The influence of individual, social and physical environment factors on physical activity in the adult population in Andalusia, Spain.

A person's physical and social environment is considered as an influencing factor in terms of rates of engagement in physical activity. This study analyses the influence of socio-demographic, physical and social environmental factors on physical activity reported in the adult population in Andalusia. This is a cross-sectional study using data collected in the Andalusia Health Survey in 1999 and 2003. In addition to the influence of the individual's characteristics, if there are no green spaces in the neighbourhood it is less likely that men and women will take exercise (OR = 1.26; 95% CI = 1.13, 1.41). Likewise, a higher local illiteracy rate also has a negative influence on exercise habits in men (OR = 1.39; 95% CI = 1.21, 1.59) and in women (OR = 1.22; 95% CI = 1.07, 1.40). Physical activity is influenced by individuals' characteristics as well as by their social and physical environment, the most disadvantaged groups are less likely to engage in physical activity.

Impact of Pre-Existing Immunity on the Selection of Rare Adenovirus Vector Candidates: Implications for HIV Vaccine Development

Background: Adenovirus serotype 5 (Ad5) phase IIb vaccine trial (STEP) was prematurely stopped due to a lack of efficacy and two-fold higher incidence of HIV infection among Ad5 seropositive vaccine recipients. We have recently demonstrated that Ad5 immune complexes (Ad5 ICs)-mediated activation of the dendritic cell (DC)-T cell axis was associated with the enhancement of HIV infection in vitro. Although the direct role of Ad5 neutralizing antibodies (NAbs) in the increase of HIV susceptibility during the STEP trial is still under debate, vector-specific NAbs remain a major hurdle for vector-based gene therapies or vaccine strategies. To surmount this obstacle, vectors based on ''rare'' Ad serotypes including Ad6, Ad26, Ad36 and Ad41 were engineered.Methods: The present study aimed to determine whether Ad ICmediated DC maturation could be circumvented using these Advector candidates.Results: We found that all Ad vectors tested forming ICs with plasma containing serotype-specific NAbs had the capacity to 1) mature human DCs as monitored by the up-regulation of costimulatory molecules and the release of pro-inflammatory cytokines (TNF-a), via the stabilization of Ad capsid at endosomal but not lysosomal pH rendering Ad DNA/TLR9 interactions possible and 2) potentiate Ad-specific CD4 and CD8 T cell responses.Conclusion: In conclusion, despite a conserved DC maturation potential, the low prevalence of serotype-specific NAbs renders rare Ad vectors attractive for vaccine strategies.

Burnout and associated factors in employees of a Swiss teaching hospital

Background Working in a teaching hospital is a highly stressful occupation, which can lead to burnout. The consequences of burnout in health professionals can be very serious, both for themselves and patients. The aim of this cross-sectional study was to assess the extent of burnout and associated factors in hospital employees. Methods In the Fall of 2007, all employees of a Swiss teaching hospital were invited to complete a job satisfaction survey. It included the work-related burnout scale (scored 0-100) of the Copenhagen Burnout Inventory (CBI-French version), measuring the degree of physical and psychological fatigue and exhaustion perceived as related to the person's work; a high degree of burnout was defined as a score _50. Logistic regression analyses were used to determine factors associated with a high degree of burnout. Results A total of 4575 individuals returned the questionnaire (response rate 54%). Of them, 1503 (33%) had a high degree of burnout. The rate of burnout was higher among women (34.3% versus 30.5%, P = 0.012) and respondents younger than 40 years (37.7% versus 28.6%, P < 0.001). Executives were less prone to burnout than employees (27.1% versus 33.9%, P < 0.0019). Rates of burnout differed by profession: nurses and physicians had higher rates than administrative and logistic staff (42.8% and 37.4% versus 25.6% and 20.9%, respectively P < 0.001). Burnout was inversely associated with job satisfaction. In multivariate analysis, factors associated with burnout were overall dissatisfaction (OR 3.23; 95% CI 2.66-3.91), dissatisfaction with workload (OR 2.09; 95% CI 1.74-2.51) and work-life balance (OR 2.25; 95% CI 1.83-2.77), being a woman (OR 1.56; 95% CI 1.28-1.90), working fulltime (OR 1.41; 95% CI 1.08-1.85) and working as a nurse, a physician or in the psychosocial sector. Conclusions One-third of respondents, mostly nurses and physicians, experienced burnout and had lower levels of job satisfaction. The factors associated with burnout may help to tailor programmes aiming at reducing burnout at both the individual and organizational level within the hospital.

Surgical site infections in colon surgery: the patient, the procedure, the hospital, and the surgeon.

Objective: To determine the role of the surgeon in the occurrence of surgical site infection (SSI) following colon surgery, with respect to his or her adherence to guidelines and his or her experience.Design, Setting, and Patients: Prospective cohort study of 2393 patients who underwent colon surgery performed by 31 surgeons in 9 secondary and tertiary care public Swiss hospitals, recruited from a surveillance program for SSI between March 1, 1998, and December 31, 2008, and followed up for 1 month after their operation.Main Outcome Measures: Risk factors for SSI were identified in univariate and multivariate analyses that included the patients' and procedures' characteristics, the hospitals, and the surgeons as candidate covariates. Correlations were sought between surgeons' individual adjusted risks, their self-reported adherence to guidelines, and the delay since their board certification.Results: A total of 428 SSIs (17.9%) were identified, with hospital rates varying from 4.0% to 25.2% and individual surgeon rates varying from 3.7% to 36.1%. Features of the patients and procedures associated with SSI in univariate analyses were male sex, age, American Society of Anesthesiologists score, contamination class, operation duration, and emergency procedure. Correctly timed antibiotic prophylaxis and laparoscopic approach were protective. Multivariate analyses adjusting for these features and for the hospitals found 4 surgeons with higher risk of SSI (odds ratio [OR] = 2.37, 95% confidence interval [CI], 1.51-3.70; OR = 2.19, 95% CI, 1.41-3.39; OR = 2.15, 95% CI, 1.02-4.53; and OR = 1.97, 95% CI, 1.18-3.30) and 2 surgeons with lower risk of SSI (OR = 0.43, 95% CI, 0.19-0.94; and OR = 0.19, 95% CI, 0.04-0.81). No correlation was found between surgeons' individual adjusted risks and their adherence to guidelines or their experience.Conclusion: For reasons beyond adherence to guidelines or experience, the surgeon may constitute an independent risk factor for SSI after colon surgery.

Potencial de alimentação de Chrysoperla externa (Hagen, 1861) (Neuroptera, Chrysopidae) em diferentes densidades de Uroleucon ambrosiae (Thomas, 1878) (Hemiptera, Aphididae)

Feeding potential of Chrysoperla externa (Hagen) (Neuroptera, Chrysopidae) in different densities of Uroleucon ambrosiae (Thomas) (Hemiptera, Aphididae). The feeding potential of 2nd and 3rd instar larvae of Chrysoperla externa (Hagen, 1861) in relation to different densities of 30, 40 and 50 nymphs of Uroleucon ambrosiae (Thomas, 1878) at 3rd and 4th instars was evaluated. The treatments were individualized into 2.5 cm in diameter and 8.5 cm tall flat bottom glass vials and maintained in a controlled environmental chamber at 25±2 ºC temperature, 70±10% RH and 14 h photophase. A completely randomized experimental design with 10 replications was used. The consumption of the prey nymphs by the predator larvae was evaluated after 1, 2, 4, 8, 16 and 24 h from the beginning of the experiment and at every subsequent 24 h period until 2nd instar larvae molted or 3rd instar larvae pupated. Results have shown that for 2nd instar larvae, during the 1 h to 24 h period, there was a decreasing prey consumption at the 30 and 40 prey densities. However an increase in the consumption at the 50 prey density was observed. After this period, C. externa larvae presented a progressive increase on nymphs consumption as a function of the prey density. The same occurred with de 3rd instar predator larvae in all treatments. When daily mean consumption was evaluated the predator/prey ratio was 1:23, 1:27 and 1:33 for 2nd instar larvae and 1:27, 1:33 and 1:41 for 3rd instar larvae at 30, 40 and 50 nymph densities, respectively.

MGMT promoter methylation is prognostic but not predictive for outcome to adjuvant PCV chemotherapy in anaplastic oligodendroglial tumors: a report from EORTC Brain Tumor Group Study 26951.

PURPOSE: O6-methylguanine-methyltransferase (MGMT) promoter methylation has been shown to predict survival of patients with glioblastomas if temozolomide is added to radiotherapy (RT). It is unknown if MGMT promoter methylation is also predictive to outcome to RT followed by adjuvant procarbazine, lomustine, and vincristine (PCV) chemotherapy in patients with anaplastic oligodendroglial tumors (AOT). PATIENTS AND METHODS: In the European Organisation for the Research and Treatment of Cancer study 26951, 368 patients with AOT were randomly assigned to either RT alone or to RT followed by adjuvant PCV. From 165 patients of this study, formalin-fixed, paraffin-embedded tumor tissue was available for MGMT promoter methylation analysis. This was investigated with methylation specific multiplex ligation-dependent probe amplification. RESULTS: In 152 cases, an MGMT result was obtained, in 121 (80%) cases MGMT promoter methylation was observed. Methylation strongly correlated with combined loss of chromosome 1p and 19q loss (P = .00043). In multivariate analysis, MGMT promoter methylation, 1p/19q codeletion, tumor necrosis, and extent of resection were independent prognostic factors. The prognostic significance of MGMT promoter methylation was equally strong in the RT arm and the RT/PCV arm for both progression-free survival and overall survival. In tumors diagnosed at central pathology review as glioblastoma, no prognostic effect of MGMT promoter methylation was observed. CONCLUSION: In this study, on patients with AOT MGMT promoter methylation was of prognostic significance and did not have predictive significance for outcome to adjuvant PCV chemotherapy. The biologic effect of MGMT promoter methylation or pathogenetic features associated with MGMT promoter methylation may be different for AOT compared with glioblastoma.

Estudio de reconocimiento en el Norte del Perù Salaverry – Puerto Pizarro

Breve recuento de observaciones efectuadas e impresiones registradas durante un estudio de reconocimiento de la actividad pesquera en la Región del Norte del Perú, hecho durante la primera quincena de abril de 1962. El viaje se efectuó en camioneta, duró trece días y fueron cubiertos cerca de 3,500 kilómetros desde Lima hasta la frontera con el Ecuador. En total, se visitaron 17 comunidades pesqueras y 4 ciudades y centros de comercio de pescado desde el norte de Chimbote

Biologia e exigências térmicas de Trichogramma pretiosum Riley (Hymenoptera, Trichogrammatidae) "linhagem bonagota" criado em ovos de Bonagota salubricola (Meyrick) (Lepidoptera, Tortricidae)

Neste trabalho foi estudada a biologia de Trichogramma pretiosum Riley (Hymenoptera, Trichogrammatidae) "linhagem bonagota" criado em ovos de Bonagota salubricola (Meyrick) (Lepidoptera, Tortricidae), determinando-se as exigências térmicas e o número de gerações do parasitóide para diferentes regiões produtoras de maçã do Rio Grande do Sul e Santa Catarina. Ovos de B. salubricola com 24 horas de idade foram submetidos ao parasitismo de T. pretiosum durante 24 horas, sendo posteriormente transferidos para câmaras climatizadas reguladas nas temperaturas de 18, 20, 22, 25, 28, 30 e 32ºC. A duração do ciclo biológico (ovo-adulto) foi significativamente influenciada pela temperatura variando de 8,18 a 18,12 dias a 32 e 18°C, respectivamente. A porcentagem de emergência dos parasitóides foi maior (66,2%) a 22°C. A razão sexual de T. pretiosum variou de 0,61 a 0,72 não sendo influenciada pela temperatura. A maior relação de parasitóides/ovo foi encontrada a 30°C (1,41). A constante térmica (K) e a temperatura base (Tb) foram de 187,7 graus dias e 7,42ºC, respectivamente. O número estimado de gerações anuais de T. pretiosum para os municípios de Fraiburgo e São Joaquim, SC e Vacaria, RS foi de 17,5; 11,6 e 16,8, respectivamente.

Insights into low fish mercury bioaccumulation in a mercury-contaminated reservoir, Guizhou, China.

We examined Hg biogeochemistry in Baihua Reservoir, a system affected by industrial wastewater containing mercury (Hg). As expected, we found high levels of total Hg (THg, 664-7421 ng g(-1)) and monomethylmercury (MMHg, 3-21 ng g(-1)) in the surface sediments (0-10 cm). In the water column, both THg and MMHg showed strong vertical variations with higher concentrations in the anoxic layer (>4m) than in the oxic layer (0-4 m), which was most pronounced for the dissolved MMHg (p < 0.001). However, mercury levels in biota samples (mostly cyprinid fish) were one order of magnitude lower than common regulatory values (i.e. 0.3-0.5 mg kg(-1)) for human consumption. We identified three main reasons to explain the low fish Hg bioaccumulation: disconnection of the aquatic food web from the high MMHg zone, simple food web structures, and biodilution effect at the base of the food chain in this eutrophic reservoir.

Le syndrome d'épuisement professionnel (burnout) des médecins

Les médecins sont soumis à différents facteurs de stress qui les prédisposent à l'épuisement professionnel, mais aussi à d'autres problèmes de santé psychique : dépression, abus de substances, suicide sont des thèmes que l'on retrouve souvent lorsque l'on parle de la santé des médecins. Le burnout est un syndrome qui peut toucher toute les professions, mais ce sont celles en lien à la relation d'aide qui sont les plus susceptibles d'en développer les stigmates. Car le burnout est une véritable maladie de la relation d'aide. Maslach et Jackson ont le mieux défini cet incendie intérieur : conséquence d'une exposition chronique et répétitive à un stress émotionnel, il se manifeste par : 1. L'épuisement relationnel 2. La déshumanisation de la relation à l'autre. 3. Le sentiment d'échec professionnel ou la diminution de l'accomplissement personnel. [Auteur]

Intravenous thrombolysis in patients with stroke attributable to small artery occlusion.

BACKGROUND: Intravenous thrombolysis (IVT) for stroke seems to be beneficial independent of the underlying etiology. Recent observations raised concern that IVT might cause harm in patients with strokes attributable to small artery occlusion (SAO). OBJECTIVE: The safety of IVT in SAO-patients is addressed in this study. METHODS: We used the Swiss IVT databank to compare outcome and complications of IVT-treated SAO-patients with IVT-treated patients with other etiologies (non-SAO-patients). Main outcome and complication measures were independence (modified Rankin scale <or=2) at 3 months, intracranial hemorrhage (ICH), and recurrent ischaemic stroke. RESULTS: Sixty-five (6.2%) of 1048 IVT-treated patients had SAO. Amongst SAO-patients, 1.5% (1/65) patients died, compared to 11.2% (110/983) in the non-SAO-group (P = 0.014). SAO-patients reached independence more often than non-SAO-patients (75.4% versus 58.9%; OR 2.14 (95% CI 1.20-3.81; P = 0.001). This association became insignificant after adjustment for age, gender, and stroke severity (OR 1.41 95% CI 0.713-2.788; P = 0.32). Glucose level and (to some degree) stroke severity but not age predicted 3-month-independence in IVT-treated SAO-patients. ICHs (all/symptomatic) were similar in SAO- (12.3%/4.6%) and non-SAO-patients (13.4%/5.3%; P > 0.8). Fatal ICH occurred in 3.3% of the non-SAO-patients but none amongst SAO-patients. Ischaemic stroke within 3 months after IVT reoccurred in 1.5% of SAO-patients and in 2.3% of non-SAO-patients (P = 0.68). CONCLUSION: IVT-treated SAO-patients died less often and reached independence more often than IVT-treated non-SAO-patients. However, the variable 'SAO' was a dependent rather than an independent outcome predictor. The absence of an excess in ICH indicates that IVT seems not to be harmful in SAO-patients.

Densidade do solo, atributos químicos e sistema radicular do milho afetados pelo pastejo e manejo do solo

A integração lavoura-pecuária é uma alternativa de renda dos produtores no sul do Brasil. Entretanto, o pisoteio animal e, ou, o preparo de solo podem compactá-lo, prejudicando o crescimento radicular e a produtividade das plantas. Estudaram-se os efeitos do pisoteio animal em regime de pastejo contínuo durante o inverno/primavera e do impacto do plantio direto e do preparo convencional de solo no estado de compactação, atributos químicos e distribuição radicular. Em Podzólico Vermelho-Amarelo de textura superficial franca, foi implantada uma pastagem de estação fria composta por aveia (Avena strigosa Schreb) e azevém (Lolium multiflorum L.). A carga animal variou conforme o crescimento da pastagem. Em dezembro de 1996, foi implantada a cultura do milho (Zea mays L.) para a produção de silagem, usando os seguintes tratamentos: plantio direto na área não pastejada, plantio direto após o pastejo, preparo convencional de solo na área não pastejada e preparo convencional de solo após pastejo. As avaliações apresentadas neste estudo são referentes ao terceiro ano de cultivo, no qual houve um período de pastejo de 107 dias. Aos 45 dias da emergência do milho, foram abertas trincheiras (100 x 40 cm) para visualizar a distribuição do sistema radicular e coletar amostras de solo, a cada 5 cm, para caracterização química e determinação da densidade do solo e de raízes. Ao longo do perfil (0-40 cm), o desenho da distribuição de raízes indicou maior quantidade de raízes no preparo convencional de solo, concordando com os resultados de densidade de raízes. O pisoteio animal não teve efeito sobre as características físicas, possivelmente pelo fato de o resíduo da pastagem permanecer próximo a 1,0 Mg ha-1 de matéria seca. A densidade do solo no plantio direto, na camada de 5-10 cm, foi de 1,41 Mg m-3, tanto na área pastejada como na não pastejada. No preparo convencional de solo, esses valores foram de 1,15 Mg m-3, na área pastejada e de 1,12 Mg m-3, na área não pastejada. A produtividade de grãos de milho (4,55 Mg ha-1) e de silagem (34,66 Mg ha-1) não foi afetada pelo pastejo ou pelo preparo do solo. O sistema de manejo do solo teve maior influência na densidade do solo do que o pisoteio animal, considerando o controle da carga animal ajustado ao crescimento da pastagem.

Iron supplementation in a large Swiss cohort of IBD patients demonstrates a shift from oral to intravenous iron over time

Background: The 2007 European Crohn's and Colitis Organization guidelines on anemia in inflammatory bowel disease (IBD) favour intravenous (iv) over oral (po) iron supplementation due to better effectiveness and tolerance. We aimed to determine the percentage of IBD patients under iron supplementation therapy and the dynamics of prescription habits (iv versus po) over time. Methods: Helsana, a leading Swiss health insurance company provides coverage for approximately 18% of the Swiss population, corresponding to about 1.2 million enrollees. Patients with Crohn's disease (CD) and ulcerative colitis (UC) were analyzed from the anonymised Helsana database. Results: In total, 629 CD (61% female) and 398 UC (57% female) patients were identified, mean observation time was 31.8 months for CD and 31.0 months for UC patients. Of the entire study population, 27.1% were prescribed iron (21.1% in males and 31.1% in females). Patients treated with IBDspecific drugs (steroids, immunomodulators, anti-TNF agents) were more frequently treated with iron compared to patients without any medication (35.0% vs. 20.9%, OR 1.91, 95%- CI 1.41 2.61). The prescription of iv iron increased from 2006/2007 (48.8% of all patients receiving any iron priscription) to 65.2% in 2008/2009 by a factor of 1.89. Conclusions: One third of the IBD population was treated with iron supplementation. A gradual shift from oral to iv iron was observed over time. This switch in prescription habits goes along with the implementation of the ECCO consensus guidelines on anemia in IBD.

Effects of zoledronate versus placebo on spine bone mineral density and microarchitecture assessed by the trabecular bone score in postmenopausal women with osteoporosis: A three-year study.

The trabecular bone score (TBS) is an index of bone microarchitectural texture calculated from anteroposterior dual-energy X-ray absorptiometry (DXA) scans of the lumbar spine (LS) that predicts fracture risk, independent of bone mineral density (BMD). The aim of this study was to compare the effects of yearly intravenous zoledronate (ZOL) versus placebo (PLB) on LS BMD and TBS in postmenopausal women with osteoporosis. Changes in TBS were assessed in the subset of 107 patients recruited at the Department of Osteoporosis of the University Hospital of Berne, Switzerland, who were included in the HORIZON trial. All subjects received adequate calcium and vitamin D3. In these patients randomly assigned to either ZOL (n = 54) or PLB (n = 53) for 3 years, BMD was measured by DXA and TBS assessed by TBS iNsight (v1.9) at baseline and 6, 12, 24, and 36 months after treatment initiation. Baseline characteristics (mean ± SD) were similar between groups in terms of age, 76.8 ± 5.0 years; body mass index (BMI), 24.5 ± 3.6 kg/m(2) ; TBS, 1.178 ± 0.1 but for LS T-score (ZOL-2.9 ± 1.5 versus PLB-2.1 ± 1.5). Changes in LS BMD were significantly greater with ZOL than with PLB at all time points (p < 0.0001 for all), reaching +9.58% versus +1.38% at month 36. Change in TBS was significantly greater with ZOL than with PLB as of month 24, reaching +1.41 versus-0.49% at month 36; p = 0.031, respectively. LS BMD and TBS were weakly correlated (r = 0.20) and there were no correlations between changes in BMD and TBS from baseline at any visit. In postmenopausal women with osteoporosis, once-yearly intravenous ZOL therapy significantly increased LS BMD relative to PLB over 3 years and TBS as of 2 years. © 2013 American Society for Bone and Mineral Research.