Estimating trends in working life expectancy based on health insurance data from Germany - Challenges and advantages.

Against the backdrop of population aging and growing strain on pension systems, monitoring the development of Working Life Expectancy (WLE) is vital to assess whether the policies taken are effective. This is the first study investigating time trends and educational inequalities in WLE based on German health insurance data. The analyses are based on the data of the AOK Lower Saxony (N = 3,347,912) covering three time periods (2006-08, 2011-13, and 2016-18). WLE is defined as years spent in the labor force (i.e. in employment and unemployment) and was calculated for each age between 18 and 69 years for the three periods to depict changes over time using multistate life table analysis. Educational inequalities in 2011-13 are reported for two educational levels (8-11 years and 12-13 years of schooling). WLE increased in both sexes with increases being stronger among women. This holds irrespective of whether WLE at age 18 (35.8-38.3 years in men, 27.5-34.0 years in women) or the older working-age (e.g. at age 50 10.2-11.7 years in men, 7.8-10.5 years in men) is considered. Among women at all ages and men from their mid-20s onwards, WLE was higher among higher-educated individuals. Inequalities were most pronounced among women (e.g. Δ3.1 years in women, Δ1.3 years in men at age 50). The study supports previous research indicating that measures to extend working life are effective, but that noticeable inequalities in WLE exist. Health insurance data represent a valuable source for such research that has so far remained untapped. The data provide a suitable basis to investigate trends and inequalities in WLE. Future research should build on the strengths of the data by broadening the research towards a more comprehensive analysis of the development of WLE from a health perspective.

[Smoking behaviours among staff of two university hospitals in Paris, 2021]. / Tabagisme du personnel de deux hôpitaux de l'Assistance Publique­Hôpitaux de Paris, 2021.

INTRODUCTION: A survey on smoking prevalence was conducted among staff at the Georges Pompidou and Corentin Celton hospitals in the framework of the "smoke-free hospital" project. It aimed to determine the smoking status of different categories of personnel, their desire to be helped to quit and, as regards healthcare staff, whether or not they were encouraging patients who smoked to try to quit. METHODS: From February to May 2021, an anonymous survey was distributed, first on paper in the occupational health unit, and then online in all wards. RESULTS: All in all, 775 people, three quarters of whom were women, participated in the survey (15% of the workforce). Among the respondents, 27% said they smoked: 29.6% of the men and 26.1% of the women. Unsurprisingly, the age group with the highest prevalence was 18-24years. High prevalence was likewise found among technical and administrative staff. More than half of the smokers, who consumed an average of 8 cigarettes a day, were interested in receiving smoking cessation support. As regards smoking cessation support for patients, 49% of medical and nursing staff (70% of the doctors) frequently or systematically advised them to quit. CONCLUSION: Our results illustrate a need to reach high-prevalence categories of smokers in a hospital setting, the objective being to help them to consider quitting, and also a need to train health professionals in smoking cessation counseling.

[Systematic identification of smokers and tobacco smoking management in the general hospital]. / Repérage systématique et prise en charge du tabagisme à l'hôpital général.

INTRODUCTION: The prevalence of daily smoking in France was 24 % in 2019 and tobacco control remains a major public health issue. A hospital stay provides an opportunity for smoking cessation intervention. Identification and management of smokers during a hospital stay may be variously integrated into electronic health records (EHR). STATE OF THE ART: Smoking status identification, which have included pre-filled forms, check-box, reminders, icons, is heterogeneous. Specific modules in EHR have been implemented for smoking cessation management such as counselling sessions, tobacco cessation prescriptions, smoking cessation guidelines and long-term follow-up. EHR-based intervention to identify and manage smokers with a long-term follow-up for at least one month after hospital discharge has shown an increase in smoking abstinence at 6-12 months. OUTLOOK: Due to the lower quality of free data about smoking status, systematic identification with check-box, reminders or icons in EHR may be more appropriate. Integration of functionalities such as help for prescription, reminders and follow-up of patients would make tobacco cessation management easier for health professionals. CONCLUSION: EHR interventions to identify smokers and manage smoking cessation during hospital stays are an opportunity to increase smoking cessation.

Efectividad de la vacuna antineumocócica en pacientes mayores de 65 años / Effectiveness of pneumococcal vaccine in patients aged 65 years or older

Fundamentos: la efectividad de la vacuna antineumocócica de 23 serotipos (VAN 23S) respecto a la prevención de la adquisición de la infección está actualmente en discusión, y ésta además parece disminuir en la población anciana. Sin embargo, la indicación de la vacuna sigue manteniéndose en este grupo de edad. El objetivo de nuestro estudio fue evaluar la efectividad de la vacuna antineumocócica en dos cohortes (vacunados y no vacunados) de personas mayores de 65 años mediante comparación de tasas de incidencia y nivel de severidad de las neumonías en ambas cohortes. Métodos: estudio de cohortes retrospectivo realizado en una Área Básica de Salud urbana (ABS), sobre dos cohortes de personas mayores de 65 años: 301 vacunados (CV) en 1993 y 301 no vacunados (CNV) hasta la actualidad. Se identificaron todas las neumonías acaecidas durante el periodo 1994-1999, calculando tasas de incidencia, grado de severidad e índice de letalidad. Resultados: la tasa de incidencia media anual de neumonía fue de 13,29 en personas mayores de 65 años (16,6 en CV y 9,96 en CNV), siendo el riesgo relativo para la cohorte vacunada de 1,67(IC 95 por ciento: 0,95-2,92). No observamos diferencias significativas en cuanto al índice de letalidad (CV 13,7 por ciento frente a 15,7 por ciento en CNV) y el grado de severidad en las neumonías de ambas cohortes. Conclusiones: en nuestro ámbito no se ha podido demostrar un efecto protector de la VAN en CV respecto a CNV ante la infección y tampoco se ha evidenciado efecto sobre la disminución de la severidad en las neumonías acaecidas en CV (AU)

The effect of talisay (Terminalia catappa) extract on Staphylococcus aureus growth in vitro and Staphylococcus aureus-infected wounds in guinea pig (Cavia porcellus)

Seventeen Philippine plants were subjected to antimicrobial screening against Staphylococcus aureus and Escherichia coli using antimicrobial disc assay. The result showed that Terminalia catappa, locally known as "talisay", exhibited the highest antimicrobial activity against S. aureus and none against E. coli. The growth of Staphylococcus aureus inoculated in nutrient broth with different concentrations of the T. catappa extract was determined by measuring cell density at 0 hours and 24 hours of inoculation. The results showed that bacterial cell density decreased significantly after 24 hours of inoculation in the plant extract. Talisay was further tested for its wound healing properties on 2 groups (group 1: standard drug vs. negative control; group 2: herbal extract vs. negative control) of guinea pigs using the abrasion method. A swab of inoculum of S. aureus was applied for infecting the wound. Differences in degrees of wound healing determined by free radical scavenging activity, colony forming units (CFU) counting and histopathologic analysis were noted. Samples from wound abscesses remaining after 48 hours of application of extract were swabbed in petriplates containing 20 ml nutrient agar and were verified using the catalase test. The CFUs were counted 24 hours after incubation. Crude extract was further subjected to High Pressure Liquid Chromatography (HPLC) yielding a polar substance suspected to be of the aromatic tannin family. ANOVA revealed significant difference in the positive control and negative control results against the T. catappa extract treatment in the in vivo antimicrobial activity model. Among these setups, the wounds treated with the extract exhibited advanced healing as supported by significantly lower absorbance levels in the antioxidant assay, lower CFU count, and significantly higher grade in wound healing parameters for histopathologic analysis. The T. catappa extract under study showed significant inhibition of growth of S. aureus and effective healing of infected wounds

Electrophysiology and GABA-immunocytochemistry in the vestibular nuclei of normal (C57BL/6J) and Leaner mutant mice.

Neurological disorders of genetic origin that lead to distinct disarrangements of the cerebellar wiring and cause a specific motor behaviour are likely to differentially influence the response properties and activity of postsynaptic cerebellar target neurons in the deep cerebellar (DCN) and vestibular nuclei (VN). Comparative electrophysiological and morphological analyses of these neurons in different mutants may increase our understanding of the physiological consequences of cell damage to the cerebellum and help to elucidate the relationships between histopathology and severeness of motor impairment. The Leaner mutation removes GABAergic inhibitory input to the VN predominantly originating from Purkinje cells (PC) located in the anterior lobe of the cerebellum and causes extremely severe motor disability when compared to other cerebellar mutants. In the present study the electrophysiological properties of naturally stimulated (sinusoidal head and body rotation) neurons in the VN of Leaner mutants and their corresponding wild-types (C57BL/6J) were investigated. Neuronal activity of VN single units in Leaner mutants is significantly increased over that of wild-types (frequency range 0.2-0.6 Hz) and more pronounced for type I neurons than for type II. Phase relationships and spontaneous activity are similar at these frequencies in both groups. To elucidate the degree of GABAergic input loss of VN-neurons, quantitative morphometric and numerical analyses of GABA-immunopositive synaptic boutons in the lateral VN of Leaner mutants were performed in addition and revealed significantly smaller terminals and a massive decrease (80%) in Leaner mutant terminal numbers compared to controls. In the context of the findings recently obtained in Weaver and Purkinje cell degeneration (PCD) mutants, the results in Leaner suggest that the loss of inhibition due to the PC degeneration in the anterior vermis leads to a differential enhancement of type I and type II target neuron activity in the VN. The overall activity in Leaner is intermediate between PCD (no increase in activity) and Weaver (strong increase of type I but no increase of type II). GABA-immunocytochemistry supports the idea that in Leaner the lost GABAergic PC-innervation of the lateral VN has not been replaced by surviving PCs, which is in contrast to Weaver where sprouting of GABAergic terminals in this nucleus was observed. Substitution of lost cerebellar inhibition by non-cerebellar sources, as suggested in the case of PCD-mutants, is uncertain in Leaner due to the increased activity of type I target neurons. These conditions may contribute, among others, to the severe motor disturbances in Leaner.

Relationship of apolipoproteins AI, B and lipoprotein Lp(a) to hepatic function of liver recipients during the early post-transplant period.

To evaluate serum apo AI, apo B, Lp(a) and the ratio of unesterified cholesterol to total cholesterol as markers of hepatic synthetic capacity after orthotopic liver transplantation, serial measurements of these variables were performed on post-transplant days 1, 3, 5, 7, 10 and 14 in 70 patients. Liver function was assessed by a quantitative dynamic test based on the hepatic conversion of lidocaine to monoethylglycinexylidide (MEGX). Patients were divided into two groups on the basis of clinical and laboratory findings, those with evidence (n = 46) and those without evidence (n = 24) of hepatic dysfunction. Apo AI levels fell in both groups to day 5, but then began to increase in the group with good hepatic function, a highly significant (P < 0.001) positive correlation being found with the results of the MEGX test on post-transplant days 7, 10 and 14. The ratio of unesterified cholesterol to total cholesterol rose in both groups from days 1 to 7 and then began to fall in the group without hepatic dysfunction; a highly significant (P < 0.001) negative correlation was observed with the results of the MEGX test on days 10 and 14, Apo B levels rose in both groups from days 1 to 10, with no significant differences between the two groups; no correlation was observed with the results of the MEGX test on any study day.(ABSTRACT TRUNCATED AT 250 WORDS)