only retirement pension (RP) and DP-status seemed to be significant outcome predictors: six months after inclusion, patients on RP (patients >68 years, n = 40) reported larger pain reduction (30 mm on the VAS scale) than patients < or =68 years (8 mm on the VAS scale)(P = 0.001). Patients applying for DP-pension (n = 26) did not improve. Patients on DP (n = 54) and patients not receiving DP (n = 50) obtained moderate improvements, but the improvements were significantly larger than the improvements observed in the ApplyDP-group (P = 0.05). The same pattern was seen for changes in psychological well-being (PGWB) and social functioning (SF36-SFA). No improvements were obtained in SF36-Physical functioning scores. DP-status predicted improvement in pain and social functioning even when controlling for the effect of other demographic variables, pain intensity and HRQL at referral. The present study indicates that the multidimensional problems experienced by patients applying for DP are dominated by socioeconomic factors. Focus on solving these socioeconomic problems is important if chronic pain patients are to benefit from multidisciplinary pain treatment.

Utilisation of health care system by chronic pain patients who applied for disability pensions.

The objective of this study was to investigate how economic compensation for disability (disability pensions) to chronic pain patients affected their utilisation of health care services. The study was carried out as a register investigation. Inclusion of 144 study patients was based on records from 1989 and 1990 of the Rehabilitation and Pension Board in the Municipality of Copenhagen. Only patients of Danish origin with chronic non-malignant pain were included. The study period was divided into three: Subperiod 1: The year preceding the submission of the application for a disability pension. Subperiod 2: The period from the submission of the application to the decision was made. Subperiod 3: The year following the final decision of the health authorities. The patients were divided into 4 Subgroups according to whether disability pensions was awarded or rejected, or whether the patients accepted or appealed the decision. Based on number and charges of visits to the GPs the total costs of care in the primary sector were calculated. By means of number of bed days, visits to outpatients clinics, operations, blood samples, and various investigations, the total costs of hospital care were calculated. We found that application for a disability pension in chronic pain patients significantly influenced the health care utilisation. Chronic pain patients had a significantly lower health care utilisation after receiving a disability pension than before the pension was awarded. Chronic pain patients who did not get a disability pension and those who were not satisfied with the level of the pension awarded, maintained their health care utilisation after the decision. The mean health care use by the patients who appealed the level of the pension was three times higher than the mean health care use by the patients who accepted the level of the pension awarded. The study may indicate that lack of or insufficient economic compensation from the social system in chronic pain patients contribute to an inexpedient pain behaviour resulting in increased expenses for the health care sector.