Changes in estimated coronary risk in the 1980s: data from 38 populations in the WHO MONICA Project

The World Health Organization (WHO) MONICA Project is a 10-year study monitoring trends and determinants of cardiovascular disease in geographically defined populations. Data were collected from over 100 000 randomly selected participants in two risk factor surveys conducted approximately 5 years apart in 38 populations using standardized protocols. The net effects of changes in the risk factor levels were estimated using risk scores derived from longitudinal studies in the Nordic countries. The prevalence of cigarette smoking decreased among men in most populations, but the trends for women varied. The prevalence of hypertension declined in two-thirds of the populations. Changes in the prevalence of raised total cholesterol were small but highly correlated between the genders (r = 0.8). The prevalence of obesity increased in three-quarters of the populations for men and in more than half of the populations for women. In almost half of the populations there were statistically significant declines in the estimated coronary risk for both men and women, although for Beijing the risk score increased significantly for both genders. The net effect of the changes in the risk factor levels in the 1980s in most of the study populations of the WHO MONICA Project is that the rates of coronary disease are predicted to decline in the 1990s.

The knowledge gap: A perspective on trade, industry, technology and policy from pre-war Australian music technology manufacturing (1903-30)

Australia struggles to achieve economic competitiveness, prevent expansion of the trade deficit and develop value-added production despite applications of policy strategies from protectionism to trade liberalisation. This article argues that these problems were emerging at the turn of the century, and that an investigation of music technology manufacturing in the first two decades of this century reveals fundamental problems in the conduct of relevant policy analysis. Analysis has focused on the trade or technology gap which is only symptomatic of an underlying knowledge gap. The article calls for a knowledge policy approach which can allow protection without the negative effects of isolation from global markets and without having to resort to unworkable utopian free-trade dogma. A shift of focus from a 'goods traded' view to a knowledge transaction (or diffusion) perspective is advocated.

The politics and ethics of relocated art

At the end of Word War II, Soviet occupation forces removed countless art objects from German soil. Some of them were returned during the 1950s, but most either disappeared for good or were stored away secretly in cellars of Soviet museums. The Cold War then covered the issue with silence. After the collapse of the Soviet Union, museums in St Petersburg and Moscow started to exhibit some of the relocated art for the first time in half a century. The unusual quality of the paintings-mostly impressionist masterpieces-not only attracted the attention of the international art community, but also triggered a diplomatic row between Russia and Germany. Both governments advanced moral and legal claims to ownership. To make things even more complicated, many of the paintings once belonged to private collectors, some of whom were Jews. Their descendants also entered the dispute. The basic premise of this article is that the political and ethical dimensions of relocated art can be understood most adequately by eschewing a single authorial standpoint. Various positions, sometimes incommensurable ones, are thus explored in an attempt to outline possibilities for an ethics of representation and a dialogical solution to the international problem that relocated art has become.

Estimation of contribution of changes in classic risk factors to trends in coronary-event rates across the WHO MONICA Project populations

Background From the mid-1980s to mid-1990s, the WHO MONICA Project monitored coronary events and classic risk factors for coronary heart disease (CHD) in 38 populations from 21 countries. We assessed the extent to which changes in these risk factors explain the variation in the trends in coronary-event rates across the populations. Methods In men and women aged 35-64 years, non-fatal myocardial infarction and coronary deaths were registered continuously to assess trends in rates of coronary events. We carried out population surveys to estimate trends in risk factors. Trends in event rates were regressed on trends in risk score and in individual risk factors. Findings Smoking rates decreased in most male populations but trends were mixed in women; mean blood pressures and cholesterol concentrations decreased, body-mass index increased, and overall risk scores and coronary-event rates decreased. The model of trends in 10-year coronary-event rates against risk scores and single risk factors showed a poor fit, but this was improved with a 4-year time lag for coronary events. The explanatory power of the analyses was limited by imprecision of the estimates and homogeneity of trends in the study populations. Interpretation Changes in the classic risk factors seem to partly explain the variation in population trends in CHD. Residual variance is attributable to difficulties in measurement and analysis, including time lag, and to factors that were not included, such as medical interventions. The results support prevention policies based on the classic risk factors but suggest potential for prevention beyond these.

Conservation farming projects in the Philippine uplands: Rhetoric and reality

The phenomenon of agricultural land degradation in the Philippine uplands has been regarded by scientists and policy-makers as a major environmental and rural development problem. Numerous conservation farming projects have been implemented in the past two decades to address this problem, apparently with little success. Most of these projects have espoused the currently fashionable principles of community-based sustainable development. This paper examines case histories of three completed upland conservation projects. The aim is to compare the rhetoric of project documents and evaluations with the reality of on-going land management practices as seen from the perspective of the land managers themselves. (C) 2000 Elsevier Science Ltd. All rights reserved.

Reducing the harms caused by cannabis use: the policy debate in Australia

The debate about cannabis policy in Australia has revolved around the harms that cannabis causes to users and the community, on the one hand, and the harms that are caused by the prohibition of its use, on the other. This paper assesses evidence on: (1) the harms caused to users and the community by cannabis use (derived from the international scientific literature) and (2) the harms that arise from prohibition (as reflected in Australian research). The most probable harms caused by cannabis use include: an increased risk of motor vehicle accidents; respiratory disease; dependence; adverse effects on adolescent development; and the exacerbation of psychosis. The harms of the current prohibition on cannabis use policy are less tangible but probably include: the creation of a large blackmarket; disrespect for a widely broken law; harms to the reputation of the unlucky few cannabis users who are caught and prosecuted; lack of access to cannabis for medical uses; and an inefficient use of law enforcement resources. Cannabis policy unavoidably involves trade offs between competing values that should be made by the political process. Australian cannabis policy has converged on a solution which continues to prohibit cannabis but reduces the severity of penalties for cannabis use by either removing criminal penalties or diverting first time cannabis offenders into treatment and education. (C) 2001 Elsevier Science Ireland Ltd. All rights reserved.