Alchemical Practice: Looking Towards the Chemical Humanities.

This special issue of Ambix is an outgrowth of the Tenth Annual Postgraduate Workshop titled "Society and the Creation of (al)Chemical Knowledge" hosted by the Embassy of the Free Mind in Amsterdam, 29-30 November 2019. This meeting of early career scholars with a shared interest in the history of alchemy and chemistry illustrated the diversity of methodological approaches that contribute to this subfield. Alchemical knowledge, created through practice, language, and material culture, has permeated society since the ancient world. Adepts and laity alike learned to navigate and appropriate the seemingly paradoxical hermetic language and images of alchemy, applying them to an array of societal needs that span time and place. The editorial essay to this special issue of Ambix considers alchemical knowledge-creation through the social lens of language and practice and proposes the inclusive concept of the "Chemical Humanities" to address variations within alchemical practice and the diverse scholarly research methodologies presented in this special issue. We examine the history of chemistry using approaches from the humanities, arts, and sciences and consider the effects of interdisciplinary research today and for the future of alchemical scholarship.

Recommendations for Effective Intersectoral Collaboration in Health Promotion Interventions: Results from Joint Action CHRODIS-PLUS Work Package 5 Activities.

The burden of chronic disease in Europe continues to grow. A major challenge facing national governments is how to tackle the risk factors of sedentary lifestyle, alcohol abuse, smoking, and unhealthy diet. These factors are complex and necessitate intersectoral collaboration to strengthen health promotion, counter-act the social determinants of health, and reduce the prevalence of chronic disease. European countries have diverse intersectoral collaboration to encourage health promotion activities. In the Joint Action CHRODIS-PLUS success factors for intersectoral collaboration within and outside healthcare which strengthen health promotion activities were identified with a mixed method design via a survey of 22 project partners in 14 countries and 2 workshops. In six semi-structured interviews, the mechanisms underlying these success factors were examined. These mechanisms can be very context-specific but do give more insight into how they can be replicated. In this paper, 20 health promotion interventions from national programs in CHRODIS PLUS are explored. This includes community interventions, policy actions, integrated approaches, capacity building, and training activities. The interventions involved collaboration across three to more than six sectors. The conclusion is a set of seven recommendations that are considered to be essential for fostering intersectoral collaboration to improve health-promoting activities.

Rethinking Performative Methods in the History of Science.

Performative methods have been part of history of science research and education for at least three decades. Understood broadly, they cover every methodology in which a historian or philosopher of science engages in embodied interaction with sources, tools and materials that do not traditionally belong to historical research, with the aim of answering a historical research question. The question no longer appears to be whether performative methods have a place within history and philosophy of science research, but what their place is, could, or should be; when and how they can and cannot be used. Because although performative methods are seen as an enrichment of the field by many, their growing popularity also raises questions: what new insights and challenges has the increased use of performative methods in the history of science brought us? How has it changed the field? Should performative research methods become a mandatory part of the training of new generations of historians of science? In this special issue, historians and philosophers of science for whom performative methods play an important role in their work reflect on these questions from their own research and teaching practices.

Boerhaave's Furnace. Exploring Early Modern Chemistry through Working Models.

This article discusses the (re)construction and use of an Early modern instrument, better known as Herman Boerhaave's (1668-1738) little furnace. We investigate the origins, history and materiality of this furnace, and examine the dynamic relationship between historical study and reconstructing and handling an object. We argue that combining textual analysis with performative methods allows us to gain a better understanding of both the role of lost material culture in historical chemical practice, pedagogy, and knowledge production, and provide a deeper understanding of the embodied experiences and knowledge of historical actors. Having made and used two versions of Boerhaave's furnace, we provide insight in what present-day working models can tell us about historical materials and practices approximately three centuries ago.

Casting life, casting death: connections between early modern anatomical corrosive preparations and artistic materials and techniques.

Although the historical connections between anatomy and the visual arts have been explored in quite some depth, especially in the cases of early modern anatomical drawing, sculpting, the making of wet preparations and wax modelling, the role of artistic techniques in the creation of corrosive preparations has received little attention thus far. This is remarkable, as there appear to be significant similarities between casting techniques like those employed by the influential artist Wenzel Jamnitzer (1508-85) and anatomical corrosive techniques. This paper explores the connections between the two domains and argues that, although artistic and anatomical techniques were often very similar in terms of the materials used, the skills that had to be developed to apply them successfully, and the visual results, there were distinct materialities and techniques in each realm. It is demonstrated that the creation of corrosion casts, particularly wax-based casts, required particular skills that were unlike others in the period. The paper does so by analysing the material and technical qualities of corrosive preparations from the period 1700-1900, and by comparing the results of this analysis with written instructions for making corrosive preparations and making casts from the same period in both anatomical and artist handbooks.

Boerhaave's Mineral Chemistry and Its Influence on Eighteenth-Century Pharmacy in the Netherlands and England.

In the eighteenth century, the use of mineral or fossil substances was relatively common in European medicine and pharmacy. However, this period also saw profound changes in ideas about the nomenclature, chemistry, and curative properties of minerals. Jonathan Simon has recently argued that an increasing orientation towards the mineral kingdom and the chemical transformation of minerals, and a rise in the number of mineral preparations demanded of the pharmacist, were characteristic for eighteenth-century chemistry within pharmacy. Yet in the Netherlands, and to a certain extent in England, another pattern is visible: although there certainly was an interest in the mineral kingdom and the chemical transformation of nonorganic materials, nothing suggests that this resulted in a strong increase in the demand for mineral-based pharmaceutical preparations - rather the contrary. Unlike English and French eighteenth-century pharmacy, Dutch pharmacy and its relation to academic medicine and chemistry have hardly received attention from historians of science thus far. This paper aims to fill that gap and argues that Herman Boerhaave's (1668-1738) view on mineral medicine was crucial in the development of a certain wariness of "mineral medicine" in the eighteenth-century Netherlands and England, especially among apothecaries.

Limited salt consumption reduces the incidence of chronic kidney disease: a modeling study.

Background: In addition to blood pressure and cardiovascular disease, high-salt intake has been associated with renal diseases. The aim of this study is to estimate the potential health impact of salt reduction on chronic kidney disease (CKD) and end-stage kidney disease (ESKD) in the Netherlands. Methods: We developed a dynamic population health modeling tool to estimate the health impact of salt reduction on CKD and ESKD. We used data from the PREVEND study and extrapolated that to the Dutch population aged 30-75 years. We estimated the potential health impact of salt reduction comparing the current situation with the health impact of the adherence to the recommended maximum salt intake of 6 g/d. Results: In the recommended maximum intake scenario, a cumulative reduction in CKD of 1.1% (N = 290 000; interquartile range (IQR) = 249 000) and in ESKD of 3.2% (N = 470; IQR = 5080) would occur over a period of 20 years. Conclusions: Our health impact estimation showed that health benefits on CKD might be achieved when salt intake is reduced to the recommended maximum intake of 6 g/d.

Identification of differences in health impact modelling of salt reduction.

We examined whether specific input data and assumptions explain outcome differences in otherwise comparable health impact assessment models. Seven population health models estimating the impact of salt reduction on morbidity and mortality in western populations were compared on four sets of key features, their underlying assumptions and input data. Next, assumptions and input data were varied one by one in a default approach (the DYNAMO-HIA model) to examine how it influences the estimated health impact. Major differences in outcome were related to the size and shape of the dose-response relation between salt and blood pressure and blood pressure and disease. Modifying the effect sizes in the salt to health association resulted in the largest change in health impact estimates (33% lower), whereas other changes had less influence. Differences in health impact assessment model structure and input data may affect the health impact estimate. Therefore, clearly defined assumptions and transparent reporting for different models is crucial. However, the estimated impact of salt reduction was substantial in all of the models used, emphasizing the need for public health actions.

Salt Reductions in Some Foods in The Netherlands: Monitoring of Food Composition and Salt Intake.

BACKGROUND AND OBJECTIVES: High salt intake increases blood pressure and thereby the risk of chronic diseases. Food reformulation (or food product improvement) may lower the dietary intake of salt. This study describes the changes in salt contents of foods in the Dutch market over a five-year period (2011-2016) and differences in estimated salt intake over a 10-year period (2006-2015). METHODS: To assess the salt contents of foods; we obtained recent data from chemical analyses and from food labels. Salt content of these foods in 2016 was compared to salt contents in the 2011 version Dutch Food Composition Database (NEVO, version 2011), and statistically tested with General Linear Models. To estimate the daily dietary salt intake in 2006, 2010, and 2015, men and women aged 19 to 70 years were recruited through random population sampling in Doetinchem, a small town located in a rural area in the eastern part of the Netherlands. The characteristics of the study population were in 2006: n = 317, mean age 49 years, 43% men, in 2010: n = 342, mean age 46 years, 45% men, and in 2015: n = 289, mean age 46 years, 47% men. Sodium and potassium excretion was measured in a single 24-h urine sample. All estimates were converted to a common metric: salt intake in grams per day by multiplication of sodium with a factor of 2.54. RESULTS: In 2016 compared to 2011, the salt content in certain types of bread was on average 19 percent lower and certain types of sauce, soup, canned vegetables and legumes, and crisps had a 12 to 26 percent lower salt content. Salt content in other types of foods had not changed significantly. Between 2006, 2010 and 2015 the estimated salt intake among adults in Doetinchem remained unchanged. In 2015, the median estimated salt intake was 9.7 g per day for men and 7.4 g per day for women. As in 2006 and 2010, the estimated salt intake in 2015 exceeded the recommended maximum intake of 6 g per day set by the Dutch Health Council. CONCLUSION: In the Netherlands, the salt content of bread, certain sauces, soups, potato crisps, and processed legumes and vegetables have been reduced over the period 2011-2016. However, median salt intake in 2006 and 2015 remained well above the recommended intake of 6 g.

Implementation conditions for diet and physical activity interventions and policies: an umbrella review.

BACKGROUND: This umbrella review aimed at identifying evidence-based conditions important for successful implementation of interventions and policies promoting a healthy diet, physical activity (PA), and a reduction in sedentary behaviors (SB). In particular, we examined if the implementation conditions identified were intervention-specific or policy-specific. This study was undertaken as part of the DEterminants of DIet and Physical Activity (DEDIPAC) Knowledge Hub, a joint action as part of the European Joint Programming Initiative a Healthy Diet for a Healthy Life. METHODS: A systematic review of reviews and stakeholder documents was conducted. Data from nine scientific literature databases were analyzed (95 documents met the inclusion criteria). Additionally, published documentation of eight major stakeholders (e.g., World Health Organization) were systematically searched (17 documents met the inclusion criteria). The RE-AIM framework was used to categorize elicited conditions. Across the implementation conditions 25 % were identified in at least four documents and were subsequently classified as having obtained sufficient support. RESULTS: We identified 312 potential conditions relevant for successful implementation; 83 of these received sufficient support. Using the RE-AIM framework eight implementation conditions that obtained support referred to the reach in the target population; five addressed efficacy of implementation processes; 24 concerned adoption by the target staff, setting, or institutions; 43 referred to consistency, costs, and adaptations made in the implementation process; three addressed maintenance of effects over time. The vast majority of implementation conditions (87.9 %; 73 of 83) were supported by documents referring to both interventions and policies. There were seven policy-specific implementation conditions, which focused on increasing complexities of coexisting policies/legal instruments and their consequences for implementation, as well as politicians' collaboration in implementation. CONCLUSIONS: The use of the proposed list of 83 conditions for successful implementation may enhance the implementation of interventions and policies which pursue identification of the most successful actions aimed at improving diet, PA and reducing SB.

Health gain by salt reduction in europe: a modelling study.

Excessive salt intake is associated with hypertension and cardiovascular diseases. Salt intake exceeds the World Health Organization population nutrition goal of 5 grams per day in the European region. We assessed the health impact of salt reduction in nine European countries (Finland, France, Ireland, Italy, Netherlands, Poland, Spain, Sweden and United Kingdom). Through literature research we obtained current salt intake and systolic blood pressure levels of the nine countries. The population health modeling tool DYNAMO-HIA including country-specific disease data was used to predict the changes in prevalence of ischemic heart disease and stroke for each country estimating the effect of salt reduction through its effect on blood pressure levels. A 30% salt reduction would reduce the prevalence of stroke by 6.4% in Finland to 13.5% in Poland. Ischemic heart disease would be decreased by 4.1% in Finland to 8.9% in Poland. When salt intake is reduced to the WHO population nutrient goal, it would reduce the prevalence of stroke from 10.1% in Finland to 23.1% in Poland. Ischemic heart disease would decrease by 6.6% in Finland to 15.5% in Poland. The number of postponed deaths would be 102,100 (0.9%) in France, and 191,300 (2.3%) in Poland. A reduction of salt intake to 5 grams per day is expected to substantially reduce the burden of cardiovascular disease and mortality in several European countries.

Good practice characteristics of diet and physical activity interventions and policies: an umbrella review.

BACKGROUND: This umbrella review aimed at eliciting good practice characteristics of interventions and policies aiming at healthy diet, increasing physical activity, and lowering sedentary behaviors. Applying the World Health Organization's framework, we sought for 3 types of characteristics, reflecting: (1) main intervention/policy characteristics, referring to the design, targets, and participants, (2) monitoring and evaluation processes, and (3) implementation issues. This investigation was undertaken by the DEDPIAC Knowledge Hub (the Knowledge Hub on the DEterminants of DIet and Physical ACtivity), which is an action of the European Union's joint programming initiative. METHODS: A systematic review of reviews and stakeholder documents was conducted. Data from 7 databases was analyzed (99 documents met inclusion criteria). Additionally, resources of 7 major stakeholders (e.g., World Health Organization) were systematically searched (10 documents met inclusion criteria). Overall, the review yielded 74 systematic reviews, 16 position review papers, and 19 stakeholders' documents. Across characteristics, 25% were supported by ≥ 4 systematic reviews. Further, 25% characteristics were supported by ≥ 3 stakeholders' documents. If identified characteristics were included in at least 4 systematic reviews or at least 3 stakeholders' documents, these good practice characteristics were classified as relevant. RESULTS: We derived a list of 149 potential good practice characteristics, of which 53 were classified as relevant. The main characteristics of intervention/policy (n = 18) fell into 6 categories: the use of theory, participants, target behavior, content development/management, multidimensionality, practitioners/settings. Monitoring and evaluation characteristics (n = 18) were grouped into 6 categories: costs/funding, outcomes, evaluation of effects, time/effect size, reach, the evaluation of participation and generalizability, active components/underlying processes. Implementation characteristics (n = 17) were grouped into eight categories: participation processes, training for practitioners, the use/integration of existing resources, feasibility, maintenance/sustainability, implementation partnerships, implementation consistency/adaptation processes, transferability. CONCLUSIONS: The use of the proposed list of 53 good practice characteristics may foster further development of health promotion sciences, as it would allow for identification of success vectors in the domains of main characteristics of interventions/policies, their implementation, evaluation and monitoring processes.

Anatomical Mercury: Changing Understandings of Quicksilver, Blood, and the Lymphatic System, 1650-1800.

The use of mercury as an injection mass in anatomical experiments and preparations was common throughout Europe in the long eighteenth century, and refined mercury-injected preparations as well as plates of anatomical mercury remain today. The use and meaning of mercury in related disciplines such as medicine and chemistry in the same period have been studied, but our knowledge of anatomical mercury is sparse and tends to focus on technicalities. This article argues that mercury had a distinct meaning in anatomy, which was initially influenced by alchemical and classical understandings of mercury. Moreover, it demonstrates that the choice of mercury as an anatomical injection mass was deliberate and informed by an intricate cultural understanding of its materiality, and that its use in anatomical preparations and its perception as an anatomical material evolved with the understanding of the circulatory and lymphatic systems. By using the material culture of anatomical mercury as a starting point, I seek to provide a new, object-driven interpretation of complex and strongly interrelated historiographical categories such as mechanism, vitalism, chemistry, anatomy, and physiology, which are difficult to understand through a historiography that focuses exclusively on ideas.

Potential effect of salt reduction in processed foods on health.

BACKGROUND: Excessive salt intake has been associated with hypertension and increased cardiovascular disease morbidity and mortality. Reducing salt intake is considered an important public health strategy in the Netherlands. OBJECTIVE: The objective was to evaluate the health benefits of salt-reduction strategies related to processed foods for the Dutch population. DESIGN: Three salt-reduction scenarios were developed: 1) substitution of high-salt foods with low-salt foods, 2) a reduction in the sodium content of processed foods, and 3) adherence to the recommended maximum salt intake of 6 g/d. Health outcomes were obtained in 2 steps: after salt intake was modeled into blood pressure levels, the Chronic Disease Model was used to translate modeled blood pressures into incidences of cardiovascular diseases, disability-adjusted life years (DALYs), and life expectancies. Health outcomes of the scenarios were compared with health outcomes obtained with current salt intake. RESULTS: In total, 4.8% of acute myocardial infarction cases, 1.7% of congestive heart failure cases, and 5.8% of stroke cases might be prevented if salt intake meets the recommended maximum intake. The burden of disease might be reduced by 56,400 DALYs, and life expectancy might increase by 0.15 y for a 40-y-old individual. Substitution of foods with comparable low-salt alternatives would lead to slightly higher salt intake reductions and thus to more health gain. The estimates for sodium reduction in processed foods would be slightly lower. CONCLUSION: Substantial health benefits might be achieved when added salt is removed from processed foods and when consumers choose more low-salt food alternatives.

Monitoring salt and iodine intakes in Dutch adults between 2006 and 2010 using 24 h urinary sodium and iodine excretions.

OBJECTIVE: To monitor the effectiveness of salt-reduction initiatives in processed foods and changes in Dutch iodine policy on Na and iodine intakes in Dutch adults between 2006 and 2010. DESIGN: Two cross-sectional studies among adults, conducted in 2006 and 2010, using identical protocols. Participants collected single 24 h urine samples and completed two short questionnaires on food consumption and urine collection procedures. Daily intakes of salt, iodine, K and Na:K were estimated, based on the analysis of Na, K and iodine excreted in urine. SETTING: Doetinchem, the Netherlands. SUBJECTS: Men and women aged 19 to 70 years were recruited through random sampling of the Doetinchem population and among participants of the Doetinchem Cohort Study (2006: n 317, mean age 48·9 years, 43 % men; 2010: n 342, mean age 46·2 years, 45 % men). RESULTS: While median iodine intake was lower in 2010 (179 µg/d) compared with 2006 (257 µg/d; P < 0·0001), no difference in median salt intake was observed (8·7 g/d in 2006 v. 8·5 g/d in 2010, P = 0·70). In 2006, median K intake was 2·6 g/d v. 2·8 g/d in 2010 (P < 0·01). In this 4-year period, median Na:K improved from 2·4 in 2006 to 2·2 in 2010 (P < 0·001). CONCLUSIONS: Despite initiatives to lower salt in processed foods, dietary salt intake in this population remains well above the recommended intake of 6 g/d. Iodine intake is still adequate, although a decline was observed between 2006 and 2010. This reduction is probably due to changes in iodine policy.

No consistent association between consumption of energy-dense snack foods and annual weight and waist circumference changes in Dutch adults.

BACKGROUND: There is conflicting evidence regarding an association between the consumption of energy-dense snack (EDS) foods and the development of overweight. OBJECTIVE: In the current study, we examined whether there was an association between the intake of EDS foods and annual weight and waist circumference changes in normal-weight and overweight Dutch adults. DESIGN: The study population included 9383 men and women from the MORGEN-EPIC (Monitoring Project on Risk Factors for Chronic Diseases in the Netherlands-European Prospective Investigation into Cancer and Nutrition) study, which is a population-based cohort study in 3 towns in the Netherlands (Amsterdam, Maastricht, and Doetinchem), who had a body mass index (in kg/m(2)) <30 and who were not dieting. Participants were enrolled between 1993 and 1997 and followed for an average of 8.1 y (Amsterdam and Maastricht: 9.9 y; Doetinchem: 4.9 y). Intake of EDS foods (sweets, cakes and pastries, and savory snacks) was assessed at baseline by using a validated food-frequency questionnaire. Multivariate linear and multinomial logistic regression models were applied and stratified by center to examine the association between energy from EDS foods (kcal) and annual weight and waist circumference changes. RESULTS: The mean (±SD) daily energy intake from EDS foods was 294 ± 192 kcal. In Amsterdam and Maastricht, the annual weight change was 168 ± 572 g/y, whereas in Doetinchem, the annual weight change was 444 ± 816 g/y. In the multivariate regression analysis adjusted for follow-up duration and anthropometric, dietary, and lifestyle factors, there was some, but inconsistent, evidence of an association of EDS-food consumption with annual weight change. CONCLUSION: Our study provides some, but inconsistent, evidence that consumption of EDS foods is positively associated with an increase in annual weight in normal- to overweight Dutch adults.

Impact of substituting added sugar in carbonated soft drinks by intense sweeteners in young adults in the Netherlands: example of a benefit-risk approach.

PURPOSE: Substituting added sugar in carbonated soft drinks with intense sweeteners may have potential beneficial, but also adverse health effects. This study assessed the benefits and risks associated with substituting added sugar in carbonated soft drinks with intense sweeteners in young adults in the Netherlands. METHODS: A tiered approach was used analogous to the risk assessment paradigm, consisting of benefit and hazard identification, exposure assessment and finally benefit and risk characterization and comparison. Two extreme scenarios were compared in which all carbonated soft drinks were sweetened with either intense sweeteners or added sugar. National food consumption survey data were used, and intake of added sugar and intense sweeteners was calculated using the food composition table or analytical data for sweetener content. RESULTS: Reduction in dental caries and body weight were identified as benefits of substituting sugar. The mean difference in total energy intake between the scenarios was 542 kJ per day in men and 357 kJ per day in women, under the assumption that no compensation takes place. In the 100% sweetener scenario, the average BMI decreased 1.7 kg/m(2) in men and 1.3 kg/m(2) in women when compared to the 100% sugar scenario. Risks are negligible, as the intake of intense sweeteners remains below the ADI in the substitution scenario. CONCLUSIONS: Substitution of added sugar by intense sweeteners in carbonated soft drinks has beneficial effects on BMI and the reduction in dental caries, and does not seem to have adverse health effects in young adults, given the available knowledge and assumptions made.

A tiered approach for risk-benefit assessment of foods.

Risk-benefit analyses are introduced as a new paradigm for old problems. However, in many cases it is not always necessary to perform a full comprehensive and expensive quantitative risk-benefit assessment to solve the problem, nor is it always possible, given the lack of required date. The choice to continue from a more qualitative to a full quantitative risk-benefit assessment can be made using a tiered approach. In this article, this tiered approach for risk-benefit assessment will be addressed using a decision tree. The tiered approach described uses the same four steps as the risk assessment paradigm: hazard and benefit identification, hazard and benefit characterization, exposure assessment, and risk-benefit characterization, albeit in a different order. For the purpose of this approach, the exposure assessment has been moved upward and the dose-response modeling (part of hazard and benefit characterization) is moved to a later stage. The decision tree includes several stop moments, depending on the situation where the gathered information is sufficient to answer the initial risk-benefit question. The approach has been tested for two food ingredients. The decision tree presented in this article is useful to assist on a case-by-case basis a risk-benefit assessor and policymaker in making informed choices when to stop or continue with a risk-benefit assessment.