Voiko terveellinen syöminen muuttua sairaudeksi?

Yhä useampi suomalainen noudattaa erityisruokavaliota muusta kun sairaudellisesta syystä. Ortoreksia nervosa on ilmiö, jossa elämää hallitsee pakkomielle syödä terveellisesti. Ortorektisina pidetyt ruokavaliot keskittyvät usein raaka-aineiden puhtauteen, laatuun, alkuperään sekä lisäaineettomuuteen. Lipsahdus ruokavaliosta aiheuttaa ortorektisesti oireilevalle paljon ahdistusta ja usein myös syömisen tiukentamista. Tässä artikkelissa esitän lääkäreille suunnatun yleiskatsauksen ortoreksiasta Pubmedtietokannasta löytyvien artikkeleiden perusteella. Pubmed-tietokannasta löytyy kirjoittamisen hetkellä vajaa sata artikkelia ”orthorexia” hakusanalla. Kyseistä ilmiötä ei ole Suomessa aiemmin käsitelty lääketieteellisestä näkökulmasta, vaikka aiheesta on keskusteltu täällä jo 15 vuoden ajan. Vielä ei löydy vallitsevaa mielipidettä siitä, miten ortoreksiaan tulisi suhtautua - itsenäisenä sairautena, syömishäiriöiden variaationa vai terveen käyttäytymisen äärimuotona. Tunnetuin diagnostinen työkalu ortoreksian suhteen on kiistelty ORTO-15 kysely, joka ei ole vielä Suomessa käytössä. Esiintyvyyden on arvioitu olevan 3,3 % - 74,2 %, yksittäisissä riskiryhmissä jopa 86%. Riskiryhmiin lukeutuu ravitsemustiedettä opiskelevat sekä terveydenhuollon ammattilaiset. Sekä anoreksialla että pakko-oireisella häiriöllä on monta yhteistä riskitekijää ortoreksian kanssa, kuten esimerkiksi pakonomaisuus ja täydellisyyden tavoittelu. Vakavia haittoja on kuvattu ainakin seitsemässä tapausselostuksessa. On kuitenkin huomattavasti yleisempää että ortorektinen oireilu esiintyy lievänä ja useimmiten harmittomana.Allt fler finländare följer en specialdiet på grund av andra orsaker än sjukdomar. Ortorexia nervosa är ett fenomen där personens liv kretsar kring att tvångsmässigt äta hälsosamt. Dieter som anses vara ortorektiska fokuserar oftast på råvarornas renhet, kvalité, ursprung och frihet från tillsatsämnen. En person med ortorektiskt beteende känner ångest om hen avviker från sin strikta diet. Detta leder ofta till att personen begränsar sin diet ytterligare som straff för avvikelsen. I denna artikel presenterar jag en översikt av fenomenet ortorexi baserat på medicinska artiklar i Pubmed-databasen. I skrivande stund finns det knappa hundra artiklar med nyckelordet ”orthorexia” i Pubmed-databasen. I Finland har ämnet i fråga inte tidigare behandlats ur en medicinsk syndvinkel, trots att ämnet diskusterats här i över femton års tid. Än så finns det ingen enhetlig åsikt om hur man borde förhålla sig till ortorexi – är det sin egen sjudom, en variation i ätstörningsspektret eller en extrem form av ett normalt beteende? Det kändaste diagnostiska redskapet gällande ortorexi är det omstridda ORTO-15 frågeformuläret. Frågeformuläret är inte ännu i användning i Finland. Med hjälp av ORTO-15 har man beräknat att ortorexiprevalensen i västvärlden ligger mellan 3,3% - 74,2% . I vissa enstaka riskgrupper nådde prevalensen upp till 86%. Till riskgrupperna hör studeranden med näringsvetenskap som huvudämne samt personer som arbetar inom hälsovården. Ortorexi delar på flera gemensamma riskfaktorer med både anorexi och tvångssyndrom. Perfektionism, kontrollbehov och tvångsmässigt beteende är exempel på dessa riskfaktorer. Allvarliga följder av ortorexi har rapporterats i sju fallbeskrivningar. Det är dock betydligt vanligare att det ortorektiska beteendet är lindrigt och huvudsakligen harmlöst

Abstinence-Only Education: Protecting the Public's Health or Poor Public Policy?

American adolescents are paying a heavy price for their sexual activity: contending with one million pregnancies annually, suffering from 250,000 cases of HIV, and bearing a disproportionate burden of the most commonly reported sexually transmitted infections (STis). The grim state of adolescent sexual health makes reduction of the behaviors associated with pregnancy and STI/HIV risk a high priority. Interest in reducing the nation's adolescent pregnancy and STI/HIV burden is part public policy and part politics; while there exists a desire to reduce the infection and pregnancy burden for the betterment of the community, many individuals view adolescent sexual activity and its consequences, such as out-of-wedlock births, as immoral. This difference of opinion acts as a barrier to developing initiatives to reduce adolescent sexual risk. President Bush's adolescent risk reduction strategy is focused on the use of socalled abstinence-only programs to encourage teen sexual abstention. While few would argue against the promotion of teen abstinence, abstinence-only curriculums lack scientific evidence to prove they are effective in reducing adolescent sexual risk. Data does exist, however, to support comprehensive, community-tailored programs that target teenagers, but the funding for such programs relative to abstinence-only curriculums is abysmal. The issue of teen sexuality has followed the same path as abortion and physician-assisted suicide, where religious theory and political election concerns, not empirical evidence, drive policy decisions.Master of Public Healt

Transition towards Circular Economy in the Food System

Growing population and increased demand for food, inefficient resource use and food distribution, environmental impacts, and high rates of food wasted at all stages of the food system are all calling for transition towards more sustainable practices. In this article we apply the concept of circular economy to the case of a sustainable food system. Furthermore, we explore the transition towards a circular food system through the lens of socio-technical transition theory towards sustainability. We discuss challenges and potential solutions for the production stage (focusing on nutrient flow), the consumption stage (focusing on meat consumption), and food waste and surplus management and prevention.Peer reviewe

Multiple components of PKA and TGF-beta pathways are mutated in pseudomyxoma peritonei

Pseudomyxoma peritonei (PMP) is a subtype of mucinous adenocarcinoma mainly restricted to the peritoneal cavity and most commonly originating from the appendix. The genetic background of PMP is poorly understood and no targeted treatments are currently available for this fatal disease. While RAS signaling pathway is affected in most if not all PMP cases and over half of them also have a mutation in the GNAS gene, other genetic alterations and affected pathways are, to a large degree, poorly known. In this study, we sequenced whole coding genome of nine PMP tumors and paired normal tissues in order to identify additional, commonly mutated genes and signaling pathways affected in PMP. These exome sequencing results were validated with an ultra-deep amplicon sequencing method, leading to 14 validated variants. The validated results contain seven genes that contribute to the protein kinase A (PKA) pathway. PKA pathway, which also contains GNAS, is a major player of overproduction of mucin, which is the characteristic feature of PMP. In addition to PKA pathway, we identified mutations in six genes that belong to the transforming growth factor beta (TGF-beta) pathway, which is a key regulator of cell proliferation. Since either GNAS mutation or an alternative mutation in the PKA pathway was identified in 8/9 patients, inhibition of the PKA pathway might reduce mucin production in most of the PMP patients and potentially suppress disease progression.Peer reviewe

Expression of ODC Antizyme Inhibitor 2 (AZIN2) in Human Secretory Cells and Tissues

Ornithine decarboxylase (ODC) antizyme inhibitor 2 (AZIN2), originally called ODCp, is a regulator of polyamine synthesis that we originally identified and cloned. High expression of ODCp mRNA was found in brain and testis. We reported that AZIN2 is involved in regulation of cellular vesicle transport and/or secretion, but the ultimate physiological role(s) of AZIN2 is still poorly understood. In this study we used a peptide antibody (K3) to human AZIN2 and by immunohistochemistry mapped its expression in various normal tissues. We found high expression in the nervous system, in type 2 pneumocytes in the lung, in megakaryocytes, in gastric parietal cells co-localized with H, K-ATPase beta subunit, in selected enteroendocrine cells, in acinar cells of sweat glands, in podocytes, in macula densa cells and epithelium of collecting ducts in the kidney. The high expression of AZIN2 in various cells with secretory or vesicle transport activity indicates that the polyamine metabolism regulated by AZIN2 is more significantly involved in these events than previously appreciated.Peer reviewe

A CX3CRI Reporter hESC Line Facilitates Integrative Analysis of In-Vitro-Derived Microglia and Improved Microglia Identity upon Neuron-Glia Co-culture

Multiple protocols have been published for generation of iMGLs from hESCs/iPSCs. To date, there are no guides to assist researchers to determine the most appropriate methodology for microglial studies. To establish a framework to facilitate future microglial studies, we first performed a comparative transcriptional analysis between iMGLs derived using three published datasets, which allowed us to establish the baseline protocol that is most representative of bona fide human microglia. Secondly, using CRISPR to tag the classic microglial marker CX3CR1 with nanoluciferase and tdTomato, we generated and functionally validated a reporter ESC line. Finally, using this cell line, we demonstrated that co-culture of iMGL precursors with human glia and neurons enhanced transcriptional resemblance of iMGLs to ex vivo microglia. Together, our comprehensive molecular analysis and reporter cell line are a useful resource for neurobiologists seeking to use iMGLs for disease modeling and drug screening studies.Peer reviewe

Transitioning towards a Sustainable Wellbeing Economy— Implications for Rural–Urban Relations

This article focuses on the question of how a shift from a narrow economic perspective to a wider sustainable wellbeing focus in regional development strategies and actions might change rural–urban relations. A brief review of relevant research and discourses about economic develop-ment models provides the foundation for the analysis. The review leads to the development of an analytical framework that puts the notion of sustainable wellbeing at its center. The criteria included in the analytical framework are then used to assess the current situation, challenges and perceived ways forward based on data and analyses from 11 European regions. The focus of the analysis is on different expressions of a sustainable wellbeing economy, and aspects of territorial development that are consistent with the basic features of a wellbeing economy are identified. Development dy-namics and tensions between different development goals and resource uses, strategies and actions that are in favor of sustainable wellbeing goals, and conditions for a more mutually beneficial rural–urban relationship are discussed. The article concludes with the implications for local government, and governance and policy frameworks. Reference is made to current high-level strategic policy frameworks and the European Green Deal

Developing the specifications of an Open Angle Glaucoma screening intervention in the United Kingdom : a Delphi approach

PMID: 23216983 [PubMed - indexed for MEDLINE] PMCID: PMC3563574 Free PMC Article Acknowledgements We thank all the glaucoma specialists who took part in the Delphi process. We thank the Glaucoma screening Platform Study advisory panel including R Bativala, D Crabb, D Garway-Heath, M Griffiths, R Hitchings; S McPherson, A Tuulonen, A Viswanathan, H Waterman, R Wormald, D Wright for their guidance and contribution to the Delphi process and Luke Vale and Rodolfo Hernandez for their advice on development of the Delphi questionnaires. This paper was developed from the first phase of a project funded by the MRC (project reference G0701759) Developing the intervention & outcome components of a proposed randomized controlled trial of screening for open angle glaucoma. The Health Services Research Unit is core funded by the Chief Scientist Office of the Scottish Government Health Directorates. The views expressed in this report are those of the authors and not necessarily those of the funders.Peer reviewedPublisher PD

Robust estimation of bacterial cell count from optical density

Optical density (OD) is widely used to estimate the density of cells in liquid culture, but cannot be compared between instruments without a standardized calibration protocol and is challenging to relate to actual cell count. We address this with an interlaboratory study comparing three simple, low-cost, and highly accessible OD calibration protocols across 244 laboratories, applied to eight strains of constitutive GFP-expressing E. coli. Based on our results, we recommend calibrating OD to estimated cell count using serial dilution of silica microspheres, which produces highly precise calibration (95.5% of residuals <1.2-fold), is easily assessed for quality control, also assesses instrument effective linear range, and can be combined with fluorescence calibration to obtain units of Molecules of Equivalent Fluorescein (MEFL) per cell, allowing direct comparison and data fusion with flow cytometry measurements: in our study, fluorescence per cell measurements showed only a 1.07-fold mean difference between plate reader and flow cytometry data

Staining of normal gastric mucosa (corpus).

<p>AZIN2 reactivity in a tubular pattern in parietal cells (insert) (a). A consecutive section stained with mAb to H,K-ATPase revealed a similar distribution (b). Confocal microscopy of double immunofluorescence staining of AZIN2 (e) and H,K-ATPase (c) show co-distribution in the merged picture (d).</p