TY - JOUR A1 - Mnich, Carina T1 - Is there Europeanization of physical activity promotion? BT - A neofunctional approach JF - Health policy N2 - Physical inactivity is a problem in Europe, contributing to various non-communicable diseases (NCDs). While health sciences offer data and models for preventing the development of NCDs through health promotion, they do not explain the dynamics between the different institutions and actors in the health field. Neofunctionalism refers to these different actors and suggests that their interaction leads to the construction of a supranational authority, allowing the actors to cooperate on common policies, rules and institutions, resulting in integration and Europeanization. Indeed, there are a variety of European Union (EU) institutions and policies concerned with physical activity (PA), however, the purpose of this paper is to analyze if Europeanization and integration are happening in PA promotion, through the lens of neofunctionalism. Analysis uses process tracing for investigating the emergence of PA on the EU agenda, the legal background, existing policies and institutions. Findings indicate that Europeanization and integration of PA promotion are happening, although the opportunity for actions of the EU are restricted to voluntary actions of the EU Member States due to the agreements in the Treaty of Lisbon. This only allows the EU institutions to apply soft law approaches on PA promotion, which seems to be implemented in some Member States despite its non-binding character. The findings are discussed and further implications for public health professionals and policies outlined. KW - EUROPE KW - European Union/organization & administration KW - Exercise KW - health policy KW - Health Promotion/organization & administration KW - Humans Y1 - 2019 U6 - https://doi.org/10.1016/j.healthpol.2019.01.004 VL - 123 IS - 3 SP - 317 EP - 326 PB - Elsevier ER - TY - JOUR A1 - Cichy, Ireneusz A1 - Kruszwicka, Agnieszka A1 - Palus, Patrycja A1 - Przybyla, Tomasz A1 - Schliermann, Rainer A1 - Wawrzyniak, Sara A1 - Klichowski, Michal A1 - Rokita, Andrzej T1 - Physical Education with Eduball Stimulates Non-Native Language Learning in Primary School Students JF - International Journal of Environmental Research and Public Health (Int. J. Environ. Res. Public Health) N2 - Although the neuronal mechanisms of action and cognition are related, the division of intellectual and physical lessons is standard in schools. This is surprising, because numerous studies show that integrating physical education (PE) with teaching content stimulates critical skills. For example, several experiments indicate that Eduball-based PE (i.e., lessons in a sports hall during which students play team mini-games with educational balls with printed letters, numbers, and other signs) develops mathematical and language competencies. At the same time, the Eduball method does not slow down learners' physical development. However, we have little knowledge about the effects of such techniques on non-native language learning. Consequently, the absence of incorporating core academic subjects into PE in dual-language schools or during foreign language education is exceptionally high. Here, we replicated the Eduball experiment, but with the goal of testing this method for non-native language learning. Thus, the intervention occurred in a dual-language primary school and we evaluated second language (L2) learning. As before, we used the technique of parallel groups (experimental and control); in both groups, there were three 45-min PE classes per week. In the experimental class, two of them were held using Eduball. After a half-year experiment, children from the experimental group (one second-grade, N = 14) improved their non-native language skills significantly more than their peers from the control group (one second-grade, N = 12). These findings demonstrate that Eduball-type intervention stimulates non-native language learning in children. Hence, our report suggests that specific body training forms can support L2 learning. KW - Child KW - Humans KW - Language KW - Learning KW - Physical Education and Training KW - Schools KW - Students Y1 - 2022 U6 - https://doi.org/10.3390/ijerph19138192 VL - 19 IS - 13 SP - 1 EP - 14 PB - MDPI CY - Basel ER - TY - JOUR A1 - Bender, Guzide A1 - Fahrioglu Yamaci, Rezan A1 - Taneri, Bahar T1 - CRISPR and KRAS: a match yet to be made JF - Journal of biomedical science N2 - CRISPR (clustered regularly interspaced short palindromic repeats) systems are one of the most fascinating tools of the current era in molecular biotechnology. With the ease that they provide in genome editing, CRISPR systems generate broad opportunities for targeting mutations. Specifically in recent years, disease-causing mutations targeted by the CRISPR systems have been of main research interest; particularly for those diseases where there is no current cure, including cancer. KRAS mutations remain untargetable in cancer. Mutations in this oncogene are main drivers in common cancers, including lung, colorectal and pancreatic cancers, which are severe causes of public health burden and mortality worldwide, with no cure at hand. CRISPR systems provide an opportunity for targeting cancer causing mutations. In this review, we highlight the work published on CRISPR applications targeting KRAS mutations directly, as well as CRISPR applications targeting mutations in KRAS-related molecules. In specific, we focus on lung, colorectal and pancreatic cancers. To date, the limited literature on CRISPR applications targeting KRAS, reflect promising results. Namely, direct targeting of mutant KRAS variants using various CRISPR systems resulted in significant decrease in cell viability and proliferation in vitro, as well as tumor growth inhibition in vivo. In addition, the effect of mutant KRAS knockdown, via CRISPR, has been observed to exert regulatory effects on the downstream molecules including PI3K, ERK, Akt, Stat3, and c-myc. Molecules in the KRAS pathway have been subjected to CRISPR applications more often than KRAS itself. The aim of using CRISPR systems in these studies was mainly to analyze the therapeutic potential of possible downstream and upstream effectors of KRAS, as well as to discover further potential molecules. Although there have been molecules identified to have such potential in treatment of KRAS-driven cancers, a substantial amount of effort is still needed to establish treatment strategies based on these discoveries. We conclude that, at this point in time, despite being such a powerful directed genome editing tool, CRISPR remains to be underutilized for targeting KRAS mutations in cancer. Efforts channelled in this direction, might pave the way in solving the long-standing challenge of targeting the KRAS mutations in cancers. KW - Animals KW - Clustered Regularly Interspaced Short Palindromic Repeats KW - Humans KW - Mice KW - Mutation KW - Proto-Oncogene Proteins p21(ras)/therapeutic use Y1 - 2021 U6 - https://doi.org/10.1186/s12929-021-00772-0 VL - 28 SP - 1 EP - 25 PB - Springer Nature ER - TY - JOUR A1 - Chatterjee, Subhomoy A1 - Kobylinski, Sabine A1 - Basu, Bikramjit T1 - Finite Element Analysis to Probe the Influence of Acetabular Shell Design, Liner Material, and Subject Parameters on Biomechanical Response in Periprosthetic Bone JF - Journal of Biomechanical Engineering N2 - The implant stability and biomechanical response of periprosthetic bone in acetabulum around total hip joint replacement (THR) devices depend on a host of parameters, including design of articulating materials, gait cycle and subject parameters. In this study, the impact of shell design (conventional, finned, spiked, and combined design) and liner material on the biomechanical response of periprosthetic bone has been analyzed using finite element (FE) method. Two different liner materials: high density polyethylene-20% hydroxyapatite-20% alumina (HDPE-20%HA-20%Al2O3) and highly cross-linked ultrahigh molecular weight polyethylene (HC-UHMWPE) were used. The subject parameters included bone condition and bodyweight. Physiologically relevant load cases of a gait cycle were considered. The deviation of mechanical condition of the periprosthetic bone due to implantation was least for the finned shell design. No significant deviation was observed at the bone region adjacent to the spikes and the fins. This study recommends the use of the finned design, particularly for weaker bone conditions. For stronger bones, the combined design may also be recommended for higher stability. The use of HC-UHMWPE liner was found to be better for convensional shell design. However, similar biomechanical response was captured in our FE analysis for both the liner materials in case of other shell designs. Overall, the study establishes the biomechanical response of periprosthetic bone in the acetabular with preclinically tested liner materials together with new shell design for different subject conditions. KW - Acetabulum/physiology KW - Biomechanical Phenomena KW - Body Weight KW - Finite element analysis KW - GAIT KW - Hip Prosthesis KW - Humans KW - Linear Models KW - Mechanical Phenomena KW - Prosthesis Design KW - Stress, Mechanical Y1 - 2018 U6 - https://doi.org/10.1115/1.4040249 SN - 1528-8951 VL - 140 IS - 10 PB - ASME ER - TY - JOUR A1 - Treutwein, Marius A1 - Steger, Felix A1 - Löschel, Rainer A1 - Kölbl, Oliver A1 - Dobler, Barbara T1 - The influence of radiotherapy techniques on the plan quality and on the risk of secondary tumors in patients with pituitary adenoma JF - BMC cancer N2 - BACKGROUND: This planning study compares different radiotherapy techniques for patients with pituitary adenoma, including flatness filter free mode (FFF), concerning plan quality and secondary malignancies for potentially young patients. The flatness filter has been described as main source of photon scatter. MATERIAL AND METHODS: Eleven patients with pituitary adenoma were included. An Elekta Synergy™ linac was used in the treatment planning system Oncentra® and for the measurements. 3D plans, IMRT, and VMAT plans and non-coplanar varieties were considered. The plan quality was evaluated regarding homogeneity, conformity, delivery time and dose to the organs at risk. The secondary malignancy risk was calculated from dose volume data and from measured dose to the periphery using different models for carcinoma and sarcoma risk. RESULTS: The homogeneity and conformity were nearly unchanged with and without flattening filter, neither was the delivery time found substantively different. VMAT plans were more homogenous, conformal and faster in delivery than IMRT plans. The secondary cancer risk was reduced with FFF both in the treated region and in the periphery. VMAT plans resulted in a higher secondary brain cancer risk than IMRT plans, but the risk for secondary peripheral cancer was reduced. Secondary sarcoma risk plays a minor role. No advantage was found for non-coplanar techniques. The FFF delivery times were not shortened due to additional monitor units needed and technical limitations. The risk for secondary brain cancer seems to depend on the irradiated volume. Secondary sarcoma risk is much smaller than carcinoma risk in accordance to the results of the atomic bomb survivors. The reduction of the peripheral dose and resulting secondary malignancy risk for FFF is statistically significant. However, it is negligible in comparison to the risk in the treated region. CONCLUSION: Treatments with FFF can reduce secondary malignancy risk while retaining similar quality as with flattening filter and should be preferred. VMAT plans show the best plan quality combined with lowest peripheral secondary malignancy risk, but highest level of second brain cancer risk. Taking this into account VMAT FFF seems the most advantageous technique for the treatment of pituitary adenomas with the given equipment. KW - Adenoma/radiotherapy KW - Age Factors KW - Female KW - Humans KW - Male KW - Pituitary Neoplasms/radiotherapy KW - Radiotherapy Dosage KW - risk factors Y1 - 2020 U6 - https://doi.org/10.1186/s12885-020-6535-y VL - 20 SP - 1 EP - 13 PB - Springer ER - TY - JOUR A1 - Alvarez Moret, Judit A1 - Obermeier, Tina A1 - Pohl, Fabian A1 - Löschel, Rainer A1 - Kölbl, Oliver A1 - Dobler, Barbara T1 - Second cancer risk after radiation therapy of ependymoma using the flattening filter free irradiation mode of a linear accelerator JF - Journal of Applied Clinical Medical Physics N2 - Pediatric patients suffering from ependymoma are usually treated with cranial or craniospinal three-dimensional (3D) conformal radiotherapy (3DCRT). Intensity-modulated techniques spare dose to the surrounding tissue, but the risk for second malignancies may be increased due to the increase in low-dose volume. The aim of this study is to investigate if the flattening filter free (FFF) mode allows reducing the risk for second malignancies compared to the mode with flattening filter (FF) for intensity-modulated techniques and to 3DCRT. A reduction of the risk would be advantageous for treating pediatric ependymoma. 3DCRT was compared to intensity-modulated radiation therapy (IMRT) and volumetric-modulated arc therapy (VMAT) with and without flattening filter. Dose-volume histograms (DVHs) were compared to evaluate the plan quality and used to calculate the excess absolute risk (EAR) to develop second cancer in the brain. Dose verification was performed with a two-dimensional (2D) ionization chamber array and the out-of-field dose was measured with an ionization chamber to determine the EAR in peripheral organs. Delivery times were measured. Both VMAT and IMRT achieved similar plan quality in terms of dose sparing in the OAR and higher PTV coverage as compared to 3DCRT. Peripheral dose in low-dose region, which is proportional to the EAR in organs located in this region, for example, gonads, bladder, or bowel, could be significantly reduced using FFF. The lowest peripheral EAR and lowest delivery times were hereby achieved with VMATFFF . The EAR calculated based on DVH in the brain could not be reduced using FFF mode. VMATFFF improved the target coverage and homogeneity and kept the dose in the OAR similar compared to 3DCRT. In addition, delivery times were significantly reduced using VMATFFF . Therefore, for radiotherapy of ependymoma patients, VMATFFF may be considered advantageous for the combination of Elekta Synergy linac and Oncentra External Beam planning system used in this study. KW - Adolescent KW - Child KW - Child, Preschool KW - Ependymoma/radiotherapy KW - Humans KW - Infant KW - Neoplasms, Radiation-Induced KW - Neoplasms, Second Primary KW - Particle Accelerators KW - Radiotherapy Dosage KW - Radiotherapy Planning, Computer-Assisted KW - Radiotherapy, Intensity-Modulated KW - Retrospective Studies Y1 - 2018 U6 - https://doi.org/10.1002/acm2.12438 VL - 19 IS - 5 SP - 632 EP - 639 PB - Wiley ER - TY - JOUR A1 - Grabitz, Peter A1 - Friedmann, Zoe A1 - Gepp, Sophie A1 - Hess, Leonard U. A1 - Specht, Lisa A1 - Struck, Maja A1 - Tragert, Sophie Kira A1 - Walther, Tobias A1 - Klemperer, David T1 - Quantity and quality of conflict of interest policies at German medical schools BT - a cross-sectional study and survey JF - BMJ open N2 - OBJECTIVES: To assess the quantity and evaluate the quality of policies and curricula focusing on conflicts of interests (COI) at medical schools across Germany. DESIGN: Cross-sectional study, survey of medical schools, standardised web search. SETTING: Medical schools, Germany. PARTICIPANTS: 38 German medical schools. - INTERVENTIONS: We collected relevant COI policies, including teaching activities, by conducting a search of the websites of all 38 German medical schools using standardised keywords for COI policies and teaching. Further, we surveyed all medical schools' dean's offices. Finally, we adapted a scoring system for results we obtained with 13 categories based on prior similar studies. MAIN OUTCOMES AND MEASURES: Presence or absence of COI-related policies, including teaching activities at medical school. The secondary outcome was the achieved score on a scale from 0 to 26, with high scores representing restrictive policies and sufficient teaching activities. RESULTS: We identified relevant policies for one medical school via the web search. The response rate of the deans' survey was 16 of 38 (42.1%). In total, we identified COI-related policies for 2 of 38 (5.3%) German medical schools, yet no policy was sufficient to address all COI-related categories that were assessed in this study. The maximum score achieved was 12 of 26. 36 (94.7%) schools scored 0. No medical school reported curricular teaching on COI. CONCLUSIONS: Our results indicate a low level of action by medical schools to protect students from undue commercial influence. No participating dean was aware of any curriculum or instruction on COI at the respective school and only two schools had policies in place. The German Medical Students Association and international counterparts have called for a stronger focus on COI in the classroom. We conclude that for German medical schools, there is still a long way to go. KW - Conflict of Interest KW - Cross-Sectional Studies KW - Curriculum KW - Germany KW - Humans KW - Policy KW - Schools, Medical Y1 - 2020 U6 - https://doi.org/10.1136/bmjopen-2020-039782 VL - 10 IS - 9 SP - 1 EP - 8 PB - BMJ Publishing Group ER - TY - JOUR A1 - Lenk, Christian A1 - Duttge, Gunnar A1 - Flatau, Laura A1 - Frommeld, Debora A1 - Poser, Wolfgang A1 - Reitt, Markus A1 - Schulze, Thomas A1 - Weber, Alexandra A1 - Zoll, Barbara T1 - A look into the future? Patients' and health care staff's perception and evaluation of genetic information and the right not to know JF - American journal of medical genetics. Part B, Neuropsychiatric genetics : the official publication of the International Society of Psychiatric Genetics N2 - The progress of medical genetics leads to a significant increase in genetic knowledge and a vast expansion of genetic diagnostics. However, it is still unknown how these changes will be integrated into medical practice and how they will change patients' and healthy persons' perception and evaluation of genetic diagnoses and genetic knowledge. Therefore, we carried out a comprehensive questionnaire survey with more than 500 patients, clients seeking genetic counseling, health care staff, and healthy persons (N = 523). The questionnaire survey covered detailed questions on the value of genetic diagnoses for the different groups of study participants, the right to know or not to know genetic diagnoses, possible differences between genetic and other medical diagnoses, and the practical use and implications of genetic knowledge with a special focus on hereditary neuropsychiatric diseases. A huge majority of the participants (90.7%) stated to have a right to learn every aspect of her or his genetic make-up. Similarly, study participants showed high interest (81.8%) in incidental health care findings-independent of whether the diseases are treatable or not. One can derive from the data outcome that study participants did not follow the implications of a "genetic exceptionalism" and often considered genetic findings as equivalent in relation to other medical diagnoses. KW - Attitude of Health Personnel KW - Female KW - Genetic Counseling/methods KW - Genetic Testing/ethics KW - Health Knowledge, Attitudes, Practice KW - Humans KW - Incidental Findings KW - Male KW - Middle Aged KW - Surveys and Questionnaires Y1 - 2019 U6 - https://doi.org/10.1002/ajmg.b.32751 VL - 180 IS - 8 SP - 576 EP - 588 PB - Wiley ER - TY - JOUR A1 - Schüz, B. A1 - Dräger, D. A1 - Richter, Stefanie A1 - Kummer, K. A1 - Kuhlmey, A. A1 - Tesch-Römer, C. T1 - Autonomie trotz Multimorbidität im Alter - Der Berliner Forschungsverbund AMA JF - Zeitschrift fur Gerontologie und Geriatrie N2 - Mit zunehmendem Alter steigt der Anteil mehrfach erkrankter Menschen und immer mehr Menschen erreichen ein sehr hohes Lebensalter. Trotz des medizinischen Fortschritts und verbesserter Lebenslagen müssen viele alte Menschen körperliche, psychische und soziale Einschränkungen bewältigen. Es ist eine große gesundheits- und sozialpolitische Herausforderung, diese alten Frauen und Männer mit gesundheitlichen Beeinträchtigungen in ihrem Bestreben nach einer weitestgehend autonomen Lebensgestaltung zu unterstützen und zu stärken. Vor diesem Hintergrund widmete sich der Forschungsverbund „Autonomie trotz Multimorbidität im Alter“ (AMA I) der Leitfrage, inwieweit eine selbstbestimmte Lebensgestaltung alter mehrfach erkrankter Menschen erhalten werden kann. Um der Vielfalt der Lebenswelten älterer Menschen gerecht zu werden, wurden im Alltag wenig eingeschränkte und pflegebedürftige sowie kognitiv beeinträchtigte Personen in die Untersuchung einbezogen. Darunter waren Frauen und Männer, die noch im eigenen Haushalt und solche die im Pflegeheim lebten. Im Fokus der Untersuchungen standen die Ressourcen, die den alten Menschen in ihrer jeweiligen Lebenssituation zur Verfügung standen und die Frage, wie diese gestärkt werden können. Der Beitrag präsentiert Ergebnisse zu dieser Forschungsfrage aus der 1. Förderphase des AMA-Verbundes. Darauf aufbauend werden in einer 2. Förderphase (2011–2013, AMA II) nunmehr nachhaltige praxisrelevante Interventionen zur Mobilisierung von autonomierelevanten Ressourcen mehrfach erkrankter alter Menschen entwickelt und auf ihre Praxistauglichkeit getestet. T2 - Autonomy despite multimorbidity in old age – The Berlin-based AMA research consortium KW - Aged KW - Aged, 80 and over KW - Chronic Disease/epidemiology KW - Clinical Trials as Topic KW - Comorbidity KW - Evidence-Based Medicine KW - Germany KW - Health Services for the Aged KW - Health Services Research/organization & administration KW - Humans KW - Interinstitutional Relations KW - United States Y1 - 2011 U6 - https://doi.org/10.1007/s00391-011-0248-4 SN - 1435-1269 SN - 0948-6704 VL - 44 IS - Suppl. 2 SP - 9 EP - 26 PB - Springer Medizin ER - TY - JOUR A1 - Richter, Stefanie T1 - Integrierte Versorgung für Menschen mit Demenz : Ein Beispiel für gelingende Praxis JF - Gesundheitswesen N2 - The rising number of cases of people with dementia, the need for complex care and the insufficient care available call for innovative and sustainable solutions. The article presents a specialised dementia care model that has been developed to manage acute difficulties of care. The model implements comprehensive, patient-oriented care across different sectors. The structure and requirements of successful cooperation and comprehensive care will be described. N2 - Steigende Fallzahlen von Menschen mit Demenz, der komplexe Bedarf und eine unzureichende Versorgungsrealität erfordern innovative und nachhaltige Lösungsansätze. Der Beitrag stellt ein Versorgungsmodell für Menschen mit Demenz vor, das infolge akuter Versorgungsprobleme entwickelt wurde und das eine umfassende, patientenorientierte Versorgung über Sektorengrenzen hinweg umsetzt. Beschrieben werden Struktur und Bedingungen gelingender Kooperation und umfassender Versorgung. T2 - Integrated Care for People with Dementia : Integrated Care for People with Dementia KW - Aged, 80 and over KW - Delivery of Health Care, Integrated/organization & administration KW - Delivery of Health Care/organization & administration KW - Dementia/diagnosis/therapy KW - Female KW - Germany KW - Health Services for the Aged/organization & administration KW - Humans KW - Male KW - Middle Aged KW - Models, Organizational KW - Organizational Objectives Y1 - 2015 U6 - https://doi.org/10.1055/s-0035-1559706 SN - 1439-4421 SN - 0941-3790 VL - 77 IS - 11 SP - 845 EP - 847 PB - Thieme CY - Stuttgart ER -