Do flavan-3-ols from green tea reach the human brain?

Following acute ingestion of green tea by six human subjects, HPLC-MS2 analysis revealed that flavan-3-ol methyl, glucuronide and sulfate metabolites appeared in the bloodstream but did not pass through the blood-cerebrospinal fluid barrier. These observations emphasize the discrepancies between in vitro and in vivo evidence on the neuroprotective role of these compounds. If, as has been proposed, green tea exerts neuroprotective effects, this finding indicates that the active components are not flavan-3-ols or their metabolites. Alternatively, a systemic action may be hypothesised whereby dietary flavan-3-ols up-regulate antioxidant defences and/or reduce inflammation, the benefit of which may be effective throughout the body.     

Updated bioavailability and 48 h excretion profile of flavan-3-ols from green tea in humans

Green tea is a popular beverage, prepared with infusion of unfermented dried leaves of Camellia sinensis, and is one of the most relevant sources of polyphenolic compounds in the human diet. This study reports green tea flavan-3-ol absorption, metabolism and complete urinary excretion up to 48?h in 20 healthy volunteers. Urinary and tea samples were analysed by high-performance liquid chromatography coupled with tandem mass spectrometry. Green tea contained monomeric flavan-3-ols and proanthocyanidins with a total polyphenol content of 728?μmol. A total of 41 metabolites were identified in urines, all present in conjugated forms. Among these, six colonic metabolites of green tea flavan-3-ols were identified for the first time after green tea consumption in humans. The average 48?h bioavailability was close to 62%, major contributors being microbial metabolites. Some volunteer showed a 100% absorption/excretion, whereas some others were unable to efficiently absorb/excrete this class of flavonoids. This suggests that colonic ring fission metabolism could be relevant in the putative bioactivity of green tea polyphenols.     

Do green areas affect health? Results from a Danish survey on the use of green areas and health indicators

The article presents the result from a Danish survey on access and use of green areas and the impact on experienced stress and obesity. The statistical results indicate that access to a garden or short distances to green areas from the dwelling are associated with less stress and a lower likelihood of obesity. The number of visits cannot explain the effects of green areas on the health indicators. It is suggested that the significance of distance to green areas is mainly derived from its correlation with the character of the neighbourhood and its conduciveness to outdoor activities and "healthy" modes of travel.     

Do women gain anything from coitus apart from pregnancy? Changes in the human female genital tract activated by coitus

This article reviews critically studies that describe changes occurring in the female genital tract and pelvic musculature from sexual reflexes activated by stimuli that mimic coitus or induced by sexual arousal. I conclude that apart from the normal erotic pleasure, women gain and maintain vaginal and pelvic functionality from these and, subsequently, from coitus.     

Is the medical brain drain beneficial? Evidence from overseas doctors in the UK

The 'beneficial brain drain' hypothesis suggests that skilled migration can be good for a sending country because the incentives it creates for obtaining training increase that country's net supply of skilled labour. Necessary conditions for this hypothesis to work are that the possibility of migration significantly affects decisions to take medical training and that migrants are not strongly screened by the host country. We conducted a survey among overseas doctors in the UK in 2002, which suggested that neither condition is likely to be fulfilled. Apart from the 'beneficial brain drain' argument, the survey findings also cast light on the backgrounds and motives of migrant doctors, and finds evidence that there could, nonetheless, be other benefits to sending countries via routes like remittances and return migration.     

Do health insurers innovate? Evidence from the anatomy of physician payments

One of private health insurers’ main roles in the United States is to negotiate physician payment rates on their beneficiaries’ behalf. We show that these rates are often set in reference to a government benchmark, and ask how often private insurers customize their fee schedules away from this default. We exploit changes in Medicare’s payments and dramatic bunching in markups over Medicare’s rates to address this question. Although Medicare’s rates are influential, 25 percent of physician services in our data, representing 45 percent of covered spending, deviate from the benchmark. Heterogeneity in the pervasiveness and direction of deviations suggests that the private market coordinates around Medicare’s pricing for simplicity but abandons it when sufficient value is at stake.     

Do essential service packages benefit the poor? Preliminary evidence from Bangladesh

In 1998 Bangladesh began a sector wide approach (SWAp) to the extension of health care to vulnerable groups in the country. The central feature of this approach is the funding of an essential service package (ESP) emphasizing maternal care, certain communicable diseases and child health. This study examines the way in which public sector expenditures are distributed by comparing the actual beneficiaries of spending with the target groups identified by the sector strategy. It finds that while the ESP is helping to target resources at priority services, considerable barriers to access by vulnerable groups persist. The study suggests a number of issues that need to be addressed to improve the performance of the programme. First, improved targeting requires greater emphasis on the process of access to key services. Secondly, improving the efficiency of service provision at primary level is a key element to increasing access, since individual primary providers are often not ready to provide the standard of care required by the ESP approach to services. Finally, the system of financial control and management needs to be modified in order to make allocations more responsive to the priorities determined by the SWAp. Given the widespread adoption of the ESP approach to health care, the paper also suggests a wider research agenda that examines its impact in other countries and evaluates this worldwide experiment in health service prioritization.     

Did we reach the 2005 targets for tuberculosis control?

The World Health Assembly set targets to detect by 2005 at least 70% of all new sputum smear-positive cases arising each year and to cure at least 85% of these cases. The national tuberculosis (TB) control programmes of 199 countries reported that in 2005, 2.3 million new smear-positive cases were diagnosed under WHOs DOTS strategy, out of an estimated 3.9 million (95% confidence limit (CL) 3.4 million to 4.4 million) new smear-positive cases arising in that year, a global case detection rate of 60% (95% CL 52% to 69%). Of 2.1 million new smear-positive patients registered for treatment in 2004, 84% had successful outcomes. Of the regions, only the WHO Western Pacific Region reached both targets, with case detection and treatment success rates of 76% and 91%, respectively; South-East Asia reached the treatment success target with a rate of 87%. In relation to countries, WHO estimates that 67 achieved the target detection rates and 57 achieved the target for treatment success, with 26 - including high-burden countries China, the Philippines and Viet Nam - achieving both targets. DOTS programmes diagnosed more than 26 million patients (all forms of TB) in 1995-2005. Building on this success, the Global Plan to Stop TB 2006-2015, describes the actions needed to implement WHOs new Stop TB Strategy over the coming decade to reduce TB incidence, prevalence and deaths in line with the Millennium Development Goals.     

Do the elderly benefit from annual physical examination? An example from Kaohsiung City,Taiwan

BACKGROUND: This study evaluates the impact of free annual health examinations on survival of elderly (> or =65 years of age) residents in Kaohsiung City, Taiwan. METHODS: A stratified random sample scheme was used in each of the 11 districts of Kaohsiung City. A total of 1,193 elderly people were selected and interviewed in 1993; deaths and results of health check-ups were recorded through 1998. RESULTS: While over 50% of the subjects received at least one health examination between 1993 and 1998, only 18% received three or more. Most (60%) subjects who received examinations in a given year also received examinations the subsequent year; most (over 70%) who did not receive examinations in a given year did not receive check-ups the following year. Cox proportional hazards model showed that those who utilized the examination service had better survival probability than those who did not, given the same age, sex, education, marital status, living arrangements, and number of chronic diseases at baseline: The relative risk (RR) of mortality for those who ever utilized the health examination service was 0.50 (P < 0.0001). CONCLUSIONS: Elderly subjects who received annual health examinations had lower mortality than those who did not. This finding should be interpreted cautiously, however, as the difference in survival may reflect better general health behaviors among those who participated in the program.