Evidence-based lifestyle interventions in the workplace--an overview.

BACKGROUND: Lifestyle-related health issues affect the economic position of organizations and contribute to reduced productivity, increased absenteeism and health care costs. AIMS: To summarize the effectiveness of different workplace health interventions for promoting healthy lifestyle, preventing diseases and reducing health care costs. METHODS: We searched MEDLINE via Pubmed, EMBASE, Cochrane Library, NelH, HighWire Press and Google Scholar in March 2012. Systematic reviews and meta-analyses of workplace interventions aimed at promoting physical activity, healthy weight and good nutrition were included. Three authors assessed the quality of the reviews and extracted data on methods, interventions, outcomes, results and effect sizes. RESULTS: We identified 15 publications covering a total of 379 original studies. Three systematic reviews found beneficial effects of workplace nutrition interventions on employees' dietary behaviour. Three reviews found multi-component physical activity interventions to be effective in increasing employees' physical activity and fitness. The other activity promotion interventions were less effective regarding physical activity and weight-related outcomes. In terms of weight management, our findings favour multi-component interventions that focus on both physical activity and nutrition over single dietary programmes. CONCLUSIONS: Workplace health promotion interventions may improve physical activity, dietary behaviour and healthy weight. There is no evidence of increased efficacy associated with specific intervention types. Workplace health promotion should focus on either physical activity or weight or nutrition behaviour to maximize effectiveness. Best evidence is available for multi-component interventions.

Perinatal survivin is essential for the establishment of pancreatic beta cell mass in mice.

AIMS/HYPOTHESIS: Pancreatic beta cells undergo dynamic remodelling during the perinatal period, with enhanced neogenesis, proliferation and apoptosis observed. The molecular mechanisms responsible for these processes have yet to be elucidated. Survivin is an inhibitor of apoptosis, first described as being exclusively expressed in tumour and embryonic tissues with regulatory functions in mitosis and apoptosis. The aim of the present study was to define the essential physiological role of survivin in the pancreas. METHODS: The expression profile of survivin was assessed in the mouse pancreas, and we generated a Pdx1 promoter-driven Survivin (also known as Birc5) knockout mouse using the Cre-loxP recombination system to determine the essential physiological function of survivin in the pancreas. RESULTS: Survivin is transiently expressed in mouse pancreatic islets during the embryonic and neonatal periods. Targeted deletion of Survivin in the pancreas resulted in a significant decline in beta cell mass throughout the perinatal period, leading to glucose intolerance in the adult. Survivin-deficient islets showed decreased cell proliferation as a result of a delay in cell cycle progression with perturbations in cell cycle proteins. Survivin did not, however, play an essential role in beta cell apoptosis either during the physiological remodelling period or in response to streptozotocin. Islet development, islet architecture, microvasculature and apoptosis were not affected by the absence of survivin in the pancreas. CONCLUSIONS/INTERPRETATION: Survivin expression in the pancreatic islets during the perinatal remodelling period is essential for the establishment of beta cell mass through cell cycle regulation.

M type 1 and 3 group A streptococci stimulate tissue factor-mediated procoagulant activity in human monocytes and endothelial cells.

Streptococcal toxic shock syndrome (StrepTSS) is an invasive infection characterized by marked coagulopathy, multiple organ failure, and rapid tissue destruction and is strongly associated with M type 1 and 3 group A streptococci (GAS). Initiation of the coagulation cascade with formation of microvascular thrombi contributes to multiple organ failure in human cases of gram-negative bacteremia; however, little is known regarding the mechanism of coagulopathy in StrepTSS. Thus, we investigated the abilities of several strains of M type 1 and 3 GAS isolated from human cases of StrepTSS to stimulate production of tissue factor (TF), the principal initiator of coagulation in vivo. Washed, killed M type 1 and 3 GAS, but not M type 6 GAS, elicited high-level TF-mediated procoagulant activity from both isolated human monocytes and cultured human umbilical vein endothelial cells. M type 1 GAS consistently elicited higher levels of TF from monocytes than did M type 3 GAS. GAS-induced TF synthesis in monocytes did not correlate with production of tumor necrosis factor alpha or interleukin-8. Conversely, M type 3 GAS were consistently more potent than M type 1 GAS in stimulating endothelial cell TF synthesis. These results demonstrate that (i) M type 1 and 3 strains of GAS are potent inducers of TF synthesis, (ii) GAS-induced TF synthesis is not simply an epiphenomenon of cytokine generation, and (iii) induction of TF in endothelial cells and monocytes may be M type specific. In total, these findings suggest that a novel interaction between GAS and host cells contributes to the observed coagulopathy in StrepTSS.

Effectiveness of different emulsifiers for neem oil against the western flower thrips (Thysanoptera, Thripidae) and the warehouse moth (Lepidoptera, Pyralidae).

The neem tree produces highly specified acting insecticides mainly in its seeds. By pressurizing or extracting the seeds an insecticide oil can be manufactured. For successful application emulsifiers are needed to render the oil soluble in water. The heavy oil has to be stable in emulsion, but on the other hand the surfactant should not reduce the ecological property of the neem oil. The emulsifiers Lutensol TO10, Emulan ELP, Rimulgan and Tween 80 and for comparison the formulation NeemAzal-T/S were tested in their emulsion stability, as well as in their insecticidal effects towards two different insect pests: The western flower thrips Frankliniella occidentalis and the ware house moth Ephestia elutella. The emulsifiers were applied purely, and in different contents mixed in neem oil. Data showed significant differences of mortality and development on the tested pests. Lutensol TO10 and Emulan ELP caused spontaneous mortality on the western flower thrips and an additive efficacy when mixed with neem oil. Rimulgan led to mortality of the larvae of the warehouse moth. NeemAzal showed in both bioassays the highest efficacy of 95% mortality.

Acrosomal status and motility of guinea pig spermatozoa during in vitro penetration of the cumulus oophorus.

Previous studies have suggested that both acrosome-intact and acrosome-reacted guinea pig sperm are capable of binding to the zona pellucida of cumulus-free oocytes, but the acrosomal status of guinea pig sperm during penetration of the cumulus has not been reported. We made video recordings of the interaction between capacitated guinea pig sperm and cumulus-invested guinea pig oocytes. The videotapes were analysed to identify sperm with hyperactivated motility and to classify the acrosomal status of sperm during penetration of the cumulus and after binding to the zona pellucida. The resolution of the video recordings was not sufficient to recognise sperm with swollen acrosomes. However, sperm that had completed the acrosome reaction were easily identified. Acrosome-reacted sperm were found adherent to the outer boundary of the cumulus, but were never observed to penetrate the cumulus. The percentage of acrosome-intact, hyperactivated sperm was higher in the cumulus oophorus than in culture medium, suggesting that changes in motility were elicited in response to contact with the cumulus. Fully acrosome-reacted sperm were found adherent to the zona pellucida, and solubilised guinea pig zona pellucida was capable of inducing acrosome reactions in capacitated guinea pig sperm. Acrosome-intact sperm were also observed on the zona, but they were not tightly bound and did not have hyperactivated motility, suggesting that these sperm were not functionally capacitated. Our observations demonstrate that guinea pig sperm penetrate the cumulus matrix in an acrosome-intact state. Although we did not observe sperm undergoing the acrosome reaction, our observations and experimental data suggest that the acrosome reaction of guinea pig sperm is completed on or near the surface of the zona pellucida.

Relationship of study participation to health-related behaviors.

This study explores the ways in which clinical trial participation influences a person's health and health-promoting behaviors. Active study subjects with a minimum of 4 months' clinical trial participation were mailed a nurse-developed questionnaire. Seventy-three percent of the targeted group returned the survey by the deadline. The majority of respondents made changes toward better health. Diet modification, initiation of an exercise program, and smoking cessation were the changes cited most frequently. The study team was found to be influential in promotion of health. The nurse, the pivotal member of the team, provided subjects with the most health-related information. Most respondents believed they had enough information to change behaviors detrimental to health.

The perspective of patients with vascular disease on participation in clinical trials.

Very little objective data are available concerning the patient's perspective on clinical trial participation. Participants from the Asymptomatic Carotid Atherosclerosis Study and Clopidogrel vs. Aspirin in Patients at Risk for Ischemic Events Trial were personally interviewed by the nurse coordinator to document their views. A questionnaire including both closed-ended and open-ended questions was used. The main advantages to participation in a study were close follow-up and the opportunity for improved health. More than half of the subjects saw no disadvantages to participation. The physician was the primary motivator for entering trials. Most patients expressed an interest in future study participation.

Busulfan pharmacokinetics in bone marrow transplant patients: is drug monitoring warranted?

Pharmacokinetics were studied in relation to hepatic side-effects in 20 patients (19 adults aged 18-53 years and one child of 11 years) undergoing BMT after conditioning with 1 mg/kg busulfan (every 6 hours for 16 doses). Busulfan was quantitated in plasma samples at 10 time points within the 6 h dosing interval using HPLC before and after dose numbers 1, 2, 5, 13 and 14. For 13 patients data on all five doses are available; for the remaining seven patients three to four doses were studied. Mean maximum concentrations were 1512 ng/ml; mean trough levels for second and subsequent doses were 615 ng/ml. Maxima (Cmax) tended to be lower and times of maxima (Tmax) were later when busulfan was taken with a meal. Correlation of the area under the concentration versus time curve (AUC0-6h) between different doses was low within patients. In several patients problems with compartmental fitting of concentration data were observed mainly caused by the short dosing interval, which made estimates of T1/2 and model derived AUCs unstable. Three patients experienced hepatic veno-occlusive disease; kinetic parameters were not helpful in describing a particulate risk constellation for this subgroup. In our experience, the role of drug monitoring in this setting needs to be defined more clearly.

[Case report of Möbius syndrome]. / Kasuistischer Beitrag zum Möbius-Syndrom.

The authors describe a 5-year-old girl with congenital unilateral paralysis of the oculomotor nerve and bilateral paralysis of the facial nerve. Additionally, there was a strange innervation anomaly, which manifested as paradoxical movements of the lids in horizontal gaze movements. The case is considered to be a form of oculofacial paralysis and the findings are compared to those published in the literature.