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The Finnmark Intervention Study: is it possible to change CVD risk factors by community-based intervention in an Arctic village in crisis?

AIMS: Owing to high cardiovascular mortality, the Norwegian Government introduced the programme "Health and Inequalities in Finnmark" in 1988. One of the projects in this programme was aimed at changing cardiovascular risk factors through community-based intervention in a fishing community in the Norwegian Arctic. METHODS: The intervention community Båtsfjord and the three control communities were selected from the same coastal area. The intervention was based on a quasi-experimental design, and evaluated by population surveys before (1987) and after (1993) the invention. The attending cohort was analysed. The intervention method was based on empowerment and cooperation between different organizations, and the primary healthcare system. RESULTS: From 1987 - 93, the male cohort in Båtsfjord had a more favourable development when compared with changes in the control communities regarding the 8.6% increase in physical activity (p = 0.047), the reduction in systolic blood pressure by 0.01 mmHg (p = 0.002), and the reduction in diastolic blood pressure by 2.1 mmHg (p < 0.001). The female cohort in Båtsfjord had a more favourable development when compared with changes in the control communities regarding the 11.2% increase in use of low-fat milk (p = 0.046), the increase in systolic blood pressure by 2.1 mmHg (p = 0.024), and the reduction in diastolic blood pressure by 2.1 mmHg (p < 0.001). CONCLUSION: Despite a difficult economic situation for the Arctic coastal communities, the study found it possible for voluntary organizations, local public administration, and local health personnel to promote change in lifestyle and blood pressure using a community intervention approach.

Adult↗

Noninvasive, quantitative respirator fit testing through dynamic pressure measurement.

A new method has been invented for the noninvasive and quantitative determination of fit for a respirator. The test takes a few seconds and requires less expensive instrumentation than presently used for invasive testing. In this test, the breath is held at a negative pressure for a few seconds, and the leak-induced pressure decay inside the respirator cavity is monitored. A dynamic pressure sensor is attached to a modified cartridge of an air-purifying respirator or built into the respirator body or into the air supply line of an air-supplied respirator. The method is noninvasive in that the modified cartridge can be mounted onto any air-purifying respirator. The pressure decay during testing quantifies the airflow entered through the leak site. An equation has been determined which gives the air leakage as a function of pressure decay slope, respirator volume and the pressure differential during actual wear--all of which are determined by the dynamic pressure sensor. Thus, the ratio of air inhaled through the filters or via the air supply line to the leak rate is a measure of respirator fit, independent of aerosol deposition in the lung and aerosol distribution in the respirator cavity as found for quantitative fit testing with aerosols. The new method is shown to be independent of leak and sensor locations. The concentration and distribution of aerosols entered through the leak site is dependent only on the physical dimensions of the leak site and the air velocity in it, which can be determined independently.(ABSTRACT TRUNCATED AT 250 WORDS)

Humans↗

Quantitative respirator fit testing: dynamic pressure versus aerosol measurement.

A noninvasive, fast, inexpensive new fit testing method has been invented which relates the slope of the pressure decay inside a respirator during breath-holding to the fit of the respirator on the wearer's face. The dynamic pressure test has been compared with the conventional aerosol test at different leakage levels. The results of this comparison show that the sensitivity of the dynamic pressure test is similar to that of the aerosol test. The pressure test, however, is independent of leak site and probe location and can be performed on respirators before and after their use.

Aerosols↗

Electromagnetic hypersensitivity: biological effects of dirty electricity with emphasis on diabetes and multiple sclerosis.

Dirty electricity is a ubiquitous pollutant. It flows along wires and radiates from them and involves both extremely low frequency electromagnetic fields and radio frequency radiation. Until recently, dirty electricity has been largely ignored by the scientific community. Recent inventions of metering and filter equipment provide scientists with the tools to measure and reduce dirty electricity on electrical wires. Several case studies and anecdotal reports are presented. Graham/Stetzer (GS) filters have been installed in schools with sick building syndrome and both staff and students reported improved health and more energy. The number of students needing inhalers for asthma was reduced in one school and student behavior associated with ADD/ADHD improved in another school. Blood sugar levels for some diabetics respond to the amount of dirty electricity in their environment. Type 1 diabetics require less insulin and Type 2 diabetics have lower blood sugar levels in an electromagnetically clean environment. Individuals diagnosed with multiple sclerosis have better balance and fewer tremors. Those requiring a cane walked unassisted within a few days to weeks after GS filters were installed in their home. Several disorders, including asthma, ADD/ADHD, diabetes, multiple sclerosis, chronic fatigue, fibromyalgia, are increasing at an alarming rate, as is electromagnetic pollution in the form of dirty electricity, ground current, and radio frequency radiation from wireless devices. The connection between electromagnetic pollution and these disorders needs to be investigated and the percentage of people sensitive to this form of energy needs to be determined.

Adult↗

Inspiratory muscle training compared with other rehabilitation interventions in adults with chronic obstructive pulmonary disease: a systematic literature review and meta-analysis.

The purpose of this systematic review was to determine the effect of inspiratory muscle training (IMT) (alone or combined with exercise and/or pulmonary rehabilitation) compared to other rehabilitation interventions such as: exercise, education, other breathing techniques or exercise and/or pulmonary rehabilitation among adults with chronic obstructive pulmonary disease (COPD). A systematic review of the literature on IMT and COPD was conducted according to the Cochrane Collaboration protocol. Inclusion criteria for the review included randomized controlled trials, published in English, comparing IMT or combined IMT and exercise/pulmonary rehabilitation with other rehabilitation interventions such as general exercise, education, other breathing techniques or exercise/pulmonary rehabilitation among adults with COPD. 274 articles were retrieved, and 16 met the inclusion criteria. Seven meta-analyses were performed that compared targeted or threshold IMT to exercise (n = 3) or to education (n = 4). Results showed significant improvements in inspiratory muscle strength and endurance, and in the dyspnea scale on a quality of life measure, for participants in the IMT versus education group. In other instances where meta-analyses could not be performed, a qualitative review was performed. IMT results in improved inspiratory muscle strength and endurance compared to education. Further trials are required to investigate the effect of IMT (or combined IMT) compared to other rehabilitation inventions for outcomes such as dyspnea, exercise tolerance, and quality of life.

Adult↗

A woman down to her bones. The anatomy of sexual difference in the sixteenth and early seventeenth centuries.

Based on a wide range of Latin and vernacular sources, this essay reexamines Thomas Laqueur's and Londa Schiebinger's influential claim that the idea of incommensurable anatomical difference between the sexes was "invented" in the eighteenth century, reflecting, in particular, a need to resort to nature in order to justify female subordination against new ideals of equality and universal rights. It provides ample evidence that already around 1600 many leading physicians, rather than proclaiming a "one-sex model" of female inferiority, insisted on the unique and purposeful features of the female skeleton and the female genital organs and illustrated them visually. The author shares Laqueur's and Schiebinger's assumption that the shift toward incommensurable anatomical difference helped legitimize woman's subordinate position as housewife and mother as naturally given. But around 1600 Enlightenment ideals as yet played no role. Instead, this shift reflected, in particular, contemporary physicians' growing appreciation of personal discovery and innovation, the rise of a specialist gynecology, and new views on marriage and motherhood in the upper classes among whom the physicians lived and whose support they sought.

Anatomy↗

Deception, efficiency, and random groups. Psychology and the gradual origination of the random group design.

In the life sciences, psychology, and large parts of the other social sciences, the ideal experiment is a comparative experiment with randomly composed experimental and control groups. Historians and practitioners of these sciences generally attribute the invention of this "random group design" to the statistician R.A. Fisher, who developed it in the 1930s for agricultural research. This essay argues that the random group design was advanced in psychology before Fisher introduced it in agriculture and that in this context it was the unplanned outcome of a lengthy historical process rather than the instantaneous creation of a single genius. The article analyzes how the random group design came about bit by bit when methodological practices from nineteenth-century psychophysical laboratories were gradually adapted, extended, and codified by twentieth-century educational psychologists to support procedural objectivity in educational administration. In passing, the article also amends the received historiography of the separate elements of randomization and control groups.

Europe↗

"Giving body" to embryos. Modeling, mechanism, and the microtome in late nineteenth-century anatomy.

Reinvestigating the work of the anatomist Wilhelm His (1831-1904) shows how engaging with models in three dimensions can revise our accounts of scientific change. His is known to historians of biology for articulating a mechanical approach to embryology and for inventing a section cutter, or microtome. Focusing on the wax models that he also made in the late 1860s shows how the other two innovations were linked; reconstructing embryos from the sections, His claimed, provided compelling evidence for mechanical views. The next generation of embryologists appropriated His's work selectively. In the 1880s anatomists took up "plastic reconstruction" to visualize the complex forms of higher vertebrate, especially human, embryos. An increasingly dominant experimental embryology, by contrast, drew on His's mechanical approach but had little use for the waxes and effaced them from the history of his work. Recovering these models offers a fresh perspective on the transformation of a central science of animal life and enriches our understanding of the relations between representation in two dimensions and three.

Animals↗

The genetic or mythical ancestry of descent groups: lessons from the Y chromosome.

Traditional societies are often organized into descent groups called "lineages," "clans," and "tribes." Each of these descent groups claims to have a common ancestor, and this ancestry distinguishes the group's members from the rest of the population. To test the hypothesis of common ancestry within these groups, we compared ethnological and genetic data from five Central Asian populations. We show that, although people from the same lineage and clan share generally a recent common ancestor, no such common ancestry is observed at the tribal level. Thus, a tribe might be a conglomerate of clans who subsequently invented a mythical ancestor to strengthen group unity.

Asia, Central↗

A mathematical model for the quantitative study of left to right cardiac shunt.

Non-invasive radioisotope cardiographic techniques have become a useful tool for studying the anatomy and function of the heart. The mathematical model described justifies the phenomenological analysis of pulmonary time-activity histograms and was invented for quantitative study of left to right cardiac shunt. The model also gives a theoretical insight into such an empirically proposed diagnostic method and represents an adequate framework for the understanding of other possible approaches to the problem of left to right shunt.

Blood Circulation↗

Medical phase contrast x-ray imaging: current status and future prospects.

The exploitation of phase contrast appears to offer the tantalising possibility of creating the biggest change in medical x-ray imaging since the invention of computed tomography. A considerable number of experiments performed by researchers across four continents have produced some extraordinary images. These images have demonstrated greatly enhanced contrast over conventional methods revealing soft tissue discrimination at micron scale resolutions. Contrast improvements can be achieved at doses rather less than those required by conventional x-ray imaging. The use of synchrotrons has revealed the possibilities offered by these techniques but unfortunately the application of these ideas in a clinical context requires that technology be pushed to its limits in a number of areas including x-ray sources, optics and detectors. The current state of the art is reviewed.

Angiography↗

Relationship between nitric oxide production and choroidal blood flow.

PURPOSE: To invent a drug which can specifically facilitate choroid blood flow via increase of nitric oxide (NO). METHOD: Cell culture was used for in vitro experiments to determine the production of NO by NO donors and colored microsphere technique was used for in vivo experiments to determine the blood flow in various tissues of rabbit eyes. RESULTS: ZX-5 and ZX-4 are two geographic isomers with ZX-5 as trans-form and ZX-4 as cis-form. (1-phenyl-3-[3-methoxy-2-propoxy-5-[4-(3,4,5-trimethoxy-phenyl)-1,3-d lane-2-yl]phenyl]thiourea). It was found that ZX-5 released significant amount of NO at 3, 10, 30 microg/ml concentrations and increased choroid blood flow at 1%, 50 microl instillation into eyes. It was not effective on the blood flow of iris or ciliary body. The corresponding ZX-4 was not effective on ocular blood flow nor it released NO. CONCLUSION: ZX-5 can specifically increase the choroidal blood flow which could be useful to suppress the choroidal neovascularization in age-related macular degeneration (AMD). It is hoped that ZX-5 type of compounds could be used for the treatment/prevention of AMD in the elderly.

Animals↗

A moment in time: AIDS and business.

Business has transformed the planet. But this gives it new responsibilities. People now expect business leaders to lead--and not just respond when things go wrong. HIV/AIDS is a global problem, with over 16.3 million people now thought to have died of the disease (Global Summary of HIV/AIDS Epidemic, UNAIDS, December 1999). Without action now, the pandemic will worsen, health services will come under relentless pressure and the number of people dying will increase exponentially. So why should business sit up and take notice? First: money. AIDS is slowly strangling many businesses and economies--and in a global market, everyone eventually suffers. Without profit, there is no business--so the business community needs to act to protect its bottom line. Second: people. Over 80% of those dying are in their 20s, 30s, and 40s. Businesses are losing workers and customers, and human networks that have taken decades to build. Third: imagination. Business is inventive, creative and fast-moving. It has the opportunity to use these strengths for the benefit of the wider community. It's time to pit business ideas (and some money, too) against the threat of AIDS. The course of the AIDS epidemic is not inevitable. The world's businesses have the skills and intensity to make a measurable difference, especially if they find public sector and NGO partners with whom they share a vision. A focused, coordinated, results-driven effort will hit AIDS hard. The HIV virus moves fast (and is mutating all the time). Business has the opportunity to make a difference. It must grasp this opportunity. And grasp if fast.

Commerce↗

Variability of insulin absorption and insulin action.

Subcutaneous (s.c.) injections of identical insulin doses may lead to considerable intra- and inter-individual differences in the current metabolic control of patients with diabetes mellitus. This well-known variability of the metabolic effect of insulin hampers practical insulin therapy considerably. The aim of this review is to summarize the knowledge about this topic, with a special focus on the variability of insulin action after pulmonary administration of insulin. A number of studies have been published describing the variability of insulin absorption from the s.c. depot. Only in a few published studies has the variability of insulin action after s.c. administration been quantified. Under controlled experimental conditions s.c. injections of regular insulins result in an intra-individual coefficient of variation (CV) of 15-25% of certain pharmacodynamic summary measures--which characterize the metabolic effect of the applied insulin--in healthy subjects. The inter-individual variability was approximately 10% higher than the intra-individual variability. Subcutaneously injected intermediate- and long-acting insulin preparations were described to have an even greater variability (> 50%) than subcutaneously injected regular insulin. However, in a glucose clamp study s.c. application of NPH insulin led to an intra-individual CV in the range of 12-45% in healthy subjects. The reason for this discrepancy might be that the NPH insulin suspension was sufficiently shaken prior to drawing up the dose. Compared with conventional insulin formulations, rapid- and long-acting insulin analogues appear to have a similar variability, which means that, unfortunately, no considerable advantages in terms of variability were achieved by the invention of these novel insulin preparations. There are no appropriate studies available investigating the variability of the metabolic effect after s.c. insulin administration in patients with diabetes. The inhalation of insulin is a novel form of insulin administration that is currently under clinical development. The variability of the metabolic effect induced by the inhalation of insulin has up to now only been investigated in a small number of (published) studies. In a glucose-clamp study with healthy subjects the inhalation of an identical insulin dose on three study days led to an intra-individual variability that was comparable to that after s.c. injection of regular insulin. In a dose-response study with patients with type 1 diabetes the intra-individual CV was 34% for the area under the curve of the glucose infusion rate for 0-10 h. Studies with patients with type 2 diabetes have shown that the intra-individual CVs were within the range seen after s.c. insulin administration or even lower. In summary, the intra-individual variability of the metabolic effect observed after insulin application, be it subcutaneously injected or be it inhaled, is considerable and, therefore, hampers practical diabetes therapy. To date no means have been found that could lead to a clinically relevant reduction in the variable metabolic effect.

Administration, Inhalation↗

Pronuclear microinjection.

Last year marked the 20th anniversary of the invention of the term "transgenic" and the development of pronuclear microinjection, a straightforward technique designed to transfer genetic information from nearly any living organism to mammals. After two decades of use, pronuclear microinjection protocols have changed little from the reliable, if not efficient, method described by Gordon and Ruddle. Experience has taught us that once microinjection skills are perfected there are only a few parameters one needs to be concerned about to successfully produce transgenic animals. Those parameters will be discussed, as will some new innovations that promise to finally increase efficiency of pronuclear microinjection methodology.

Animals↗

MSC, a new benzoquinone-containing natural product with antimetastatic effect.

An orally applicable fermentation product of wheat germ containing 0.04% substituted benzoquinone (MSC) has been invented by Hungarian chemists under the trade name of AVEMAR. Oral administration (3 g/kg body weight) of MSC enhances blastic transformation of splenic lymphocytes in mice. The same treatment shortens the survival time of skin grafts in a co-isogenic mouse skin transplantation model, pointing to the immune-reconstructive effect of MSC. A highly significant antimetastatic effect of MSC has been observed in three metastasis models (3LL-HH, B16, HCR-25). The antimetastatic effect of MSC--besides the immune-reconstitution--may also be due to its cell adhesion inhibitory, cell proliferation inhibitory, apoptosis enhancing, and antioxidant characteristics, also observed in our in vitro experiments. It is even more noteworthy that combined treatment with MSC and one of the following antineoplastic agents (5-FU and DTIC)--both in wide use in every day clinical practice--exhibited a significantly enhanced antimetastatic effect in appropriate metastasis models (established from C38 mouse colon carcinoma and B16 mouse melanoma respectively) as compared to the effect elicited by any component of these therapeutic compositions (MSC + 5-FU and MSC + DTIC) administered alone. The results show that the fermented wheat germ extract (MSC) has more than an additive effect and synergistically enhanced the metastasis inhibitory effect of both antineoplastic agents studied till now. It is also worthy of mention that the synchronous treatment with MSC profoundly decreased the toxic side effects of the applied antineoplastic agents (decreased weight loss etc). Based on the biological effects of MSC--shown to be non-toxic by subacute toxicology studies--this product may be used as an adjuvant in the therapy of malignant neoplasia and other diseases caused by or following immune-deficiency.

Animals↗

Benedict Cassen: the father of body organ imaging.

The invention of the radioisotope scanner by Benedict Cassen was seminal to the development of body organ imaging. Cassen assembled the first automated scanning system in 1950. It was a motor-driven scintillation detector coupled to a printer. The scanner was used to image the thyroid gland after the administration of radioiodine. Later, with the development of organ-specific radiopharmaceuticals the scanner was widely used during the late 50s until the early 70s to image the body organs.

Adenoma↗