Search

Laura Hoffmann,1,2,&ast; Susanne Müller,1,3,&ast; Lucas M Bachmann,4,5 Daniela Claessens,6 Katja Hatz1,7 1Medical Retina & Research Department, Vista Eye Clinic Binningen, Binningen, Switzerland; 2Department of Ophthalmology, University Hospital Charité - Campus Benjamin Franklin, Berlin, Germany; 3Department for Health Sciences, Donau University Krems, Krems, Austria; 4Oculocare Medical, Medignition AG, Zurich, Switzerland; 5Faculty of Medicine, University of Zurich, Zurich, Switzerland; 6Gemeinschaftspraxis Augenheilkunde Lindenthal, Cologne, Germany; 7Faculty of Medicine, University of Basel, Basel, Switzerland&ast;These authors contributed equally to this workCorrespondence: Katja Hatz, Vista Augenklinik, Hauptstrasse 55, Binningen, 4102, Switzerland, Tel +41 61 426 60 79, Fax +41 61 426 60 01, Email katja.hatz@unibas.ch; katja.hatz@vista.chPurpose: To assess the ability of two self-monitoring digital devices to detect metamorphopsia in myopic choroidal neovascularization (mCNV) and compare their usability.Patients and Methods: This was a 12-month prospective observational study at a tertiary care eye hospital, Switzerland. Twenty-three Caucasian patients with mCNV were recruited, 21 eyes were analyzed. Primary and secondary outcome measures: Primary outcome measures were the metamorphopsia index scores as assessed by the two self-monitoring digital devices (Alleye App and AMD – A-Metamorphopsia-Detector software) at baseline, at 6 and 12 months and individual optional visits in between. Secondary outcome measures included best corrected visual acuity and morphological parameters (including disease activity) as evaluated by spectral-domain optical coherence tomography and fundus autofluorescence imaging. Location of mCNV was graded using the Early Treatment of Diabetic Retinopathy Study grid overlay. A usability questionnaire was administered at 12 months. Bland-Altman plots evaluated the limits of agreement of both devices. Linear regression analysis assessed the correlation between the difference and the average of the two scores.Results: A total of 202 tests were performed. Disease activity of mCNV was observed at least once in 14 eyes. Both scores concordantly detected metamorphopsia exhibiting a displaced scale of measurement yielding a coefficient of determination of 0.99. Concordance rate for pathological scores was 73.3%. Both scores were not significantly different in active and inactive mCNV. Overall, the usability scores were higher for the Alleye App than the AMD – A-Metamorphopsia-Detector software (4.61± 0.56 vs 3.31± 1.20; p< 0.001). In subjects aged > 75 years, scores were slightly lower (4.08± 0.86 vs 2.97± 1.16; p= 0.032).Conclusion: Whilst both self-monitoring devices concordantly identified metamorphopsia, they might act as an adjunct to hospital visits, but due to slight reactivations in mCNV and presence of metamorphopsia also in inactive disease the ability of detecting early mCNV activity might be limited.Keywords: myopic CNV, metamorphopsia, disease activity, self-monitoring, optical coherence tomography

Pomace as a side stream from black currant juice production is mostly discarded, even though it is rich in nutrients like protein, fiber, sugars, anthocyanins, polyphenols, and other secondary metabolites. Fungi from the division of Basidiomycota have a great enzymatic toolbox to recycle these complex mixtures of nutrients. In particular, the edible medicinal fungus Wolfiporia cocos has been described as a suitable biocatalyst to form pleasant aroma compounds in fermentation processes. Therefore, medium optimization, upscaling, and filtration were performed to produce a beverage based on black currant pomace fermented with W. cocos. A trained panel described the beverage as highly pleasant, reminiscent of honey, flowers and berries with a well-balanced sour and sweet taste. The flavor compounds linalool (citrus), geraniol (flowery), phenylacetic acid (honey), methyl phenylacetate (honey), eugenol (clove), and 2-phenylethanol (rose) were produced during fermentation and the concentrations exceeded their respective odor thresholds. The produced beverage was evaluated with 8.0 ± 1.4 from 10 for the question of whether panelists would buy the product. Fungal fermentation with the edible fungus W. cocos enabled the production of a highly pleasant beverage and additionally may reduce waste by using pomace and table sugar as sole ingredients.

Purpose The construct of social participation is still not clearly defined. To reach a better understanding of social participation, the perspectives of adolescents must be taken into account. This study explores the adolescent concept of social participation and expands knowledge of the meaning of subjective components of the term. Methods Thirty-four semi-structured interviews were conducted with adolescents with and without physical disabilities or chronic diseases between the ages of 12 and 17 and analyzed according to grounded theory. Results Adolescents describe social participation as involving reflexive interaction with their social environment. Furthermore, forming a social environment plays an important role. All components of the concept are embedded in a context that influences the ways adolescents participate. Adolescents differentiate between active and passive forms of social participation. The concept of reflexive interaction is situated within an interdependent structure of components such as the “feeling of belonging” and the feeling of “well-being” among adolescents. Conclusion The results expand the current state of knowledge regarding the theoretical differentiation of social participation by exploring subjective components of the term. This offers the possibility of supplementing the theoretical frameworks of social participation and supports the understanding of the critical importance of social participation for adolescents.

Several adjunct therapies to the gold standard anti-vascular endothelial growth factor (anti-VEGF) intravitreal injections have been discussed for the treatment of neovascular age-related macular degeneration (nAMD). Low-dose stereotactic radiotherapy (SRT) showed the potential to lower the treatment burden by reducing the anti-VEGF treatment frequency at least over 2–3 years but was associated with retinal microvascular abnormalities in a few cases. We report a 6-year follow-up of a case with bilateral nAMD under anti-VEGF treatment which developed multiple polypoid choroidal vasculopathy (PCV) lesions in the eye adjunct treated with low-dose SRT. The fellow eye suffering from nAMD for the same period of time but never been treated with SRT did not show PCV during the long-term follow-up. We hope to increase the awareness of possible choroidal changes such as PCV in similar patients by sharing this report.

Background Studies on adolescent secondhand smoke exposure within the family often dichotomously operationalize migration background without paying attention to social and cultural diversity within migrant populations. As a result, little is known about variation within migrant groups in smoke-free family environments (SFFEs). This study analyses the association between SFFEs and parental migration from different world regions. Methods Data from 14- to 16-year-old adolescents (N = 17 144) on SFFEs and parental migration were obtained from cross-sectional repeated SILNE-R surveys. A multivariable multinomial regression was applied, presenting relative risks (RRs) with 95% confidence intervals (CIs) for maternal or paternal tobacco smoking and home smoking bans. Variation in migration background was measured according to parental sex and place of birth. Results Approximately 18% of adolescents are exposed to maternal smoking, and 25% are exposed to paternal smoking. Almost half of the respondents do not live in SFFEs but are subject to permissive (5%) or partial (39%) smoking bans at home. We found that adolescents of Eastern European descent are at a higher risk of being exposed to both paternal and maternal smoking. A sex difference in parental smoking was found among Arabic/Islamic migrants, where mothers are less likely to be smokers. Maternal and paternal African origins are associated with prohibitive smoking bans at home. Eastern European mothers show higher odds of permissiveness and freely allowing smoking at home. Conclusion Notable within-differences according to parental sex and place of birth were found for SFFEs and should be taken into account when implementing equity-sensitive tobacco prevention programs.

In the German context, there is hardly any quantitative data about the implementation of school tobacco polices that include the perspective of both teachers and students. The aim of the study is to investigate the associations between implemented school tobacco policies and the perceived prevalence of smoking at the level of school staff and adolescents.The repeated cross-sectional study (2013 and 2017) is based on pooled responses of 13- to 17-year-old adolescents (N = 2393) and school staff (N = 85) from 25 schools located in the West German metropolitan region of Hanover. In linear regression models, average marginal effects (AMEs) with 95% confidence intervals (CI95%) and robust standard errors for perceived tobacco prevalence are reported separately for school tobacco policies assessed by teachers and students (scale 0-6). All models were controlled for sociodemographic, school-, and smoking-specific covariates.On average, adolescents perceive a smoking prevalence of 30% ([Formula: see text]; s: 24.0) for their school. A comprehensive school tobacco policy is consistently associated with lower school smoking prevalence both from the point of view of teachers (AME: -3.54 CI95% -6.49 to -0.58) and students (AME: -1.69 CI95% -2.52 to -0.86). The number of smoking friends (e.g., "most of them are smokers" +14%: AME: 14.13 CI95% 10.46 to 17.80) and the type of school are the most relevant determinants of a high school smoking prevalence. School types with a nonacademic track report a 15% (AME: 15.03 CI95% 10.13 to 19.93) higher prevalence compared to grammar schools.Progressive school tobacco control policies should focus more on school types with nonacademic tracks, certain groups at risk, and those schools that do not strictly enforce school tobacco policies.HINTERGRUND: Für Deutschland sind kaum Daten zur Implementierung schulischer Tabakkontrolle bekannt, die sowohl die Perspektive von Lehrer- als auch von Schüler*innen einbeziehen. Ziel der Studie ist es, den Zusammenhang zwischen implementierter schulischer Tabakkontrollpolitik und der wahrgenommenen Raucherprävalenz auf den Ebenen des Schulpersonals und der Jugendlichen zu untersuchen.Die wiederholte Querschnittsstudie (2013 und 2017) basiert auf gepoolten Angaben von 13- bis 17-jährigen Jugendlichen (N = 2393) und Schulpersonal (N = 85) aus 25 Schulen in der westdeutschen Metropolregion Hannover. In linearen Regressionsmodellen werden durchschnittlich marginale Effekte (AMEs) mit 95 %-Konfidenzintervallen (KI95 %) und robuste Standardfehler für die wahrgenommenen Tabakprävalenzen getrennt für die von Lehrer- und Schüler*innen bewertete schulische Tabakkontrollpolitik (Skala 0–6) unter Kontrolle soziodemografischer, schul- und rauchspezifischer Variablen berichtet.Die Jugendlichen nehmen durchschnittlich eine Raucherprävalenz von 30 % ([Formula: see text]; s: 24,0) für ihre Schule wahr. Eine strikte schulische Tabakkontrolle ist konsistent mit einer geringeren schulischen Raucherprävalenz assoziiert, sowohl aus Sicht von Lehrer- (AME: −3,54 KI95 % −6,49 bis −0,58) als auch der Schüler*innen (AME: −1,69 KI95 % −2,52 bis −0,86). Die Anzahl rauchender Freunde (z. B. „die meisten“ +14 %: AME: 14,13 KI95 % 10,46–17,80) und der Schultyp sind die relevantesten Determinanten für eine hohe schulische Raucherprävalenz. Nichtgymnasiale Schulformen berichten eine 15 % (AME: 15,03 KI95 % 10,13–19,93) höhere Raucherprävalenz im Vergleich zu Gymnasien.Progressive schulische Tabakkontrollpolitiken sollten den Fokus auf nichtgymnasiale Schulformen, Risikogruppen und jene Schulen legen, die Tabakkontrolle nicht strikt durchsetzen.

The search for natural wood preservatives is becoming increasingly evident due to industrial preservatives presenting several environmental restrictions, such as soil, water and ecosystems contamination. Therefore, the objective of the present study is to evaluate the antifungal activity of Cinnamomum zeylanicum bark natural extract subjected to rotting fungi. In order to obtain the aqueous extract, two methods were performed with different concentrations, 50 and 100 g L-1, using Pycnoporus sanguineus e Gloeophyllum trabeum, mycelium. In the first, we kept the C. Zeylanicum bark with distilled water for 1 h in water bath and, in the second, the same concentrations were used, however, this was kept in a recipient for 24 h. Then, the extract was subjected to sterilization along with the BDA medium in autoclave at 120ºC for 20 min, they were then put in petri dishes for later evaluation of the mycelium root growth compared with the control. The fungi Pycnoporus sanguineus presented higher fungal activity, obtaining total inhibition of all treatments and extract concentrations, however, for the fungi Gloeophyllum trabeum, the 100 g L-1 concentration warmed in water bath obtained a better result than the others. Therefore, it can be concluded that the Cinnamomum zeylanicum aqueous extract presented inhibitory potential. Considering this, we suggest that more studies with this thematic should be carried out, seeking to discover new alternatives for wood preservatives that are less damaging to the environment and to mankind.

ZusammenfassungDer Beitrag gibt einen ersten Einblick in das komplexe Themenfeld der soziologischen Theorien und Perspektiven zur Erforschung von Gesundheit und Krankheit. Neben strukturtheoretischen Ansätzen, welche den Einfluss der Gesellschaft auf das individuelle Handeln untersuchen, werden auch handlungstheoretische Ansätze vorgestellt, die den Zusammenhang des Individuums auf die Gesellschaft fokussieren. Es wird zusammenfassend auf Klassiker, wie materialistische Theorien bzw. den Marxismus, die Strukturtheorie und den Strukturfunktionalismus, den symbolischen Interaktionismus sowie die moderne feministische Theorie eingegangen. Zudem kommen wichtige Untersuchungsschwerpunkte der Medizin- und Gesundheitssoziologie zur Sprache, deren Fokus vor allem auf den sozialen Faktoren, Ursachen und Kontexten von Gesundheit und Krankheit liegen. Der Beitrag beschäftigt sich zudem auch mit dem Verständnis von Gesundheit und Krankheit der naturwissenschaftlich dominierten Medizin und stellt das biomedizinische Modell dem sozialen Modell von Gesundheit gegenüber. In einem Fazit werden die gewonnenen Erkenntnisse abschließend zusammengefasst.

“Tell me how much your friends earn, and I’ll tell you if you smoke, what diseases you have and how long your life will be!” With this somewhat pointed statement, we wanted to shed light on the empirically well-confirmed connection between social and health inequalities from the perspective of network research at the beginning of this book (see chapter “Social networks and health inequalities: a new perspective for research”). Social networks are understood here as mediating entities at an intermediate or meso-level, whose structure and function mediate between vertical (income, education, occupational status, etc.) as well as horizontal (e.g., age, gender, ethnic origin) inequalities and health inequalities (e.g., life expectancy, morbidity rates). Besides this mediating influence a moderating relationship wherein social networks amplify or diminish vertical and horizontal inequalities seems to be reasonable.

IntroductionWhile studies have been undertaken to understand the adoption of outdoor and indoor smoking bans, not much is known about why implementation of smoke-free (SF) environments differs at local levels. As most European countries remain at the level of indoor bans, we aim to translate existing evidence into practical recommendations on how to improve SF (outdoor) implementation within European municipalities.MethodsWe applied six methodological steps of a realist review consistent with the RAMESES publication standards for realist syntheses. Literature search was conducted in PubMed/MEDLINE and Web of Science. In total, 3829 references were screened, of which 43 were synthesized. Studies dating from 2004 to 2015 with rigor evidence of SF implementation at the local level were selected. Implementation outcomes were SF enforcement, monitoring, nonsmoking compliance, and public support in cities.ResultsThe explanatory realist framework links four innovation stages with three context-mechanism-outcome (CMO)configurations. We identified “triggering trust,” “increasing priorities,” and “limiting opposing interests” as underlying mechanisms, when (1) establishing, (2) developing, (3) contesting, and (4) implementing local smoking bans. The CMO propositions (CMOs) support practical recommendations, such as (1) providing authorities with local data when establishing and developing bans, (2) developing long-term strategies and implementing state-funded SF programs to prioritize sustained enforcement, and (3) limiting opposing interests through the use of the child protection frame.ConclusionsThis is the first realist review on the implementation of SF enviroments at the local level. The process-oriented theory explains how and why CMOs determine SF development in cities and municipalities from planning until implementation.ImplicationsIn 2015, only 16% of the world’s population lived under the jurisdiction of comprehensive SF laws. The findings of this realist review are useful to implement WHO goals of the Framework Convention on Tobacco Control (FCTC) and specifically SF environments at more local levels and to adjust them to specific contextual circumstances. This paper unpacks three mechanisms that could be triggered by SF strategies developed at local levels and that can result in improved policy implementation. Such evidence is needed to enhance SF strategies at the level of cities and municipalities and to achieve WHO “Healthy Cities Network” objectives.

Zusammenfassung Ziel Die Studie exploriert Zugangsbarrieren sowie Optimierungspotenziale zur Kinder- und Jugendrehabilitation aus Sicht ambulant tätiger Kinder- und Jugendärzte. Methodik Leitfadengestützte Einzelinterviews (N=25) und Fokusgruppendiskussionen (N=3) mit Kinder- und Jugendärzten wurden nach der Methodik von Meuser und Nagel ausgewertet und anschließend in einer Expertenrunde mit dem mitteldeutschen Rentenversicherungsträger und dem kinderärztlichen Berufsverband diskutiert. Ergebnisse Barrieren zeigen sich aufgrund von Informationsdefiziten bzgl. trägerorientierter Zugangskriterien. Eine wahrgenommene zeitintensive Antragsstellung, hohe Ablehnungsquoten mit intransparenten Begründungen sowie eine fehlende Rückkopplung des Trägers an den Arzt hemmen die Antragsmotivation. Optimierungspotenziale münden in dem Wunsch einer direkten Rückkopplung der Antragsentscheidung an den Arzt, fallspezifischen Ablehnungsbegründungen, adressatenorientierten Informationsangeboten sowie einer erhöhten Reha-Präsenz auf pädiatrischen Kongressen und Weiterbildungen. Schlussfolgerung Zur Stärkung der Rehabilitation im pädiatrischen Versorgungskontext sind Informationen und Kompetenzen in der Zuweisung und Antragsstellung bei ambulant tätigen Kinder- und Jugendärzten zu fördern sowie Kommunikationsbarrieren zwischen Leistungsträgern und -erbringern abzubauen.

The objective of this study was to evaluate the biological resistance of agglomerated panels made from agricultural residues (grapevine, annoni grass), urban (carton pack, plastic) and forest (Pinus sp. Wood) of white rot, Pycnoporus sanguineus. For the evaluations, the accelerated rotting test was performed according to the recommendations of the American standard ASTM D 2017. The specimens were removed from the center of the panels, with dimensions of 2.0 x 2.0 cm, totaling 25 samples divided into 5 treatments. The resistance to attack of the fungus was then determined by mass loss. The averages at 5% of significance differed statiscally, among 3 treatments by the Duncan test. Scanning microscopy (SEM) allowed visualization of the panel particles before and after the fungus attack, facilitating the understanding of the results obtained in the loss of mass. The 100% panel of pine wood was classified as non-resistant, and the addition of percentages of agricultural residues (stump, annoni grass) and urban (carton and plastic) residues improved the resistance class of the panels, becoming resistant and very resistant, respectively.