Professor, University of Kansas School of Medicine
Neuroendocrine theory: this is based on the importance of the hormones secreted in the brain (hypothalamic gastritis zeluca proven florinef 0.1 mg, pituitary gastritis cancer purchase 0.1mg florinef otc, and adrenal hormones) in the regulation of organismic aging and on the decrement in brain neurons [18] gastritis diet 5 2 buy florinef mastercard. Immunologic theory: this is based on the decreased T-cell response and increased autoimmune reactions during aging [19]. As for the neuroendocrine theory, the weak point is that complex immune and neuronal systems are not present in simple eukaryotes although theyshow characteristics of aging comparable to higher organisms. Cellular senescence: cellular cultures were used as a model for the comprehension of senescence processes due to their usefulness in studying the basic molecular mechanisms, unlike the whole organisms. Data on the genetic effectors responsible for the regulation of cell senescence sustain the hypothesis that organismic aging reects the senescence of single cell lines or tissues. Cellular senescence is often indicated as replicative senescence, since the genes involved in this phenomenon are mainly genes related to the replication machinery and since the cellular senescence becomes evident through decline in growth rate and proliferative activity and alterations in the signal transduction and adaptive response pathways. All these alterations characterize a senescent cell growth status, which is quite different from the young cells [20]. The rst event characterized as a potential cellular clock was the mechanism of telomere shortening [21]. Another two genes of the replicative machinery, retinoblastoma and p53, are well known to be involved in cell senescence; their activity is generally increased in senescent cells [22]. These data are consistent with the hypothesis that cellular senescence has evolved as a mechanism of tumor suppression [8]. Cell death: strictly linked to the mechanisms of cellular replication and senescence, the mechanism of apoptosis is considered as a cause of aging since it consists of a process of active, gene-dependent and injury-independent cell death [23]. More recently, evidence that epigenetic mechanisms could have a role in cellular degeneration and aging has been supported by technical advances allowing a detailed study of the epige- nome and of the epigenetic mechanisms and by the discovery of a complex, non-Mendelian, nature of many age-associated disorders. In yeast and mice, signicant changes in gene expression during cellular degeneration are related to signicant and net loss of heterochromatin, with consequent overexpression of heterochromatin-associated silenced genes [24]. For this reason, it has been proposed that loss of repressive chromatin domains (heterochromatin) may contribute to cellular degeneration and aging processes. Other CpG islands in promoter regions of several genes exhibit age- related hypermethylation in colon mucosa [29,34]. Most of the CpG islands found hyper- methylated in primary colon tumors were hypermethylated to a lesser extent in the aging colon, but a minor number of islands were hypermethylated only in subsets of colon cancers. These ndings stress the hypothesis that two kinds of methylation exist: (1) one age-related methylation, presents in the normal mucosa as a function of the age and (2) a cancer-related methylation, not observed in normal colon. More recently, thanks to the power of the genome-wide studies comparing younger to older subjects, it was possible to conrm on a large-scale basis that methylation changes (both in the direction of hyper- and hypo-methylation) are associated with aging, both in humans [36e38] and in animal models [39]. Even after these recent results, the idea that the methylation status of a larger part of the examined genes and sequences seem unchanged during aging [35] is, so far, still preserved. This is not at all, of course, a negative or controversial result for the disciples of the epigenetic theory of aging, but it just points out the idea that the age-associated epigenetic drift targets specic genes involved in aging processes. Aberrant methylation of CpG islands in the promoter region may contribute to the progressive inactivation of growth-inhibitory genes during aging, resulting in the clonal selection of cells with growth advantage towards cancer development. All the above-reported data evidence that the methylation pattern established during the development is not stable or denitive in adult life and, in particular, during aging. In our laboratory, we obtained earlier indirect indications that rapid demethyl- ation, not compatible with the time necessary for cellular replication, occurred at a specic CpG site of myogenin gene promoter during myogenic differentiation in vitro [52]. Using a transgenic mouse model of Alzheimers disease we showed that the inhibition of the metabolic pathway that generates the methyl donor S-adenosylmethionine resulted in the impairment of the methylase activities and the improvement of the demethylase activity in mice brain d a tissue known for its scarce cellular proliferation. We can therefore conclude that the methylation pattern of specic genes is not xed in adults and non- proliferating tissues but undergoes dynamic regulation under appropriate stimuli. Neurodegenerative disorders represent the main class of age-associated diseases and, among these, Alzheimers disease represents the most prevalent form of neurodegenerative disease.
Overexpression of miR-10b increases cell motility and invasiveness gastritis pediatric symptoms buy florinef line, effects that are reversed upon inhibition of expression gastritis diet укр purchase florinef 0.1mg with visa, both in vitro [65] and in vivo [66] gastritis duodenitis diet florinef 0.1mg on line, suggesting a prometastatic role for miR-10b. In breast cancer, dysregulation of miR-145 and miR-21 was associated with tumor progression, whilst reduced let-7 expression was associated with increased lymph node metastasis and proliferation capacity [59]. In colorectal cancer, miR-21 expression is associated with tumor stage, invasion, and prognosis [69]. Whilst in lung cancer, reduced let-7 was indicative of a poor prognosis in two independent studies [62,70]. In prostate cancer [74], miR-15a and miR-16-1 were demonstrated to be down-regulated in 80% of tumors. Conversely, overexpression of miR-15a and miR-16-1 reduced growth, induced apoptosis and tumor regression in a prostate cancer xenograft model. A study by Takamizawa and colleagues was the rst to identify a potential tumor suppressor role for let-7 [70], demon- strating the down-regulation of let-7 in lung cancer, with low expression also associated with a shorter postoperative survival time. Overexpression of let-7 signicantly inhibited growth in lung cancer cells, suggesting a functional role for let-7 in modulating tumorigenesis. This is supported by several studies that have demonstrated the antiproliferative effects of let-7 in lung [4], thyroid [75], and prostate [76] cancer. Furthermore, let-7 has been demonstrated to inhibit tumor growth in vivo [77,78], further supporting a tumor suppressor role. This suggests that the frequent down-regulation of let-7 seen in multiple cancers provides a mechanism for tumor development and progression via increased expression of these gene targets. In glioblastoma and breast cancer cells, knockdown of miR-21 inhibited cell growth and induced apoptosis [50,83], suggesting that overexpression of miR-21 may promote tumor development via the negative regulation of proapoptotic factors. The oncogenic properties of miR-21 are mediated, at least in part, via its negative regulation of several important tumor suppressor genes. In addition, miR-21-mediated regulation of all three tumor suppressors is associated with increased invasion and metastasis, suggesting a role for miR-21 in cancer progression. The role of miR-21 in both the development and progression of cancer, in addition to the response to anticancer treatment, highlights the potential of miR-21 as a novel therapeutic target. The cluster is located on chromosome 13, at a region commonly amplied in a number of hematopoietic malignancies and solid tumors [93e95]. The oncogenic potential of miR-17-92 was rst highlighted in a mouse model of B-cell lymphoma [94]. These tumors also demonstrated lower apoptosis, suggesting that the role of miR-17-92 in tumor development may be via antiapoptotic mechanisms. The negative regulation of the cell cycle regulator p21 by miR-17-92 [98] may explain the effects of this polycistron on proliferation. Interestingly, miR-17-92 has been demonstrated to be directly induced by the oncogene c-myc [99], which is frequently up-regulated in cancer, further supporting an oncogenic role for miR-19-72. Surprisingly, loss of the genomic region encoding the miR-17-92 cluster has also been linked to malignancy in hepatocellular cancer [100]. This potential tumor suppressor role of miR-17-92 may be explained by its negative regulation of the transcription factor E2F1 [99]. E2F1 is induced by c-myc and promotes cell cycle progression [101], it also forms a positive feedback loop by inducing c-myc expression [102]. Thus, the repression of E2F1 by miR-17-92 provides a mechanism for inhibition of c-myc-mediated growth. The down-regulation of miR- 17-92 in hepatocellular cancer may therefore provide a mechanism for tumor development.
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States that have made large investments in comprehensive tobacco control programs have seen cigarette sales drop more than twice as much as in the United States as a whole gastritis stories purchase 0.1 mg florinef overnight delivery. National trends in per capita cigarette consumption are strongly correlated with national trends in lung cancer mortality rates and consumption trends are recommended as a primary surveillance indicator for lung cancer control efforts diffuse gastritis definition purchase florinef 0.1mg line. In 2005 gastritis diet кино discount 0.1 mg florinef visa, annual per capita cigarette consumption among adults aged 18 and older was 1,716, a more than five percent decrease from 2004. Similarly, the percentage of the nonsmokers aged 4 years and older with self-reported home secondhand smoke exposure declined from 20. Lung, trachea, and bronchus cancers account for 13 percent of all cancer diagnoses and 29 percent of all cancer deaths; smoking is a primary cause of these cancers. Rationale and Recent Accomplishments: Poor nutrition, physical inactivity, and unhealthy weight not only increase the risk of many diseases and health conditions, they also have a major economic impact. In 2008, 21 the cost of obesity in the United States was estimated at $147 billion. Annual Medical Spending Attributable To Obesity: Payer-And Service-Specific Estimates; Health Affairs, 28, no. One such program is Smart Choices, which promotes healthy items in vending machines and concession stands across Georgia parks and recreation facilities. Six sites participated in the initial pilot program, and ten local public health districts have been funded to implement the program in 2009. In 2005, Georgia adopted the Georgia Recreation and Parks Healthy Vending Resolution to provide healthier items for vending machines and concession stands. These efforts have resulted in environmental changes to retail and other store venues that provide consistent messages about fruit and vegetable consumption. This will accelerate further development of evidence-based policy and environmental nutrition, physical activity, and obesity strategies. Community Health funding will be used to support the programs and initiatives described below. This program will fund up to ten of the largest cities through competitive cooperative agreements. The Recovery Act communities provide a platform for testing wide-scale application of a focused set of evidence-based policy, environmental, and systems strategies. Best practices and lessons learned from Recovery Act will serve to inform the large cities funded through this initiative. Large cities have high population density and represent a large proportion of the national population. Consequently, a focused investment in a limited set of large cities is an efficient way to reach large populations. Cities themselves have identified Federal guidance and support as a key to turning the tide in chronic disease. Large cities possess unique regulatory authority and ability to make policy and environmental changes that affect large populations city-wide. Funded big cities will implement evidence-based programs using proven policy, environmental, and systems change strategies to address three public health priorities: tobacco prevention and control; obesity prevention and control (through improved nutrition and physical activity); and chronic disease detection and management. The program will also include the creation of Action Institutes to provide training and technical assistance for teams of community leaders to help them develop community action plans. Program strategies aim to bridge the gaps between the health care system and minority communities; respond to unique social, economic, and cultural circumstances; and change the conditions and risk factors in local communities that have kept racial and ethnic minority groups from improving their health. These Centers of Excellence have expertise in working with specific ethnic groups and help to train new communities and disseminate effective strategies. These communities will establish a solid foundation and be poised to implement evidence-based strategies within their communities. The program mobilizes community leadership and resources to bring change to the places and organizations that touch peoples lives every day at work sites, schools, community centers, and health care settings to stem the growth of chronic disease.
Indeed diet with gastritis purchase discount florinef on-line, youth face unprecedented challenges in society today compared to 20 years ago gastritis diet 5 2 buy discount florinef 0.1mg online, and these Suggested Reading challenges shape their long-term functioning in funda- Beauchaump gastritis what to eat purchase cheap florinef on-line, T. On stigma and its consequences: evidence from a longi- tudinal study of men with dual diagnoses of mental illness and and in fact, it is through the successful resolution of substance abuse. Journal of Health and Social Behavior, 38, these experiences that most youth achieve significant 177190. Recent diagnosed among youth, and that more than 30% may census data show that the majority of these youth lived have some mental health symptoms. Based on emerged as a major health and mental health concern current projections, the racial and ethnic makeup of the because evidence points to serious risks associated with adolescent population in the United States will become poor nutrition and excess weight. Poverty is related to a host of conditions Experimentation and risk taking are hallmarks of that negatively affect youths development, including adolescence, yet the negative health consequences increased exposure to crime and unemployment, poor today are more serious than ever before. Unprotected health status, low-quality schools, and limited access to sex will not only result in unwanted pregnancy, but it health care and adequate housing. Illegal substances hardship on the family influences adolescents function- are more potent and more addictive, and cars and guns ing and well-being through increased parental distress are easily accessible. Tobacco use adolescents living in two-parent households has fallen peaked in 1997 but appears to have stabilized, while sharply over the past 20 years particularly for minority alcohol use remains high. Almost half of all high school youth, and nearly 42% of teens living in single-parent seniors report using marijuana at some point in their female-headed households are poor. However, only 30% report using condoms consistently, and almost 75% The majority of adolescents appear to be in good-to- of high school seniors have had sexual intercourse. Biological Changes The Surgeon General recently released a report on mental health indicating that nearly 21% of youth aged Adolescence marks the most rapid and significant 917 meet criteria for a diagnosable mental or addictive biological changes throughout the life span with the 69 Adolescence exception of infancy. Puberty and menarche (see there is extensive evidence to suggest that teens assume entries in this encyclopedia) end with the ability to transient peer values such as music, fashion, clothes, and reproduce and the appearance of a physical adult form. Romantic relationships a dramatic growth in height and weight, further devel- increase in significance with age with early romantic opment of the gonads or sex glands (i. The changes in appearance evoke emergence of close social ties is an important develop- mixed reactions from the teenager about herself and mental milestone during adolescence and failure to mark critical shifts in family relationships, peer relation- achieve close interpersonal relationships is associated ships, and societal expectations (see below). Family relationships Cognitive Changes shift with the transformation of the parentchild rela- There are important changes in cognitive function- tionship. Parental control over adolescent behavior is ing during adolescence that have far-reaching implica- more limited, and there is a redefinition of the bound- tions for achievement and interpersonal relationships. A key challenge for the family during increasingly capable of abstract and logical thought. Autonomy and connectedness in the family their own, although shifts in emotions may impair their may be viewed along a continuum with either end lead- judgment at times. When there is think in a multidimensional way rather than being limited too much autonomy or chaos, reliable parental figures to a single issue, and they begin to think more about the are absent, and teens seek a secure environment out- process of thinking or metacognition. At the other extreme are families who maintain centrism, and the belief that ones own experiences are rigid roles and relationships, adhere unbendingly to unique. These cognitive changes may lead to increased rules, and show little tolerance for deviance. Adolescent conflict in the family as youth become increasingly aware identity formation is compromised because there is min- of their parents limitations. Youth typically assume they imal acceptance of self-expression, differing opinions, are immortal and invulnerable, and these beliefs have and independence.
Finally gastritis diet 7 up cake florinef 0.1mg with visa, nurse-midwives salaries are much increases gastritis constipation generic 0.1mg florinef free shipping, the prevalence of male-dominated faculty is lower than that of obstetricians (Achterberg gastritis diet 21 purchase florinef 0.1 mg mastercard, 1990). The first female dean of a are briefly discussed, although it must be noted that this pharmacy school was appointed in 1987, and in 2000 is by no means a complete list of health professions that approximately 36% of full-time professors were women women practice. In 1981, the American treatment and prevention of tooth, mouth, and gum Pharmaceutical Associations Task Force on Women in diseases. There are many different health care profes- Pharmacy Final Report recommended that women insist sionals in this field including dental hygienist, dental on equal pay and should seek out management assistant, and dentist. While dentistry is a fast-growing occupational A 1978 study compared male and female pharma- area for women, barriers to job advancement and career cists salary and benefits (Shoaf & Gagnon, 1980). This satisfaction may continue to occur for women entering study found that 29% of women worked part-time, com- these professions. There was no difference in almost 27% of dental hygienists reported sexual harass- disability insurance, sick days, or paid vacation. It was ment, with the majority reporting their employer/dentist found that men had higher salaries, because they had as the perpetrator. They usually would have participated in a Another study examined the perceptions of work dental assistant program at a community college level. This study found no difference in the graduate level coursework and then graduate from a perceived amount of time spent performing clinical dental school. However, women felt that they spent more one of eight fields including orthodontics and periodon- time in dispensing activities such as screening drug tics. As had been seen in previous studies, men women in dentistry were expected to enter certain areas reported a greater job satisfaction and women had a of the profession, such as maternity and child welfare greater likelihood of leaving the profession (Quandt & services (Stewart & Drummond, 2000). Recent data show that women (Wolfgand, 1995), no difference was found between the make up 38% of dental school students and approxi- genders. Scarbecz and Ross there was a negative relationship between career com- (2002) recently studied gender differences in the moti- mitment and professional recognition stress. This study found that female students ranked people-oriented motives higher than their male counterparts. Male students felt that self- Other Health Professions employment and business-related reasons were more There are a multitude of other health professions in important. As noted in the fields gains and flexibility of career as being equally important. These fields career group, more men were in private practice whereas 28 Women in the Health Professions more women were faculty at dental schools. The majority of respiratory thera- lished career group, more men were group practice own- pists are women. They treat all ages, from premature ers and women were more likely to be in a solo practice. Approximately 80% of 80% of respondents reported that they were satisfied respiratory therapists work in hospitals, while others with their career (Price, 1990), and that they had a good work in doctors offices and in home care settings. The median length of career break cations may include specific degrees, or certificate pro- taken by a woman dentist has been reported to be grams. Most states have licensure requirements for 9 months, that of hygienists 11 months, and that of den- respiratory therapists. Most of the career breaks elderly Americans, many of whom may develop chronic taken by women dentists are for childcare reasons. Physical therapy is the discipline been the primary caregivers of children and those with where scientific physical procedures are used to treat disabilities; and they dominate the field of occupational people with disabilities or diseases with the goal of therapy (Froehlich, 1992).
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