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Putting people into the picture.
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Dianne Dillon-Ridgley: putting it all together newsmaker interview.
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A Better Life for Future Generations: Amsterdam Declaration, November 1989.
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An integration programme of poverty alleviation and development with family planning.
The State Council (the central government) recently issued a Circular for Speeding Up the Integration of Poverty Alleviation and Development with the Family Planning Programme during the Ninth Five-year Plan (1996-2000). The Circular was jointly submitted by the State Family Planning Commission and the Leading Group for Poverty Alleviation and Development. The document sets the two major tasks as solving the basic needs for food and clothing of the rural destitute and the control of over-rapid growth of China's population. Practice indicates that a close Integration Programme is the best way for impoverished farmers to alleviate poverty and become better-off. Overpopulation and low educational attainments and poor health quality of population in backward areas are the major factors retarding socioeconomic development. Therefore, it is inevitable to integrate poverty alleviation with family planning. It is a path with Chinese characteristics for a balanced population and sustainable socioeconomic development. The targets of the Integration Programme are as follows: The first is that preferential policies should be worked out to guarantee family planning acceptors, especially households with an only daughter or two daughters, are the first to be helped to eradicate poverty and become well-off. They should become good examples for other rural poor in practicing fewer but healthier births, and generating family income. The second target is that the population plans for the poor counties identified by the central government and provincial governments must be fulfilled. This should contribute to breaking the vicious circle of poverty leading to more children, in turn generating more poverty. The circular demands that more efforts should focus on the training of cadres for the Integrated Programme and on services for poor family planning acceptors.
Sustainable partnerships for integrated care: the role of decision making and its environment.
This paper is intended to further the understanding of the role of the characteristics of decision making and its environment in the development of sustainable partnerships in health care, and to illustrate how this subject can be studied from a combined theoretical and methodological perspective. With the aid of a conceptual model covering sensitizing concepts from contingency theory (that refer to environmental characteristics--particularly institutions--the process course of decision making and its outcomes) and the case study methodology (explanation-building, triangulation, document study and interviews), two Dutch cases were analysed. The findings indicate which environmental characteristics are responsible for the differences in the process course and outcomes between the cases.
Sinusoidal stimulation of myocardial tissue: effects on single cells.
INTRODUCTION: Cardiac tissue subjected to sinusoidal stimulus is characterized by action potentials (APs) that have extended plateau phases, sustained for the duration of the stimulus. Extended action potential durations (APDs) are beneficial because they disrupt wandering wavelets in the fibrillating heart. To investigate the mechanisms by which periodic stimulus affects cardiac tissue, particularly the development of sustained depolarization, computer simulations of single cardiac cells exposed to alternating current (AC) are performed. METHODS AND RESULTS: Two modes of stimulation of the cell are examined: external field stimulation and transmembrane current injection. Several membrane models, including Luo-Rudy I and II, are used in the simulations. External AC field stimuli increase the APD of the single cell. The extended plateau of the cellular AP is characterized by periodic oscillations that are 1:2 phase locked with the applied stimulus. This specific behavior is due to the variations in stimulus magnitude and polarity along the cell border, which elicit opposite electrical responses from the cell sides. These pointwise responses are averaged in the macroscopic cellular response and result in sustained oscillatory depolarization that lasts for the duration of the stimulus. In contrast, the cell undergoing current injection does not develop an extended APD. CONCLUSION: The simulations demonstrate that variation of membrane potential within a cell is of paramount importance to the formation of an extended AP plateau in response to AC stimulation.
Angiographic and electrophysiologic substrates of ventricular tachycardia in chronic Chagasic myocarditis.
Forty-three consecutive symptomatic patients with chronic Chagasic myocarditis and ventricular tachycardia (VT) underwent clinical evaluation, 24-hour Holter monitoring, left ventricular angiography and electrophysiologic testing including programmed ventricular stimulation at 3 drive cycle lengths at 2 sites in the right ventricle. The mean ejection fraction was 42 +/- 10%. Sixteen patients had clinical sustained VT and 27 nonsustained VT. VT was reproducibly initiated in 13 of 16 (81%) patients with sustained VT and in 14 of 27 (52%) patients with nonsustained VT. Electrocardiographic conduction disturbances were seen in 15 of 16 (94%) patients with sustained VT and in 17 of 27 (63%) patients with nonsustained VT (p less than 0.05). Five of 16 (31%) sustained VT and none of nonsustained VT patients had left ventricular aneurysms (p less than 0.05). These data indicate that VT is frequently inducible in patients with sustained VT and nonsustained VT and chronic Chagasic myocarditis. An association appears to be present between conduction disturbances on the electrocardiogram, left ventricular aneurysms and development of sustained ventricular arrhythmias.
Concentration- and time-dependence of phosphoinositide hydrolysis induced by endothelin-1 in relation to the positive inotropic effect in the rabbit ventricular myocardium.
The effects of endothelin-1 on phosphoinositide hydrolysis in relation to the positive inotropic effect of the compound were studied in the rabbit ventricular myocardium. Endothelin-1 elicited a concentration- and time-dependent accumulation of [3H]inositol monophosphate (IP1) in ventricular muscle slices prelabeled with myo-[3H]inositol in concentrations similar to those that caused a positive inotropic effect. The EC50 value of endothelin-1, both for the induction of [3H]IP1 accumulation and for the positive inotropic effect was 6 x 10(-9) M. The endothelin-induced positive inotropic effect was linearly related to [3H]IP1 accumulation. Endothelin-1 induced a small transient negative inotropic effect before the onset of a gradually developing and sustained positive inotropic effect which reached a steady level at 30 min. After administration of endothelin-1, [3H]IP3 accumulated rapidly and transiently before the development of the positive inotropic effect. [3H]IP2 accumulated slowly and peaked at 20 min. [3H]IP1 accumulation occurred more slowly and of the inositol phosphates its time course coincided best with that of the positive inotropic effect. Phorbol 12,13-dibutyrate inhibited both the [3H] IP1 accumulation and positive inotropic effect induced by endothelin-1. The present results indicate that an acceleration of phosphoinositide hydrolysis induced by activation of endothelin-1 receptors may be responsible for induction of the positive inotropic effect of endothelin-1 on rabbit ventricular myocardium.
Immunosuppression in mice after inoculation with 334C, a murine lymphatic leukemia-inducing virus.
334C murine leukemia virus, which induces a high incidence of lymphatic leukemias (80-90%) in susceptible mice following a long latency period, was found to cause a severe in vivo suppression of direct plaque-forming cells from the spleen, following antigenic stimulation with sheep red blood cells. Neonatally infected inbred BALB/c and outbred Ha/ICR Swiss mice, which develop a sustained viremia, were highly susceptible to the immunosuppressive effect of this virus as early as 1 week after virus infection, long before any detectable histologic evidence of leukemia development. Ha/ICR Swiss mice, which are highly resistant to the leukemogenic potential of this virus following infection in adult life, were highly resistant to its immunosuppressive action; only a moderate and transient suppression, without viremia, occurred 2 weeks after virus infection. In marked contrast, BALB/c mice were highly susceptible to the immunosuppressive action of 334C murine leukemia virus following infection in adult life; a severe and sustained suppression was observed as early as 1 week after virus infection and was followed by a sustained viremia, beginning at 2 weeks, with a 55-60% incidence of leukemia observed over a period of 1 year. Infectious virus was essential to produce theimmunosuppressive effect; heat-inactivated (56 degrees C/30 min) and attenuated (4 degrees C/4 1/2 mo) virus preparations were ineffective. The plaque-forming response of spleen cells from lethally irradiated syngeneic adult BALB/c mice was markedly suppressed following reconstitution with thymus-dependent (T) or thymus-independent (B) cells from the thymus and bone marrow, respectively, of virus-infected mice, in combination with each other, or with the appropriate cell populations from normal mice.
A preliminary study on potential of developing shower/laundry wastewater reclamation and reuse system.
With the ever-increasing urban population and economic activities, water usage and demand are continuously increasing. Hence, finding/re-creating adequate water supply and fully utilizing wastewater become important issues in sustainable urban development and environmental benign aspect. Considering Hong Kong's situation, e.g., lack of natural fresh water, domination of municipal wastewater, etc., developing wastewater reclamation and reuse system is of specific significance to exploit new water resource and save natural fresh water supplied from Mainland China. We propose and have carried out some preliminary studies on the potential of categorizing municipal wastewater, developing grey and storm water recycling system in public housing estate, investigating the feasibility and potential of using reclaimed grey water, etc. Since there is very limited experience in grey water recycling, such initial studies can help to understand and increase knowledge in utilizing grey water, to foresee the feasibility of developing new water resource, to estimate the cost-effectiveness of reclaiming grey water in metropolitan city.
Gap junctional remodeling in relation to stabilization of atrial fibrillation in the goat.
OBJECTIVE: It has been postulated that high atrial rate induced changes at the level of the gap junctions ('gap junctional remodeling', i.e. changes in distribution, intercellular orientation and expression of gap junction proteins), could be part of the vicious circle of electrophysiologic and structural changes leading to sustained atrial fibrillation (AF). To obtain experimental evidence in favour of such a postulate the timing of this remodeling process was studied in relation to the development of sustained AF in a goat model. METHODS AND RESULTS: Thin sections from the left (LAA) and right atrial appendage (RAA) from goats in sinus rhythm (SR) or AF, induced through programmed endocardial burst pacing for time periods between 0 and 16 weeks, were immunolabeled with antibodies against connexin(Cx)40 and Cx43 and analysed by immunofluorescence and confocal laser scanning microscopy. During SR the distribution pattern for Cx43 was completely homogeneous (LAA and RAA) and for Cx40 mostly homogeneous (LAA: all five goats, RAA: three out of five goats). The distribution pattern for Cx43 remained stable during AF, while the Cx40 distribution pattern became increasingly heterogeneous, both in the LAA and RAA, with increasing duration of pacing. This increase in heterogeneity in Cx40 distribution correlated (Spearman rank order) with an increase in stability of AF and the occurrence of structural changes (myolysis) in atrial myocytes. The Cx40/Cx43 immunofluorescence signal ratio in both the LAA and RAA appeared to be significantly lower in AF (1-16 weeks) as compared to SR (0 weeks); going from 0 to 16 weeks average ratios decreased 54.5% (n=5; P=0.026) in the LAA and 35.8 (n=5; P=0.034) in the RAA. Western blot analyses revealed similar decreases in the total Cx40/Cx43 protein ratio, on average 50.0% (n=5; P=0.008) and 47.8% (n=5; P=0.02) in the LAA and RAA, respectively. No changes were measured in the levels of Cx40 or Cx43 mRNA, as was assessed through RT-PCR. CONCLUSION: The time course of changes in the distribution and content of Cx40 gap junctions as observed during endocardial burst pacing of the goat atrium suggests that Cx40 gap junctional remodeling might be involved in the pathogenesis of sustained atrial fibrillation.
Differential regulation of intracellular Ca2+ signalling induced by high K+ and endothelin-1 in single smooth muscle cells of intact canine basilar artery: detection by means of confocal laser microscopy.
Changes in intracellular calcium concentration ([Ca2+]i) in smooth muscle cells play the key role in regulation of vascular smooth muscle tone and pathogenesis of cerebral vasospasm. In this study, we adopted the confocal laser microscopy to detect the fluorescence signals arising from the individual smooth muscle cells of canine basilar artery. Ring preparations were made, loaded with fluo-3 and changes in fluorescence induced by high K+ and endothelin-1 (ET-1) were measured by confocal laser microscopy. In some unstimulated smooth muscle cells Ca2+ waves arising from discrete region of the cell propagated to the whole cell with a velocity of approximately 10 microm/s. High K+ (80 mmol/L) induced a rapid rise in [Ca2+]i, the peak level being consistently reached approximately 10 s after stimulation. In contrast, the time to peak level of [Ca2+]i induced by ET-1 (0.3 micromol/L) varied widely between 13 and 26 s among individual cells, an indication that the extent of nonuniform coordination of increases in [Ca2+]i in individual cells may be partly responsible for the different time courses of tension development of vascular smooth muscle in response to the vasoactive stimulants. The increase in [Ca2+]i induced by ET-1 was transient but a pronounced and sustained contraction developed further in response to ET-1. Thus ET-1 has a biological property as a potential candidate to elicit cerebral vasospasm. Confocal laser microscopy could be a useful tool to measure the changes in [Ca2+]i in individual smooth muscle cells of cerebral artery.
Empowering women. The solution to a global crisis.
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Measuring family planning sustainability at the outcome and programme levels.
The paper examines the validity of two indices of sustainability: family planning programme sustainability (PSI) and outcome sustainability (OSI) developed by Tsui and Knight (1997) by applying their original method to recent data. The indices succeed in identifying the directional path of programme and outcome sustainability. Close correlations are found between PSI and OSI predicted values and actual programme and outcome values. The indices provide a repeatable method for measuring sustainability, although they are sensitive to data measurement errors. The indices provide a policy tool for funding decisions but should be used with other data sources to judge sustainability.
Social marketing: its place in public health.
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Regulation of bcl-2 family proteins during development and in response to oxidative stress in cardiac myocytes: association with changes in mitochondrial membrane potential.
Cardiac myocyte apoptosis is potentially important in many cardiac disorders. In other cells, Bcl-2 family proteins and mitochondrial dysfunction are probably key regulators of the apoptotic response. In the present study, we characterized the regulation of antiapoptotic (Bcl-2, Bcl-xL) and proapoptotic (Bad, Bax) Bcl-2 family proteins in the rat heart during development and in oxidative stress-induced apoptosis. Bcl-2 and Bcl-xL were expressed at high levels in the neonate, and their expression was sustained during development. In contrast, although Bad and Bax were present at high levels in neonatal hearts, they were barely detectable in adult hearts. We confirmed that H(2)O(2) induced cardiac myocyte cell death, stimulating poly(ADP-ribose) polymerase proteolysis (from 2 hours), caspase-3 proteolysis (from 2 hours), and DNA fragmentation (from 8 hours). In unstimulated neonatal cardiac myocytes, Bcl-2 and Bcl-xL were associated with the mitochondria, but Bad and Bax were predominantly present in a crude cytosolic fraction. Exposure of myocytes to H(2)O(2) stimulated rapid translocation of Bad (<5 minutes) to the mitochondria. This was followed by the subsequent degradation of Bad and Bcl-2 (from approximately 30 minutes). The levels of the mitochondrial membrane marker cytochrome oxidase remained unchanged. H(2)O(2) also induced translocation of cytochrome c from the mitochondria to the cytosol within 15 to 30 minutes, which was indicative of mitochondrial dysfunction. Myocytes exposed to H(2)O(2) showed an early loss of mitochondrial membrane potential (assessed by fluorescence-activated cell sorter analysis) from 15 to 30 minutes, which was partially restored by approximately 1 hour. However, a subsequent irreversible loss of mitochondrial membrane potential occurred that correlated with cell death. These data suggest that the regulation of Bcl-2 and mitochondrial function are important factors in oxidative stress-induced cardiac myocyte apoptosis.
Farmers knew prosperity lies in family planning: Prof. Gao Yuanxiang.
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