ABSTRACT
This paper aims to historically re-evaluate the issues surrounding resident participation in health care and its legacy by examining the community participation in health care. In the 1970s and 1980s, community participation was one of crucial trends and a controversial topic in the international health as well as the international aid. Throughout the 1970s, local participation was regarded as one of essential elements for the access to basic healthcare and primary health care in developing countries. Community health projects which aimed to apply primary health care were implemented in rural areas and some urban areas in the 1970s and 1980s. Village Health Workers(VHWs) were a symbolic example of community participation in these projects. They consisted of local women and led health activities with simple skills in their villages. They served as a bridge between the project team and the residents. Health professionals expected them to be health leaders for “self-help” in health of their communities. In the mid-1980s, however, as the number of health facilities and professional health care workers increased, the activities of VHSs were decreased. The mixed understanding of the responsibilities and roles of VHSs among the health professionals affected the skeptical view on the achievement and effects of community participation in health care. In the mid-1980s, as the government officially organized the VHWs, the dilemma surrounding community participation intensified. When the community health projects were ended, most of the VHW organizations were also disbanded. After the projects, the spirit of community participation was only inherited by some healthcare movement organizations, such as medical cooperatives.
ABSTRACT
Background@#The increased prevalence of obesity has led to increases in the prevalence of chronic diseases worldwide. There is interest whether probiotics have an effect on obesity, but the effectiveness and safety of only a few probiotics for the treatment of obesity have been reported. The purpose of this study was to investigate whether ingestion of Lactobacillus sakei (CJLS03) derived from kimchi causes weight loss in people with obesity. @*Methods@#This randomized, double-blind, placebo-controlled, clinical trial involved 114 adults with a body mass index (BMI) ≥25 kg/m2 who were assigned randomly to a CJLS03 or placebo group. The groups received two allocations of either 5×109 colony-forming units of CJLS03/allocation or the equivalent vehicle for 12 weeks. Demographic and biochemical parameters, and body composition including fat and muscle mass were measured at baseline and after 12 weeks. Changes in body fat, weight, and waist circumference were compared between the two treatment groups. Adverse events were monitored during study period. @*Results@#Body fat mass decreased by 0.2 kg in the CJLS03 group and increased by 0.6 kg in the placebo group (0.8 kg difference, P=0.018). After the 12 weeks, waist circumference was 0.8 cm smaller in the CJLS03 group than in the placebo group (P=0.013). BMI and body weight did not change after the 12 weeks. Adverse events were mild and did not differ between the two groups. @*Conclusion@#These data suggest that L. sakei (CJLS03) might help people with obesity reduce body fat mass without serious side effects (ClinicalTrials.gov: NCT03248414).
ABSTRACT
Tomato extract has been shown to exert antiplatelet activity in vitro and to change platelet function ex vivo, but with limitations. In this study, antiplatelet activity of water soluble tomato concentrate (Fruitflow I) and dry water soluble tomato concentrate (Fruitflow II) was investigated using rat platelets. Aggregation was induced by collagen and adenosine diphosphate and granule-secretion, [Ca2+]i, thromboxane B2, cyclic adenosine monophosphate (cAMP) and cyclic guanosine monophosphate (cGMP) levels were examined. The activation of integrin αIIbβ3 and phosphorylation of signaling molecules, including mitogen-activated protein kinase (MAPK) and PI3K/Akt, were investigated by flow cytometry and immunoblotting, respectively. Prothrombin time (PT) and activated partial thromboplastin time (aPTT) were examined. Moreover, in vivo thrombus weight was tested by an arteriovenous shunt model. Fruitflow I and Fruitflow II significantly inhibited agonist induced platelet aggregation, adenosine triphosphate and serotonin release, [Ca2+]i, and thromboxane B2 concentration, while having no effect on cAMP and cGMP levels. Integrin αIIbβ3 activation was also significantly decreased. Moreover, both concentrates reduced phosphorylation of MAPK pathway factors such as ERK, JNK, P38, and PI3K/Akt. In vivo thrombus formation was also inhibited. Taken together, these concentrates have the potential for ethnomedicinal applications to prevent cardiovascular ailments and can be used as functional foods.