Getting food policy on the Mayoral table: a comparison of two election cycles in New York and London.

Cities and Mayors are increasingly being recognized as important in shaping social policy and improving social well-being. And municipal food policies are increasingly important as a tool to reduce food insecurity and prevent diet-related chronic diseases. Thus city governments have a unique ability to improve local food environments. To realize this potential for improving urban food environments, nutrition advocates will need to find innovative approaches for influencing municipal food policy. This paper examines Mayoral elections as a vehicle to advance food policy. To explore this strategy, Mayoral elections in two cities, New York City (NYC) and London, during two recent cycles were compared. To gather evidence multiple sources were used including campaign documents, media and opinion polls as well as the authors' own observations as food policy observers and participants in the two cities. Mayoral governance differs between NYC and London, with the Mayor in NYC having greater powers of management and administration, whilst the London Mayor has a more strategic role and may need to also use 'influence'. Food policy and related issues did not feature strongly in the first election cycles in either city. However by the 2012 and 2013 elections food issues were definitely 'on the table' and featured in main candidates' campaign literature. These latter elections also saw the importance of food advocates coming together to form common alliances and place food issues higher on the municipal agenda. In this way, food policy has become part of the election dialogue in both cities and candidates are expected to consider food policy issues. This analysis leads to make observations which could guide advocates as to how to use Mayoral elections to raise policy objectives for the benefit of public health.

Diet-related determinants of childhood obesity in urban settings: a comparison between Shanghai and New York.

Over the past three decades, both Shanghai and New York City (NYC), have experienced dramatic rises in childhood obesity rates. Given the role that obesity plays in the aetiology of chronic diseases such as diabetes and heart disease, the elevated rates are a major concern. Despite differences in governance systems and cultures, Shanghai and NYC have experienced rapid industrialization, a growing population and a rise in income inequality. The prevalence of childhood obesity in Shanghai and NYC is greater than their respective national rate. However, the trajectory and development of this epidemic has differed between the cities. The distribution of obesity by race and ethnicity, socio-economic status, sex, and age differs markedly between the two cities. To reduce prevalence and inequities within this complex epidemic requires an understanding of the dynamic changes in living conditions among social groups in each city and the behaviours that are influenced by such changes. By comparing changes in the influences on dietary behaviours, such as food distribution, pricing, gender values, and media and marketing, this highlights opportunities for Shanghai, NYC, and other world cities with high or rising rates of childhood obesity to inform future program and policy initiatives. It reiterates the importance of a comprehensive and multilevel approach that includes action at the individual, family, community, municipal, national, and global levels.

The role of urban food policy in preventing diet-related non-communicable diseases in Cape Town and New York.

OBJECTIVES: Cities are important settings for production and prevention of non-communicable diseases. This article proposes a conceptual framework for identification of opportunities to prevent diet-related non-communicable diseases in cities. It compares two cities, Cape Town in South Africa and New York City in the United States, to illustrate municipal, regional, national and global influences in three policy domains that influence NCDs: product formulation, shaping retail environments and institutional food practices, domains in which each city has taken action. STUDY DESIGN: Comparative case study. METHODS: Critical analysis of selected published studies and government and non-governmental reports on food policies and systems in Cape Town and New York City. RESULTS: While Cape Town and New York City differ in governance, history and culture, both have food systems that make unhealthy food more available in low-income than higher income neighborhoods; cope with food environments in which unhealthy food is increasingly ubiquitous; and have political economies dominated by business and financial sectors. New York City has more authority and resources to take on local influences on food environments but neither city has made progress in addressing deeper social determinants of diet-related NCDs including income inequality, child poverty and the disproportionate political influence of wealthy elites. CONCLUSIONS: Through their intimate connections with the daily lives of their residents, municipal governments have the potential to shape environments that promote health. Identifying the specific opportunities to prevent diet-related NCDs in a particular city requires intersectoral and multilevel analyses of the full range of influences on food environments.

Institutional food as a lever for improving health in cities: the case of New York City.

OBJECTIVES: To describe and examine the factors that most facilitate and impede the provision of healthy foods in a complex institutional food system. STUDY DESIGN: Comparative case study of three institutional food settings in New York City. METHODS: Document review and interviews with relevant city government staff. RESULTS: Factors that facilitate and impede the provision of healthy food vary across institutional food settings, and particularly between centralized and decentralized settings. Generally pro-health factors include centralized purchasing and the ability to work with vendors to formulate items to improve nutritional quality, though decentralized purchasing may offer more flexibility to work with vendors offering healthier food items and to respond to consumer preferences. Factors most often working against health in more centralized systems include financing constraints that are unique to particular settings. In less centralized systems, factors working against health may include both financing constraints and factors that are site-specific, relating to preparation and equipment. CONCLUSIONS: Making changes to institutional food systems that will meaningfully influence public health requires a detailed understanding of the diverse systems supporting and shaping public food provision. Ultimately, the cases in this study demonstrate that agency staff typically would like to provide healthier foods, but often feel limited by the competing objectives of affordability and consumer preference. Their ability to address these competing objectives is shaped by a combination of both forces external to the institution, like nutritional regulations, and internal forces, like an agency's structure, and motivation on the part of staff.

[Pseudo-mesotheliomatous adenocarcinoma of the lung]. / Pseudomesotheliomatöses Adenokarzinom der Lunge.

Both pathologists and clinicians are challenged by the diagnosis of a particular variant of the peripheral adenocarcinoma with involvement of the pleura parietalis, the so-called pseudo-mesotheliomatous adenocarcinoma of the lung (PMAC), which is hard to differentiate from epithelioid mesothelioma on imaging and cytology, macroscopically as well as histologically. However, the exact diagnosis is not only crucial for the patient's therapy but also for insurance matters. Immunohistochemical evaluation represents a quick and a relatively cheap tool for which a few antibody panels have been proposed in recent years as being suitable to distinguish between these two entities. One of the positive markers for epithelioid mesothelioma most often suggested seems to be calretinin. We would like to report on a case of PMAC with the special feature of positive calretinin immunohistochemical staining. Using histochemistry and a few additional antibodies we were able to reliably characterize the tumor and provide the patient with appropriate therapy. This article gives a short overview of the possibilities available for distinguishing between these two entities in the context of a case report.

Infection of C57BL/10ScCr and C57BL/10ScNCr mice with Leishmania major reveals a role for Toll-like receptor 4 in the control of parasite replication.

The innate immune system is essential for host defense; it senses the presence of potentially pathogenic-invading microorganisms, and the contribution of Toll-like receptors (TLRs) to this response is increasingly recognized. In the present study, we investigated the contribution of TLR4 to the course of cutaneous leishmaniasis in vivo. We used C57BL/10ScNCr (TLR4(0/0)) and C57BL/10ScCr [TLR4/interleukin-12 (IL-12)Rbeta2(0/0)] mice and compared the course of Leishmania major infection, parasite load, cell recruitment, and cytokine profile with those of wild-type C57BL/10ScSn mice. Our results confirm the importance of IL-12 receptor-mediated signaling in resistance to L. major infections. Importantly, we show that the lack of TLR4 results in an increased permissiveness for parasite growth during the innate and adaptive phase of the immune response and in delayed healing of the cutaneous lesions. The use of the tlr4 transgenic mouse strain TCr5 demonstrated unequivocally that TLR4 contributes to the efficient control of Leishmania growth in vivo.

Primary osteosarcoma of the thyroid gland.

Primary extraosseous osteosarcoma of the thyroid gland is a rare tumor which is associated with a poor prognosis. In this report, we discuss such a tumor and its recurrence in a 78-yr-old female with multinodular goiter, focusing on the imaging evaluation of this unusual tumor.

Infiltration of lung carcinomas with macrophages of the 27E10-positive phenotype.

In order to gain insight into the role of macrophages in human lung carcinomas, we investigated material from 35 lung carcinomas and 5 healthy lungs with 4 different antibodies (CD68, MRP8, MRP14, 27E10) recognizing different macrophage subtypes. Infiltration with CD68-positive macrophages was highest and comparable in healthy lungs and lung carcinomas. Compared to healthy lungs, the infiltration of MRP8- and MRP14-positive macrophages was reduced in lung carcinomas while the number of 27E10-positive cells was enhanced. No difference in the infiltration of macrophages was observed between the different histological subtypes of carcinomas such as squamous carcinoma, small lung carcinoma, adenocarcinoma and bronchio-alveolar carcinoma. Furthermore, we present a highly suitable technique for the isolation and enrichment of macrophages from human lung carcinomas resulting in a 5-10 fold enrichment and a yield of e.g. 2-3 x 10(6) 27E10-positive macrophages/g tumor biopsy. Together with the recent findings that 27E10-positive macrophages are prevalent in early acute inflammation and release cytotoxic mediators and to inhibit tumor cell proliferation our findings suggest that 27E10-positive macrophages may play a role in antitumor cytotoxicity in human lung carcinomas.

Early detection of metastasis by alterations in the cellular immune system in the murine liver and blood.

We investigated the reaction of the cellular immune system of liver and blood in the C57BL/6 mouse to a metastasizing Lewis lung carcinoma. The cellular immune system of the liver consists of mature and immature macrophages, B-cells, T-cells including their subpopulations, and natural killer cells, and their percentage frequencies differ significantly from those in the corresponding mononuclear blood cell (MBC) compartment. This suggests that the hepatic immune cells represent a system with autonomous function showing a typical homing of its members. Imminent metastasis to the liver is signalled by impressive alterations in the percentage frequencies of nonparenchymal liver cells (NPLC). There are a dramatic loss of mature macrophages, an increase in immature macrophages, a reduction of T-helper cells leading to a low CD4/CD8 ratio, and an increase in natural killer cells. In the blood, the corresponding precursor cells show comparable changes with a delay of at least 2 days. Early metastasis is accompanied by a significant increase in mononuclear NPLC producing tumour necrosis factor alpha. The alterations in percentage frequencies of the NPLC during tumour metastasis differ markedly from the changes in these cells in the liver during endotoxinaemia.

Experimental gluing of the bronchial stump after pneumonectomy in rats.

OBJECTIVE: The objective of this experimental study was to evaluate the usefulness of gelatin-resorcinol-dialdehyde adhesive in sutureless closure of bronchial stumps. METHODS: In 40 male Wistar rats bronchial stumps after left-sided pneumonectomy were closed by gluing with gelatin-resorcinol-dialdehyde adhesive. For macroscopic and microscopic examination four animals were sacrificed on postoperative days 2, 7 and 14 each, 14 animals on postoperative days 28 and 120 each. RESULTS: On macroscopic examination the gelatin-resorcinol-dialdehyde adhesive proved in all cases effective in tight bronchial stump closure. The adhesive did not cause local infection or necrosis of the bronchial stump nor other intrathoracic inflammatory complications. All animals survived and made an uncomplicated postoperative recovery. Microscopic examination revealed that the gelatin-resorcinol-dialdehyde adhesive initially evoked an acute inflammatory response with polymorphonuclear neutrophils predominating. After an intermediate stage characterized by a granulomatous reaction and resorption of the adhesive by multinucleated giant cells, 120 days postoperatively the bronchial stumps at the sites of previous gluing showed a regular fibrous scar tissue without inflammatory cells. CONCLUSION: The gelatin-resorcinol-dialdehyde adhesive showed effective in closing bronchial stumps after pneumonectomy in rats. The clinical extrapolation of this effect to thoracic surgical patients is uncertain at this time.

Preoperative CT and MR imaging of inferior vena cava leiomyosarcoma.

We investigated the radiological findings of five patients with primary leiomyosarcoma of the inferior vena cava (IVC) comparing cavography, computed tomography (CT), and magnetic resonance imaging (MRI). The radiographic presentation ranged from an intraluminal lesion with obstruction of the IVC to a tumor mass extending from the media musculature into the surrounding perivascular tissue with only slight protrusion into the lumen. The lesions were associated with late or few symptoms. Pathognomonic radiological findings could not be established. In cases with an extraluminal growth a lobulated, well-defined, encapsulated tumor with an inhomogeneous contrast uptake is characteristic in CT studies. Additional information was provided by MRI. Leiomyosarcomas with extraluminal involvement showed homogeneous intermediate signal intensity (SI) on T1-, and mixed intermediate/high SI on T2-weighted images. In cases with predominantly intraluminal growth, both CT and MRI demonstrated the IVC to be dilatated and allowed to differentiate between tumor extent and obliterating thrombosis. Modern imaging modalities allow an early and accurate pre-operative diagnosis resulting in a higher rate of surgical resection and improvement of survival.

One method for assessing HIV/AIDS peer-education programs.

This study offers a new evaluation methodology for peer-education programs. Peer educators' knowledge, self-esteem, peer pressure, and the number of friends, neighbors, and relatives given HIV/AIDS information were compared before and after training using self-administered questionnaires. Significant changes were observed in knowledge, peer pressure, self-efficacy, numbers of people given condoms, number of formal and informal HIV/AIDS presentations, and numbers of HIV/AIDS discussions with friends and neighbors.

Distribution and localization of endotoxin in the reticulo-endothelial system (RES) and in the main vessels of the rat during shock.

The fate of endotoxin was followed with immunohistochemistry and radio-labelled lipopolysaccharide (LPS) in organs of the reticulo-endothelial system (RES), in the great vessels and the thoracic duct of rats during a 14 day period after the injection of a shock-inducing amount of endotoxin. The immunohistochemical detectability of LPS in most tissues increased continuously during the first 48 hours, showing the strongest LPS staining in the liver and adrenal gland. Macrophages were found to be the most important cells of primary LPS uptake in all organs except the adrenal glands, where endotoxin was mainly present in phagocytic vacuoles of the cortical epithelium. The comparison of results obtained with the immunoperoxidase method and radioactivity measurements revealed that at a later stage of the experiment the persisting LPS in liver and spleen looses its antigenic activity. The correlation between the appearance of LPS positive macrophages and histological signs of tissue injury during endotoxin shock is striking.

[The effect of diatrizoate (Angiografin) on the aortic endothelium of rats (author's transl)]. / Wirkung von Diatrizoat (Angiografin) auf das Aortenendothel von Ratten.

The damaging effect of methylglucamine diatrizoate on the aortic endothelium is tested and compared to the action of a 22% sorbit solution both with the same hypertonicity. In the first group the contrast medium is injected into the aorta once. In a second group three consecutive injections 5 minutes apart are performed. Aortic specimens are investigated by the "Häutchen" method. The degree of endothelial lesion due to contrast medium is direct proportional to the rate of proliferation of endothelial cells as analized by autoradiography. The damage to the aortic endothelium is independent of number of injections (once or three times). The sorbit solution caused no injury to the aortic endothelium. A generalized endothelial damage--as it is seen in shock--could be excluded.

[Effect of x-ray contrast media on the vena cava endothelium of rats]. / Wirkung von Röntgenkontrastmitteln auf das Endothel der Vena cava der Ratte.

A study comparing the effects of diatrizoate, ioxitalamate, metrizamide, ioxaglate, iopamidol and a hyperosmotic sorbitol and sodium chloride solution on the endothelium of the vena cava of the rat was performed. In each case 1 ml. of the respective solution was injected intravenously. Endothelial damage was seen after injection of metrizamide, diatrizoate and ioxitalamate. After injection of ioxaglate only minor endothelial changes were observed, whereas after administration of both hyperosmotic solution no endothelial damage could be observed.

[The cutting biopsy cannula for histological diagnosis of abdominal and retroperitoneal masses. Sonographic or computed tomographic guided puncture?]. / Die Schneidbiopsiekanüle zur histologischen Diagnostik abdomineller und retroperitonealer Raumforderungen. Sonographische oder computertomographisch gesteuerte Punktion?

A new cutting biopsy needle has been used to obtain histologically useful material while causing the minimum of trauma. It permits biopsies of organs, but its small external diameter of 0.8 or 0.95 mm makes it possible to carry out transperitoneal puncture of the stomach, colon or liver and of the retroperitoneal space, using a ventral approach. Tissue samples were obtained in 96% of 63 patients. The risk of complications is no higher than for conventional needles used for cytology. The accuracy with which the material can be obtained is therefore the most important problem. The position of the area to be biopsied should determine whether the biopsy is to be aided by sonography or CT. Biopsies of organs can be appropriately carried out under ultrasound control, but processes in the pelvis and in retroperitoneal-paravertebral and extra-peritoneal positions are best biopsied under CT control.

[The effect of diatrizoate (Angiografin) on the aortic endothelium of the rat in shock]. / Uber die Wirkung von Diatrizoat (Angiografin) auf das Aortenendothel der Ratte im Schock.

Investigations have been carried out on the endothelial damage produced by diatrizoate (Angiografin) during the course of endotoxin shock. A single injection was given directly into the aorta of 1 ml of the contrast medium, with an iodine content of 300 mg/ml. The increased proliferation of the aortic endothelium could be shown to be due to the endotoxin shock, but was not further increased by administration of the contrast medium.

Collaboration among community members, local health service providers, and researchers in an urban research center in Harlem, New York.

The Urban Research Center at the Center for Urban Epidemiologic Studies brings together community members and researchers working in Harlem, New York. A Community Advisory Board (CAB) composed of community members, service providers, public health professionals, and researchers was formed to assist the Center's research and interventions and to guide community partnerships. Through a collaborative process, the CAB identified three public health problems-substance use, infectious diseases, and asthma-as action priorities. To deal with substance use, the Center created a Web-based resource guide for service providers and a "survival guide" for substance users, designed to improve access to community services. To deal with infectious diseases, the Center is collaborating with local community-based organizations on an intervention that trains injection drug users to serve as peer mentors to motivate behavior change among other injection drug users. To deal with asthma, the Center is collaborating with community child care providers on an educational intervention to increase asthma awareness among day care teaching staff, enhance communication between staff and families, and improve the self-management skills of children with asthma. The Center's experience has demonstrated that active communities and responsive researchers can establish partnerships that improve community health.

Coming up in the boogie down: the role of violence in the lives of adolescents in the South Bronx.

This article presents data gathered from young people in a poor urban community in New York City, the South Bronx. It seeks to help public health professionals better understand young people's perceptions of violence in the context of their daily lives. Sources of data include a street survey, five focus groups, interviews with incarcerated young males, and observations of several youth programs. These data suggest that violence is pervasive in the lives of both young men and women, although gender plays an important role in shaping the experience of violence. Other factors that influence the experience of violence include patterns of substance use, availability and use of weapons, and a perception that the police do not respect young people. Despite numerous challenges, many young people do take actions to reduce violence. The article suggests actions public health professionals can take to strengthen the ability of families, schools, youth organizations, and young people themselves to reduce violence in low-income urban communities.

Treatment with diltiazem preoperatively in open heart surgery for myocardial protection: experimental studies in dogs with chronic healed myocardial infarction.

Calcium antagonists have become important in open heart surgery because of their effects on myocardial protection and cardioplegia. We evaluated the effect of pretreatment with the calcium antagonist diltiazem for myocardial protection in dogs with experimentally induced, chronic, healed myocardial infarction in a double-blind randomized study. One group consisted of 5 dogs treated with diltiazem (10 mg/kg bodyweight) for 7 days preoperatively, while a second group of 4 dogs were treated with placebo. All animals then underwent hypothermic, ischemic cardiac arrest (90 min) with extracorporeal circulation (ECC), followed by 30 min of reperfusion. Hemodynamic parameters were measured before and after ECC. An EKG was recorded during the entire procedure. The myocardium was studied by light microscopy for fresh necroses. The old, experimentally induced infarction scars were quantified by a new method that was developed for planimetry of the histological specimens. The diltiazem group compared with the placebo group showed myocardial cell necroses to a smaller extent. The hemodynamic studies supported the contention that diltiazem given preoperatively has a myocardial protective effect. These results encourage further studies on the use of diltiazem preoperatively for myocardial protection.