Management of hypertension in children and adolescents

Hypertension has been recognized as an important health issue in the pediatric population over the past years. This emphasizes the need for an organized and effective plan for diagnosis and management. This review provides information to guide physicians through a structured approach to (1) screen children for hypertension during routine visits; (2) use normative blood pressure tables for diagnosis and classification; (3) perform a clinical evaluation to identify the presence of risk factors, comorbidities and/or target organ damage; and (4) initiate an individualized plan of care that includes follow-up blood pressure measurement, therapeutic lifestyle changes and - if necessary - pharmacological therapies

Boundaries between Chinese and Japanese Cultures as Reflected in European Perceptions

Throughout history it seems that definitions of Japanese cultural identity were invariably shaped by a pre-existing self-definition of China and Asia (especially India and Central Asia), and after the Meiji Restoration by a pre-existing self-definition of "the West." Due to the distance of perception Europeans have tended to view the Far East (Tōyō) as one single lump. When they conceptualize the Far East, they officially include China, Japan and Korea, in that order, but often they actually mean China. When in the second half of the 19th century Japan seemed to be the more successful member of that threesome in transforming itself into a modern nation, the Western way of conceptualizing Japan within the wider Far Eastern culture changed accordingly, and put more emphasis on the originality of Japanese culture than on what it has in common with the others. This changing perception was also carried over in the orientation of the academic study of Tōyō in Europe. On the other hand, when we shift our vantage point to Japan, it is safe to say that until the nineteenth century Japan on account of its geographical isolation has had difficulty in constructing the "other." There were not enough "others" in its immediate vicinity, and therefore they had to be forcefully created and emphasized. In the early periods it was China and India. Especially the Buddhist worldview greatly helped in imagining the other. This lack of an imminent other led the Japanese to stress the derivative character of their culture. By doing so, they intensified the faint presence of the other and stressed, for internal consumption, the notion that Japan was part of a wider \u27civilization.\u27 Consequently, just as the uniquely Japanese culture is a construction, the image of indebtedness to continental civilization was also carefully and meticulously crafted and cultivated. This latter construction largely worked and works through the mechanism of translation, which is not simply a replicating or duplicating process. The translated object is divorced from its original and is transferred into a context that is different from its original one. Its meaning in the new context is often uncertain, vague, indeterminate or ambiguous. The "difference" between the original and the target context is usually played out on the level of connotation, sometimes even on that of denotation. The connotation implies a difference of value: a higher or lower value or prestige clings to the translated culture. Usually Chinese ranks higher, while Japanese ranks lower, although in some cases it is the reverse. In either case the distinction between Wa 和 and Kan 漢 is conceived in terms of hierarchy or circumscribed areas of applicability.文部科学省グローバルCOEプログラム 関西大学文化交渉学教育研究拠点松浦章教授古稀記念号[東アジアの歴史と動態

Carbon sequestration in short-rotation forestry plantations and in Belgian forest ecosystems

In deze studie werd nagegaan in hoeverre plantages met een korte omloopstijd en Belgische bossen kunnen bijdragen tot het bereiken van de broeikasgasemissiereductiedoelstelling die de Belgische overheid aangegaan is onder het Kyoto Protocol

Therapeutic efficacy and safety of ACE inhibitors in the hypertensive paediatric population: a review

Purpose: Since 1997, strong incentives have been introduced worldwide to improve access to safe and effective medicines addressing the therapeutic needs of children. ACE inhibitors, the most prescribed antihypertensive drugs in the paediatric population, are one of the prototype drugs targeted by the legislation initiatives. Our purpose in assembling this review is to evaluate and describe the current evidence for the efficacy and safety profile of ACE inhibitors in the paediatric population. Methods: The authors made a descriptive review of the literature from 1980 to 2015 using the following search terms: hypertension, child, paediatric, ACE (inhibitors), renin angiotensin aldosterone system, captopril, lisinopril, enalapril, ramipril and fosinopril. Results: A total of 16 studies evaluating efficacy and safety of ACE inhibitors were included in this review. The included studies demonstrate that ACE inhibitors have the potency to decrease the systolic and/or diastolic blood pressure with an overall favourable safety profile in a short-term period. More importantly, the incentives resulted in an improvement of the overall availability of paediatric labelling, dosing and safety information for ACE inhibitors. However, they failed to fulfil several of paediatric needs: absence of long-term safety data on growth and maturation, absence of commercially available child-friendly formulations and incomplete evaluation of the entire paediatric hypertension population. Conclusion: Additional efforts are needed to close the gap between the availability of drugs that are labelled and indicated for paediatric use and the actual drug usage in children, especially in young children, neonates and children with severe hypertension, renal transplantation or severe renal impairment