Overweight prevention in adolescents and children (behavioural and environmental prevention)

Health political background In 2006, the prevalence of overweight and adiposity among children and adolescents aged three to 17 years is 15%, 6.3% (800,000) of these are obese. Scientific background Obese children and adolescents have an increased body fat ratio. The reasons for overweight are - among others - sociocultural factors, and a low social status as determined by income and educational level of the parents. The consequences of adiposity during childhood are a higher risk of metabolic and cardiovascular diseases and increased mortality in adulthood. Possible approaches to primary prevention in children and adolescents are measures taken in schools and kindergarten, as well as education and involvement of parents. Furthermore, preventive measures geared towards changing environmental and living conditions are of particular importance. Research questions What is the effectiveness and efficiency of different measures and programs (geared towards changing behaviour and environmental and living conditions) for primary prevention of adiposity in children and adolescents, with particular consideration of social aspects? Methods The systematic literature search yielded 1,649 abstracts. Following a two-part selection process with predefined criteria 31 publications were included in the assessment. Results The majority of interventions evaluated in primary studies take place in schools. As the measures are mostly multi-disciplinary and the interventions are often not described in detail, no criteria of success for the various interventions can be extrapolated from the reviews assessed. An economic model calculation for Australia, which compares the efficiency of different interventions (although on the basis of low evidence) comes to the conclusion that the intervention with the greatest impact on society is the reduction of TV-ads geared towards children for foods and drinks rich in fat and sugar. There is a significant correlation between adiposity and socioeconomic deprivation. The lack of interventions (especially preventive measures geared towards changing environmental and living conditions) and studies focusing on this population group is noticeable. Discussion There are only a few primary studies of high quality on adiposity prevention in children and adolescents. Especially studies which compare different measures are lacking. This holds also true for the economic analysis, which seems logical insofar, as the basis for economic analyses are usually primary studies (preferably randomized controlled trials (RCT)) due to their evidence level). Studies on interventions geared towards changing environmental and living conditions and towards specific population groups (i. e. the socially disadvantaged) are hardly available. Conclusions There are hardly any primary studies of high quality on adiposity prevention in children and adolescents, especially studies which compare different measures are lacking. Interventions geared towards specific population groups (particularly for the socioeconomically disadvantaged) are specifically underrepresented. Establishing such studies is an essential requirement of adiposity prevention. Recommended are a combination of measures geared towards changing environmental and living conditions and towards specific population groups. Furthermore, it is recommended to systematically register future programs (preferably online) in order to be able to draft criteria of success.Gesundheitspolitischer Hintergrund Die Prävalenzzahl für Übergewicht bei drei- bis 17-jährigen Kindern und Jugendlichen in Deutschland liegt 2006 bei 15%, davon leiden 6,3% (oder 800.000) an Adipositas (Fettleibigkeit). Wissenschaftlicher Hintergrund Von Adipositas (Fettleibigkeit) Betroffene weisen einen erhöhten Körperfettanteil der Gesamtkörpermasse auf. Die Ursachen von Übergewicht sind unter anderem in soziokulturellen Faktoren sowie in einem niedrigen sozialen Status - gemessen an Einkommen und Schulbildung der Eltern - zu sehen. Die Folgen der Adipositas im Kindesalter sind durch ein erhöhtes Risiko für Stoffwechsel- und Herz-Kreislauferkrankungen sowie eine erhöhte Mortalität im Erwachsenenalter gekennzeichnet. Maßnahmen in Schule und Kindergarten, aber auch die Aufklärung und Einbindung der Eltern sind mögliche Ansätze für primäre Prävention bei Kindern und Jugendlichen. Außerdem kommt vor allem verhältnispräventiven Ansätzen (Veränderung der Umwelt- und Lebensbedingungen) besondere Bedeutung zu. Fragestellung Wie sind die Effektivität und die Effizienz von verschiedenen (verhaltens- und verhältnisbezogenen) Maßnahmen und Programmen zur Primärprävention von Adipositas bei Kindern und Jugendlichen (unter besonderer Berücksichtigung sozialer Aspekte) zu bewerten? Methodik Die systematische Literatursuche ergibt 1.649 Zusammenfassungen. Nach einem zweiteiligen Selektionsprozess mit definierten Kriterien verbleiben 31 Artikel zur Bewertung. Ergebnisse Die meisten der in Primärstudien betrachteten Interventionen finden im Schulbereich statt. Da es sich meistens um multidisziplinäre Maßnahmen handelt und die Interventionen oft nicht genau beschrieben werden, können auf Basis der betrachteten Reviews keine Erfolgskriterien für die einzelnen Interventionen herausgearbeitet werden. Eine ökonomische Modellrechnung für Australien, die die Effizienz verschiedener Interventionen vergleicht (allerdings auf Grundlage niedriger Evidenz), kommt zu dem Ergebnis, dass die Intervention mit dem größten Einfluss für die Gesellschaft in der Reduktion von Fernsehwerbung für fett- und zuckerreiche Speisen und Getränke für Kinder zu sehen ist. Es zeigt sich ein signifikanter Zusammenhang zwischen Adipositas und sozioökonomischer Benachteiligung. Auffällig ist das Fehlen von Interventionen (und Studien), die diese Zielgruppe fokussieren (insbesondere verhältnispräventive Maßnahmen). Diskussion Es gibt insgesamt wenige gute Primärstudien zur Adipositasprävention bei Kindern und Jugendlichen und vor allem kaum Studien, die unterschiedliche Maßnahmen miteinander vergleichen. Dies trifft auch auf die ökonomischen Analysen zu, was insofern logisch erscheint, als die Grundlage für ökonomische Analysen in der Regel Primärstudien sind (vom Evidenzgrad her am besten randomisierte kontrollierte Studien (RCT)). Studien zu verhältnispräventiven und zielgruppenspezifische Interventionen (z. B. für sozial Benachteiligte) liegen kaum vor. Schlussfolgerungen Es gibt kaum gute Primärstudien zur Adipositasprävention bei Kindern und Jugendlichen, insbesondere an Vergleichen verschiedener Interventionen mangelt es. Zielgruppenorientierte Interventionen (vor allem für sozioökonomische Benachteiligte) sind besonders unterrepräsentiert; ihre Etablierung ist eine wesentliche Aufgabe der Adipositasprävention. Empfohlen wird dabei auf jeden Fall eine Kombination von verhältnispräventiven und verhaltenspräventiven Maßnahmen. Es wird des Weiteren empfohlen, zukünftige Programme systematisch zu erfassen (am besten online), um in Zukunft leichter Erfolgskriterien formulieren zu können

Women scientists differ in how they see the role of gender in their careers

Some downplay discrimination: 'if you're good enough you'll be treated the same as men', write Marita Haas, Sabine Theresia Koeszegi and Eva Zedlache

Entrained Flow Gasification: Impact of Fuel Spray Distribution on Reaction Zone Structure

Entrained flow gasification (EFG) is an important process for generating syngas from biogenic and anthropogenic waste based feedstocks for a future circular economy. The EFG process is characterized by complex interactions between different physical and thermo-chemical sub processes which determine syngas quality and process efficiency. The understanding of these sub processes is essential for the development of validated models, and therefore for design and scale up of EFG reactors. EFG processes using a central jet burner configuration feature flames that can be described as inverse diffusion flames superimposed by a fuel spray. The flames are characterised by (i) the conversion of liquid and slurry droplets and (ii) the oxidation of recirculating synthesis gas with the gasification medium. This work studies the interactions between fuel and oxidizer in the near-flame region of an atmospheric EFG process. The model fuel ethylene glycol was gasified using oxygen-enriched air for two different burner nozzle configurations. Spray imaging, OH-LIF and Fuel Tracer-LIF measurements were carried out in addition to gas temperature measurements to characterize the fuel distribution and the flame structure. The experimental results show that narrower fuel spray distributions result in shorter flames and changes in flame shape from a compact to a hollow cone shape in the downstream flame region. The experiments were accompanied by 2-phase free-jet modelling and RANS based CFD modeling. The models were improved to reflect the experimental findings including the fuel spray distributions. The simulation results predict the observed flame structures well using both models and for both burner nozzle configurations. The changes in flame structure for different spray distributions can be explained by local stoichiometry using the results of the 2-phase free-jet model

Entrained flow gasification: Impact of fuel spray distribution on reaction zone structure

Entrained flow gasification (EFG) is an important process for generating syngas from biogenic and anthropogenic waste based feedstocks for a future circular economy. The EFG process is characterized by complex interactions between different physical and thermo-chemical sub processes which determine syngas quality and process efficiency. The understanding of these sub processes is essential for the development of validated models, and therefore for design and scale up of EFG reactors. EFG processes using a central jet burner configuration feature flames that can be described as inverse diffusion flames superimposed by a fuel spray. The flames are characterised by (i) the conversion of liquid and slurry droplets and (ii) the oxidation of recirculating synthesis gas with the gasification medium. This work studies the interactions between fuel and oxidizer in the near-flame region of an atmospheric EFG process. The model fuel ethylene glycol was gasified using oxygen-enriched air for two different burner nozzle configurations. Spray imaging, OH-LIF and Fuel Tracer-LIF measurements were carried out in addition to gas temperature measurements to characterize the fuel distribution and the flame structure. The experimental results show that narrower fuel spray distributions result in shorter flames and changes in flame shape from a compact to a hollow cone shape in the downstream flame region. The experiments were accompanied by 2-phase free-jet modelling and RANS based CFD modeling. The models were improved to reflect the experimental findings including the fuel spray distributions. The simulation results predict the observed flame structures well using both models and for both burner nozzle configurations. The changes in flame structure for different spray distributions can be explained by local stoichiometry using the results of the 2-phase free-jet model

Prioritization strategies for pandemic influenza vaccine in 27 countries of the European Union and the Global Health Security Action Group: a review

Background: Although there is rapid progress in vaccine research regarding influenza pandemic vaccines it is expected that pandemic influenza vaccine production can only start once the pandemic virus has been recognized. Therefore, pandemic vaccine capacity will be limited at least during the first phase of an influenza pandemic, requiring vaccine prioritization strategies. WHO recommends developing preliminary priorities for pandemic vaccine use. The goal of this review is to provide a thorough overview of pandemic vaccine prioritization concepts in the 27 European Union (EU) member states and the four non-EU countries of the Global Health Security Action Group. Methods: Between September and December 2006 data was collected for each country through two data sources: (i) the national influenza pandemic plan; (ii) contacting key persons involved in pandemic planning by email and/or phone and/or fax Results: Twenty-six (84%) countries had established at least one vaccine priority group. Most common reported vaccine priority groups were health care workers (HCW) (100%), essential service providers (ESP) (92%) and high risk individuals (HRI) (92%). Ranking of at least one vaccine priority group was done by 17 (65%) of 26 countries. Fifteen (88%) of these 17 countries including a ranking strategy, decided that HCW with close contact to influenza patients should be vaccinated first; in most countries followed and/or ranked equally by ESP and subsequently HRI. Rationales for prioritization were provided by 22 (85%) of 26 countries that established vaccine priority groups. There was large variation in the phrasing and level of detailed specification of rationales. Seven (32%) of 22 countries providing rationales clearly associated each vaccine priority group with the specific rationale. Ten (32% of the 31 countries studied) countries have consulted and involved ethical experts to guide decisions related to vaccine prioritization. Conclusion: In the majority of the countries the establishment of vaccine priority groups, ranking and underlying rationales are in line with WHO recommendations. In most public plans the criteria by which prioritized groups are identified are not easily recognizable. Clarity however, may be necessary to assure public acceptability of the prioritization. Ethical experts, results of modelling exercises could play an increasing role in the future decision making process

Spiel mit mir: Die Konstruktion von Geschlecht und Professionalität in Organisationen - eine Rahmenanalyse

Die sozialkonstruktivistische Theorie des doing gender hat sich in den letzten Jahrzehnten nicht nur in feministischen und soziologischen Diskursen etabliert, sondern ist mittlerweile auch in der Organisationsforschung von eminenter Bedeutung. Die soziale und interaktive Herstellung von Geschlecht versteht sich demnach kontextspezifisch, also innerhalb von Organisationen, in denen bestimmte - unausgeglichene und oft strukturell Mehrheitsgruppen unterstützende - Machtverhältnisse bereits angelegt sind. In dem vorliegenden Beitrag befassen wir uns mit der Frage, wie soziales Geschlecht und Professionalität sowie damit verbundene Rollenerwartungen an Führungskräfte konstruiert und welche Ein- und Ausschließungspraktiken dabei bedient werden. Methodologisch beziehen wir uns auf GOFFMANs Rahmenanalyse und untersuchen eine Mikrosituation aus dem organisationalen Alltag eines IT-Unternehmens. Die detaillierte Analyse einer im Kontext eines Assessment Centers erhobenen Beobachtungssequenz legt die Wirksamkeit gängiger Herrschaftsverhältnisse sowie den impliziten Assimilationsdruck an die maskuline Norm offen. Es wird auch aufgezeigt, wie in alltäglichen Unternehmenssituationen mit Irritationen oder Brüchen von etablierten Normen umgegangen wird.The social-constructivist theory of doing gender has not only been established in feminist and sociological discourse over the last decades, but has also attained importance in organization theory. The social and interactive production of gender is context-specific; that is, organizational structures already reflect certain power relations, which are unbalanced and in general structurally supportive of majority groups. In this article, we focus on the question of how gender and professional norms, as well as related role expectations are constructed and negotiated within a specific organization. We also address the consequences of differentiation between professional and non-professional as an organizational practice of inclusion or exclusion. Using the framework analysis of GOFFMAN, a micro-situation from the selection of candidates for a management position is analyzed in order to reconstruct the situational implementation of cultural practices. The detailed analysis of a particular recruiting sequence reveals the effectiveness of established forms of domination as well as the implicit pressure to assimilate into the current masculine norm. Furthermore, it is shown how the irritation of established norms is handled in organizations