Obesity in childhood and adolescence represents a major health problem in our century. In Greece, more than 30%-35% of children and adolescents are either overweight or obese.
Using information and communication technologies, we developed a "National Registry for the Prevention and Management of Overweight and Obesity in Childhood and Adolescence" for guidance and training of Pediatricians and General Practitioners. The application supports interoperability with other national infrastructures and multi-layered security spanning preventive, detective and administrative controls. The Patient Summary Dataset includes information on medical history, family history, medications, immunizations, clinical examination and laboratory findings and appointment booking service.
AUTHORS:
Penio Kassari, Panagiotis Papaioannou, Antonis Billiris, Haralampos Karanikas, Stergiani Eleftheriou, Eleftherios Thireos, Yannis Manios, George P Chrousos, Evangelia Charmandari
Skilled Delivery Utilizations & Its Determinants in Four Regions of EthiopiaJSI
The objective was to describe improvements in community awareness of MNH, assess trends and factors contributing to skilled delivery utilization in learning sites, and identify lessons and provide recommendations for MNH program scale up and recommendations.
The conclusion was that a comprehensive approach to MNH and skilled delivery is essential to success. Strong community promotion and partnership is essential to improved service utilization. Respectful and women-friendly services are vital. Post-training mentoring and supportive supervision are indispensable and should be ongoing. Areas needing improvement are: access to transportation, referral systems. supply chain management and essential life-saving commodities, water and electricity in HCs, and improved facility infrastructure as utilization increases
Skilled Delivery Utilizations & Its Determinants in Four Regions of EthiopiaJSI
The objective was to describe improvements in community awareness of MNH, assess trends and factors contributing to skilled delivery utilization in learning sites, and identify lessons and provide recommendations for MNH program scale up and recommendations.
The conclusion was that a comprehensive approach to MNH and skilled delivery is essential to success. Strong community promotion and partnership is essential to improved service utilization. Respectful and women-friendly services are vital. Post-training mentoring and supportive supervision are indispensable and should be ongoing. Areas needing improvement are: access to transportation, referral systems. supply chain management and essential life-saving commodities, water and electricity in HCs, and improved facility infrastructure as utilization increases
Invited keynote to the 3rd February PolicyForesight conference on obesity, looking at issues in addressing covid after the pandemic, and whether a syndemic and systems approach to obesity has value
Improving health equity through action across the life course: Summary of evi...DRIVERS
Economic growth, democratisation and improved living conditions have contributed to improved health and longevity in Europe, but profound and systematic differences in health persist. These differences form a gradient that runs from the top to the bottom of society, and this pattern holds true for all European countries.
These health inequalities have existed for centuries and much is now known about their causes – many of which are potentially avoidable.
The main aim of the DRIVERS project is to deepen understanding of the relationships that exist in a European context between some of the key influences on health over the course of a person’s life - early childhood, employment, and income and social protection - and to find solutions to improve health and reduce health inequalities.
This document begins by providing an overview of DRIVERS and its most significant findings. It then describes headline principles and recommendations to help reduce health inequalities across Europe.
The goal of the DRIVERS project is to leave a lasting legacy, by providing evidence that informs the implementation of policies and programmes across different sectors that are effective in reducing health inequalities, improving social justice and contributing to societal and economic progress for all.
In recent years, Ghana, like many other developing countries has been going through an epidemiologic transition where the proportion of deaths from non-communicable diseases is rapidly increasing, particularly cardiovascular related diseases, cancers and diabetes (IHME, 2019).
Latent Class Analysis of Adolescent Health Behaviorsasclepiuspdfs
Background: Behavior is one of the most important components in health. While the impacts of adolescent risky activities have been studied extensively, less attention has been paid to health. This study examines the patterning of health behaviors among adolescents age of 10–19 years. Methods: Latent class analysis identified homogeneous, mutually exclusive “classes” (patterns) of eight, leading health behaviors - sleep, alcohol consumption, cigarette smoking, physicians’ visits, meal autonomy, wearing braces, general health assessment, and having a permanent tattoo. Results: Resulting classes include (1) healthy, (2) moderately healthy, and (3) unhealthy. The characteristic behaviors and tendencies of each class differed by gender. Conclsion: This study attempts to classify adolescents by their own health behavior without including parental attributes. While adolescents do not typically prescribe to predictable behaviors and actions, the emphasis on healthy behaviors by some suggests an individual awareness of behavioral impacts and importance of healthy lifestyle choices
Spain, like its European neighbours, is waking up to a looming obesity problem. Although obesity prevalence is roughly around the European average, levels of awareness and concern about the problem are lower than in many other European countries.
Poster: Determinants of Health Care Seeking for Childhood Illnesses and Vacc...JSI
In urban Ethiopia, there are substantial gaps in child health service utilization rates. Socio-demographic factors including maternal age, educational attainment, occupation, parity, household wealth, and religion all play a role in influencing access to services. At the Consortium of Universities in Global Health (CUGH) Conference in 2105, JSI staff presented findings from an investigation using data from the 2011 Ethiopian Demographic and Health Survey that explored associations between use of child health services and socio-demographic factors.
Aene project a medium city public students obesity studyCIRINEU COSTA
Identifying undernutrition and obesity on students and propose public policies of health are urgent issues. This paper presents a study with weight and stature from students collected by physical education teachers (PEF) in schools of a city near São Paulo. The PEF collected the data and they were inserted in a program especially developed for each school Department (AENE Project). The datas were analyzed by software and evaluation done based on a World Health Organization (WHO_2007) table, that develops health programs worldwide. The results evaluations were used to raise the students and family, teachers and responsibles for treatment search (when required).
Today it’s critical for providers to devote time to patient education; inform patients about their conditions and how to prevent, treat, and manage them. Proper management of chronic conditions extends well beyond episodic and infrequent visits to a provider’s office. This population health white paper discusses why patients must become responsible for their day-to-day disease management. Patients will frequently be required to self-monitor their health indicators, observe symptoms, and note behavior, but they must also adhere to complex medication regimens
Invited keynote to the 3rd February PolicyForesight conference on obesity, looking at issues in addressing covid after the pandemic, and whether a syndemic and systems approach to obesity has value
Improving health equity through action across the life course: Summary of evi...DRIVERS
Economic growth, democratisation and improved living conditions have contributed to improved health and longevity in Europe, but profound and systematic differences in health persist. These differences form a gradient that runs from the top to the bottom of society, and this pattern holds true for all European countries.
These health inequalities have existed for centuries and much is now known about their causes – many of which are potentially avoidable.
The main aim of the DRIVERS project is to deepen understanding of the relationships that exist in a European context between some of the key influences on health over the course of a person’s life - early childhood, employment, and income and social protection - and to find solutions to improve health and reduce health inequalities.
This document begins by providing an overview of DRIVERS and its most significant findings. It then describes headline principles and recommendations to help reduce health inequalities across Europe.
The goal of the DRIVERS project is to leave a lasting legacy, by providing evidence that informs the implementation of policies and programmes across different sectors that are effective in reducing health inequalities, improving social justice and contributing to societal and economic progress for all.
In recent years, Ghana, like many other developing countries has been going through an epidemiologic transition where the proportion of deaths from non-communicable diseases is rapidly increasing, particularly cardiovascular related diseases, cancers and diabetes (IHME, 2019).
Latent Class Analysis of Adolescent Health Behaviorsasclepiuspdfs
Background: Behavior is one of the most important components in health. While the impacts of adolescent risky activities have been studied extensively, less attention has been paid to health. This study examines the patterning of health behaviors among adolescents age of 10–19 years. Methods: Latent class analysis identified homogeneous, mutually exclusive “classes” (patterns) of eight, leading health behaviors - sleep, alcohol consumption, cigarette smoking, physicians’ visits, meal autonomy, wearing braces, general health assessment, and having a permanent tattoo. Results: Resulting classes include (1) healthy, (2) moderately healthy, and (3) unhealthy. The characteristic behaviors and tendencies of each class differed by gender. Conclsion: This study attempts to classify adolescents by their own health behavior without including parental attributes. While adolescents do not typically prescribe to predictable behaviors and actions, the emphasis on healthy behaviors by some suggests an individual awareness of behavioral impacts and importance of healthy lifestyle choices
Spain, like its European neighbours, is waking up to a looming obesity problem. Although obesity prevalence is roughly around the European average, levels of awareness and concern about the problem are lower than in many other European countries.
Poster: Determinants of Health Care Seeking for Childhood Illnesses and Vacc...JSI
In urban Ethiopia, there are substantial gaps in child health service utilization rates. Socio-demographic factors including maternal age, educational attainment, occupation, parity, household wealth, and religion all play a role in influencing access to services. At the Consortium of Universities in Global Health (CUGH) Conference in 2105, JSI staff presented findings from an investigation using data from the 2011 Ethiopian Demographic and Health Survey that explored associations between use of child health services and socio-demographic factors.
Aene project a medium city public students obesity studyCIRINEU COSTA
Identifying undernutrition and obesity on students and propose public policies of health are urgent issues. This paper presents a study with weight and stature from students collected by physical education teachers (PEF) in schools of a city near São Paulo. The PEF collected the data and they were inserted in a program especially developed for each school Department (AENE Project). The datas were analyzed by software and evaluation done based on a World Health Organization (WHO_2007) table, that develops health programs worldwide. The results evaluations were used to raise the students and family, teachers and responsibles for treatment search (when required).
Today it’s critical for providers to devote time to patient education; inform patients about their conditions and how to prevent, treat, and manage them. Proper management of chronic conditions extends well beyond episodic and infrequent visits to a provider’s office. This population health white paper discusses why patients must become responsible for their day-to-day disease management. Patients will frequently be required to self-monitor their health indicators, observe symptoms, and note behavior, but they must also adhere to complex medication regimens
Non-invasive Diagnostic Tools: Cardiometabolic Risk Assessment and Predictionasclepiuspdfs
Cardiometabolic risks (CMRs) have rapidly increased to epidemic proportions worldwide in the past three decades. Cardiovascular disease (CVD) remains the number one killer. No country has reduced, reversed, or prevented the increase in the incidence or prevalence of chronic metabolic diseases. Framingham Heart Study group described the modifiable risk factors that promote the development of CVD. They also developed risk calculators, for the prediction of acute vascular events such as heart attacks and stroke. The risk predictor algorithms were fine-tuned, as and when additional risk factors were discovered. However, at the time of this writing, there is no such calculator for assessment, stratification, and management of CMRs. On the other hand, numbers of non-invasive diagnostic devices have been developed for continuous monitoring of blood pressure and glucose profiles. We have described in our earlier articles, non-invasive diagnostic platform developed by LD-Technologies,
The U.S. Government’s Global Health Initiativejehill3
The U.S. Government’s Global Health Initiative
Richard Greene, Director, Office of Health, Infectious Diseases and Nutrition, Bureau for Global Health, USAID
CORE Group Spring Meeting, Tuesday April 27, 2010
A systemic approach to the operations of the Education Department of large or...Panagiotis Papaioannou
The purpose of this study is to present a series of systemic methodologies that can be used to design effective training programs in medium to large scale organizations. The study had been initiated as an intervention in the Education Department of a medium-sized company but afterwards, it was generalized as a general case covering the education and training issue in any organization.
Using the Design and Control Systemic Methodology to calculate Systems Comple...Panagiotis Papaioannou
This work deals with the systems or models complexity and proposes a method to measure the complexity of a system designed using the Design and Control Systemic Methodology (DCSYM).
Applying systemic methodologies to bridge the gap between a process-oriented ...Panagiotis Papaioannou
This work is an application of the Soft Systems Methodology (SSM) to improve an information system to fully support the related process-based management system and help its internal improvement. Design and Control Systemic Methodology (DCSYM) is used as a modelling tool to facilitate conceptual models comparison within the SSM context.
Process Mining applications and a correlation with the Systemic Approach (app...Panagiotis Papaioannou
This contribution presents a Process Mining application in the Blood Bank division of a public hospital in Greece and aims to explore the relation between Process Mining and the Systemic Approach.
Software ecosystems and IT ecosystems are modern terms used to describe complex networks of IT applications. The idea comes from the perspective that IT systems are made by people, serve people in the context of socio-technical systems and, finally, affect the lives of more people. All that stuff live and evolve together, each having its own properties and dynamics. All together form a kind of ecosystem that exposes its own emergent behaviour. It is a perfect field to apply systemic approaches in order to create a holistic approach, to reveal the underlying dynamic structure, to cope with complexity and to extract order out of the mess. The final objective is to bridge the gap between business and IT helping the organization to serve its purpose.
What Domain-Driven Design (DDD) is, how to set about doing it, why it could be used in nearly every enterprise software project and why the costs of doing it are coming down. What systemic approach is and how it helps to tackle complexity and implementing DDD.
Domain Driven Design and Soft Systems Methodology for Information Systems in ...Panagiotis Papaioannou
Domain-Driven Design (DDD) is a software development approach intended for complex projects where complexity refers to the requirements as well as the interactions between designers, developers and users of the product. It was introduced by Eric Evans (2004) in his book of the same title.
Soft Systems Methodology (SSM) is an approach to the management of change that has been developed primarily by Peter Checkland and his colleagues as an action research program.
Since both DDD and SSM are based on models, a modelling approach is needed. Design and Control Systemic Methodology (DCSYM) offers a means to create models in a systemic context and to use them as a basis for the collaboration between the interested parties.
DOMAIN-DRIVEN DESIGN AND SOFT SYSTEMS METHODOLOGY AS A FRAMEWORK TO AVOID SOF...Panagiotis Papaioannou
A crisis is considered to be an issue concerning complex systems like societies, organizations or even families. It can be defined as the situation in which the system functions poorly, the causes of the dysfunction are not immediately identified and immediate decisions need to be made.
The type and duration of a crisis may require different kinds of decision making. In a long-term crisis, when system changes may be required, the active participation of the affected people may be more important than the power and dynamics of the leadership. Software crises, in their contemporary form as organizational malfunctions, can still affect the viability of any organization.
In this paper, we highlight the systemic aspects of a crisis, the complexity behind that and the role of systemic methodologies to explore its root causes and to design effective interventions. Our focus is on modelling as a means to simplify the complexity of the regarded phenomena and to build a knowledge consensus among stakeholders. Domain-Driven Design comes from software as an approach to deal with complex projects. It is based on models exploration in a creative collaboration between domain practitioners and solution providers. SSM is an established methodology for dealing with wicked situations. It incorporates the use of models and, along with Domain-Driven Design and other systemic methodologies can be employed to develop a common perception of the situation and a common language between interested parties in a crisis situation.
Conceptual modelling for Digital Transformation. Software maps, software as a complex system, value mapping, modelling with DCSYM, mapping on a business model, processes as a software map background.
Business Process Management (BPM) refers to disciplines, methodologies, and tools for managing the operations within an organization aiming at ensuring the consistency of the final products and finding opportunities for improving quality and efficiency.
Coming to Business Intelligence (BI), its purpose is to exploit and interpret data to enable more effective decision-making at either strategic, tactical, or operational levels. However, the objective is not just the data since the change will come by changing the processes.
Business Process Management as an enabling factor for Digital TransformationPanagiotis Papaioannou
Digital transformation is about shifting an organization to new ways of doing business using modern and emerging digital technologies to improve internal operations or the interaction with the customers or partners. However, it is the internal processes that produce the organization's output, either tangible or intangible. When people try to improve a part of the business cycle, they have already taken the first step towards Business Process Management.
Business Process Management as the basis for Digital TransformationPanagiotis Papaioannou
Digital transformation is about shifting an organization to new ways of doing business using modern and emerging digital technologies to improve internal operations or the interaction with the customers or partners.
However, it is the internal processes that support the organization's competences and cause the observed organizational behaviour. Business Process Management (BPM) is about supervising how works are performed within an organization to ensure the consistency of outputs and to explore improvement opportunities.
Working on processes will not only highlight opportunities and priorities for Digital Transformation but will also support IT projects by facilitating the implementation of the organizational change.
Reengineering of the Process of a Call Center Using Systemic Methodologies, H...Panagiotis Papaioannou
A systemic approach to a problem identified in the operation of the call centre of a company that provides public services concerning water and sewage treatment.
Systemic Modeling and Relations Thinking for Risk Assessment and IT Resources...Panagiotis Papaioannou
Systems of any kind expose behaviors that are not directly related to the individual attributes or behaviors of their constituting elements. These are known as emergent behaviors and their existence is a challenge for the manager who oversees an organization or when an intervention is attempted. In this study we argue that interactions or relations provide the main contribution to the existence of the emergent properties and studying these relations can be the starting point for examining or assessing emergent properties or behaviors. Two typical examples of emergent behaviors in an organization which operates as a sociotechnical system are: (a) risk and opportunities and (b) the effectiveness of the information systems. The most systemic organizational paradigms are management systems following an ISO management standard, like ISO 9001:2015. Thus, our approach is aimed at systems of this type.
Applied Process Mining in a Blood Bank and correlation with the Systemic Appr...Panagiotis Papaioannou
Process Mining is a set of methods, tools and techniques that allows business process analysis based on event logs produced by the information systems. Process Mining can be used for three main purposes: (1) To discover the process model from the event log (2) To check process conformance with an existing process model and (3) To improve an existing process model based on actual process information found in the event log. Process Mining (PM) can be applied in a variety of domains.
This specific application comes from the healthcare area and, more specifically, from the blood bank division of a hospital. In this division the blood is collected from donors, separated into blood products, stored, and prepared for transfusion to patients. The PM “Case” is the Blood Unit and its route from donation to transfusion. Activities in blood unit lifecycle include: Donation, Laboratory Testing, Splitting into products, Compatibility testing, Sending, Returning, Transfusion, Destruction etc. The events data correspond to blood units donated in a period of 3 months.
In Process Mining literature it is widely accepted that a holistic approach is needed to derive the right conclusions from event data. Holistic approach refers to Systemic Approach or to Systems Theory methodologies and tools. In this study we argue that there is a strong relation between Process Mining and Systemic Approach.
Much more important can be the contribution of PM to the Systemic Analysis. PM can help to discover systems and their structure and to provide a reference point for comparing mental models with the reality which is the final objective of any systemic methodology.
Presentation given at "Software for Domain Experts", Athens, Nov 2016. It is about Software for Domain Experts, Domain Driven Design and Systemic Approach. Its purpose is to show how we can follow the Domain Driven Design approach along with the Systemic Approach in order to produce high quality Software for Domain Experts.
Applying systemic methodologies to “IT ecosystems” in order to harmonize business operations and information systems within the organization
Software ecosystems and IT ecosystems are modern terms used to describe complex networks of IT applications. The idea comes from the perspective that IT systems are made by people, serve people in the context of socio-technical systems and, finally, they affect the lives of more people. All that stuff live and evolve together, each having its own properties and dynamics. All together form a kind of ecosystem which exposes its own emergent behavior. It is a perfect field to apply systemic approach in order to create a holistic approach, to reveal the underlying dynamic structure, to cope with complexity and to extract order out of the mess. The final objective is to bridge the gap between business and IT helping the organization to serve its purpose.
Adv. biopharm. APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMSAkankshaAshtankar
MIP 201T & MPH 202T
ADVANCED BIOPHARMACEUTICS & PHARMACOKINETICS : UNIT 5
APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMS By - AKANKSHA ASHTANKAR
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
2. 1 | INTRODUCTION
Obesity in childhood and adolescence represents a major
health problem of our century. In the United States (US),
the prevalence of a body mass index (BMI; the weight in
kilograms divided by the square of the height in meters)
above the 95th percentile among children aged 6-11 years
increased from 4.2% in 1963-1965 to 15.3% in 1999-2002,
and might have plateaued during the first decade of the
21st century.1
In the United Kingdom (UK), 30% of adults
have obesity, while 30% of children aged 2-15 years have
overweight or obesity.2
The prevalence of obesity is pro-
jected to reach 75% by 2030 in the US population3
and
50% by 2050 in the UK population.2
In Greece, more than
30%-35% of children and adolescents have increased BMI.4
Given that in our country there are approximately 100 000
live births per year, there are currently 1 800 000 children
and adolescents (from birth to 18 years), and 540 000-
630 000 (30%-35% of 1 800 000) of those have increased
BMI. The incidence of childhood overweight and obesity
is similarly high in other European and non European
countries.2
Overweight and obesity in childhood and adoles-
cence lead to obesity in adulthood and are associated
with significant morbidity and mortality.5–10
It is likely
that the “obesity epidemic” may reverse the current
trend of the declining rate of mortality from cardiovas-
cular causes, leading to a shorter lifespan for today’s
children.
Furthermore, overweight and obesity account for a sig-
nificant increase in public health costs. The financial impli-
cations of treating obesity itself are extensive, even without
incorporating the huge costs of treating its comorbidities
and addressing its socioeconomic impact. In the US, the
estimated medical expenditures attributed to overweight
and obesity were 149.4 billion in 2014 US dollars per
year.11
A recent study in the US demonstrated that the
direct health care costs attributable to obesity and over-
weight will more than double every decade. By 2030, costs
could range from 860.7 to 956.9 billion US dollars,
accounting for 1 in every 6 dollars spent on health care. In
the UK, by 2030 this condition is predicted to cost approx-
imately £2 billion GBP per year.2
Therefore, it is imperative that we take all necessary
measures not only to treat but mostly to prevent overweight
and obesity in childhood, so that we can ensure improved
health in adulthood, as well as reduced medical costs
owing to complications of obesity.
The progressively increasing prevalence of overweight
and obesity in Greece, and possibly other countries, indi-
cate that our current health policies are not effective. Some
explanations include:
1. Inadequate documentation of the BMI when children
and adolescents are seen by Pediatricians or General
Practitioners (GPs) on account of acute or chronic medi-
cal problems.
2. Pediatricians and GPs are not given clear guidance and
instructions about the management of overweight and
obesity in childhood and adolescence.
3. In many countries, GPs conduct annual Preventive Child
Health Examinations (PCHEs) and play an important
role in preventing, identifying and managing overweight
in children. At the five-year PCHE, almost one-third of
children with increased BMI were assessed to be nor-
mal-weight by GPs.12
Additionally, few providers feel
competent in the use of behaviour-modification strate-
gies and the time available may not suffice to identify
the targets and strategies for behavioural change.13
4. Inadequate coordination of all health-related organiza-
tions involved in the management of overweight and
obesity in childhood and adolescence; and
5. Inadequate education and/or information of parents, guar-
dians, teachers and the public in general about obesity, its
complications, as well as its prevention and management.
Our aim was to develop a comprehensive and persona-
lized plan of action for the prevention and management of
overweight and obesity in childhood and adolescence in
Greece.
2 | MATERIALS AND METHODS
Using information and communication technologies
(ICT),14–16
we developed a web application, the National
Registry for the Prevention and Management of Over-
weight and Obesity in Childhood and Adolescence, which
supports interoperability with other national infrastructures
(ie ePrescription) and multi-layered security spanning pre-
ventive, detective and administrative controls. This includes
transparent data encryption, data redaction, data masking,
privileged user controls, privilege usage analysis, condi-
tional auditing and real application security. The Installa-
tion and Hosting of the Central Database have been offered
by the Athens Medical Society, and the development was
implemented by Datamed SA—a systems integration and
consulting services company.17
The project is part of the overall Greek and European
policy to develop and use reliable Patient Registries, and as
such was designed to meet all the latest European direc-
tives and regulations. In addition, it complies with all the
latest institutional developments in Greece, which are
related to the creation of National Primary Healthcare Net-
work and development of clinical governance applications.
2 of 9
| KASSARI ET AL.
3. More specifically, we developed an Electronic Medical
Records File (EMRF) for the electronic documentation of
the history and clinical examination findings, as well as
Therapeutic Algorithm Files (TAF), which provide specific
and detailed information on the management of overweight
and obesity. There are many TAFs implemented into the
Electronic Database System (EDS) to allow for the EDS to
choose the most appropriate one for each patient’s case.
We provide each Pediatrician and GP with a personal ID
code. We have ensured safe access and data encryption, as
well as assistance for all enquiries. We have also obtained
approval by the local Ethics Committee and by the Hel-
lenic Data Protection Authority (HDPA) for accessing and
processing personal data. It is important to note that what
distinguishes this project from a simple registry is its
dynamic design, resulting from integrated treatment proto-
cols and algorithms, which provides clinical guidelines and
management guidance for the prevention and treatment of
overweight and obesity in childhood and adolescence.
The Patient Summary Dataset includes:
• Personal and Demographic Data: personal data, such as
Social Security Number, name, surname, father’s and
mother’s names, birth date, etc., and demographic data,
such as gender, nationality and region of residence.
• Medical History: perinatal history (pregnancy, delivery
and neonatal period), present and past medical history,
nutrition, level of physical activity and exercise, aller-
gies, immunizations, hospitalizations, surgeries, gynaeco-
logical history and medical treatments.
• Family History: height, weight and BMI of the parents,
as well as any family history of disease.
• Clinical Examination: complete clinical examination,
including the anthropometry parameters (weight, height,
body mass index, waist/hip ratio) and arterial blood
pressure.
• Patient Consent: in compliance with the respective laws
and directives, the application has provisioned a process
to enable the patient to give consent to the doctor to
access his/her personal medical file.
The application core functions are the following:
• Patient File: the patients are managed in accordance with
international standards (ICD-10). There is also provision
for free text entry.
• History: any information registered is kept in the data-
base and displayed in an appropriate manner so as to be
available to the physician when needed.
• Diagnosis: based on the international standard classifica-
tion diagnosis ICD-10.
• Allergies: notification of registered allergies with appro-
priate signs.
• Visits: management of the complete history of visits and
treatment guidelines issued by the doctor.
• Immunizations: full history of previous immunizations
and reminders about future immunizations.
• Medical Report: management of medical reports.
• Laboratory Investigations: ability for documentation of
laboratory investigations.
• Reminders: reminders are forwarded to the physician or
patient via email (if given email).
• Printouts: possibility to printout every screen, such as
medical reports, nutrition guidelines, questionnaires and
recommendations to parents.
3 | RESULTS
The National Registry for the Prevention and Management
of Overweight and Obesity in Childhood and Adolescence
was launched in September 2015 and is accessible by:
http://app.childhood-obesity.gr/. Figure 1, shows the home
page, main menu, health data menu, therapeutic interven-
tions and national immunization program.
Upon entering the EMRF, each doctor has the opportu-
nity to create a new EMRF for new patients to be recorded
and is able to view only the EMRFs of the patients under
his/her care. In the EMRF, the physician records informa-
tion on the current history, the past medical history, the
family history, all anthropometry parameters (weight,
height, BMI, waist-to-hip ratio) and the findings of clinical
examination. Additional information on diet and exercise is
also included in the EMRF. The EDS then automatically
calculates the BMI from the data on height and weight and
informs the physician whether the patient has normal or
increased BMI. In addition, the corresponding growth chart
for BMI appears on the computer screen. Subsequently, the
EDS selects the most appropriate TAF, which provides a
comprehensive and personalized multidisciplinary manage-
ment plan for the prevention and/or management of over-
weight and obesity for the patient. The TAF indicates what
the initial advice to the patient and his/her family should
be; when the physician should reassess the patient; how he/
she will manage the patient if he/she responds to the thera-
peutic interventions and how if he/she does not respond to
the therapeutic interventions despite compliance with those;
when he/she will request laboratory investigations and
which ones; when he/she will refer the patient to a Pedia-
tric Dietician or Psychologist; and when he/she will refer
the patient to a Pediatric Endocrinologist and a specialist
centre with expertise in the management of overweight and
obesity.17
All the above ensure a unified approach throughout the
country with respect to the management of overweight and
obesity in childhood and adolescence and provide very
KASSARI ET AL. | 3 of 9
4. FIGURE 1 The National Registry for the Prevention and Management of Overweight and Obesity in Childhood and Adolescence, which is
accessible by the URL: http://app.childhood-obesity.gr/. (A) Home page; (B) Main menu; (C) Health data menu; (D) Therapeutic intervention; (E)
National Immunisation Program. (A) Home page. It shows the home page of the application (http://app.childhood-obesity.gr/), where the doctors
can register and sign in. There is also a provision to contact the administration in case they have forgotten their password. (B) Main menu. Top-left:
The main menu in tabs in 1 line. Top-Right: The name of the doctor appears at the first line, beneath there is a tab in case he/she wants to change
the password code and the log-off tab. At the line, the name of the last patient is displayed. Centre: From right to left at the first line, the first tab
enters to the patients’ files already registered, the second to the visits and the third to the appointments. At the second line, the doctor presses the
first tab when he/she wants to record a new patient, the second to read or create a reminder and the last tab is for the administrator of the system.
Down: The visit status is displayed (eg in progress), as well as the name of the patient. (C) Health data menu. Left to right: The first column
includes in different fields; patient’s personal and demographic data, reference cause, allergies, laboratory investigations and examination,
psychological history, growth, health behavioural customs, perinatal history, hospital admissions, surgeries, fractures, diseases, drugs, weight
history, gynaecological history and clinical examination. The second column includes on top the list of the current visits, following by the list of
the appointments, the reminders, printouts and lastly a tab where the doctor can upload files or pictures. (D) Therapeutic intervention. The EDS
automatically calculates the BMI from the data on height and weight entered by the physician, and informs the physician whether the patient has
normal BMI or is overweight or obese. In addition, the corresponding growth chart for BMI appears on the computer screen to enable the physician
to share this information with the parents/guardians, if necessary. Based on the data that the doctor is registering, the system calculates a
personalized therapeutic algorithm that provides information on diet, physical exercise and sleep, as well as guidance on laboratory investigations
and referral to specialized centres. (E) National Immunization Program. The system fully supports the Immunization program of a child
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| KASSARI ET AL.
5. specific and detailed guidance about the management of
this problem to all Pediatricians and GPs in district areas
with limited access to specialized Pediatric Endocrinology
Clinics.
The evaluation of the effectiveness of the interventions
that are proposed through this web application was
performed through our Out-patient Clinic for the Preven-
tion and Management of Overweight and Obesity at the
Division of Endocrinology, Metabolism and Diabetes, First
Department of Pediatrics, National and Kapodistrian
University of Athens Medical School, “Aghia Sophia”
Children’s Hospital, Athens, Greece.
FIGURE 1 Continued
KASSARI ET AL. | 5 of 9
7. One thousand two hundred and seventy (n = 1270)
children and adolescents (mean age SD: 10.06
3.29 years; 573 males, 697 females; 608 prepubertal, 508
pubertal) were studied prospectively for 1 year. All sub-
jects were consecutive attendees at the “Out-patient Clinic
for the Prevention and Management of Overweight and
Obesity in Childhood and Adolescence,” “Aghia Sophia”
Children’s Hospital, Athens, Greece, which was developed
as part of the program entitled “Development of a National
System for the Prevention and Management of Overweight
and Obesity in Childhood and Adolescence in Greece”
with the view to evaluate the proposed interventions.
According to their BMI, subjects were classified as obese,
overweight or of normal BMI using the International Obe-
sity Task Force (IOTF) cut-off points. All subjects were
clinically well, with no evidence of an endocrine or any
other disorder, and did not receive any medication. The
study was approved by the Committee on the Ethics
Human Research of “Aghia Sophia” Children’s Hospital.
Written informed consent was obtained in all cases by a
parent, and assent was given by children older than
7 years.
All participants were admitted to the Endocrine Unit
early in the morning on the day of the study, and a detailed
medical history and clinical examination, including pubertal
assessment and standard anthropometric measurements
(weight, height, waist circumference, hip circumference),
were obtained by a single trained observer. At initial
assessment, all subjects were evaluated by a Pediatric
Dietician with respect to their daily nutritional habits, as
well as by a professional Gymnacist/Personal Trainer with
respect to their activities and hobbies throughout the week,
including the type, frequency, duration and intensity of
each activity. They also received detailed personalized
advice on diet and exercise. Psychological and psychiatric
assessment and management was offered when required.
Endocrinological and biochemical investigations were per-
formed at the beginning and at the end of the study. Obese
subjects were followed up at least every month, overweight
subjects every 2 months and normal-BMI subjects every
3 months.
At initial evaluation, 60.2% of subjects were obese,
28.4% overweight and 11.4% of normal BMI. A signifi-
cantly higher number of boys were obese compared with
girls (68.5% vs 53.3%, P .001), while a higher number
of girls were overweight compared with boys (30.7% vs
25.6%, P .001). The onset of weight gain had been
observed beyond the age of 5 years and was progressive
throughout childhood and adolescence. Following 1 year of
the multi-disciplinary management interventions, the preva-
lence of obesity and overweight was decreased by 30% and
35%, respectively, normal BMI increased by 8%, and the
cardiometabolic risk indices improved substantially. These
results indicate that our personalized multi-disciplinary
management plan is effective at reducing the prevalence of
obesity in childhood and adolescence for at least 1 year.18
4 | DISCUSSION
Obesity should be perceived as a chronic disease.19,20
Vari-
ous scientific and health organizations have advocated the
use of new technologies20,21
to address the obesity epi-
demic. Few published studies have investigated the effect
of the use of e-health applications22
to weight loss inter-
ventions and evaluated their effectiveness for more than a
year.
Among those are the Child Health and Obesity Informat-
ics System (CHOIS), a HIPAA (Health Insurance Portability
and Accountability Act) FERPA (Family Educational
Rights and Privacy Act) compliant secure system, which
integrates large databases in a high-performance grid com-
puting environment. This is a web application that provides
web-based forms for data entry (such as demographics,
height and weight for BMI computation, as well as genomic
information), which enables school nurses to enter data on
school children, identify those at-risk for obesity and enrol
them in prevention and intervention programs.23
The Resource Information Program for Parents on Life-
style and Education (RIPPLE) represents an e-health
screening, brief intervention and referral to treatment
(SBIRT) system for parents to help prevent childhood obe-
sity in primary health care. It was viewed by the partici-
pants as practical, well-designed and innovative;
nonetheless, they recommended improvements to certain
features, such as weight-related terms, because they per-
ceived it may evoke adverse responses from some par-
ents.24
The MINSTOP (Mobile-based Intervention Intended to
Stop Obesity in Preschoolers) is a web- and mobile phone-
based intervention designed to help parents promote
healthy eating and physical activity in children. Its effec-
tiveness is still to be reported.25
The HopSCOTCH (Shared-Care Obesity Trial in Chil-
dren) included the development of a web-based shared-care
software with the following goals: (i) allow the obesity spe-
cialists and GPs to collaborate and communicate closely
for the best care of their patients, (ii) provide a structured
yet efficient approach to weight management care, (iii) pro-
vide a mechanism to allow both GPs and specialists to
record and track patient progress simultaneously, and (iv)
integrate this with the GP’s existing desktop software. The
project exceeded software cost and experienced problems
with installation, error messages and download delays. It
was difficult to implement and it underperformed in the
real-world settings.26
KASSARI ET AL. | 7 of 9
8. Finally, the Child-Teen Obesity Treatment Service Plat-
form included: (i) two patient/parent mobile applications,
(ii) one web-monitoring service for medical staff, (iii) one
mobile application for food-craving endurance, and (iv)
one mobile application for medical examinations. The inte-
gration was successfully completed to the hospital where
the pilot program took place. Its effectiveness will be veri-
fied in the future when other organizations will be involved
as well.27
In the present study, we developed a National e-Health
System for the prevention and management of overweight
and obesity, which registers all children and adolescents
in the country. To the best of our knowledge, the Hel-
lenic National Registry for the Prevention and Manage-
ment of Overweight and Obesity in Childhood and
Adolescence is unique and innovative, given that it is the
first web-based e-health professional application world-
wide that offers through predefined therapeutic algorithms
a designed comprehensive personalized multi-disciplinary
intervention program. Furthermore, it can be translated
into various languages and can be used in different coun-
tries by making the necessary adjustments on the pro-
posed interventions and by taking into consideration
cultural and societal differences.28
Moreover, it can be
used as a registry for immunizations, as it fully supports
the immunization program of a child. It can also be
expanded to include programs for the prevention and
management of obesity in adulthood or other chronic dis-
eases. It is important to note that the long-term effective-
ness of this e-health system for the prevention of
childhood obesity requires the support of public health
authorities, long-term funding by national authorities and
the commitment of Pediatricians and GPs to enter all chil-
dren and adolescents into the system.21,29
ACKNOWLEDGEMENTS
We are most grateful to the Athens Medical Society, which
supports the hosting of the Database on a nonprofit basis.
We are also grateful to the children and adolescences and
their families for participating in our studies, as well as all
the staff of the Out-Patient Clinic for the Prevention and
Management of Overweight and Obesity.
DISCLOSURE
The authors declared no conflict of interest.
AUTHOR CONTRIBUTIONS
Penio Kassari and Evangelia Charmandari undertook the
literature search and wrote the paper. Antonis Billiris, Har-
alampos Karanikas and Stergiani Eleftheriou participated in
the preparation of the figures and contributed to the litera-
ture search. Panagiotis Papaioannou, Yannis Manios, Eleft-
herios Thireos and George P. Chrousos reviewed the paper
critically and offered their comments. All the authors have
read and approved the final version of the manuscript.
ORCID
Penio Kassari http://orcid.org/0000-0003-2464-1825
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