► CCl4-intoxication caused a severe liver damage in mice. ► Rosmarinic acid significantly ameliorated oxidative/nitrosative stress and apoptosis in the liver. ► Rosmarinic acid significantly ...suppressed inflammatory response in the liver. ► Rosmarinic acid prevented hepatic stellate cells activation and fibrogenesis.
The aim of this study was to investigate the therapeutic potential of rosmarinic acid (RA), a natural phenolic, in the treatment of acute liver toxicity. RA at 10, 25 and 50mg/kg was administered by gavage once daily for 2 consecutive days, 6h after CCl4 intoxication. CCl4 intoxication caused hepatic necrosis and increased serum ALT activity. In the livers, oxidative/nitrosative stress was evidenced by increased 3-nitrotyrosine (3-NT) and thiobarbituric acid reactive substances (TBARS) formation and a significant decrease in Cu/Zn superoxide dismutase (SOD) activity. CCl4 administration triggered inflammatory response in mice livers by activating nuclear factor-kappaB (NF-κB), which coincided with the induction of tumor necrosis factor-alpha (TNF-α) and cyclooxygenase-2 (COX-2). RA improved histological and serum markers of liver damage and significantly ameliorated oxidative/nitrosative stress and inflammatory response in liver tissue. Additionally, RA prevented transforming growth factor-beta1 (TGF-β1) and alpha-smooth muscle actin (α-SMA) expression, suggesting suppression of profibrotic response. Furthermore, RA significantly inhibited the CCl4-induced apoptosis, which was evident from decreased cleavage of caspase-3. The hepatoprotective activity of RA coincided with enhanced NF-E2-related factor 2 (Nrf2) and heme oxygenase-1 (HO-1) expression. The results of this study indicates that RA possesses antioxidant, anti-inflammatory, antiapoptotic and antifibrotic activity against acute liver toxicity.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
Aim： To investigate the mechanisms underlying the protective effects of quercetin-rutinoside （rutin） and its aglycone quercetin against CCl4-induced liver damage in mice. Methods： BALB/cN mice were ...intraperitoneally administered rutin （10, 50, and 150 mg/kg） or quercetin （50 mg/kg） once daily for 5 consecutive days, followed by the intraperitoneal injection of CCl4 in olive oil （2 mL/kg, 10% v/v）. The animals were sacrificed 24 h later. Blood was collected for measuring the activities of ALT and AST, and the liver was excised for assessing Cu/Zn superoxide dismutase （SOD） activity, GSH and protein concentrations and also for immunoblotting. Portions of the livers were used for histology and immunohistochemistry.Results： Pretreatment with rutin and, to a lesser extent, with quercetin significantly reduced the activity of plasma transaminases and improved the histological signs of acute liver damage in CCl4-intoxicated mice. Quercetin prevented the decrease in Cu/Zn SOD activity in CCl4-intoxicated mice more potently than rutin. However, it was less effective in the suppression of nitrotyrosine formation. Quercetin and, to a lesser extent, rutin attenuated the inflammation in the liver by down-regulating the CCl4-induced activation of nuclear factor-kappa B （NF-κB）, tumor necrosis factor-α （TNF-α） and cyclooxygenase （COX-2）. The expression of inducible nitric oxide synthase （iNOS） was more potently suppressed by rutin than by quercetin. Treatment with both flavonoids significantly increased NF-E2-related factor 2 （Nrf2） and heme oxygenase （HO-1） expression in injured livers, although quercetin was less effective than rutin at an equivalent dose. Quercetin more potently suppressed the expression of transforming growth factor-β1 （TGF-β1） than rutin.Conclusion： Rutin exerts stronger protection against nitrosative stress and hepatocellular damage but has weaker antioxidant and anti-inflammatory activities and antifibrotic potential than quercetin, which may be attributed to the presence of a rutinoside moiety in position 3 of the C ring.
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EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
Aims
To evaluate specific process components of the Urban Health Centres Europe (UHCE) approach; a coordinated preventive care approach aimed at healthy ageing by decreasing falls, polypharmacy, ...loneliness and frailty among older persons in community settings of five cities in the United Kingdom, Greece, Croatia, the Netherlands and Spain.
Design
Mixed methods evaluation of specific process components of the UHCE approach: reach of the target population, dose of the intervention actually delivered and received by participants and satisfaction and experience of main stakeholders involved in the approach.
Methods
The UHCE approach intervention consisted of a preventive assessment, shared decision‐making on a care plan and enrolment in one or more of four coordinated care‐pathways that targeted falls, polypharmacy, loneliness and frailty. Quantitative data from a questionnaire and quantitative/qualitative data from logbooks were collected among older persons involved in the approach. Qualitative data from focus groups were collected among older persons, informal caregivers and professionals involved in the approach. Quantitative data were analysed by means of descriptive statistics and multilevel logistic regression models. Qualitative data were analysed through thematic analysis.
Results
Having limited function was associated with non‐enrolment in falls and loneliness care‐pathways (both p < .01). The mean rating of the approach was 8.3/10 (SD 1.9). Feeling supported by a care professional and meeting people were main benefits for older persons. Mistrust towards unfamiliar care providers, lack of confidence to engage in care activities and health constraints were main barriers towards engagement in care.
Conclusions
Although the UHCE approach was received generally positively, health constraints and psychosocial barriers prevented older person's engagement in care.
Impact
Coordinated preventive care approaches for older community‐dwelling persons should address health constraints and psychosocial barriers that hinder older person's engagement in care. Trial registration: ISRCTN registry number is ISRCTN52788952. Date of registration is 13/03/2017.
目的
评估欧洲城市保健中心(UHCE)方法具体流程组成部分;采取致力于通过减少英国、希腊、克罗地亚、荷兰和西班牙五个城市的社区中老人跌倒、多重用药、孤独和脆弱的协调预防护理方法。
设计
对欧洲城市保健中心(UHCE)方法具体流程部分的评估:目标人群范围、实际提供和受试者接收到的干预剂量以及参与方法的主要利益相关者的满意度和体验。
方法
欧洲城市保健中心(UHCE)方法干预包括预防评估、共享护理计划决策以及以减少跌倒、多重用药、孤独和脆弱为目标的四种协调护理方式之一或其中多个。问卷调查中的定量数据以及日志中的定量或定性数据是从参与该方法的老年人中收集而来。焦点小组的定性数据是从参与该方法的老年人、非正式护理人员以及健康专家中收集而来。采用描述性统计和多层逻辑回归模型对定量数据进行分析。采用专题分析对定性数据进行分析。
结果
功能受限与跌倒和孤独感护理方法并未注册相关(两者均p<.01)。该方法的平均评分为8.3/10(标准差(SD)为1.9)。老年人主要受益在于得到专业人员的护理以及与人见面。不信任不熟悉的护理人员以及缺乏参与护理活动的信心和健康约束是参与护理的主要障碍。
结论
虽然欧洲城市保健中心(UHCE)方法普遍被积极接受,健康约束和心理障碍阻碍了老年人参与护理。
影响
针对社区老年人的协调预防护理方法应解决阻碍老年人参与护理的健康约束和心理障碍。
试验注册
ISRCTN注册号是ISRCTN52788952。注册日期为2017年3月13日。
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK, VSZLJ
Abstract
Background
Polypharmacy can be defined as using five or more medications simultaneously. “Medication-related problems”, an extension of polypharmacy, includes inappropriate prescribing, poor ...adherence, overdosage, underdosage, inappropriate drug selection, inadequate monitoring, adverse drug effects, and drug interactions. Polypharmacy and the high risk of medication-related problems among older people are associated with adverse health consequences due to drug-drug interactions, drug-disease interactions, and adverse drug effects. This study aims to assess the factors associated with polypharmacy and the high risk of medication-related problems among community-dwelling older people in the Netherlands, Greece, Croatia, Spain, United Kingdom.
Method
This longitudinal study used baseline and follow-up data from 1791 participants of the Urban Health Center European project. Polypharmacy and the risk of medication-related problems were evaluated at baseline and follow-up using the Medication Risk Questionnaire. We studied factors in the domains (a) sociodemographic characteristics, (b) lifestyle and nutrition, and (c) health and health care use. Hierarchical logistic regression analyses were used to examine the factors associated with polypharmacy and the high risk of medication-related problems.
Results
Mean age was 79.6 years (SD ± 5.6 years); 60.8% were women; 45.2% had polypharmacy, and 41.8% had a high risk of medication-related problems. Women participants had lower odds of polypharmacy (OR = 0.55;95%CI:0.42–0.72) and a high risk of medication-related problems (OR = 0.50; 95%CI:0.39–0.65). Participants with a migration background (OR = 1.67;95%CI:1.08–2.59), overweight (OR = 1.37; 95%CI:1.04–1.79) and obesity (OR = 1.78;95%CI:1.26–2.51) compared to ‘normal weight’, with lower physical HRQoL (OR = 0.96, 95%CI:0.95–0.98), multi-morbidity (OR = 3.73, 95%CI:2.18–6.37), frailty (OR = 1.69, 95%CI:1.24–2.30), visited outpatient services (OR = 1.77, 95%CI: 1.09–2.88) had higher odds of polypharmacy. The associations with the high risk of medication-related problems were similar.
Conclusions
Multiple factors in demography, lifestyle, nutrition, and health care use are associated with polypharmacy and the high risk of medication-related problems. Polypharmacy is a single element that may reflect the number of medications taken. The broader content of medication-related problems should be considered to assess the context of medication use among older people comprehensively. These provide starting points to improve interventions to reduce polypharmacy and high risk of medication-related problems. In the meantime, health professionals can apply these insights to identify subgroups of patients at a high risk of polypharmacy and medication-related problems.
Trial registration
The intervention of the UHCE project was registered in the ISRCTN registry as ISRCTN52788952. The date of registration is 13/03/2017.
International studies provide an overview of socio-demographic characteristics associated with loneliness among older adults, but few studies distinguished between emotional and social loneliness. ...This study examined socio-demographic characteristics associated with emotional and social loneliness.
Data of 2251 community-dwelling older adults, included at the baseline measure of the Urban Health Centers Europe (UHCE) project, were analysed. Loneliness was measured with the 6-item De Jong-Gierveld Loneliness Scale. Multivariable logistic regression models were used to evaluate associations between age, sex, living situation, educational level, migration background, and loneliness.
The mean age of participants was 79.7 years (SD = 5.6 years); 60.4% women. Emotional and social loneliness were reported by 29.2 and 26.7% of the participants; 13.6% experienced emotional and social loneliness simultaneously. Older age (OR: 1.16, 95% CI: 1.06-1.28), living without a partner (2.16, 95% CI: 1.73-2.70), and having a low educational level (OR: 1.82, 95% CI: 1.21-2.73), were associated with increased emotional loneliness. Women living with a partner were more prone to emotional loneliness than men living with a partner (OR: 1.78, 95% CI: 1.31-2.40). Older age (OR: 1.11, 95% CI: 1.00-1.22) and having a low educational level (OR: 1.77, 95% CI: 1.14-2.74) were associated with increased social loneliness. Men living without a partner were more prone to social loneliness than men living with a partner (OR: 1.94, 95% CI: 1.35-2.78).
Socio-demographic characteristics associated with emotional and social loneliness differed regarding sex and living situation. Researchers, policy makers, and healthcare professionals should be aware that emotional and social loneliness may affect older adults with different socio-demographic characteristics.
There is something horrible about throwing food in the bin. Based on existing literature, 30-50 percent (i.e. 1.2-2 billion tons) of the produced food never reaches anyone’s plate. Global food ...production can be split into production losses, consumers’ waste and consumption. In a world where 850 million people are undernourished, global food supply per person approximates to 570 kg: roughly, 380 kg is consumed, 140 kg is lost in the production and 50 kg is wasted by consumers. Households generate 53% of the total food waste in Europe, the processing industry 19%, food services 12%, the primary production sector 11%, and the retail/wholesale sector 5%. The European hospitality industry is a small food waster that generates only 12% of the total food waste in Europe. Wasted food is accountable for 3.3 GtCO2e. The average carbon footprint of food wastage is about 500 kg of CO2 equivalents per person per year. The blue water footprint of food wastage is about 250 km3. 1.4 billion Ha of land – 28% of the world’s agricultural area – is used annually to produce food that is either lost or wasted. The food which is not eaten contributes to the loss of biodiversity through habitat change, overexploitation, pollution and climate changes. Prompted in part by global food production inefficiency, 9.7 million hectares are deforested annually to grow food – 74% of the total annual deforestation. The scale of global food wastage is shocking, and this wasted food results in a number of ethically questionable implications. Pope Francis rightfully points out that from the moral standpoint prodigal expenditure and wasting of food is no better than stealing from the hungry and poor. From the ecological standpoint, it is no better than stealing from our own children. But moralizing, identifying problems, knowledge and information distribution, and suggesting solutions surely will not convince people to implement offered solutions. The world needs progressive politics for a fairer world to achieve more equitable distribution of wealth. Tourism and the whole hospitality industry can and must play an important role in raising awareness of the value of food. The entire touristic sector can promote changes in food management and consumption with very positive environmental and economic results.
Globalna proizvodnja hrane može se podijeliti na proizvodne gubitke, gubitke vezane uz
potrošače i na konzumaciju hrane. U svijetu u kojemu je 850 milijuna ljudi pothranjeno,
globalno se po osobi proizvede oko 580 kg hrane: 380 kg se konzumira, 140 kg se izgubi
u proizvodnji, a 50 kg završi kao otpad potrošača. Kućanstva proizvode 53 % ukupnog
otpada od hrane u Europi, prerađivačka industrija 19 %, prehrambene usluge 12 %, primarni
proizvodni sektor 11 %, a sektor maloprodaje/veleprodaje 5 %. Europska ugostiteljska
industrija mali je rasipnik hrane koji proizvodi samo 12 % ukupnog otpada od hrane u
Europi. Otpad od hrane uzrokuje 3,3 GtCO2e. Prosječni ugljični otisak povezan s rasipanjem
hrane iznosi oko 500 kg ekvivalenta CO2 po osobi godišnje. Plavi vodeni otisak povezan s
rasipanjem hrane iznosi oko 250 km3. Čak 1,4 milijardi hektara zemlje – 28 % obradive
površine svijeta – godišnje se upotrebljava za proizvodnju hrane koja se izgubi ili baci. Hrana
koja se ne konzumira pridonosi smanjenju biološke raznolikosti kao posljedica promjena
staništa, prekomjerne eksploatacije, zagađenja i klimatskih promjena. Djelomično zahvaljujući
neučinkovitosti globalne proizvodnje hrane godišnje se raskrči 9,7 milijuna hektara šume radi
proizvodnje hrane – 74 % ukupne godišnje deforestacije. Rasipanje hrane na globalnoj je
razini šokantno, a to rasipanje hrane rezultira nizom etički upitnih implikacija. Papa Franjo
s pravom ističe da je s moralnog gledišta bacanje i rasipanje hrane kao da krademo od onih
koji su siromašni i gladni. S ekološkog gledišta, to je isto kao da krademo od vlastite djece.
Ali moraliziranje, identificiranje problema, raspodjela znanja i informacija te predlaganje
rješenja zasigurno neće uvjeriti ljude da primjenjuju ponuđena rješenja. Svijetu je potrebna
progresivna politika za pravedniji svijet kako bi se postigla pravednija raspodjela bogatstva.
Turizam i čitava ugostiteljska industrija mogu i moraju imati važnu ulogu u podizanju svijesti
o vrijednosti hrane. Cijeli turistički sektor može promicati promjene u upravljanju i potrošnji
hrane s vrlo pozitivnim ekološkim i gospodarskim rezultatima.
The Social Engagement Framework for Addressing the Chronic-disease-challenge (SEFAC) project intends to empower citizens at risk of or with type 2 diabetes (T2DM) and/or cardiovascular disease (CVD) ...to self-manage their chronic conditions through the SEFAC intervention. The intervention combines the concepts of mindfulness, social engagement and information and communication technology support, in order to reduce the burden of citizens with chronic conditions and to increase the sustainability of the health system in four European countries.
A prospective cohort study with a 6-month pre-post design will be conducted in four European countries: Croatia, Italy, the Netherlands and the United Kingdom. A total of 360 community-dwelling citizens ≥50 years of age will be recruited; 200 citizens at risk of T2DM and/or CVD in the next 10 years (50 participants in each country) and 160 citizens with T2DM and/or CVD (40 participants in each country). Effects of the intervention in terms of self-management, healthy lifestyle behavior, social support, stress, depression, sleep and fatigue, adherence to medications and health-related quality of life will be assessed. In addition, a preliminary cost-effectiveness analysis will be performed from a societal and healthcare perspective.
The SEFAC project will further elucidate whether the SEFAC intervention is feasible and (cost-) effective among citizens at risk of and suffering from T2DM and/or CVD in different settings.
ISRCTN registry number is ISRCTN11248135 . Date of registration is 30/08/2018 (retrospectively registered).
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
The World Health Organization recommends adjusting salt intake as a part of the nine global targets to reduce premature mortality from non-communicable chronic diseases as a priority and the most ...cost-effective intervention. In 2006, the main aim of the Croatian Action on Salt and Health was to decrease salt intake by 16% because of its critical intake and consequences on human health. We have organized educative activities to increase awareness on salt harmfulness, define food categories of prime interest, collaborate with industries and determine salt intake (24 h urine sodium excretion). It was determined that the proportion of salt in ready-to-eat baked bread should not exceed 1.4%. In the period 2014-2022, salt in semi-white bread was reduced by 14%, 22% in bakery and 25% in the largest meat industry. Awareness of the harmfulness of salt on health increased from 65.3% in 2008 to 96.9% in 2023 and salt intake was reduced by 15.9-1.8 g/day (22.8% men, 11.7% women). In the last 18 years, a significant decrease in salt intake was achieved in Croatia, awareness of its harmfulness increased, collaboration with the food industry was established and regulatory documents were launched. However, salt intake is still very high, underlying the need for continuation of efforts and even stronger activities.
Liver fibrosis is the result of chronic liver injury, and it represents a widespread medical problem. The aim of this study is to investigate the antifibrotic activity of isoquinoline alkaloid ...berberine in carbon tetrachloride (CCl₄)-induced damage in mice. Hepatic fibrosis was induced by intraperitoneal (i.p.) administration of CCl₄ (2 mL/kg, 20% v/v in olive oil) twice a week for 8 weeks. Berberine at the doses of 3 and 9 mg/kg and silymarin at the dose of 50 mg/kg were given i.p. once daily for the next 2 weeks. CCl₄ intoxication increased the levels of serum transaminases and induced oxidative stress in the liver. Hepatic fibrosis was evidenced by a massive deposition of collagen, which coincided with increased expression of tumor necrosis factor (TNF)-α and transforming growth factor (TGF)-β1 and the activation of hepatic stellate cells. The high-dose berberine (9 mg/kg) ameliorated oxidative stress, decreased TNF-α and TGF-β1 expression, increased the levels of matrix metalloproteinase (MMP)-2, and stimulated the elimination of fibrous deposits. Berberine at the dose of 9 mg/kg exhibited stronger therapeutic activity against hepatic fibrosis than silymarin at the dose of 50 mg/kg. In vitro analyses show an important scavenging activity of berberine against oxygen and nitrogen reactive species. The results of this study suggest that berberine could ameliorate liver fibrosis through the suppression of hepatic oxidative stress and fibrogenic potential, concomitantly stimulating the degradation of collagen deposits by MMP-2.
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