Quantifying Policy Options for Reducing Future Coronary Heart Disease Mortality in England: A Modelling Study

Aims

To estimate the number of coronary heart disease (CHD) deaths potentially preventable in England in 2020 comparing four risk factor change scenarios.

Methods and Results

Using 2007 as baseline, the IMPACT_SEC model was extended to estimate the potential number of CHD deaths preventable in England in 2020 by age, gender and Index of Multiple Deprivation 2007 quintiles given four risk factor change scenarios: (a) assuming recent trends will continue; (b) assuming optimal but feasible levels already achieved elsewhere; (c) an intermediate point, halfway between current and optimal levels; and (d) assuming plateauing or worsening levels, the worst case scenario. These four scenarios were compared to the baseline scenario with both risk factors and CHD mortality rates remaining at 2007 levels. This would result in approximately 97,000 CHD deaths in 2020. Assuming recent trends will continue would avert approximately 22,640 deaths (95% uncertainty interval: 20,390-24,980). There would be some 39,720 (37,120-41,900) fewer deaths in 2020 with optimal risk factor levels and 22,330 fewer (19,850-24,300) in the intermediate scenario. In the worst case scenario, 16,170 additional deaths (13,880-18,420) would occur. If optimal risk factor levels were achieved, the gap in CHD rates between the most and least deprived areas would halve with falls in systolic blood pressure, physical inactivity and total cholesterol providing the largest contributions to mortality gains.

Conclusions

CHD mortality reductions of up to 45%, accompanied by significant reductions in area deprivation mortality disparities, would be possible by implementing optimal preventive policies.     

Masochistic Dreams: A Gender-Related Diathesis for Depression Revisited

Masochistic dreams, as defined by Beck (1967), are reportedly more prevalent among women and individuals with past or present depression. However, it is unclear whether these prevalence differences are a function of depressogenic personality traits or fluctuating mood symptoms. In the present study, 30 men and 30 women without histories of major depression slept two consecutive nights in a sleep laboratory and reported their dreams from each REM period on the second night. Dream content from this sample was compared to that of 60 depressed participants who were studied previously under the same protocol. Analyses did not support a heightened prevalence of masochistic dreams among women or depressed individuals. Interestingly, the masochistic dreams of the non-depressed sample were equally distributed across the night, whereas depressed individuals tend to report masochistic dreams closer to morning. This hypothesized pattern suggests that masochistic dreams may be pathognomic of depression in that their occurrence near the end of the night affects morning mood with negative dream residue.     

Responses of a fringing Cyperus papyrus L. swamp to changes in water level

Over a 9-year period (1993–2001), the land-water width of a papyrus fringe on the southern shore of Lake Naivasha, Kenya, varied between 40 and 60 m. Increases in width via rhizome spreading into open water followed the 1997/1998 El Niño flood when water depths rose by about 2 m. Germination of papyrus seeds also responded to water depth with a mean ± S.E. rate in experiments of 23 ± 6% after 21 days when water level was 5 cm below the sediment surface. No germination occurred when sediment was flooded or allowed to desiccate. Rhizome spreading from floating mats appeared to be favoured by deep water with seedling spread favoured on newly inundated, low-gradient slopes in shallow water. Although natural regenerative capacity was influenced by water depth, the height, density, biomass and chemical content of papyrus were not. Total average biomass along a land-water transect was 6950 ± 860 g m⁻² which was large in relation to nutrient and mineral contents. Culms contained 0.47 ± 0.14% N and 0.06 ± 0.05% P and rhizomes 0.71 ± 0.21% and 0.10 ± 0.06%. Sediment underlying the swamp was aerobic and there were small land-water gradients in the BOD of swamp water and sediment. However, chemical gradients were weak compared with wider papyrus swamps elsewhere. Lake and swamp water mixed in the narrow fringe studied and residence times for organic matter may not have been long enough for organic material to mineralise before entering lake water.     

The impact of <Emphasis Type="Italic">MTHFR</Emphasis> 677C → T risk knowledge on changes in folate intake: findings from the Food4Me study

Background

It is hypothesised that individuals with knowledge of their genetic risk are more likely to make health-promoting dietary and lifestyle changes. The present study aims to test this hypothesis using data from the Food4Me study. This was a 6-month Internet-based randomised controlled trial conducted across seven centres in Europe where individuals received either general healthy eating advice or varying levels of personalised nutrition advice. Participants who received genotype-based personalised advice were informed whether they had the risk (CT/TT) (n?=?178) or non-risk (CC) (n?=?141) alleles of the methylenetetrahydrofolate reductase (MTHFR) gene in relation to cardiovascular health and the importance of a sufficient intake of folate. General linear model analysis was used to assess changes in folate intake between the MTHFR risk, MTHFR non-risk and control groups from baseline to month 6 of the intervention.

Results

There were no differences between the groups for age, gender or BMI. However, there was a significant difference in country distribution between the groups (p?=?0.010). Baseline folate intakes were 412?±?172, 391?±?190 and 410?±?186 μg per 10 MJ for the risk, non-risk and control groups, respectively. There were no significant differences between the three groups in terms of changes in folate intakes from baseline to month 6. Similarly, there were no changes in reported intake of food groups high in folate.

Conclusions

These results suggest that knowledge of MTHFR 677C?→?T genotype did not improve folate intake in participants with the risk variant compared with those with the non-risk variant.

Trial registration

ClinicalTrials.gov NCT01530139

     

Oriented migration of interstitial cells and nematocytes inHydra attenuata

Summary The migratory properties of hydra cells within the tissue were studied. The extent and direction of cell migration were examined in budding, non-budding, and regenerating animals. Nematocytes and a small number of single big interstitial cells (the multipotent interstitial cells) actively migrate preferentially in an apical direction. Basal migration of these cells occurs only when a bud is present and, in which case, the cells migrate into the developing bud. The regeneration of the hypostome and tentacles does not affect cell migration in either direction, except for apical migration of stenotele nematocytes, which was markedly reduced.This research was supported by National Science Foundation Grant (GB 29284), National Institute of Health Grant (HD 08086-01), and N.I.H. Public Health Service Training Grant (HD 00347).     

Radioautographic studies of the initial site of formation of protein-bound iodine in the rat thyroid gland

1. Predominantly cellular labelling was observed in radioautographs of rat thyroid glands fixed by perfusion from the aorta at intervals between 5 and 55s after [(125)I]iodide administration via the aorta. 2. When perfusion was delayed for 2min, or if immersion fixation was used, the labelling was predominantly over the peripheral portion of the follicular lumen, in agreement with the observations of other investigators. 3. The findings support the concept that the initial site of binding of iodine to protein is intracellular, but the nature of this protein has not been established.