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Berntsson SG, Reis J, Tulek Z, Spencer PS, Imhoff M, Joao M, Lafta MS, Najar Y, Tolf A, Selander V, Söderfeldt Y, Landtblom AM. Developing education in environmental health and medicine focusing on neurology: Initiatives in Sweden (the UPRISE model), France, and Turkey. J Neurol Sci 2024; 463:123117. [PMID: 38959823 DOI: 10.1016/j.jns.2024.123117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2024] [Accepted: 06/26/2024] [Indexed: 07/05/2024]
Abstract
BACKGROUND The role of environmental factors in neurological disorders constitutes a topic of increasing importance. Teaching in European universities should expand and update this field gaining future health professionals including adjacent disciplines. AIM To describe recent efforts to create courses that cover crucial interdisciplinary content that we believe should be included in modern education, and to adapt modern pedagogic strategies. METHODS In collaboration with RISE (Rencontres Internationales Santé Environnement), elective courses focused on Environmental Health and Medicine (EHM) were developed, in France, Sweden, and Turkey. The courses combined classic teaching methods and new pedagogic and digital solutions to create environment-related health awareness and facilitate future interprofessional collaboration in this field. RESULTS UPRISE is an innovative elective course introduced in 2020 in Sweden's Uppsala University with the participation of lecturers from several countries and aim to recruit students from different universities. A total of 45, mainly female students (68%), participated in the course. In Strasbourg, France, a novel course on environmental medicine was held in 2019-2023 and examined 90 students, of which more than half were female. Nine graduate nurse students in Turkey attended ten seminar series focused on EHM. Overall, students expressed satisfaction with the courses. CONCLUSIONS This European project for courses in higher education arising from RISE was met with appreciation and challenges from academic institutions. However, due to considerable efforts to introduce the EHM concept, a unique compulsory course for all medical students in the second year of training started in 2023 in all French medical faculties. In 2023, UPRISE was integrated into ENLIGHT, the European University Network to promote equitable quality of Life, sustainability, and Global engagement through Higher education Transformation.
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Affiliation(s)
| | - J Reis
- Department of Neurology, Centre Hospitalier Universitaire, University of Strasbourg, France
| | - Z Tulek
- Istanbul University - Cerrahpasa, Florence Nightingale Faculty of Nursing, Turkey
| | - P S Spencer
- Department of Neurology, School of Medicine, Oregon Health & Science University, Portland, OR, USA
| | - M Imhoff
- Faculty of Medicine, University of Strasbourg, France
| | - Moniz Joao
- Department of Medical Sciences, Neurology, Uppsala University, Uppsala, Sweden
| | - Muataz S Lafta
- Department of Surgical Sciences, Functional Pharmacology and Neuroscience, Uppsala University, Uppsala, Sweden
| | - Y Najar
- Department of Medical Sciences, Neurology, Uppsala University, Uppsala, Sweden
| | - A Tolf
- Department of Medical Sciences, Neurology, Uppsala University, Uppsala, Sweden
| | - V Selander
- Department of Medical Sciences, Medical School, Uppsala University, Uppsala, Sweden
| | - Y Söderfeldt
- Centre for Medical Humanities, Department of History of Science and Ideas, Uppsala University, Sweden
| | - A M Landtblom
- Department of Medical Sciences, Neurology, Uppsala University, Uppsala, Sweden; Department of Clinical and Biomedical Sciences, Linköping University, Sweden
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Senneby A, Fransson H, Vareman N. What is risk? The challenge of defining 'risk' in caries risk assessment. Acta Odontol Scand 2024; 83:42-46. [PMID: 37982589 DOI: 10.1080/00016357.2023.2275032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 10/17/2023] [Accepted: 10/18/2023] [Indexed: 11/21/2023]
Abstract
No Abstract.
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Affiliation(s)
- Anna Senneby
- Department of Oral Radiology, Skåne University Hospital, Malmö, Sweden
| | - Helena Fransson
- Department of Endodontics, Faculty of Odontology, Malmö University, Malmö, Sweden.
| | - Niklas Vareman
- Department of Medical Ethics, Lund University, Lund, Sweden
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Reis J, Buguet A, Román GC, Spencer PS. Environmental neurology: Concepts and short history of an interdisciplinary approach to etiology, treatment and prevention. J Neurol Sci 2023; 454:120861. [PMID: 37924592 DOI: 10.1016/j.jns.2023.120861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 08/09/2023] [Accepted: 10/27/2023] [Indexed: 11/06/2023]
Abstract
Environmental Neurology (EN), a sub-discipline of Neurology and Neurological Sciences, favors an interdisciplinary collaboration allowing a holistic approach to understanding the impact of environmental factors on the nervous system and their relationship with neurological diseases. Several examples of diseases and conditions show the large scope of subjects addressed by EN. The EN sub-discipline focuses on both individual and population issues thus joining patient care and public health, respectively. Neuropathogenesis is addressed by several major questions: How do the environment and nervous system interact? Which exogenous factors can trigger neurological disease? When, where and how do they act? What are the therapeutic implications, and how can these disorders be controlled or prevented. To answer such questions, we address the incentive for, philosophy of and methods developed by EN, which seeks to safeguard Brain Health and, thus, the quality of life.
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Affiliation(s)
- Jacques Reis
- Department of Neurology, Centre Hospitalier Universitaire, 1 Avenue Molière, 67200 Strasbourg, France; Association RISE, 67205 Oberhausbergen, France.
| | - Alain Buguet
- Malaria Research Unit, UMR 5246 CNRS, Claude-Bernard Lyon-1 University, 69622 Villeurbanne, France
| | - Gustavo C Román
- Department of Neurology, Neurological Institute, Houston Methodist Hospital, 6560 Fannin Street, Suite 802, Houston, TX 77030, USA
| | - Peter S Spencer
- Department of Neurology, School of Medicine, Oregon Institute of Occupational Health Sciences, Oregon Health & Science University, Portland, OR 97239, USA.
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Reis J, Spencer PS, Román GC, Buguet A. Environmental neurology in the tropics. J Neurol Sci 2020; 421:117287. [PMID: 33445007 DOI: 10.1016/j.jns.2020.117287] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 10/02/2020] [Accepted: 12/17/2020] [Indexed: 01/11/2023]
Abstract
We address the impact of the tropical environment on the human nervous system using the multifaceted approach characteristic of environmental neurology. First, environmental factors are examined according to their nature (physical, chemical and biological) and in relation to human activity and behavior. Some factors are specific to the tropics (climate and infections), while others are non-specific (chemicals, human communities and their way of life). Second, we examine the major role of human adaptation to the success of Homo sapiens, with emphasis on the linkage between thermoregulation and sleep-wake regulation. Third, we examine the performance of environmental neurology as a clinical discipline in tropical climates, with focus on the diagnostic and therapeutic challenges posed by human African trypanosomiasis. Finally, the prevention, early detection and monitoring of environmental neurological diseases is examined, as well as links with political and economic factors. In conclusion, practitioners of environmental neurology seek a global, multidisciplinary and holistic approach to understanding, preventing and treating neurological disorders within their purview. Environmental neurology integrates an expanded One Health concept by linking health and wellness to the interaction of plants, animals, humans and the ecosystem. Recent epidemics and the current COVID-19 pandemic exemplify the need for worldwide action to protect human health and biodiversity.
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Affiliation(s)
- J Reis
- Faculté de médecine, Université de Strasbourg, 4, rue Kirschleger, 67000 Strasbourg, France; Association RISE, 3 rue du loir, 67205 Oberhausbergen, France.
| | - P S Spencer
- Department of Neurology, School of Medicine, Oregon Institute of Occupational Health Sciences, Oregon Health & Science University, Portland, Oregon, USA.
| | - G C Román
- Department of Neurology, Neurological Institute, Houston Methodist Hospital, Houston, TX 77030, USA.
| | - A Buguet
- Malaria Research Unit, UMR 5246 CNRS, Claude-Bernard Lyon-1 University, 69622 Villeurbanne, France.
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Reis J, Román GC, Giroud M, Palmer VS, Spencer PS. Medical management, prevention and mitigation of environmental risks factors in Neurology. Rev Neurol (Paris) 2019; 175:698-704. [PMID: 31648732 DOI: 10.1016/j.neurol.2019.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2019] [Revised: 09/29/2019] [Accepted: 10/02/2019] [Indexed: 11/25/2022]
Abstract
The human environment and exposures arising therefrom are major contributors to neurological disorders ranging from stroke to neurodegenerative diseases. Reduction of exposure to environmental risk factors, with the goal of disease prevention or control, is addressed at the individual as well as the societal level and in recognition of differential subject vulnerability. We examine some practical solutions in high-income countries that may allow a better adaptation to environmental risks and reduce their adverse impact on the nervous system. We consider the citizen's role in reducing unhealthy exposures and explore new approaches to treatment.
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Affiliation(s)
- J Reis
- Department of neurology, university of Strasbourg, university hospital of Strasbourg, Strasbourg, France; Association RISE, 3, rue du Loir, 67205 Oberhausbergen, France.
| | - G C Román
- Department of neurology, methodist neurological institute and research institute, Houston methodist hospital, Houston, TX, USA; Weill Cornell medical college, Cornell university, New York, NY, USA
| | - M Giroud
- Dijon stroke registry, EA 7460, university of Bourgogne-Franche Comté, Inserm, santé publique France, university hospital of Dijon, Dijon, France
| | - V S Palmer
- Department of neurology, school of medicine, Oregon health & science university, Portland, OR, USA
| | - P S Spencer
- Department of neurology, school of medicine, Oregon health & science university, Portland, OR, USA
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Environmental Neurology has become a hot topic. Rev Neurol (Paris) 2019; 175:579-580. [PMID: 31611008 DOI: 10.1016/j.neurol.2019.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 09/16/2019] [Accepted: 09/26/2019] [Indexed: 11/21/2022]
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Reis J. Environmental Risk Factors for Stroke and Cardiovascular Disease. ENCYCLOPEDIA OF CARDIOVASCULAR RESEARCH AND MEDICINE 2018. [PMCID: PMC7150018 DOI: 10.1016/b978-0-12-809657-4.64111-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Besides the classical individual stroke risk factors a new class has appeared, the environmental risk factors. After a review of the evidences demonstrating that air pollution is a potent risk factor (Part 1), we propose an update of other physical, chemical, and biological factors, now considered as risk factors (Part 2). One of the challenges is to precise their specific roles as they can be combined in their noxious impacts (traffic air pollution + noise + weather + infections). This knowledge has practical consequences; From now on, medical advices cannot be limited to individual recommendations but must also deal with environmental public health issues.
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Calderón-Garcidueñas L, Leray E, Heydarpour P, Torres-Jardón R, Reis J. Air pollution, a rising environmental risk factor for cognition, neuroinflammation and neurodegeneration: The clinical impact on children and beyond. Rev Neurol (Paris) 2015; 172:69-80. [PMID: 26718591 DOI: 10.1016/j.neurol.2015.10.008] [Citation(s) in RCA: 125] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Revised: 10/27/2015] [Accepted: 10/27/2015] [Indexed: 12/12/2022]
Abstract
Air pollution (indoors and outdoors) is a major issue in public health as epidemiological studies have highlighted its numerous detrimental health consequences (notably, respiratory and cardiovascular pathological conditions). Over the past 15 years, air pollution has also been considered a potent environmental risk factor for neurological diseases and neuropathology. This review examines the impact of air pollution on children's brain development and the clinical, cognitive, brain structural and metabolic consequences. Long-term potential consequences for adults' brains and the effects on multiple sclerosis (MS) are also discussed. One challenge is to assess the effects of lifetime exposures to outdoor and indoor environmental pollutants, including occupational exposures: how much, for how long and what type. Diffuse neuroinflammation, damage to the neurovascular unit, and the production of autoantibodies to neural and tight-junction proteins are worrisome findings in children chronically exposed to concentrations above the current standards for ozone and fine particulate matter (PM2.5), and may constitute significant risk factors for the development of Alzheimer's disease later in life. Finally, data supporting the role of air pollution as a risk factor for MS are reviewed, focusing on the effects of PM10 and nitrogen oxides.
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Affiliation(s)
- L Calderón-Garcidueñas
- The University of Montana, Missoula, MT, 59812, USA; Universidad del Valle de México, Mexico City 04850, Mexico
| | - E Leray
- EHESP Sorbonne Paris Cité, Rennes, France
| | - P Heydarpour
- MS Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - R Torres-Jardón
- Centro de Ciencias de la Atmósfera, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - J Reis
- Service de Neurologie, Centre Hospitalier Universitaire, Hôpital de Hautepierre, 1, avenue Molière, 67200 Strasbourg, France.
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Genuis SJ, Kelln KL. Toxicant exposure and bioaccumulation: a common and potentially reversible cause of cognitive dysfunction and dementia. Behav Neurol 2015; 2015:620143. [PMID: 25722540 PMCID: PMC4334623 DOI: 10.1155/2015/620143] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Revised: 12/31/2014] [Accepted: 12/31/2014] [Indexed: 01/09/2023] Open
Abstract
Juxtaposed alongside the ongoing rise in the incidence and prevalence of dementia, is the surge of recent research confirming widespread exposure and bioaccumulation of chemical toxicants. Evidence from sources such as the Centers for Disease Control reveals that most people have accrued varying degrees of assorted toxic pollutants including heavy metals, flame retardants, and pesticide residues within their bodies. It has been well established that many of these toxicants have neurodegenerative as well as neurodevelopmental impact as a result of various pathophysiologic mechanisms including neuronal mitochondrial toxicity and disruption of neurotransmitter regulation. Elimination of stockpiled toxicants from the body may diminish adverse toxicant impact on human biology and allow restoration of normal physiological function. Incorporating a review of medical literature on toxicant exposure and dementia with a case history of a lead-exposed individual diagnosed with dementia, this paper will discuss a much overlooked and potentially widespread cause of declining brain function and dementia.
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Affiliation(s)
- Stephen J. Genuis
- Faculty of Medicine at the University of Calgary, Calgary, AB, Canada T2N 4N1
| | - Kasie L. Kelln
- Faculty of Medicine at the University of Saskatchewan, Saskatoon, SK, Canada S7N 5E5
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