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Background
Back pain is not only a worldwide problem in adults, but also in children and adolescents. The prevalence rates increase with age. Risk factors for back pain in children are among others asymmetries of the spine, too heavy and asymmetrically carried school backpacks, and a sedentary lifestyle.Objectives
This paper presents a multifactorial school-based intervention program and the corresponding study protocol for a cluster-randomized, controlled evaluation of this program to address these risk factors.Materials and methods
The intervention program should be tested on pupils aged 10–12 at a German “Gymnasium” (secondary school) over the course of one school year. It contains 5 lessons on back care, 3 exercise posters for the class room, and exercises for physical education classes that strengthen and mobilize core muscles and train body perception. The evaluation instruments are motoric tests, a back-behavior test, a knowledge test, a clinical–orthopedic examination, and several questionnaires.Results and conclusions
The presented intervention program and evaluation instruments aim to show one way of planning and evaluating an intervention in the daily school environment. There is a need for high-quality studies on prevention of back pain in children and adolescents. This is a topic that has received little attention in Germany.Purpose
Phenolic compounds (PC) of virgin olive oil exert several biochemical and pharmacological beneficial effects. Some dietary PC seem to prevent/improve obesity and metabolic-related disorders such as non-alcoholic fatty liver disease (NAFLD). We investigated the possible effects of PC extracted from olive pomace (PEOP) and of the main single molecules present in the extract (tyrosol, apigenin, oleuropein, p-coumaric and caffeic acid) in protecting hepatocytes and endothelial cells against triglyceride accumulation and oxidative stress.Methods
Rat hepatoma and human endothelial cells were exposed to a mixture of oleate/palmitate to mimic the condition of NAFLD and atherosclerosis, respectively. Then, cells were incubated for 24 h in the absence or in the presence of PC or PEOP. Different parameters were evaluated, such as lipid accumulation and oxidative stress-related markers.Results
In hepatic cells, expression of peroxisome proliferator-activated receptors (PPARs) and of stearoyl-CoA desaturase 1 (SCD-1) were assessed as index of lipid metabolism. In endothelial cells, expression of intercellular adhesion molecule-1 (ICAM-1), activation of nuclear factor kappa-B (NF-kB), release of nitric oxide (NO), and wound-healing rate were assessed as index of inflammation.Conclusion
PEOP extract ameliorated hepatic lipid accumulation and lipid-dependent oxidative imbalance thus showing potential applications as therapeutic agent tuning down hepatosteatosis and atherosclerosis.Evidence-based policy measures need non-interest-guided information about the health status of a population and the diseases that affect the population the most. In such cases, a national burden of disease study can provide reliable insights at the regional level.
AimThis article presents the potential of the BURDEN 2020 project and its expected outcome for Germany at the national and regional level.
MethodsThe BURDEN 2020 project uses several indicators including years of life lost (YLL) to cover the impact of mortality and years lived with disability (YLD) to cover morbidity. The sum of both is the measure of population health called disability adjusted life years (DALY).
ResultsThe study ranks individual diseases and risk factors based on their impact on population health. The burden of disease approach is assumed to be sensitive to subnational differences and may generate immediate benefits for regional planning. The BURDEN 2020 study will pilot a national burden of disease study for Germany that will later be transformed into a continuous data processing and visualization tool. This is done by using, modifying and supplementing the methodology employed by the Global Burden of Disease (GBD) study to better fit the needs of health policy in Germany. This study is aimed at calculating the disease burden for up to 17 preselected diseases. Furthermore, the estimates of burden of disease are attributed to a selected set of risk factors.
ConclusionThe Burden 2020 study will provide the results of a new, health-related data processing system to the public. This includes a noninterest-guided presentation of the burden of disease (DALY) in Germany at the national and regional level.
相似文献Areas covered: We review the regulatory and ethical challenges encountered in efforts to optimize expanded access.
Expert opinion: In the era of personalized medicine, patients may benefit from novel therapeutic agents that demonstrate encouraging results in early studies. However, drug approval is a lengthy and cumbersome procedure that might exceed the time frame of a life-threatening disease. Expanded access provides options to patients with unmet needs. It may provide informative safety and efficacy data to the manufacturers and the scientific and regulatory organizations.
Ongoing efforts are being made by global governmental and scientific committees, regulatory agencies, and patient organizations to address the ethical and regulatory issues and to optimize the expanded access process. Their goal is to expand access to promising novel drugs for individual patients and to accelerate the necessary procedures while preserving patient safety. 相似文献