ABSTRACT
The risk concept intends to make hazards linked to industrialisation and modernisation calculable and to limit and to counterbalance them. Since the possibility of health damages by pollutants can not be excluded once a population has been exposed to them, the task is to estimate and quantify these hazards as risk. In environmental medicine risk stands for the probability that a part of a population exposed to a pollutant will be harmed. The scientific estimation and quantification of health risks is restricted by epistemological, methodological and practical limits. It can not be predicted in a particular case to what extent this not determinable part of the risk contributes to the overall risk. The process of the evaluation of risks with respect to their social justifiability includes value judgements influenced by the respective social area and its interests. The acceptability of risks can only be weighed in relation to their associated benefits. Acceptance of risks requires full knowledge and awareness and mutual confidence which only slowly can grow as the result of a longlasting authentic communication.
Subject(s)
Environmental Exposure/adverse effects , Environmental Pollutants/adverse effects , Public Health , Germany , Humans , Risk AssessmentABSTRACT
In a state of the art paper a four step approach is made in order to investigate the question why public health research is necessary at all. 1. Expectations concerning public health research: The classical topics of public health research will continue to be relevant. Additionally, health promotion especially for low income and other risk groups should become important. For this purpose public health should try to relate to politics. Considering available resources and the quality of services goals should be determined as regulative criterias for the health system. Public health research will only remain relevant in the future if it turns from the traditional approach of public health medicine to what is called the new public health paradigm and if it adds the system approach to the population approach. 2. Target groups of public health research are policy makers and institutions as well as persons in the health care system. It has to be checked if these target groups are reached. Policy impact is more important than science impact. 3. Expectations to public health research concern the transfer of public health into other areas of science, the establishment of new institutions and teaching programmes and its inter-disciplinarity. Deficits exist in the selection of relevant topics and in the innovative power of projects. 4. Proposals for further public health actions refer to politically dominant issues which are to be defined by consensus conferences.
Subject(s)
Health Services Research/trends , Public Health/trends , Forecasting , Germany , Health Policy/trends , Health Priorities/trends , Health Promotion/trends , HumansSubject(s)
Clinical Trials as Topic/methods , Adult , Age Factors , Aged , Humans , Middle Aged , Risk FactorsABSTRACT
The effects of ouabain, vasopressin, and furosemide on intracellular concentrations of total sodium([Na]) and potassium [K]), on exchangeable sodium ([Na]) and the sodium transport pool ([Nap]) were investigated in isolated short circuited skins of rana esculenta. Furosemide was added to the epithelial bathing solution, vasopressin and ouabain to the corial bathing solution. Results were compared with the amount of net sodium transport measured by short circuit current (scc). Ouabain reduces scc and increases [Na] and [Na]; [K] is decreased. The administration of vasopressin leads to a sharp increase of scc, combined with an enhancement of of [Na] and [Na]; [K] shows no significant change. [Nap] is significantly increased, too, and approximately to the same amount as [Na]. Furosemide causes an increase of scc, whereas a significant change of [Na], [Na] and [K] could not be detected. On the other hand, [Nap] was enhanced significantly. The results support the hypothesis that furosemide like vasopressin is acting by increasing the entry of sodium into the transport compartment of the active cell layer. The result is an increased transfer of sodium across the skin.
Subject(s)
Furosemide/pharmacology , Ouabain/pharmacology , Skin/metabolism , Sodium/metabolism , Vasopressins/pharmacology , Animals , Anura , Biological Transport, Active/drug effects , Body Water/metabolism , Extracellular Space/drug effects , In Vitro Techniques , Intracellular Fluid/analysis , Potassium/metabolism , Rana esculenta , Skin/drug effectsABSTRACT
Ethacrynic acid stimulates in vitro concentration dependent renal gluconeogenesis from substrates which enter the gluconeogenic pathway at the level of the triosephosphates like glycerol or fructose or from substrates which have to pass the oxaloacetate shuttle like pyruvate or from intermediary products of fatty acid oxydation or citrate cycle. Our results suggest that a site of action of ethacrynic acid in this metabolic aspect is the enzyme system fructose diphosphatase/frutose-6-phosphate kinase and eventually additionally pyruvate carboxylase.
