Forecasting science futures: legitimising hope and calming fears in the embryo stem cell debate

Controversies about biotechnologies often centre not so much on present scientific facts as on speculations about risks and benefits in the future. It is this key futuristic element in these arguments that is the focus of this article. We examine how competing visions of utopia or dystopia are defended through the use of diverse vocabularies, metaphors, associations and appeals to authority. Our case study explores how these rhetorical processes play out in the debate about embryo stem cell research in UK national press and TV news media. The findings show how predictions from those in favour of embryo stem cell research are supported by both hype and by anti-hype, by inconsistent appeals to the technologies' innovative status and by the selective deconstruction of concepts such as 'potential' and 'hope'. The debate also mobilises binary oppositions around reason versus emotion, science versus religion and fact versus fiction. This article highlights how traditional assertions of expertise are now combined with ideas about compassion and respect for democracy and diversity. It also highlights the fact that although news reporters are often responding to topical events the real focus is often on years, even decades ahead. Close attention to how images of the future are constructed, and the evolution of new strategies for legitimation are, we suggest, important areas of on-going research, particularly in discussions of scientific and medical developments and policy.     

Folate and cobalamin deficiencies and hyperhomocysteinemia in Bangladesh

BACKGROUND: Indian Asian men residing in the United Kingdom have a higher prevalence of hyperhomocysteinemia than do their European counterparts. This has been largely attributed to dietary deficiencies in cobalamin associated with vegetarianism among these Indian Asians. OBJECTIVE: We aimed to ascertain the prevalence of folate and cobalamin deficiencies and hyperhomocysteinemia in Bangladesh. DESIGN: Plasma concentrations of homocysteine, folate, and cobalamin and urinary concentrations of creatinine were assessed in 1650 adults in Bangladesh. RESULTS: The prevalence of hyperhomocysteinemia (men: >11.4 micromol/L; women: >10.4 micromol/L) was markedly (P < 0.0001) greater among men (63%; x +/- SD: 15.3 +/- 9.5 micromol/L) than among women (26%; 9.5 +/- 4.7 micromol/L). Folate was lower (9.8 +/- 6.5 and 12.3 +/- 7.6 nmol/L, respectively), whereas cobalamin was higher (281 +/- 115 and 256 +/- 118 pmol/L, respectively) (P < 0.0001 for both) among men than among women. Folate explained 15% and cobalamin explained 5% of the variation in homocysteine concentrations. For men, folate (P = 0.005) and cobalamin (P = 0.03) were positively correlated with urinary creatinine. Smoking (P < 0.0003) and betelnut use (P < 0.0002) were independent negative predictors of folate. CONCLUSIONS: Bangladeshi men have a high prevalence of hyperhomocysteinemia, which is more closely associated with folate than with cobalamin, although other factors, eg, smoking and betelnut use, may also contribute to its cause. The positive correlations between urinary creatinine and plasma folate and cobalamin were unanticipated and could suggest that, in marginal nutrition, these vitamins may be limiting for creatine biosynthesis.     

Building geographic information system capacity in local health departments: lessons from a North Carolina project

State government, university, and local health department (LHD) partners collaborated to build the geographic information system (GIS) capacity of 5 LHDs in North Carolina. Project elements included procuring hardware and software, conducting individualized and group training, developing data layers, guiding the project development process, coordinating participation in technical conferences, providing ongoing project consultation, and evaluating project milestones. The project provided health department personnel with the skills and resources required to use sophisticated information management systems, particularly those that address spatial dimensions of public health practice. This capacity-building project helped LHDs incorporate GIS technology into daily operations, resulting in improved time and cost efficiency. Keys to success included (1) methods training rooted in problems specific to the LHD, (2) required project identification by LHD staff with associated timelines for development, (3) ongoing technical support as staff returned to home offices after training, (4) subgrants to LHDs to ease hardware and software resource constraints, (5) networks of relationships among LHDs and other professional GIS users, and (6) senior LHD leadership who supported the professional development activities being undertaken by staff.     

Few middle-aged women with severe mental symptoms use psychotropic drugs: the Women's Health in Lund Area (WHILA) study

AIMS: In a population of middle-aged women a survey was carried out to ascertain the prevalence of mental symptoms and psychotropic drug use, and further to investigate whether severe mental symptoms are associated with social situation, alcohol consumption, smoking, and physical health. METHODS: All women (n = 10,766) aged 50-59 years and living in the Lund area were invited to the WHILA study, a health survey including laboratory examinations and a self-administered questionnaire; 6,917 (64.2%) participated. This study is based on the questionnaire only. RESULTS: During the past three months 25.4% (n = 1,709) had been troubled by none or 1 mental symptom (labelled "absent/slight"), 52.8% (n = 3,555) by 2-6 mental symptoms ("moderate") and 21.8% (n = 1,471) by 7-10 mental symptoms ("severe"). Among women with severe mental symptoms 15.4% regularly used psychotropic drugs, mainly antidepressants. A multiple logistic regression analysis showed that women with severe mental symptoms had higher odds for living alone (OR 1.7; CI 1.3-2.2) or as single parents (OR 2.1; CI 1.2-3.6), being university-educated (OR 1.5; CI 1.1-2.0), being on long-term sick-leave (OR 8.8; CI 3.0-25.5), using hormone replacement therapy (OR 1.3; CI 1.1-1.6), and having severe physical symptoms (136.8; CI 89.2-209.7) compared with women with absent/slight mental symptoms. CONCLUSION: Mental symptoms were common among the participating women. The presence of severe mental symptoms was strongly associated with severe physical symptoms. Few women with severe mental symptoms used psychotropic drugs. Middle-aged women with severe mental symptoms need to be identified and provided with appropriate psychopharmacological, hormonal, and/or psychosocial treatment.     

Problematic cannabis use amongst those with severe mental health problems in an inner city area of the UK

The prevalence and nature of cannabis use amongst those with severe mental health problems in community-based services in an inner city area of the UK was assessed. A questionnaire completed by keyworkers of clients engaged with statutory services assessed mental health problems, patterns of substance use, and perceived reasons for substance use. One hundred fifty-nine keyworkers gave information on 1369 clients with severe mental health problems. Three hundred twenty-four of these clients were identified as also using substances problematically. Forty-three percent (139/324) of these clients were misusing cannabis. Within mental health services, cannabis, second to alcohol, was the substance most commonly used problematically. Problematic cannabis use was most frequently associated with males and a diagnosis of schizophrenia, schizotypal or delusional disorders. The median age was 30 years. Pleasure enhancement and coping reasons were most commonly cited by keyworkers for their clients' substance use. Problematic cannabis use was common. Due to the fairly unique profile of cannabis and the emphasis/focus of treatment services, it is possible that cannabis use may be too heavily emphasised or too easily ignored by health professionals.     

Hard to swallow dry: kinetics and mechanism of the anhydrous thermal decomposition of acetylsalicylic acid

The methods of thermal analysis and mass spectrometry have been used to study the kinetics and mechanism of the anhydrous thermal decomposition of acetylsalicylic acid. Both thermogravimetric analysis (TGA) and differential scanning calorimetry (DSC) show that decomposition occurs in two steps. Mass-spectrometric analysis of the residue left after the first decomposition step (approximately equal to 60% mass loss) suggests that in the condensed phase, acetylsalicylic acid decomposes by first forming linear oligomers that are further converted into cyclic oligomers. Model-free isoconversional kinetic analysis of TGA traces has been used to determine global activation energies as a function of the extent of reaction. This method of analysis has also been used to make kinetic predictions of shelf life at ambient temperatures (20-40 degrees C) under anhydrous conditions for acetylsalicylic acid. Our estimate of a shelf life of 876 days (approximately equal to 2.4 years) for 5% decomposition at 30 degrees C is in good agreement with shelf lives of 2-3 years that are stamped on over-the-counter aspirin bottles. Hence, this approach can be used to systematically study the factors that determine the decomposition kinetics of aspirin and may be used for express screening of pharmaceuticals in order to identify those with desirable thermal stabilities.     

The sentinel role of poisons centers in the protection of children's environmental health

Growing concern exists about the threats posed by environmental pollutants and physical agents on children's health. A number offactors, including globalization, increased industrialization, and trade of chemicals and poverty have an impact on the quality of the environment and on children's health. Acute toxic exposures lead to poisoning, and chronic low-level exposures may cause functional and organ damage during periods of special vulnerability. The need to protect children's environmental health is urgent, in view of the magnitude of the problem and the fact that "children are not little adults." The effects suffered during special developmental periods-"windows of vulnerability"-can be permanent and irreversible. The main global environmental problems affecting children's health are lack of access to safe drinking water and sanitation and exposure to indoor air pollution. Furthermore, environmentally related accidents, injuries, and poisonings have a major impact on children and adolescent's morbidity and mortality. A number of examples that illustrate the complexity of assessing and dealing with children's environmental health issues are presented. A Task Force on the Protection of Children's Environmental Health that aims to prevent disease and disability in children associated with chemical and physical threats was set up in 1999 by the World Health Organization. The priorities for action include the consideration of accidents, injuries, and poisonings (accidental, intentional, and occupational), and children in the workplace (e.g., scavenging children, children in cottage industries). Poisons Centers and related toxicology centers are in a strategic position to play a "sentinel" role in the protection of children's environmental health. They record acute and chronic toxic exposures in children in a harmonized manner, using controlled vocabularies and definitions. This will allow collecting a large, highly valuable database on the main toxicological problems affecting children, including those of environmental origin. The analysis of observations entered in such a database will help assess the burden of disease and collect the evidence for planning prevention and promoting regulatory measures. Centers are called to play a proactive role in raising awareness about children's environmental health and contribute to research, information dissemination, training, and other activities required for the protection of children's health and development.     

Porphyrinogenic xenobiotic-induced N-alkylprotoporphyrin IX formation: a bioassay utilizing chick embryo hepatic ferrochelatase

INTRODUCTION: The porphyrinogenicity of some xenobiotics results from mechanism-based inactivation of selected cytochrome P450 (CYP) enzymes accompanied by conversion of prosthetic heme groups to N-alkylprotoporphyrins (N-alkylPPs), some of which inhibit ferrochelatase (FC). Problems have arisen in extrapolating xenobiotic porphyrinogenicity observed in test animals to humans, due in part to differences among CYP enzymes. Our goal was to develop a bioassay to detect N-alkylPPs formed following interaction of porphyrinogenic xenobiotics with rat liver microsomal CYP. METHODS: Seventeen-day-old chick embryo livers were homogenized, and the mitochondrial fraction was isolated. The FC activity of this fraction was determined by means of the pyridine hemochromogen method. Inhibition of FC was used to detect N-alkylPP formation following interaction of porphyrinogenic xenobiotics with rat liver microsomes. RESULTS: The 17-day-old chick embryo hepatic mitochondrial preparation served as a stable source of FC activity, which was linear with respect to time and protein concentration. FC activity was higher than previously reported in a homogenate of 17-day-old chick embryo hepatocytes in culture and in an aqueous extract of 17-day-old chick embryo mitochondria. The EC(50) of N-methylprotoporphyrin IX in the chick embryo liver mitochondrial preparation was similar to that in the homogenate of chick embryo liver cell culture. The FC bioassay could detect N-alkylPPs formed following the interaction of porphyrinogenic xenobiotics with rat liver microsomes containing 2.4-9.0 nmol of CYP. DISCUSSION: In future studies investigating N-alkylPP formation following interaction of xenobiotics with CYP enzymes, we recommend using a combination of a fluorescence technique and the chick embryo hepatic mitochondrial FC assay. This would provide information both on the formation of N-alkylPPs and distinguish between those N-alkylPPs that produced porphyrin accumulation via FC inhibition and those that do not.     

Physical frailty in older adults is associated with metabolic and atherosclerotic risk factors and cognitive impairment independent of muscle mass

Objective  

Metabolic and atherosclerotic diseases are known risk factors for disability in old age, and can result in sarcopenia as well as cognitive impairment, which are both components of frailty syndrome. As muscle loss increases with ageing, it is unclear whether muscle loss per se, or the diseases themselves, are the underlying cause of physical frailty in those suffering from these diseases. We tested the hypothesis that metabolic and atherosclerotic diseases and cognitive impairment are associated with physical frailty independent of muscle loss in old age, and further examined their impact on the relationship between physical frailty and mortality.