Cholesterol-raising diterpenes in types of coffee commonly consumed in Singapore, Indonesia and India and associations with blood lipids: A survey and cross sectional study

<p>Abstract</p> <p>Background</p> <p>To measure the content of cholesterol-raising diterpenes in coffee sold at the retailer level in Singapore, Indonesia and India and to determine the relationship of coffee consumption with lipid levels in a population-based study in Singapore.</p> <p>Methods</p> <p>Survey and cross-sectional study in local coffee shops in Singapore, Indonesia and India to measure the diterpene content in coffee, and a population-based study in Singapore to examine the relationship of coffee consumption and blood lipid levels. Interviews and coffee samples (n = 27) were collected from coffee shops in Singapore, Indonesia and India. In addition, 3000 men and women who were Chinese, Malay, and Indian residents of Singapore participated in a cross-sectional study.</p> <p>Results and Discussion</p> <p>The traditional 'sock' method of coffee preparation used in Singapore resulted in cafestol concentrations comparable to European paper drip filtered coffee (mean 0.09 ± SD 0.064 mg/cup). This amount would result in negligible predicted increases in serum cholesterol and triglyceride concentrations. Similarly low amounts of cafestol were found in Indian 'filter' coffee that used a metal mesh filter (0.05 ± 0.05 mg/cup). Coffee samples from Indonesia using the 'sock' method (0.85 ± 0.41 mg/cup) or a metal mesh filter (0.98 mg/cup) contained higher amounts of cafestol comparable to espresso coffee. Unfiltered coffee from Indonesia contained an amount of cafestol (4.43 mg/cup) similar to Scandinavian boiled, Turkish and French press coffee with substantial predicted increases in serum cholesterol (0.33 mmol/l) and triglycerides (0.20 mmol/l) concentrations for consumption of 5 cups per day. In the Singaporean population, higher coffee consumption was not substantially associated with serum lipid concentrations after adjustment for potential confounders [LDL-cholesterol: 3.07 (95% confidence interval 2.97-3.18) for <1 cup/week versus 3.12 (2.99-3.26) for ≥ 3 cups/day; p trend 0.12].</p> <p>Conclusions</p> <p>Based on the low levels of diterpenes found in traditionally prepared coffee consumed in Singapore and India, coffee consumption in these countries does not appear to be a risk factor for elevation of serum cholesterol, whereas samples tested from Indonesia showed mixed results depending on the type of preparation method used.</p

Admission into hospitals 1976

Evaluation of admission into hospitals / information / privacy / nursing personnel. Background variables: basic characteristics/ residence/ educatio

Tackling hospital waiting times: The impact of past and current policies in the Netherlands

tThis paper reviews the impact of health policies on hospital waiting times in the Netherlandsover the last two decades. During the 1990s hospital waiting times increased as a resultof the introduction of fixed budgets and capacity constraints for specialists, in addition tothe fixed global hospital budgets that were already in place since the 1980s. To tacklethese increased waiting times over the years 2000–2011 several policies were imple-mented, including a change from fixed budgets to activity-based funding – for both hospitalsand specialists – and increased competition among hospitals. All together these measuresresulted in a strong reduction of waiting times. In 2011 mean expected waiting times foralmost all surgical procedures varied from 2 to 6 weeks, well below the broadly acceptedspecified maximum waiting times. Hence, in the Netherlands hospital waiting times arecurrently not an important policy concern. Since the waiting time reduction was achievedat the expense of rapidly growing hospital costs, these have become now the primary pol-icy concern. This has triggered the introduction of new powerful supply-side constraints in2012, which may cause waiting times to increase for the coming years