Tobacco outlet availability in Dutch rural and urban areas

Background

The Netherlands aims to reduce the availability of tobacco outlets by implementing a sales ban for vending machines (2022) and supermarkets (2024). The government intends to further phase out tobacco sales by petrol stations and small outlets after 2030. This study aims to understand its impact on tobacco outlet availability in the Netherlands, with particular attention to rural areas.

Methods

An audit of tobacco retailers was held between Sept 2019-June 2020 in four cities (Amsterdam, Eindhoven, Haarlem, and Zwolle) and between March-Apr 2022 in seven rural municipalities (Aa en Hunze, Ermelo, Dinkelland, Montferland, Simpelveld, Veere, and Waadhoeke). Each identified retailer was visited and mapped using Global Positioning System (GPS). Tobacco outlet availability was calculated in terms of density per population and km2, and residents’ proximity to the nearest outlet.

Results

In the rural areas, we found a total of 98 tobacco outlets, of which supermarkets (n = 57), petrol stations (26), small outlets (13) and tobacco specialist shops (2). In the four cities, we found a total of 870 outlets. Tobacco outlet density was much lower in rural areas than the four cities: 0.09 vs. 2.2 per km2 and 5.05 vs. 6.2 per 10,000 capita. The average shortest distance from an address to a tobacco outlet was much higher in rural areas (1.23km) compared to cities (0.31km). After implementation of all sales bans, tobacco outlet availability will reduce to 2 outlets in rural areas and 61 in urban areas which represents 0.1 and 0.4 per 10,000 capita, respectively. The distance will increase in cities (to 1.42km), but particularly in rural areas (to 5.28km) where 5 of the 7 municipalities did no longer include a tobacco outlet.

Conclusions

The proposed restrictions on tobacco sales will strongly decrease tobacco outlet availability, and might even disappear in some rural areas. These results call into question how the tobacco industry would respond to the proposed restriction.

Key messages

Long term mortality and morbidity of Italian soldiers after deployment in Iraq as related to biomarkers assessment: Results of the SIGNUM study

INTRODUCTION

The health profile of military veterans deployed in foreign operative theatres was assessed by several international studies because of potential exposure to depleted uranium and other pollutants. Here we reported results of 15-year epidemiological surveillance assessing long-term health effects in a cohort of Italian soldiers deployed in Iraq in 2004-2005 and participating in a biomonitoring campaign to identify potential genotoxic exposure to environmental xenobiotics before and after deployment (n = 981, SIGNUM cohort).

METHODS

We evaluated mortality and hospitalization risks of the SIGNUM cohort retrospectively until 2016 and 2018 respectively. A wide cohort of military personnel never deployed abroad (n = 114,260) and the general Italian population were used as control populations in risk assessment. Causes of death and diagnoses of hospitalization were derived through deterministic record linkage with official national databases of mortality and hospital discharge. Standardized Mortality Ratio (SMR) and Standardized Hospitalization Ratio (SHR) were computed adjusting according to sex, age, area of birth, and calendar year. Differential pre-post deployment in xenobiotics concentrations and early effect biomarkers (oxidative DNA alterations and micronuclei) measured in blood serum were analysed in relation to cancer hospitalization.

RESULTS

Mortality risk due to pathologies was more than halved compared to the general population (SMR = 0.41, 95% CI 0.11-1.05) and not significantly different compared to soldiers never deployed abroad (SMR = 0.69, 95% CI 0.19-1.68). Similarly overall hospitalization risk due to pathologies was decreased with respect to the general population (SHR = 0.86, 95% CI 0.80-0.92) and comparable to the control military group (SHR = 0.99, 95% CI: 0.93-1.06). For haematological cancers a decreased hospitalization risk compared to the Italian general population was observed (SHR = 0.38, 95% CI 0-0.92). No statistically significant differences emerged in the patterns of biomarkers in association with cancer hospitalization.

CONCLUSION

The study confirms the so called 'healthy warrior' effect for the SIGNUM veterans and showed no correlation between cancer occurrence and biomonitoring markers measured on field.

Virtual bronchoscopy for evaluating cervical tumors of the fetus

We report on four cases of fetal cervical tumor, comprising three lymphangiomas and one teratoma, evaluated by ultrasound and magnetic resonance imaging (MRI) between 26 and 37 weeks' gestation. The aim was to investigate the use of virtual bronchoscopy to evaluate fetal airway patency in each case. A three-dimensional (3D) model of the airway was created from overlapping image layers generated by MRI. The files obtained were manipulated using 3D modeling software, allowing the virtual positioning of observation cameras, adjustment of lighting parameters and creation of simulated 3D movies for analysis of a virtual path through the model. In all fetuses, fetal airway patency was clearly demonstrated by virtual bronchoscopy and this was confirmed postnatally. MRI with virtual bronchoscopy could become a useful tool for studying fetal airway patency in cases of cervical tumor.

[Identification and early nutritional support in hospitalized malnourished patients]

INTRODUCTION

The prevalence of hyponutrition in hospitalized patients in our setting is 53%. The therapeutic approach is controversial.

OBJECTIVES

To determine whether an early nutritional intervention in hospitalized patients by means of oral nutritional support can improve their prognosis regarding decreased morbimortality and hospital stay.

MATERIAL AND METHODS

Randomized prospective study comprised by a treatment group and a control group of malnourished patients hospitalized at the Internal Medicine and Respiratory Medicine Departments. The nutritional diagnosis was made by using the Subjective Global Assessment. Groups B and C were assigned to receive the hospital diet according to their needs and pathology (control group) and the treatment group also received a standard nutritional supplement. We recorded the development of infections, pressure ulcers, hospitalization days, mortality, and weight.

RESULTS

We performed more than 1,700 Subjective Global Assessments. Five hundred and thirty seven patients (264 treated and 273 controls) were followed-up until hospital discharge or death. We did not find statistically significant differences in mortality, hospital stay, or occurrence of complications between the treatment group and the control group. The treatment group presented statistically significant weight increase as compared with the control group.

CONCLUSIONS

We could not demonstrate benefits when using the oral nutritional supplement in terms of mortality, hospital stay, infectious complications, or pressure ulcers. The significant weight increase in the treatment group allowed us concluding that the supplement effectively treated hyponutrition in this group. This new clinical status implies a better prognosis, as it has already been shown. However, this could not be observed by means of the study parameters. Long-term studies are required to determine for how long this nutritional improvement can be sustained, implying a better prognosis in the long run.

Purification of proteins from rat sperm membranes that interact with ligands other than phosphomannosyl residues

In this study proteins were purified from rat sperm membranes which might be the high affinity sites for ligands of epididymal fluid other than the mannose-6-phosphate receptors. The sperm membrane proteins were solubilized and passed over an affinity column containing epididymal fluid proteins coupled to a matrix. Two bands in the range of 45-55 kDa were eluted from the column with fructose-6-phosphate but not with mannose-6-phosphate. Although the molecular weight of these proteins are similar to those of the cation-dependent phosphomannosyl receptors they are not related. These two proteins may correspond either to two different receptors or to forms of the same receptor that recognize ligands from rat epididymal fluid. Sequencing and identification of these proteins will be the aim of future studies.

A cluster of ABA-regulated genes on Arabidopsis thaliana BAC T07M07

Arabidopsis thaliana BAC T07M07 encoding the abscisic acid-insensitive 4 (ABI4) locus has been sequenced completely. It contains a 95,713-bp insert and 24 predicted genes. Most putative genes were confirmed by gel-based RNA profiling and a cluster of ABA-regulated genes was identified. One of the 24 genes, designated PP2C5, encodes a putative protein phosphatase 2C. The encoded protein was expressed in Escherichia coli, and its enzyme activity in vitro was confirmed.

Changes in the content of rat epididymal fluid induced by prolonged treatment with tamoxifen

Prolonged treatment with tamoxifen induces changes in the male reproductive tract in rats. In this study changes in the protein content of the rat epididymal fluid as a consequence of prolonged treatment with tamoxifen are reported. Among five lysosomal enzymes measured in the epididymal fluid, alpha-mannosidase (alpha-MAN) significantly diminished, but other enzymes did not. Electrophoretic analysis of fluids showed that proteins of estimated molecular weight 25, 60, 80-85 and 180 kDa decreased in the treated rats. We also detected an increase in the binding of beta-galactosidase (beta-GAL) to caudal spermatozoa in treated rats. These changes may be related in part to the loss of fertilizing capacity of spermatozoa after tamoxifen treatment.

Construction of an approximately 2 Mb contig in the region around 80 cM of Arabidopsis thaliana chromosome 2

A method for construction of bacterial artificial chromosome (BAC) contigs from a yeast artificial chromosome (YAC) physical map is described. An approximately 2 Mb contig, consisting of two large BAC contigs linked by a small YAC, has been assembled in the region around 80 cM of Arabidopsis thaliana chromosome 2. Clones from this contig will facilitate gene isolation in the region and can be used directly as substrates for DNA sequencing.

Changes in N-acetyl-beta-D-glucosaminidase binding system in rat liver during growth

In this paper, we characterize the binding of N-acetyl-beta-D-glucosaminidase to membranes of rat liver during development. Cation-independent phosphomannosyl receptors were shown to be involved in the recognition of the enzyme at the following ages: 18 days of fetal life, 10-, 30- and 90-day-old rats. We remark here two important differences in the binding of the fetal enzyme when compared with that in 90-day-old rats; (a) in addition to an optimal binding at pH 7.0, the fetal enzyme showed another peak of binding at acidic pH (5.0), and (b) the binding of the fetal enzyme was also inhibited by galactose-6-phosphate. This inhibition was higher than that of mannose-6-phosphate at the acidic pH. We concluded that the lysosomal enzymes and their receptors undergo important changes around birth.

[A case control study of the relationship between diet and breast cancer in a sample from 3 Spanish hospital populations. Effects of food, energy and nutrient intake]

A case-control study was conducted to analyze the possible role of diet on the incidence of breast cancer in a group of 275 women (139 cases and 136 controls) recruited from three hospital populations (Madrid, Mérida, and Santiago de Compostela). The retrospective intake of foods was studied by a modified dietary history; from this the intake of energy, nutrients, fiber, and alcohol was derived. Intake of oils and fats was significantly higher among cases, which translates into a higher intake of lipids and vitamin E. In contrast, intake of vitamin D and legumes was significantly lower. No differences were observed regarding other foods and nutrients between cases and controls. The estimate of the odds ratio as a relative risk measure for breast cancer, adjusted and unadjusted for total energy, indicates that intake of cereals and legumes, proteins, carbohydrates and fiber is apparently a protective factor, whereas an excessive intake of meat, oils and fats and a lipid intake higher than 46% of the total caloric intake or poly-unsaturated fatty acids higher than 15 g would be a risk factor for this pathology.

A physical map of chromosome 2 of Arabidopsis thaliana

A yeast artificial chromosome (YAC) physical map of chromosome 2 of Arabidopsis thaliana has been constructed by hybridization of 69 DNA markers and 61 YAC end probes to gridded arrays of YAC clones. Thirty-four YACs in four contigs define the chromosome. Complete closure of the map was not attained because some regions of the chromosome were repetitive or were not represented in the YAC library. Based on the sizes of the YACs and their coverage of the chromosome, the length of chromosome 2 is estimated to be at least 18 Mb. These data provide the means for immediately identifying the YACs containing a genetic locus mapped on Arabidopsis chromosome 2.

[Influence of energy intake and body mass index in the incidence of cancer of the breast. Case-control study in a sample from 3 Spanish hospital populations]

A case-control study has been designed to analyze the possible role of the energy intake and obesity, judged by the body mass index, on the incidence of breast cancer in a group of 275 women (139 cases and 136 controls), coming from three hospital populations (Madrid, Mérida, and Santiago de Compostela). There are no significant differences in the of cases and controls, which, additionally, does not seem to be significantly related to the risk of breast cancer. On the other hand, the weight and the body mass index of women with breast cancer is significantly higher than that of the controls. The oods ratio, as a measure of the relative risk for breast cancer, shows that a high body mass index behaves as a risk factor (OR = 2.49; 95% IC, = 1.33-4.67, Chi2 = 8.30), a trend which remains after adjusting for energy. When considering the pre or post menopausal status, it is observed that a body mass index higher than 29, adjusted for energy intake, behaves as a risk factor only in the post-menopausal women (OR = 2.28; 95% IC = 0.95-5.46 Chi2 = 3.41).

[Importance of development disorders detection in neonatal anoxia and physiotherapy intervention]

The purpose of this study was to verify the neuropsychomotor development and the necessity of stimulation, correlating the neurological pathology diagnosis to the physiotherapeutic indication at the moment of hospital discharging. Cases studied were 27 patients with partial recovery and newborn anoxy diagnosis assisted in 1988 at the Newborn Intensive Care Unit of the University Hospital in Santa Maria-RS. The newborns were evaluated according to neuroevolutive approach during domiciliary visits to 10 patients. The results showed the necessity of physiotherapeutic intervention on cases of newborn anoxy.

[Cross-sectional study of the quantity and quality of fat consumed in Spain and the mortality by various types of neoplasms of the reproductive system]

The possible relation between the amount and composition of fat in the diet of different regions and provinces in Spain and the mortality caused by different types of cancer is studied. The quantitative information about fat intake comes from a publication entitled "Nutrition Study" (1985) which was performed by our Nutrition Department together with the National Institute of Statistics (INE). The study sample is formed by 23,972 families and is representative of the whole country and of each of the Provinces and Autonomic Communities in it. Each family is surveyed for seven days for the "Family Direct Survey". The dietetic parameters studied have been the following: total energy intake, total lipids, total fat and fatty acids as a percentage of total caloric intake, cooking fat/total fat ratio, vegetable fat, animal fat, fish fat, saturated fatty acids, monounsaturated, polyunsaturated, and cholesterol. These parameters have been correlated with mortality date due to the following tumors: malignant tumors in general, breast, uterine neck, uterus, ovary, prostate, and testicle, in each of the provinces in our country, expressed per 100,000 inhabitants, data which was obtained from the INE publication (1986). Similarly, the corresponding correlations have been carried out between dietetic parameters and breast cancer adjusted mortality rate. From our study we can conclude that there is a statistically significant negative correlation between mortality due to testicle cancer and some dietetic parameters. However, breast, prostate, and ovary neoplasias are only affected by certain parameters. These results agree with those obtained by other authors. No statisticaly significant correlation is found when adjusted rates are used.