National food environment policies can contribute to the reduction of diet-related non-communicable diseases. Yet, their implementation in the Netherlands remains low. It has been hypothesized that ...the media can play a pivotal role in inducing spikes in policy attention, thereby shaping political action. The aim of this study was to examine the discourse on food policies in Dutch newspaper articles between 2000-2022, by analyzing arguments used by various actors. A systematic search in Nexis Uni was used to identify newspaper articles that covered national-level Dutch food environment policies published in seven Dutch national newspapers between 2000-2022. Covered policies were classified into six domains including food composition, labeling, promotion, prices, provision and retail and into the four stages of the policy cycle; policy formulation, decision-making, implementation, and evaluation. A grey literature search was used to identify food policies implemented during 2000-2022. Descriptive statistics were used to summarize coverage of policies over time, policy type and policy stage. An interpretive content analysis was performed on a random subsample of the newspaper articles to determine the actors, viewpoints and arguments of the food policies. We identified 896 relevant newspaper articles. The coverage of food policies in newspapers was initially low but peaked in 2018/2021/2022. Through grey literature search we identified 6 food policies which were implemented or adjusted between 2000-2022. The majority of the newspaper articles reported on food pricing policies and were discussed in the policy formulation stage. Academics (mainly supportive) were the most and food industry (mostly opposing) the least cited actors. Supportive arguments highlighted health consequences, health inequalities and collective responsibility, whereas opposing arguments focused on unwanted governmental interference and ineffectiveness of policies. Dutch newspaper articles covering food policies represented a variety of actors and arguments, with individual versus collective responsibility for food choices playing a central role in the arguments. These insights may serve as a basis for further research into why certain arguments are used and their effect on policy attention and implementation.
Aims
This study aimed to investigate systematically (i) the appropriate dietary conditions to induce the features of the MetS in APOE*3Leiden.humanCholesteryl Ester Transfer Protein (E3L.CETP) mice ...and (ii) whether the response of this model to different antidiabetic and hypolipidemic drugs is similar as in humans.
Methods
Male obese, IR and dyslipidemic E3L.CETP mice were treated with antidiabetic drugs rosiglitazone, liraglutide or an experimental 11β‐hydroxysteroid‐dehydrogenase‐1 (HSD‐1) inhibitor, or with hypolipidemic drugs atorvastatin, fenofibrate or niacin for 4–6 weeks. The effects on bw, IR and plasma and liver lipids were assessed.
Results
Rosiglitazone, liraglutide and HSD‐1 inhibitor significantly decreased glucose and insulin levels or IR. Liraglutide and HSD‐1 inhibitor also decreased bw. Atorvastatin, fenofibrate and niacin improved the dyslipidemia and fenofibrate and niacin increased high‐density lipoprotein (HDL) cholesterol. In addition, hepatic triglycerides were significantly decreased by treatment with rosiglitazone and liraglutide, while hepatic cholesterol esters were significantly decreased by rosiglitazone and atorvastatin.
Conclusions
We conclude that the E3L.CETP mouse is a promising novel translational model to investigate the effects of new drugs, alone or in combination, that affect IR, diabetic dyslipidemia and non‐alcoholic fatty liver disease (NAFLD).
Reduction of telomere length has been postulated to be a causal factor in cellular aging. Human telomeres terminate in tandemly arranged repeat arrays consisting of the (TTAGGG) motif. The length of ...these arrays in cells from human mitotic tissues is inversely related to the age of the donor, indicating telomere reduction with age. In addition to telomere length differences between different age cohorts, considerable variation is present among individuals of the same age. To investigate whether this variation can be ascribed to genetic influences, we have measured the size of terminal restriction fragments (TRFs) in HaeIII-digested genomic DNA from 123 human MZ and DZ twin pairs 2-95 years of age. The average rate of telomere shortening was 31 bp/year, which is similar to that observed by others. Statistical analysis in 115 pairs 2-63 years of age indicates a 78% heritability for mean TRF length in this age cohort. The individual differences in mean TRF length in blood, therefore, seem to a large extent to be genetically determined.
To study associations between genetic variation and disease, large bio‐banks need to be created in multicenter studies. Therefore, we studied the effects of storage time and temperature on DNA ...quality and quantity in a simulation experiment with storage up to 28 days frozen, at 4 °C and at room temperature. In the simulation experiment, the conditions did not influence the amount or quality of DNA to an unsatisfactory level. However, the amount of extracted DNA was decreased in frozen samples and in samples that were stored for > 7 days at room temperature. In a sample of patients from 24 countries of the EUROPA trial obtained by mail with transport times up to 1 month DNA yield and quality were adequate. From these results we conclude that transport of non‐frozen blood by ordinary mail is usable and practical for DNA isolation for polymerase chain reaction in clinical and epidemiological studies.
Human genomic DNA is commonly isolated from peripheral blood samples for genetic studies of families and populations. Blood sampling, however, is expensive and an invasive procedure to which, for ...ethical reasons, objections may be raised, especially in studies involving older individuals and babies. We have developed a new noninvasive DNA sampling and isolation method involving oral samples taken with cotton swabs. Participants can take mouth swabs themselves, and can send these by mail to the research center, where DNA can be isolated at least up to 3 wk after sampling. DNA isolation from 20 cotton swabs resulted in an average yield of 40 mu g of high-molecular-weight DNA per individual, sufficient for complete genome searches with similar to 800 polymorphic DNA markers when using PCR. Compared with blood sampling, which involves clinically trained personnel, this procedure is fast, less expensive, and suitable especially for DNA collection from geographically scattered subjects.
Ample evidence supports a role for tumour necrosis factor α (TNFα) in the development of type 2 diabetes and cardiovascular disease. TNFα expression was found to be influenced by a −308G/A ...polymorphism in the promoter of the gene encoding TNFα (TNF). We investigated the contribution of this polymorphism to diabetes and cardiovascular mortality in a population-based cohort of 664 subjects aged 85 years and over (Leiden 85-plus Study). The −308G/A TNF promoter polymorphism was associated with the prevalence of diabetes in old age (P = 0.006). The risk of diabetes among subjects homozygous for the A-allele was estimated to be 4.6-fold (95% CI, 1.6–13.3) higher than among subjects homozygous for the common G-allele. The promoter polymorphism did not, however, predict mortality from all causes, cardiovascular diseases, cancer or infectious diseases during a 10-year follow-up period. In addition to the promoter polymorphism, TNFa and TNFc microsatellite genotypes were determined but these polymorphisms were not associated with morbidity or mortality. In conclusion, the −308G/A polymorphism in the TNF promoter is strongly associated with the risk of diabetes but not cardiovascular mortality in old age.
Commentary on "Penicillin". 1945 Droog, S; Fleming, Alexander
Journal of the Royal Naval Medical Service,
2015, Letnik:
101, Številka:
1
Journal Article
NHS expenditure is currently around £90 billion, and growing demographic and technological pressures make cost reduction a key concern.1 Budgetary constraints, legislation to reduce junior doctors’ ...working hours and high patient-to-doctor ratios2 have increased the difficulty in maintaining a resident specialist knowledge base at night.3 Published in 2000, The NHS Plan envisaged a hospital service delivered increasingly by fully trained doctors, and a self-sufficiency of the NHS workforce.4 In 2003 the Department of Health report Unfinished Business drew attention to the inadequate training provided for ‘the workhorses of the NHS’.5 As a result, the establishment of Medical Education England and the Postgraduate Medical Education and Training Board (PMETB) led in 2007 to the introduction of a new system of recruitment and training of hospital doctors entitled Modernising Medical Careers. While the Department of Health report Time for Training in 2010 was generally optimistic that high-quality training can be delivered in 48 hours, it highlighted the fact that, despite consultant expansion (a 62% increase between 1999 and 2009), ‘trainees are still responsible for delivering the majority of the out-of-hours service’.6 The Hospital at Night (H@N) initiative sought to reduce the out-of-hours (OOH) commitments of junior doctors by introducing a model of out-of-hours care delivered by a competency-based multidisciplinary team and to achieve better collaborative working between the emergency department (ED) and the rest of the hospital.7 Inpatient OOH cover was provided traditionally by junior doctors in the specialty concerned but cross-cover systems are increasingly becoming the norm, where a junior doctor in one specialty covers patients from his or her specialty as well as other specialties. Table 1 Audit of ENT/plastic surgery night-time ward tasks broken down into generic and specialist tasks and also into Hospital at Night triage category In total Mean per night Number of generic ward tasks 127 3.0 (Red : Amber : Green : Blue) (0 : 19 : 93 : 15) Number of specialist ENT/plastic surgery tasks 71 1.7 (Red : Amber : Green : Blue) (5 : 39 : 93 : 15) Table 2 Analysis and audit of emergency department patients treated by the nighttime ENT/plastics junior doctor prior to (cycle 1) and following intervention (cycles 2 and 3) compared against the gold standard emergency medicine clinical quality indicators Gold standard Cycle 1 Cycle 2 Cycle 3 Mean patient length of stay (mins) 182.4 147.6 144.4 Patients waiting more than 4 hours <5.00% 9.96% 4.03% 4.89% Median door-to-doctor time (mins) <60 102 77 52 Total number of patients treated 123 271 307 Patients treated by ENT/plastic surgery doctor as first clinical decision maker 35% 63% 65% Intervention Prior to the enforced reduction in SHO numbers, a counter-proposal was presented to management as an alternative to compensating the inevitable increased frequency of night shifts with yet more EWTD leave days. Results showed that: patients received more expedient care, by a more complaint-specific clinician; junior doctors benefited from more clinical exposure, a 26% increase in daytime supervised training sessions and improved remuneration; the ENT/plastic surgery directorate maintained its specialist junior doctor service at night while achieving savings; and the ED benefited from improved quality indicators, with ED staff freed of the burden of ‘double clerking’ ENT and plastic surgery cases.
Aims
This study aimed to investigate systematically (i) the appropriate dietary conditions to induce the features of the
MetS
in
APOE
*
3Leiden
.humanCholesteryl Ester Transfer Protein (
E3L
.
CETP
) ...mice and (ii) whether the response of this model to different antidiabetic and hypolipidemic drugs is similar as in humans.
Methods
Male obese,
IR
and dyslipidemic
E3L
.
CETP
mice were treated with antidiabetic drugs rosiglitazone, liraglutide or an experimental 11β‐hydroxysteroid‐dehydrogenase‐1 (
HSD
‐1) inhibitor, or with hypolipidemic drugs atorvastatin, fenofibrate or niacin for 4–6 weeks. The effects on bw,
IR
and plasma and liver lipids were assessed.
Results
Rosiglitazone, liraglutide and
HSD
‐1 inhibitor significantly decreased glucose and insulin levels or
IR
. Liraglutide and
HSD
‐1 inhibitor also decreased bw. Atorvastatin, fenofibrate and niacin improved the dyslipidemia and fenofibrate and niacin increased high‐density lipoprotein (
HDL
) cholesterol. In addition, hepatic triglycerides were significantly decreased by treatment with rosiglitazone and liraglutide, while hepatic cholesterol esters were significantly decreased by rosiglitazone and atorvastatin.
Conclusions
We conclude that the
E3L
.
CETP
mouse is a promising novel translational model to investigate the effects of new drugs, alone or in combination, that affect
IR
, diabetic dyslipidemia and non‐alcoholic fatty liver disease (
NAFLD
).
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