Actividad física, composición corporal, fuerza prensil y consumo de alimentos en trabajadores de una institución de educación superior / Handgrip strength, body composition, physical activity and food consumption in workers of a higher education institution / Força de preensão manual, composição do corpo, atividade física e consumo de comida em trabalhadores de uma instituição de ensino superior

Resumen Objetivo: Determinar los niveles de actividad física, composición corporal, fuerza prensil, consumo de alimentos, y sus posibles asociaciones, en trabajadores de una institución de educación superior. Metodología: Estudio transversal en el que participaron 141 empleados administrativos y docentes (56 % mujeres y 44 % hombres), seleccionados mediante muestreo probabilístico estratificado. Se incluyó un modelo lineal generalizado, con regresión de Poisson para la asociación de las variables con la fuerza prensil de mano dominante. Resultados: El 51,6 % de los hombres y el 46,8 % de las mujeres presentaron sobrepeso u obesidad, según el índice de masa corporal; el 39,7 % de la población se encontró clasificada con riesgo de enfermedad cardiovascular por índice cintura / estatura; el 68,8 % cumplió con el requerimiento de actividad física; el 45,7 % clasificó con bajo nivel de fuerza prensil. De acuerdo con el modelo lineal generalizado, se encontró asociación significativa entre el bajo nivel de fuerza prensil con tener mayor masa adiposa y ser hombre. En consumo de alimentos, se observaron patrones inadecuados, con elevado consumo de ácidos grasos saturados, colesterol, azúcares añadidos y baja ingesta de fibra. Conclusión: Se identificaron factores de riesgo para el desarrollo de enfermedades no transmisibles, como alto comportamiento sedentario, exceso de masa corporal y bajo nivel de fuerza prensil; esta última se asoció de forma inversa con el porcentaje de masa adiposa. Se proponen planes de intervención para promover cambios en la conducta sedentaria, la actividad física y el consumo de alimentos.

Abstract Objective: To establish the levels of physical activity, body composition, handgrip strength, food consumption and possible associations, of the workers of a higher education institution. Methodology: Cross-sectional study in which 141 administrative employees and professors (56% women and 44% men) participated, selected by Stratified random sampling. A generalized linear model with Poisson regression was included for the association of the variables with the dominant hand grip strength. Results: 51.6% of the men and 46.8% of the women were overweight or obese, according to the body mass index; 39.7% were classified with risk of cardiovascular disease by waist-to-height ratio; 68.8% met the requirement of physical activity; 45.7% classified as having a low level of handgrip strength; According to the generalized linear model, a significant association was found between the low level of handgrip strength with having a greater fat mass and being a man. In food consumption, inappropriate patterns were observed with high consumption of saturated fatty acids, cholesterol, added sugars and low fiber intake. Conclusion: Risk factors for the development of non-communicable diseases such as high sedentary behavior, excess body mass and low level of grip strength were identified; the latter was inversely associated with the percentage of adipose mass. Intervention plans are proposed to promote changes in sedentary behavior, physical activity, and food consumption.

Resumo Objetivo: Estabelecer dos níveis de atividade física, composição corporal, força de preensão, consumo alimentar e possíveis associações de trabalhadores de uma instituição de ensino superior. Metodologia: Estudo transversal no qual participaram 141 funcionários administrativos e professores (56% mulheres e 44 % homens), selecionados por amostragem probabilística estratificada. Foi incluído um modelo linear generalizado com regressão de Poisson para a associação das variáveis com a força de preensão manual dominante. Resultados: 51,6% dos homens e 46,8% das mulheres apresentavam sobrepeso ou obesidade, de acordo com o índice de massa corporal; 39,7% da população foi classificada com risco de doença cardiovascular pelo indicador cintura / altura; 68,8% atendiam à exigência de atividade física; 45,7% classificados com baixo nível de força de preensão; De acordo com o modelo linear generalizado, foi encontrada associação significativa entre o baixo nível de força de preensão com maior massa gorda e ser homem. No consumo alimentar, foram observados padrões inadequados com alto consumo de ácidos graxos saturados, colesterol, açúcares adicionados e baixo consumo de fibras. Conclusão: Foram identificados fatores de risco para o desenvolvimento de doenças não transmissíveis como alto comportamento sedentário, excesso de massa corporal e baixo nível de força de preensão; este último foi inversamente associado ao percentual de massa adiposa. Planos de intervenção são propostos para promover mudanças no comportamento sedentário, atividade física e consumo alimentar.

Consenting on Principles of Rehabilitation Nursing Care: A Delphi Study.

PURPOSE: Patient-centeredness, evidence-based interventions, and interdisciplinary teamwork have been described as key in neurological rehabilitation nursing. In order to develop future action plans, a group of Swiss rehabilitation nurses sought agreement on concrete principles that led the efforts to develop a common understanding of rehabilitation nursing care in Switzerland. DESIGN: A three-round Delphi study was conducted. METHODS: Literature-based statements were formulated and sent out twice to 54 rehabilitation nursing stakeholders. In the third round, the participants ranked the three most important statements out of 13. FINDINGS: Highest priority reached the statements: Rehabilitation nursing care (1) considers the uniqueness of the patients and their family, (2) offers support that promises the greatest potential for patients and their family, and (3) uses evidence-based knowledge. CONCLUSION: Statements on patient- and family-centeredness were ranked highest. Patients and families' preferences have to be considered as much as evidence-based knowledge and interventions to support patients and family. CLINICAL RELEVANCE: The study supported the discussion on action plans and enlivened new services and nursing interventions in a Swiss nursing community.

Evolution and molecular epidemiology of classical swine fever virus during a multi-annual outbreak amongst European wild boar.

Classical swine fever is a viral disease of pigs that carries tremendous socio-economic impact. In outbreak situations, genetic typing is carried out for the purpose of molecular epidemiology in both domestic pigs and wild boar. These analyses are usually based on harmonized partial sequences. However, for high-resolution analyses towards the understanding of genetic variability and virus evolution, full-genome sequences are more appropriate. In this study, a unique set of representative virus strains was investigated that was collected during an outbreak in French free-ranging wild boar in the Vosges-du-Nord mountains between 2003 and 2007. Comparative sequence and evolutionary analyses of the nearly full-length sequences showed only slow evolution of classical swine fever virus strains over the years and no impact of vaccination on mutation rates. However, substitution rates varied amongst protein genes; furthermore, a spatial and temporal pattern could be observed whereby two separate clusters were formed that coincided with physical barriers.

Validation of the new Lucerne ICF based Multidisciplinary Observation Scale (LIMOS) for stroke patients.

BACKGROUND: Valid and multidisciplinary assessment of a stroke patient's ability to perform activities of daily living is very important to define individual goals and to plan targeted rehabilitation. Until today, there is no observation scale that relies on International Classification of Functioning, Disability and Health (ICF). The aim of the present study was to develop and evaluate the reliability and validity of a new multidisciplinary observation scale for stroke patients, shortly called LIMOS, which is based on ICF. METHODS: In a first phase, LIMOS was defined, using a Delphi approach, by an expert panel and a pilot testing was conducted in a small group of stroke patients (n =10) to investigate feasibility and practicability. In a second phase, LIMOS was assessed for its reliability (internal consistency and test-retest reliability) and validity in a large cohort of stroke patients (n = 102). For convergent validity, the correlation between total scores of the LIMOS and the Functional Independence Measure (FIM) was assessed. RESULTS: LIMOS consisted of seven ICF chapters incorporating 45 domains. A high internal consistency (=0.98) of LIMOS was found. Furthermore, good test-retest reliability at item and subscale level was found. Principal component analysis revealed that among the seven ICF chapters, four components could be found: (1) interpersonal activities, mobility and self-care, (2) communication, (3) knowledge and general tasks, and (4) domestic life. Significant associations were found between LIMOS and the FIM indicating good convergent validity. CONCLUSIONS: The new LIMOS is a reliable and valid observation scale for stroke patients based on ICF, which can be used by a multidisciplinary team working in a neurorehabilitation setting.

Repeatability of topographic and aberrometric measurements at different accommodative states using a combined topographer and open-view aberrometer.

PURPOSE: To evaluate the repeatability of corneal first-surface aberrations and aberrometric measurements of a combined aberrometer-topographer (iTrace Visual Function Analyzer) for 5 accommodative stimuli. SETTING: Department of Ophthalmology, Goethe-University, Frankfurt, Germany. DESIGN: Prospective case series. METHODS: Eyes of young adults with low to moderate myopia or hyperopia were examined in 2 measurement series comprising 3 corneal topography measurements and wavefront measurements focusing on targets at 5 distances (0.4, 0.5, 0.6, 1.0, and 4.0 m). Repeatability was analyzed using the standard deviation (SD) within 6 measurements and the coefficient of repeatability (CoR) by Bland-Altman analysis of the means of the 2 measurement series. RESULTS: Fifty eyes (50 subjects) were evaluated. The lowest calculated mean SD/CoR measurements using the aberrometer function at 5 target distances were 0.07 µm/0.14 µm for total ocular aberrations root mean square (RMS), 0.07 µm/0.16 µm for lower-order aberrations (LOAs) RMS, 0.03 µm/0.66 µm for higher-order aberrations (HOAs) RMS, 0.10 diopter (D)/0.22 D for sphere, 0.08 D/0.13 D for cylinder, and 0.09 D/0.21 D for the spherical equivalent (SE). Repeatability of the total RMS, LOAs RMS, sphere, and SE measurements improved with increasing target distance (P < .01 for aberrometric values; P < .03 for refractive values). Measurement reproducibility using the corneal topographer showed mean SDs/CoRs of 0.19 µm/0.41 µm for total RMS, 0.19 µm/0.39 µm for LOAs RMS, and 0.08 µm/0.23 µm for HOAs RMS. CONCLUSION: The aberrometer showed satisfactory results for measurement repeatability at all target distances and declining repeatability with increasing accommodation effort. FINANCIAL DISCLOSURE: No author has a financial or proprietary interest in any material or method mentioned.

Modern adjuvants do not enhance the efficacy of an inactivated African swine fever virus vaccine preparation.

African swine fever (ASF) is among the most devastating viral diseases of pigs. In recent years, the disease has spread alarmingly. Despite intensive research activities, promising vaccine candidates are still lacking. For this reason, a study was undertaken to re-assess inactivated ASFV preparations with state-of-the-art adjuvants. Inactivated preparations of ASF virus (ASFV) "Armenia08" were adjuvanted with either Polygen™ or Emulsigen(®)-D, respectively, and used to immunize six weaner pigs two times with a three-week interval. Six weeks after the first immunization, animals were challenged with the homologues highly virulent ASFV. Although ASFV-specific antibodies were detectable in all but one vaccinated animal prior to challenge, no protective effect of immunization was observed. All animals developed acute-lethal ASF and had to be euthanized within eleven days post challenge. A slightly accelerated clinical course in vaccinees could even indicate an antibody dependent enhancement, which could also influence efficacy of other vaccine approaches.

Efficacy of marker vaccine candidate CP7_E2alf against challenge with classical swine fever virus isolates of different genotypes.

Classical swine fever (CSF) is among the most important viral disease of domestic and feral pigs and has a serious impact on animal health and pig industry. In most countries with industrialized pig production, prophylactic vaccination against CSF is banned, and all efforts are directed towards eradication of the disease, e.g. by culling of infected herds and animal movement restrictions. Nevertheless, emergency vaccination remains an option to minimize the socio-economic impact of outbreaks. For this application, potent vaccines are needed that allow differentiation of infected from vaccinated animals. Among the promising candidates for next generation marker vaccines is the chimeric pestivirus CP7_E2alf. Efficacy studies are usually carried out using highly virulent CSFV strains of genotype 1 that do not mirror the current field situation where strains of genotype 2 predominate. To prove that CP7_E2alf also protects against these strains, efficacy was assessed after single oral vaccination of wild boar and single intramuscular vaccination of domestic pigs using challenge models with recent CSFV strains and the highly virulent strain "Koslov" (genotype 1.1). It could be demonstrated that CP7_E2alf pilot vaccine batches for intramuscular and oral use were able to protect pigs from challenge infection with a highly virulent CSFV. Moreover, solid protection was also achieved in case of challenge infection with recent field strains of genotypes 2.1 and 2.3. Thus, broad applicability under field conditions can be assumed.

Pathogenesis of African swine fever in domestic pigs and European wild boar.

African swine fever (ASF) is among the most important viral diseases that can affect domestic and feral pigs. Both clinical signs and pathomorphological changes vary considerably depending on strain virulence and host factors. Acute infections with highly virulent virus strains lead to a clinical course that resembles a viral haemorrhagic fever that is characterized by pronounced depletion of lymphoid tissues, apoptosis of lymphocyte subsets, and impairment of haemostasis and immune functions. It is generally accepted that most lesions can be attributed to cytokine-mediated interactions triggered by infected and activated monocytes and macrophages, rather than by virus-induced direct cell damage. Nevertheless, most pathogenetic mechanisms are far from being understood. This review summarizes the current knowledge and discusses implications and research gaps.

[Possibilities and limitations in veterinary vaccine development using the example of classical swine fever]. / Möglichkeiten und Grenzen der Impfstoffentwicklung in der Veterinärmedizin am Beispiel der Klassischen Schweinepest.

The use of vaccines is still one of the most effective tools to control infectious diseases. Up to now, conventional vaccines are employed in the majority of cases. Drawbacks of these established vaccines include the lack of differentiability of infected from vaccinated animals (DIVA or marker strategy), limitations in the efficacy spectrum, and constraints and restrictions in production. For this reason, new vaccines, which do not show these disadvantages, are under development, especially for notifiable diseases such as classical swine fever (CSF). In principle, the following modern vaccine types can be differentiated: recombinant attenuated vaccines, recombinant inactivated vaccines or subunit vaccines, vector vaccines, and DNA/ RNA vaccines. During the last years, especially attenuated deletion vaccines or chimeric constructs have shown potential. Under field conditions, all marker vaccines have to be accompanied by a potent test system. Particularly this point often shows weaknesses. Alternative vaccine candidates are so far only prototypes and licensing is only a medium term possibility. Moreover, most of these vaccines are genetically engineered and can be problematic in terms of licensing and the public's acceptance. In conclusion, conventional vaccines still present the standard, especially in terms of efficacy. Yet, only vaccines with DIVA properties are feasible for the control of CSF. Thus, development and assessment of alternative vaccines is of paramount importance. The present overview summarizes concepts and vaccine types using the example of classical swine fever. It also recapitulates their advantages and disadvantages as well as their limitations.

Towards licensing of CP7_E2alf as marker vaccine against classical swine fever-Duration of immunity.

Classical swine fever (CSF) marker vaccine candidate CP7_E2alf was tested in a "duration of immunity" trial according to the World Organisation for Animal Heath (OIE) guidelines. To this means, 15 weaner pigs were either orally or intramuscularly vaccinated with a single dose of CP7_E2alf vaccine produced under Good Laboratory Practice (GLP) conditions. Ten additional pigs were included as controls. Six months later, all animals were oronasally challenged with highly virulent CSF virus (CSFV) strain "Koslov". Upon vaccination, all but one orally and all intramuscularly vaccinated pigs developed rising and later on stable CSFV glycoprotein E2-specific antibodies. In contrast, no CSFV E(rns)-specific "marker" antibodies were detectable prior to challenge infection. None of the co-housed control animals seroconverted. Upon challenge infection, all seropositive animals were protected from lethal challenge, whereas all control animals and the non-responder developed severe signs of CSF. One control animal recovered, the others had to be euthanised due to animal welfare reasons between days 4 and 7 post challenge infection. All protected animals showed quickly rising neutralizing antibodies reaching high titres by the end of the trial. At the end of the trial, the marker ELISA was positive for most challenged animals that survived the CSFV infection (27 out of 30). Using reverse transcription polymerase chain reaction, low level genome detection was seen in all vaccinated animals between days 4 and 10 post challenge infection, but no virus could be isolated from any samples of these animals. The OIE guidelines require seroconversion in at least 8 out of 10 vaccinated animals. This requirement was fulfilled. Moreover, only control animals should die. With this requirement, only the intramuscular vaccination fully complied as one orally vaccinated pig did not respond. Concluding, CP7_E2alf induced stable antibodies that led to protection from lethal challenge with highly virulent CSFV strain "Koslov" six months after vaccination, with the exception of one non-responder after oral vaccination.

Characterization of African swine fever virus Caucasus isolate in European wild boars.

Since 2007, African swine fever has spread from the Caucasus region. To learn more about the dynamics of the disease in wild boars (Sus scrofa), we conducted experiments by using European wild boars. We found high virulence of Caucasus isolates limited potential for establishment of endemicity.

Innocuousness and safety of classical swine fever marker vaccine candidate CP7_E2alf in non-target and target species.

Chimeric pestivirus CP7_E2alf is a promising live marker vaccine candidate against classical swine fever. Prior to a possible application in the field, several safety aspects have to be addressed. Due to the fact that CP7_E2alf is based on a bovine viral diarrhea virus backbone, its behavior in ruminants is of particular interest. In the framework of this study, its innocuousness in non-target species was addressed by inoculation of calves, young goats, lambs, and rabbits. To this means, high titres of CP7_E2alf were applied orally to three animals of each species. Additional animals were left as unvaccinated contact controls. During the study, all animals remained clinically healthy, and neither fever nor leukopenia were observed. Virus could not be isolated from purified white blood cells or from nasal or faecal excretions. Moreover, none of the animals (inoculated or contact control) seroconverted. In the target species, innocuousness, shedding and transmission of vaccine virus was addressed in different animal trials that were carried out primarily for the purpose of efficacy, potency or duration of immunity studies. In all experiments, CP7_E2alf proved to be completely safe for the vaccinees and unvaccinated contact controls. Furthermore, no shedding or transmission was detected in any of the experiments. Even after parental vaccination, vaccine virus genome was barely detectable in blood or organ samples of vaccinated animals. Thus, CP7_E2alf can be regarded as completely safe for both target and non-target species.

Genetic differentiation of infected from vaccinated animals after implementation of an emergency vaccination strategy against classical swine fever in wild boar.

Oral emergency vaccination against classical swine fever is a powerful tool to control disease outbreaks among European wild boar and thus to safeguard domestic pigs in affected regions. In the past, when virus detection was mainly done using virus isolation in cell culture or antigen enzyme-linked immunosorbent assays, modified live vaccine strains like C-strain "Riems", were barely detectable after oral vaccination campaigns. Nowadays, the use of highly sensitive molecular techniques has given rise to an increase in vaccine virus detections. This was also the case during the 2009 outbreak among German wild boar and the subsequent vaccination campaigns. To guarantee a rapid differentiation of truly infected from C-strain vaccinated animals, a combination of differentiating multiplex rRT-PCR assays with partial sequencing was implemented. Here, we report on the rational and use of this approach and the lessons learned during execution. It was shown that positive results in the recently developed vaccine strain (genotype) specific rRT-PCR assay can be taken as almost evidentiary whereas negative results should be confirmed by partial sequencing. Thus, combination of multiplex rRT-PCR assays as a first line differentiation with partial sequencing can be recommended for a genetic DIVA strategy in areas with oral vaccination against classical swine fever in wild boars.

A percepçäo do paciente sobre sua permanência na unidade de terapia intensiva / The patients's perception during their stay in the intensive care unit

Este estudo procura identificar a percepçäo do paciente sobre sua permanência na UTI. A amostra constituiu-se de 10 pacientes, submetidos à cirurgia cardíaca e que receberam intervençäo psicológica somente após a alta da UTI. Para a coleta e análise dos dados, utilizou-se uma abordagem qualitativa (análise de conteúdo). Os resultados sugerem que o paciente possue uma visäo esteriotipada da UTI, vinculada a idéia de sofrimento e morte; o enfermeiro ocupa um importante papel nos momentos de fragilidade, dependência física e emocional; a dor, por seu caráter subjetivo, individual e emocional, é invitável por estar relacionada aos procedimentos e, muitas vezes, associada ao sofrimento físico.