Gesundheitsrisiken bei Unternehmern

An einer Studie zum Zusammenhang zwischen der Gesundheit von Unternehmern, deren Arbeitsmerkmalen und deren Erfolg nahmen 53 klein- und mittelständische Unternehmer teil. Erfasste Arbeitsmerkmale waren: Handlungs-/Entscheidungsspielraum, Arbeitsintensität, Arbeitszeit, Konkurrenzdruck und Prognose über die Auftragsentwicklung. Der Unternehmenserfolg wurde über das Mitarbeiterwachstum, die Möglichkeit des Unternehmers, von seiner Firma abwesend zu sein (Urlaubstage), und dem erlebten Unternehmenserfolg operationalisiert. Gesundheitsindikatoren waren Depression, Angst, vitale Erschöpfung, Schlafstörungen und Bluthochdruck. Im Vergleich zur Gesamtbevölkerung wiesen die Unternehmer in allen untersuchten Gesundheitsvariablen häufiger Beeinträchtigungen auf. Regressionsanalysen ergaben, dass lange Arbeitszeiten und Konkurrenzdruck mit einer verzögerten Rückstellung des systolischen Blutdrucks (SBD) in der Freizeit und Nacht einhergingen. Alle untersuchten Erfolgsmerkmale waren für die Gesundheit prädiktiv. So war Mitarbeiterwachstum negativ mit dem SBD während der Arbeit sowie Schlafstörungen assoziiert. Je mehr Unternehmenserfolg erlebt wurde, desto geringer waren die Werte für vitale Erschöpfung und Depression. Die Urlaubsdauer war negativ mit Angst und vitaler Erschöpfung korreliert. Insgesamt hatte von den Arbeitsmerkmalen nur die Dauer der Arbeitszeit einen Effekt auf die Gesundheit von Unternehmern. Daneben existieren aber offensichtlich weitere Faktoren, die mit der Unternehmergesundheit in Beziehung stehen. Dies sind neben dem Konkurrenzdruck am Markt insbesondere Indikatoren des Unternehmenserfolgs. The relationship between health and workload as well as entrepreneurial success was analyzed in 53 entrepreneurs. Workload data (decision latitude, job demand, working time, competition, market development) were determined by using structured interviews and Karasek's job content questionnaire. Firm success was operationalized by employee growth, the possibility of absence from the company (days of holiday), and perceived success. Health was measured by questionnaires for sleep disturbances, vital exhaustion, depression, and anxiety, and by 24 hour ambulatory blood pressure monitoring. Regression analyses showed that working time and strength of competition within the market were predictive for systolic blood pressure (SBP) during leisure time and night, but not during work. All variables measuring entrepreneurial success were predictive for health. Employee growth was related to decreasing SBP during work and to fewer sleep disturbances. The duration of holidays was negatively related to vital exhaustion and anxiety. Perceived company success was negatively related to depression and vital exhaustion. In conclusion, only the relationship between working time and bad health conformed to findings reported for the relationship between work and health in employees. However, there were additional indicators, especially indicators of competition and entrepreneurial success, that affected the health of entrepreneurs.

Are community pharmacists prepared to work extended opening hours?

Focal points: A 5 per cent cross-sectional sample of the Royal Pharmaceutical Society's membership was targeted with a self-completion questionnaire Community pharmacy respondents were asked questions on their views on current pharmacy opening hours and their willingness to work extended opening hours Around one fifth of the community pharmacists sampled believed that patients should have access to at least one community pharmacy 24 hours a day Only 3.4 per cent of community pharmacists sampled were prepared to work at any time over a 24-hour period With the introduction of more 24-hour health care services (eg, NHS Direct), there may need to be a change in the attitudes of community pharmacists towards working extended opening hours

Manometry-Based Cough Identification Algorithm

Gastroesophageal reflux disease (GERD) is a common cause of chronic cough. For the diagnosis and treatment of GERD, it is desirable to quantify the temporal correlation between cough and reflux events. Cough episodes can be identified on esophageal manometric recordings as short-duration, rapid pressure rises. The present study aims at facilitating the detection of coughs by proposing an algorithm for the classification of cough events using manometric recordings. The algorithm detects cough episodes based on digital filtering, slope and amplitude analysis, and duration of the event. The algorithm has been tested on in vivo data acquired using a single-channel intra-esophageal manometric probe that comprises a miniature white-light interferometric fiber optic pressure sensor. Experimental results demonstrate the feasibility of using the proposed algorithm for identifying cough episodes based on real-time recordings using a single channel pressure catheter. The presented work can be integrated with commercial reflux pH/impedance probes to facilitate simultaneous 24-hour ambulatory monitoring of cough and reflux events, with the ultimate goal of quantifying the temporal correlation between the two types of events.

Phytoestrogens modulate breast cancer resistance protein expression and function at the blood-cerebrospinal fluid barrier

PURPOSE: Breast cancer resistance protein (BCRP/ABCG2) is a drug efflux transporter expressed at the blood cerebrospinal fluid barrier (BCSFB), and influences distribution of drugs into the central nervous systems (CNS). Current inhibitors have failed clinically due to neurotoxicity. Novel approaches are needed to identify new modulators to enhance CNS delivery. This study examines 18 compounds (mainly phytoestrogens) as modulators of the expression/function of BCRP in an in vitro rat choroid plexus BCSFB model. METHODS: Modulators were initially subject to cytotoxicity (MTT) assessment to determine optimal non-toxic concentrations. Reverse-transcriptase PCR and confocal microscopy were used to identify the presence of BCRP in Z310 cells. Thereafter modulation of the intracellular accumulation of the fluorescent BCRP probe substrate Hoechst 33342 (H33342), changes in protein expression of BCRP (western blotting) and the functional activity of BCRP (membrane insert model) were assessed under modulator exposure. RESULTS: A 24 hour cytotoxicity assay (0.001 µM-1000 µM) demonstrated the majority of modulators possessed a cellular viability IC50 > 148 µM. Intracellular accumulation of H33342 was significantly increased in the presence of the known BCRP inhibitor Ko143 and, following a 24 hour pre-incubation, all modulators demonstrated statistically significant increases in H33342 accumulation (P < 0.001), when compared to control and Ko143. After a 24 hour pre-incubation with modulators alone, a 0.16-2.5-fold change in BCRP expression was observed for test compounds. The functional consequences of this were confirmed in a permeable insert model of the BCSFB which demonstrated that 17-β-estradiol, naringin and silymarin (down-regulators) and baicalin (up-regulator) can modulate BCRP-mediated transport function at the BCSFB. CONCLUSION: We have successfully confirmed the gene and protein expression of BCRP in Z310 cells and demonstrated the potential for phytoestrogen modulators to influence the functionality of BCRP at the BCSFB and thereby potentially allowing manipulation of CNS drug disposition.

Trace elemental analysis of glass by inductively coupled plasma-mass spectrometry (ICP-MS) and laser ablation-inductively coupled plasma-mass spectrometry (LA-ICP-MS)

This work evaluated the capabilities of inductively coupled plasma mass spectrometry (ICP-MS) for elemental analysis of trace evidence. A method was developed and validated for the analysis of glass by ICP-MS. A database of ∼700 glass samples was analyzed for elemental composition by external calibration with internal standardization (EC) ICP-MS and refractive index (RI). Additional methods were developed during the course of this work using two well-known techniques, isotope dilution (ID) and laser ablation (LA). These methods were then applied to analyze subsets of this database. ICP-MS data from 161 containers, 45 headlamps, and 458 float glasses (among them at least 143 vehicle windows) are presented and summarized. Data from the analysis of ∼190 glass samples collected from a single glass manufacturing facility over a period of 53 months at different intervals, including 97 samples collected in a 24 hour period are presented. Data from the analysis of 125 glass samples representing 36 manufacturing plants in the U.S. are also presented. ^ The three methods used, ICP-MS, ID-ICP-MS and LA-ICP-MS, were shown to be excellent methods for distinguishing between different glass samples. The database provided information about the variability of refractive index and elemental composition in glasses from diverse population types. Using the proposed methods, the database supports the hypothesis that different glass samples have different elemental profiles and a comparison between fragments from the same source results in indistinguishable profiles. ^

Improved Annual Average Daily Traffic (AADT) estimation for local roads using parcel-level travel demand modeling

Annual Average Daily Traffic (AADT) is a critical input to many transportation analyses. By definition, AADT is the average 24-hour volume at a highway location over a full year. Traditionally, AADT is estimated using a mix of permanent and temporary traffic counts. Because field collection of traffic counts is expensive, it is usually done for only the major roads, thus leaving most of the local roads without any AADT information. However, AADTs are needed for local roads for many applications. For example, AADTs are used by state Departments of Transportation (DOTs) to calculate the crash rates of all local roads in order to identify the top five percent of hazardous locations for annual reporting to the U.S. DOT. ^ This dissertation develops a new method for estimating AADTs for local roads using travel demand modeling. A major component of the new method involves a parcel-level trip generation model that estimates the trips generated by each parcel. The model uses the tax parcel data together with the trip generation rates and equations provided by the ITE Trip Generation Report. The generated trips are then distributed to existing traffic count sites using a parcel-level trip distribution gravity model. The all-or-nothing assignment method is then used to assign the trips onto the roadway network to estimate the final AADTs. The entire process was implemented in the Cube demand modeling system with extensive spatial data processing using ArcGIS. ^ To evaluate the performance of the new method, data from several study areas in Broward County in Florida were used. The estimated AADTs were compared with those from two existing methods using actual traffic counts as the ground truths. The results show that the new method performs better than both existing methods. One limitation with the new method is that it relies on Cube which limits the number of zones to 32,000. Accordingly, a study area exceeding this limit must be partitioned into smaller areas. Because AADT estimates for roads near the boundary areas were found to be less accurate, further research could examine the best way to partition a study area to minimize the impact.^

Development and evaluation of a geographic information system based method to estimate flooding susceptibility in an area of Broward County, Florida

The objective of this study was to develop a GIS-based multi-class index overlay model to determine areas susceptible to inland flooding during extreme precipitation events in Broward County, Florida. Data layers used in the method include Airborne Laser Terrain Mapper (ALTM) elevation data, excess precipitation depth determined through performing a Soil Conservation Service (SCS) Curve Number (CN) analysis, and the slope of the terrain. The method includes a calibration procedure that uses "weights and scores" criteria obtained from Hurricane Irene (1999) records, a reported 100-year precipitation event, Doppler radar data and documented flooding locations. Results are displayed in maps of Eastern Broward County depicting types of flooding scenarios for a 100-year, 24-hour storm based on the soil saturation conditions. As expected the results of the multi-class index overlay analysis showed that an increase for the potential of inland flooding could be expected when a higher antecedent moisture condition is experienced. The proposed method proves to have some potential as a predictive tool for flooding susceptibility based on a relatively simple approach.

Densidade de estocagem em camarões da espécie Macrobrachium rosenbergii (De Man, 1879) na fase juvenil

Among the species of freshwater shrimp being cultivated, Macrobrachium rosenbergii stands out. Knowledge about the behavior of this species and the influence of certain factors on its development can help optimize management practices and minimize the likely impacts shrimp farming has on the environment and the animals themselves. The objective of this study was to characterize the species' behavior during early stages of development under different stocking densities over a 24-hour cycle. Ten day old postlarvae were transferred from the Jundiaí School of Agriculture (EAJ - Escola Agrícola de Jundiaí) in Macaíba (RN), Brazil to the Shrimp Behavior Laboratory (LSPR - Laboratório de Estudos do Comportamento do Camarão) at the Federal University of Rio Grande do Norte (UFRN), where they were weighed and measured. Eight aquaria with constant temperature, aeration and filtration, and subjected to a12 h light/12 h dark cycle were used for each experiment. Each aquarium also contained two shelters made of bricks and the water quality was monitored weekly. Behavioral observations were made at two densities: 25 individuals/m-² and 40 individuals/m-². The methods for recording behaviors were: behavioral sampling – enter and leave the shelter, exploring on the substrate, exploring in the water column, move away, attack, pursuit and cannibalism; scan sampling - inactivity, feeding, exploration, digging, swimming, cleaning and staying in the shelter. Observations were made during a 15 minute period/per aquarium at a frequency of 4 times daily, for 4 days/week, and over 4 weeks. Food was provided 2 times/day for each aquarium population, immediately before the 1st and 3rd observation periods. Our results demonstrate that at high density, there is an increased frequency of agonistic behavior; during the light phase, there is a greater frequency of behaviors that result in less exposure (inactivity, cleaning and staying in the shelter); during the dark phase, there is an increased frequency of behaviors that result in greater exposure (feeding, exploration, swimming and digging); at times of feed offer, there is an increased frequency of leaving the shelter, moving away, pursuit, feeding, exploration and swimming. At low density, the animals showed a lower frequency of agonistic behaviors, greater weight gain and higher growth rates, which indicates that this is a more favorable growing environment for cultivation and when applied, can generate better living conditions, favor survival rates and increase management success

Annotated record of the detailed examination of Mn deposits from DSDP Site 25, Leg 4 (Core 4-25A-1)

At the Leg 4 pre-cruise meeting in Miami, Florida, in January 1969, the Ridge site was proposed as an additional site to be investigated, if possible. Since the water depth and sediment thickness at this site were both minimal (2000 meters and less than 100 meters, respectively) and the location was not far from the track between initially planned sites, the shipboard party decided, upon completion of work at Site 24, to make a 24-hour drilling effort on the North Brazilian Ridge. The drilling objectives at this location were to sample and date the sediments atop the Ridge crest and to determine the nature, age and origin of the consolidated material beneath the thin mantle of sediment.

Electrophysiological study of the effects of arginine vasopressin in the rat juxtacapsular nucleus of the bed nucleus of the stria terminalis

Arginine vasopressin (AVP), a nine amino acid neuropeptide (CYFQNCPRG- NH2) fulfills a dual function: (i) in the periphery, AVP acts as a peptide hormone and (ii) in the CNS, AVP is a neuromodulatory peptide. AVP produces its effects through 3 AVP receptors (AVPRs). AVPR1a and AVPR1b are expressed in the CNS and periphery, whilst AVPR2 is not found centrally but instead solely expressed in the kidneys. Recent evidence revealed a high density of AVP-binding sites in the juxtacapsular nucleus of the bed nucleus of the stria terminalis (jxBNST). While in other regions of the brain, AVP acts at AVPRs to regulate an array of biological processes, including male-typical social behaviours, social memory, stress adaptation, fear, anxiety, and fluid homeostasis, its role in the jxBNST remains elusive. Furthermore, the neurophysiological properties of AVP in the jxBNST are unknown so this study aimed to examine how AVP modulates synaptic transmission in the rat jxBNST. The BNST being one of the most notable sexually dimorphic brain regions and AVPR expression being influenced by gonadal steroids, we investigated the putative influence of sex on the modulatory effects of AVP in the jxBNST. Finally, due to AVP being released at a substantially higher concentration following periods of water deprivation, we examined changes in AVPs modulatory role following water deprivation. Male and female Long Evans rats were euthanized and brain slice whole-cell voltage-clamp electrophysiology was done in the jxBNST to measure the effects of AVP on synaptic transmission of GABA synapses. Exogenous application of AVP produced three responses; either postsynaptic long-term potentiation (LTP) of GABAA-inhibitory postsynaptic currents (IPSC), postsynaptic long-term depression (LTD) of GABAA-IPSC, or no change in GABAA-IPSC amplitudes. Interestingly, the proportion of neurons responding in each of these ways did not differ between sexes and within females was not estrous cycle-dependent. Finally, although not statistically significant, 24-hour water deprivation abolished GABAA-LTD, an effect that was not a consequence of social isolation. Taken together, our data show that AVP modulates GABAA synaptic transmission in the jxBNST in fluid homeostasis- but not sex-dependent manner.

Fetal Movements in late Pregnancy : Categorization, Self-assessment, and Prenatal Attachment in relation to women’s experiences

Aim: To explore how pregnant women experience fetal movements in late pregnancy. Specific aims were:  to study women’s experiences during the time prior to receiving news that their unborn baby had died in utero (I), to investigate women’s descriptions of fetal movements (II), investigate the association between the magnitude of fetal movements and level of prenatal attachment (III), and to study women’s experiences using two different self-assessment methods (IV). Methods: Interviews, questionnaires, and observations were used. Results: Premonition that something had happened to their unborn baby, based on a lack of fetal movements, was experienced by the participants. The overall theme “something is wrong” describes the women’s insight that the baby’s life was threatened (I). Fetal movements that were sorted into the domain “powerful movements” were perceived in late pregnancy by 96 % of the participants (II). Perceiving frequent fetal movements on at least three occasions per 24 hours was associated with higher scores of prenatal attachment in all the three subscales on PAI-R. The majority (55%) of the 456 participants reported average occasions of frequent fetal movements, 26% several occasions and 18% reported few occasions of frequent fetal movements, during the current gestational week.  (III). Only one of the 40 participants did not find at least one method for monitoring fetal movements suitable. Fifteen of the 39 participants reported a preference for the mindfetalness method and five for the count-to-ten method. The women described the observation of the movements as a safe and reassuring moment for communication with their unborn baby (IV). Conclusion:  In full-term and uncomplicated pregnancies, women usually perceive fetal movements as powerful. Furthermore, women in late pregnancy who reported frequent fetal movements on several occasions during a 24-hour period seem to have a high level of prenatal attachment. Women who used self-assessment methods for monitoring fetal movements felt calm and relaxed when observing the movements of their babies. They had a high compliance for both self-assessment methods. Women that had experienced a stillbirth in late pregnancy described that they had a premonition before they were told that their baby had died in utero. 

The Political Economy of Reproduction: Motherhood, Work and the Home in Neoliberal Britain

This thesis investigates how the processes and practices of reproduction have been transformed not only by the ascendant political rationality of neoliberalism but also by women’s struggles that have reconfigured motherhood, the domestic home and the gendered organisation of employment. Through exploring both the 1970s feminist demand for “free 24- hour nurseries” and the contemporary provision of extended, overnight and flexible childcare, care that is often referred to as “24-hour childcare”, the research contributes to feminist understandings of the gendered and racialised class dynamics inside and outside the home and the wage. The research repositions the ‘Woman Question’ as, yet again unavoidable and necessary for comprehending and intervening in the brutalising consequences of capitalist accumulation. Situated within the Marxist feminist tradition, the work of reproduction is understood as a cluster of tasks, affective relations and employment that have historically been constructed and experienced as ‘women’s work’. The interrelation between the subjectivity of motherhood and the political economy of reproduction is analysed through a feminist genealogy of 24-hour childcare in Britain. Using ethnographic encounters, archival research and interview data with mothers and childcare workers, the research tells a story about the women who have worked both inside and outside the home, raised children, cooked and cleaned, and who, both historically and in the present, continue to create an immense amount of wealth and value. As women's labour market participation has steadily increased over the last 40 years, the discourse of reproduction has shifted to one in which motherhood is increasingly constructed as a choice. Within neoliberal discourse the decision to have a child is constructed as a private matter for which individuals bear the costs and responsibility. The thesis argues that, as a result of motherhood being constructed more and more as something that is chosen, the spaces of resistance and opposition towards motherhood have been limited and resistance has been individuated and privatised.

Cecal volvulus during pregnancy. Case report

Introduction. Acute intestinal obstruction in pregnancy is a rare, but life-threatening complication associated with high fetal and maternal mortality. Case report. A 20-year old gravida presented with a 24 hour history of several episodes of vomiting, complete constipation and severe crampy abdominal pain. The patient was admitted with the diagnosis of acute abdomen associated with septic shock. On examination echography showed distended intestinal loops and presence of free peritoneal fluid. Abdominal X-ray with shielding of the fetus revealed colonic air-fluid levels. The obstetrician consult diagnosed dead fetus in utero and was decided to operate immediately. On laparotomy was found complete cecal volvulus with gangrene of cecum, part of ascending colon and terminal ileum. A right hemicolectomy was performed with side to side ileotransverse anastomosis. Afterwards a lower segment cesarean section was made and a stillborn fetus was delivered. The patient made an uneventful recovery and was discharged on 9th postoperative day. Conclusion. Cecal volvulus during pregnancy is a rare, but serious surgical problem. Correct diagnosis may be difficult until exploratory laparotomy is performed. Undue delay in diagnosis and surgical treatment can increase the maternal and fetal mortality.

VITAMIN “A” FOOD CONSUMPTION BY PREGNANT WOMEN IN BRAZIL: A SYSTEMATIC REVIEW

Objective: To conduct a systematic review of the Vitamin “A” food consumption by pregnant women in Brazil. Methods: The review consisted of a search for articles published in the period from 1999 to 2015 in SciELO, PubMed, and LILACS databases. At the end, eight articles were selected for this review. Results: The methods used for the analysis of the intake of vitamin “A” were: food frequency questionnaire (FFQ) – considering the diet or only vitamin “A” foods and the dietary recall (24hDR). Only two articles estimated the adequacy of the Vitamin “A” food consumption by the population assessed. Some methodological limitations were quite frequent, emphasizing the lack and/or limitation of information on the sample representativeness, loss of studies, accuracy of the methods applied and the control of confounding variables. Conclusion: It is observed that there are still few studies that critically assess the Vitamin “A” food consumption by pregnant women in Brazil, and that the identification and control of possible biases of the dietary surveys can improve the reliability of the information found.

Sensitivity and specificity of the Gastrointestinal Short Form Questionnaire in diagnosis of gastroesophageal reflux disease

Introduction: Gastrointestinal Short Form Questionnaire (GSFQ) is a questionnaire for gastroesophageal reflux disease (GERD) diagnosis, with a version in Spanish language, not yet compared to an objective test. Aims: To establish GSFQ diagnostic performance against 24-hour pH monitoring carried out in two tertiary care hospitals. Methods: Consecutive adult patients with typical GERD symptoms (heartburn, regurgitation) referred for pH monitoring fulfilled the GSFQ (score range 0-30, proportional to probability of GERD). Diagnosis of GERD was established when acid exposure time in distal esophagus was superior to 4.5% or symptom association probability was greater than 95%. Receiver-operator characteristic (ROC) curves were calculated and best cut-off score determined, with corresponding sensitivity, specificity and likelihood ratios (LR) (95% confidence interval for each). Results: One hundred and fifty-two patients were included (59.9% women, age 47.9 ± 13.9; 97.4% heartburn; 71.3% regurgitation). pH monitoring was abnormal in 65.8%. Mean GSFQ score was 11.2 ± 6. Area under ROC was 56.5% (47.0-65.9%). Optimal cut-off score was 13 or greater: sensitivity 40% (30.3-50.3%), specificity 71.2% (56.9-82.9%), positive LR 1.39 (0.85-2.26) and negative LR 0.84 (0.67-1.07). Exclusion of questions 1 and 3 of the original GSFQ, easily interpreted as referred to dyspepsia and not GERD, improved only marginally the diagnostic performance: AUROC 59.1%. Conclusion: The GSFQ does not predict results of pH monitoring in patients with typical symptoms in a tertiary care setting.