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1.
Article in English | MEDLINE | ID: mdl-36674211

ABSTRACT

Despite increased awareness of the essential role of neighborhood characteristics for residents' health and wellbeing, the development of neighborhood-level indicator systems has received relatively little attention to date. To address this gap, we describe the participatory development process of a small-area indicator system that includes information on local health needs in a pilot neighborhood in the German city of Mannheim. To identify relevant indicators, we partnered with representatives of the city's public health department and used an iterative approach that included multiple Plan-Do-Check-Act cycles with ongoing feedback from local key stakeholders. The described process resulted in a web-based indicator system with a total of 86 indicators. Additionally, 123 indicators were perceived as relevant by stakeholders but could not be included due to data unavailability. Overall, stakeholders evaluated the participatory approach as useful. Even though the onset of the COVID-19 pandemic and the lack of some data elements hindered instrument development, close collaboration with public health partners facilitated the process. To identify and target sub-national health inequalities, we encourage local public health stakeholders to develop meaningful and useful neighborhood-level indicator systems, building on our experiences from the applied development process and considering identified barriers and facilitators.


Subject(s)
COVID-19 , Pandemics , Humans , COVID-19/epidemiology , Cities , Public Health/methods , Residence Characteristics
2.
Eur J Ageing ; 19(2): 263-276, 2022 Jun.
Article in English | MEDLINE | ID: mdl-35663910

ABSTRACT

Supportive family and friendship ties can serve different functions and thus might show different associations with an individual's health. Particularly, older adults might show varying health benefits of different types of supportive ties depending on their marital and retirement status. Our aim is to analyze relationships between different types of supportive social ties and autonomic nervous system (ANS) function, a physiological indicator of health that can help to establish the biological plausibility of the association-measured by heart rate variability (HRV). We present cross-sectional linear regression analyses of a German cohort of community-dwelling older adults (2008-2010; n = 1,548; mean age = 68.7 years). Our findings indicate that supportive friendship ties show significant positive associations (i.e., higher HRV) in individuals that are either not married or above retirement age. Supportive family ties show significant positive associations in individuals below retirement age. Significant results vanish or are reduced after accounting for behavioral/physical and psychological/cognitive indicators. We conclude that programs supporting the development or maintenance of friendship ties might be especially beneficial in unmarried older adults and adults above retirement age. Supplementary Information: The online version contains supplementary material available at 10.1007/s10433-021-00638-2.

3.
GMS J Med Educ ; 36(4): Doc36, 2019.
Article in English | MEDLINE | ID: mdl-31544136

ABSTRACT

Aim: Although physicians have the most contact with patients in the outpatient setting, topics relating to ambulatory medicine have been less present in medical education. To teach professional skills, practical learning opportunities must be created in which students can practice medical skills under authentic working conditions in the outpatient setting. The clinical elective in ambulatory medicine has been developed, evaluated and revised at the Mannheim Medical School as a practical, competency-based learning experience in outpatient clinics (liver clinic, psychiatric outpatient clinic, uro-oncological consultations, etc.). Methods: The elective was designed using the plan-do-check-act (PDCA) cycle in the form of a longitudinal practical course during the fourth year of study. By selecting one of four concentrations in ambulatory care, students have the opportunity to focus on and pursue an individual interest. Students are given assignments during three separate sessions at an outpatient clinic and complete a log book which contains the learning objectives, assignments and grading criteria. Once the elective had been completed, the students (n=165) and mentors (n=7) had the option to participate in a survey to evaluate knowledge gain and satisfaction with the elective. Results: The students rated their personal growth in knowledge about common diseases and patient-centered communication positively, while rating their knowledge gain in ambulatory patient management somewhat lower. The first offering of the elective was evaluated as satisfactory by students and mentors. In 85.8% of the cases, students reported that they would recommend the selected outpatient clinic for this course. Suggestions for improvement, such as those concerning the log book and scheduling system, were considered during the first revision. Conclusion: This elective provides an opportunity to become familiar with ambulatory medicine in a practical and competency-based manner during medical studies. Skills in ambulatory medicine are already taught and applied in the fourth year of study in a practical setting and also deepened further through interconnections with other courses and chosen concentrations. Moreover, this elective format may be used by other medical schools depending on which aspects of ambulatory medicine are focused on.


Subject(s)
Ambulatory Care Facilities , Ambulatory Care , Clinical Competence , Competency-Based Education , Learning , Students, Medical , Communication , Curriculum , Education, Medical, Undergraduate , Humans , Mentors , Surveys and Questionnaires
4.
BMC Public Health ; 19(1): 75, 2019 Jan 16.
Article in English | MEDLINE | ID: mdl-30651146

ABSTRACT

BACKGROUND: As health is influenced by the social, economic and environmental conditions in which individuals live, local communities are an ideal setting to promote health and wellbeing. However, up to now various health promotion interventions at the community level have had limited success, perhaps related to an incomplete understanding of local contexts and priorities. We therefore aimed to develop a broader and deeper understanding of topics or issues that were most salient to residents of a South-West German community by exploring their perceptions of needs, challenges, barriers and existing resources related to health and well-being. METHODS: As an initial step of a multi-year community-based participatory research project, we conducted semi-structured interviews with key informants (n = 30) from various community settings (e.g., child care, elderly care, businesses, non-profit organizations, village councils, and local government). The terms "health" and "wellbeing" were included in the stem of each question in the semi-structured interview guide to enable a focus on related perceived needs, challenges, barriers and existing resources. Interviews were audiotaped, transcribed verbatim and analyzed using qualitative content analysis techniques. RESULTS: Themes emerging from our interviews appeared to center primarily in three distinct areas: natural resources and built environment, access to services, and social cohesion including subthemes on the importance of social engagement and volunteerism, sense of community, and shared identity. CONCLUSIONS: That health and wellbeing were not identified explicitly as a priority by key informants suggests that these should not be presented as the primary focus of a community-wide initiative. Instead themes with a higher priority should be addressed in ways that can lead to better health and wellbeing as a secondary goal.


Subject(s)
Health Promotion/organization & administration , Residence Characteristics , Adult , Aged , Community-Based Participatory Research , Female , Humans , Male , Middle Aged , Qualitative Research
5.
Nutr J ; 16(1): 85, 2017 12 28.
Article in English | MEDLINE | ID: mdl-29282082

ABSTRACT

BACKGROUND: The obesity prevalence in children and adolescents has increased worldwide during the past 30 years. Although diet has been identified as one risk factor for developing obesity in this age group, the role of specific dietary factors is still unclear. One way to gain insight into the role of these factors might be to detect biomarkers that reflect metabolic health and to identify the associations between dietary factors and these biomarkers. This would enable nutrition-related metabolic changes to be detected early in life, which might be a promising strategy to prevent childhood obesity. However, existing literature offers only inconclusive evidence for diet and some of these obesity-related biomarkers (e.g., blood lipids). We thus conducted a systematic literature review to further examine eligible studies that investigate associations between dietary factors and 12 obesity-related biomarkers in healthy children and adolescents aged 3-18 years. METHODS: We searched the scientific databases PubMed/Medline and Web of Science Core Collection for potentially eligible articles. Our final literature search resulted in 2727 hits. After the selection process, we included 81 articles that reported on 1111 single observations on dietary factors and any of the obesity-related biomarkers. RESULTS: Around 81% of the total observations showed nonsignificant results. For many biomarkers we did not find enough observations to draw clear conclusions on possible associations between a dietary factor and the respective biomarker. In cases where we identified enough observations, the results were contradictory. Since these nonsignificant and inconclusive findings may impede the development of effective strategies against childhood obesity, this article takes a closer look at possible reasons for such findings. In addition, it provides action points for future research efforts. CONCLUSIONS: In conclusion, current evidence on associations between dietary factors and obesity-related biomarkers is inconclusive. We thus provided an overview on which specific limitations may impede current research. Such knowledge is necessary to enable future research efforts to better elucidate the role of diet in the early stages of obesity development.


Subject(s)
Biomarkers/blood , Diet , Pediatric Obesity/blood , Adolescent , Beverages/analysis , Blood Pressure , Child , Child, Preschool , Dietary Sugars/administration & dosage , Dietary Sugars/analysis , Female , Humans , MEDLINE , Male , Pediatric Obesity/epidemiology , Pediatric Obesity/etiology , Risk Factors
6.
Semin Cutan Med Surg ; 36(4): 148-154, 2017 Dec.
Article in English | MEDLINE | ID: mdl-29224031

ABSTRACT

This review describes the use of picosecond lasers for the treatment of tattoos, pigmented lesions, scars, and their use in rejuvenation. These devices have delivered enhanced efficacy for the treatment of tattoos and pigmented lesions when compared to the older 40-50 nanosecond devices. The fractional delivery with the picosecond devices have opened up a new method of rejuvenation for photodamaged skin and the treatment of scars. The delivery of these high-energy short pulses have created zones of injury in the skin referred to as areas of laser-induced optical breakdown. These areas of damage appear to produce cytokines and chemokines which result in epidermal and dermal repair and remodeling. The dual use of these devices with the flat and the fractional optics have made these devices useful in many ways that have been unanticipated.


Subject(s)
Cicatrix/therapy , Intense Pulsed Light Therapy , Pigmentation Disorders/therapy , Rejuvenation , Tattooing , Humans , Skin Aging/radiation effects
7.
BMC Public Health ; 17(1): 760, 2017 09 30.
Article in English | MEDLINE | ID: mdl-28964266

ABSTRACT

BACKGROUND: This conceptual paper aims to illustrate the ways in which communities are able to advance health improvements on a population level. Outcome measures may include increased physical activity and healthier eating habits in particular, as well as an improved health-related quality of life and social cohesion as more generic outcomes. MAIN BODY: The paper begins by asking initial questions: Why did previous health-specific interventions only show moderate effects on an individual level and mixed effects on a population level? What is the added value of a community-based public health perspective compared to the traditional biomedical perspective when it comes to prevention? Why are we living the way we are living? Why do we eat what we eat? Why do we move the way we move? Subsequently, we illustrate the broad spectrum of contextual interventions available to communities. These can have geographical and technological as well as economic, political, normative and attitude-specific dimensions. It is shown that communities have a strong influence on health-related contexts and decision-making of adults, adolescents and children. In addition contextual characteristics, effects, mediators, moderators and consequences relevant for health can differ greatly between age groups. Both small-scale settings and overarching sectors possess physical, economic, political and sociocultural characteristics that can be proactively influenced by community decision-makers in the sense of a "health in all policies"-strategy. SHORT CONCLUSION: After presenting various interdisciplinary approaches to community-based health interventions, the manuscript closes with the following core message: Successful community-based health promotion strategies consist of multilevel - multicomponent interventions on the micro, meso and macro-level-environments.


Subject(s)
Community Health Services/organization & administration , Exercise , Feeding Behavior , Environment , Humans , Obesity/prevention & control , Residence Characteristics
8.
Int J Behav Nutr Phys Act ; 14(1): 63, 2017 05 08.
Article in English | MEDLINE | ID: mdl-28482914

ABSTRACT

BACKGROUND: The prevalence of obesity increased dramatically in many European countries in the past decades. Whether the increase occurred to the same extent in all socioeconomic groups is less known. We systematically assessed and compared the trends in educational inequalities in obesity in 15 different European countries between 1990 and 2010. METHODS: Nationally representative survey data from 15 European countries were harmonized and used in a meta-regression of trends in prevalence and educational inequalities in obesity between 1990 and 2010. Educational inequalities were estimated by means of absolute rate differences and relative rate ratios in men and women aged 30-64 years. RESULTS: A statistically significant increase in the prevalence of obesity was found for all countries, except for Ireland (among men) and for France, Hungary, Italy and Poland (among women). Meta-regressions showed a statistically significant overall increase in absolute inequalities of 0.11% points [95% CI 0.03, 0.20] per year among men and 0.12% points [95% CI 0.04, 0.20] per year among women. Relative inequalities did not significantly change over time in most countries. A significant reduction of relative inequalities was found among Austrian and Italian women. CONCLUSION: The increase in the overall prevalence aligned with a widening of absolute but not of relative inequalities in obesity in many European countries over the past two decades. Our findings urge for a further understanding of the drivers of the increase in obesity in lower education groups particularly, and an equity perspective in population-based obesity prevention strategies.


Subject(s)
Educational Status , Health Status Disparities , Obesity/epidemiology , Adult , Europe/epidemiology , Female , Humans , Male , Middle Aged , Prevalence , Socioeconomic Factors
9.
PLoS One ; 11(8): e0160743, 2016.
Article in English | MEDLINE | ID: mdl-27532642

ABSTRACT

BACKGROUND: Work stress is associated with an increased risk of pre-diabetes, Type 2 diabetes, and inflammation, as well as decreased autonomic nervous system function as measured, for example, via heart rate variability. We investigated the extent to which the association between work stress and glycemic status is mediated by vagally-mediated heart rate variability (vmHRV) and/or inflammation. METHODS: Cross-sectional data from the Mannheim Industrial Cohort Study (MICS) with 9,937 participants were analyzed. The root mean squared successive differences (RMSSD) from long-term heart rate monitoring during work and night time periods was used to index vmHRV. Fasting plasma glucose and glycosylated hemoglobin were assessed to determine glycemic status. High sensitive C-reactive protein levels were observed as a measure of systemic inflammation and the Effort-Reward-Imbalance scale was used to evaluate work stress. Mediation models were adjusted for age, sex, and occupational status, and estimations were bootstrapped (5,000 replications). RESULTS: Effort-Reward-Imbalance was significantly negatively associated with RMSSD and both glycosylated hemoglobin and fasting plasma glucose during both work and night time periods. Effort-Reward-Imbalance was observed to have a significant direct effect on glycosylated hemoglobin and significant indirect effects, through RMSSD, on both glycemic measures during both time periods. Introducing C-reactive protein as a further mediator to the model did not alter the indirect effects observed. C-reactive protein, as an exclusive mediator, was observed to have smaller direct and indirect effects on the glycemic measures as compared to when Effort-Reward-Imbalance was included in the model. CONCLUSIONS: Our results suggest that the association between work stress and glycemic status is partially mediated through vmHRV independent of systemic inflammation as measured by C-reactive protein. We conclude that work stress may be an additional factor that promotes development of hyperglycemic-metabolic states. If supported by prospective evidence, these results may lead to new approaches for primary prevention of hyperglycemia in the workplace.


Subject(s)
Autonomic Nervous System/physiopathology , Blood Glucose/metabolism , Occupational Health , Stress, Psychological , Adult , Analysis of Variance , Cohort Studies , Cross-Sectional Studies , Diabetes Mellitus, Type 2/etiology , Female , Germany , Heart Rate/physiology , Humans , Inflammation/etiology , Male , Middle Aged , Occupational Diseases/etiology , Prediabetic State/etiology
10.
Neuropharmacology ; 104: 50-61, 2016 05.
Article in English | MEDLINE | ID: mdl-26519900

ABSTRACT

P2Y receptors are G-protein-coupled receptors (GPCRs) for extracellular nucleotides. There are eight mammalian P2Y receptor subtypes (P2Y1, P2Y2, P2Y4, P2Y6, P2Y11, P2Y12, P2Y13, and P2Y14). P2Y receptors are widely expressed and play important roles in physiology and pathophysiology. One important example is the ADP-induced platelet aggregation mediated by P2Y1 and P2Y12 receptors. Active metabolites of the thienopyridine compounds ticlopidine, clopidogrel and prasugrel as well as the nucleoside analogue ticagrelor block P2Y12 receptors and thereby platelet aggregation. These drugs are used for the prevention and therapy of cardiovascular events. Moreover, P2Y receptors play important roles in the nervous system. Adenine nucleotides modulate neuronal activity and neuronal fibre outgrowth by activation of P2Y1 receptors and control migration of microglia by P2Y12 receptors. UDP stimulates microglial phagocytosis through activation of P2Y6 receptors. There is evidence for a role for P2Y2 receptors in Alzheimer's disease pathology. The P2Y receptor subtypes are highly diverse in both their amino acid sequences and their pharmacological profiles. Selective receptor ligands have been developed for the pharmacological characterization of the receptor subtypes. The recently published three-dimensional crystal structures of the human P2Y1 and P2Y12 receptors will facilitate the development of therapeutic agents that selectively target P2Y receptors. This article is part of the Special Issue entitled 'Purines in Neurodegeneration and Neuroregeneration'.


Subject(s)
Purinergic P2Y Receptor Agonists/pharmacology , Purinergic P2Y Receptor Antagonists/pharmacology , Receptors, Purinergic P2Y/chemistry , Receptors, Purinergic P2Y/physiology , Adenosine Diphosphate/metabolism , Adenosine Triphosphate/metabolism , Animals , Brain/metabolism , Cardiovascular Diseases/metabolism , Humans , Microglia/metabolism , Neurodegenerative Diseases/metabolism , Neurons/metabolism , Platelet Aggregation , Receptors, Purinergic P2Y/metabolism , Uridine Triphosphate/metabolism
11.
Nutrients ; 7(8): 6938-55, 2015 Aug 18.
Article in English | MEDLINE | ID: mdl-26295254

ABSTRACT

Adequate nutrient intake during early childhood is of particular importance for optimal growth and future health. However, cross-national comparative research on nutrient intake of toddlers is still limited. We conducted a literature review to examine the nutrient intake in healthy toddlers from some of the world's most populous nations currently on different stages of socioeconomic development: Brazil, Germany, Russia and the United States. We aimed to identify national surveys reporting mean intakes of the following nutrients: vitamins A, D, E, folate, calcium, iron and zinc. To calculate the prevalence of inadequate nutrient intake, we used a modified version of the Estimated Average Requirement cut-point method. Overall, five studies with 6756 toddlers were eligible for inclusion in this review. In countries where data were available, a prevalence of inadequate intake higher than 20% was found for vitamins A, D, E and calcium. In Germany, folate intake also appeared to be inadequate. The results of our review indicate that inadequate micronutrient intake in toddlers might be a global challenge affecting also affluent countries. However, to explore the full scope of this important public health issue joint efforts of researchers worldwide are needed to combine existing data and fill in data gaps.


Subject(s)
Diet , Infant Nutritional Physiological Phenomena , Micronutrients/administration & dosage , Brazil , Calcium/administration & dosage , Calcium/analysis , Child, Preschool , Cross-Sectional Studies , Energy Intake , Folic Acid/administration & dosage , Folic Acid/analysis , Germany , Humans , Infant , Internationality , Iron/administration & dosage , Iron/analysis , Micronutrients/analysis , Micronutrients/deficiency , Nutrition Assessment , Nutritional Status , Russia , United States , Vitamin A/administration & dosage , Vitamin A/analysis , Vitamin D/administration & dosage , Vitamin D/analysis , Vitamin E/administration & dosage , Vitamin E/analysis , Zinc/administration & dosage , Zinc/analysis
12.
J Comput Aided Mol Des ; 29(8): 737-56, 2015 Aug.
Article in English | MEDLINE | ID: mdl-26194851

ABSTRACT

The G protein-coupled P2Y12 receptor (P2Y12R) is an important antithrombotic target and of great interest for pharmaceutical discovery. Its recently solved, highly divergent crystallographic structures in complex either with nucleotides (full or partial agonist) or with a nonnucleotide antagonist raise the question of which structure is more useful to understand ligand recognition. Therefore, we performed extensive molecular modeling studies based on these structures and mutagenesis, to predict the binding modes of major classes of P2Y12R ligands previously reported. Various nucleotide derivatives docked readily to the agonist-bound P2Y12R, but uncharged nucleotide-like antagonist ticagrelor required a hybrid receptor resembling the agonist-bound P2Y12R except for the top portion of TM6. Supervised molecular dynamics (SuMD) of ticagrelor binding indicated interactions with the extracellular regions of P2Y12R, defining possible meta-binding sites. Ureas, sulfonylureas, sulfonamides, anthraquinones and glutamic acid piperazines docked readily to the antagonist-bound P2Y12R. Docking dinucleotides at both agonist- and antagonist-bound structures suggested interactions with two P2Y12R pockets. Thus, our structure-based approach consistently rationalized the main structure-activity relationships within each ligand class, giving useful information for designing improved ligands.


Subject(s)
Molecular Docking Simulation/methods , Purinergic P2Y Receptor Agonists/chemistry , Purinergic P2Y Receptor Antagonists/chemistry , Receptors, Purinergic P2Y12/chemistry , Receptors, Purinergic P2Y12/metabolism , Anthraquinones/chemistry , Anthraquinones/metabolism , Crystallography, X-Ray , Humans , Ligands , Models, Molecular , Molecular Dynamics Simulation , Nucleotides/chemistry , Nucleotides/metabolism , Protein Conformation , Purinergic P2Y Receptor Agonists/metabolism , Purinergic P2Y Receptor Antagonists/metabolism , Structure-Activity Relationship , Sulfonamides/chemistry , Sulfonamides/metabolism
13.
Psychosom Med ; 77(5): 527-38, 2015 Jun.
Article in English | MEDLINE | ID: mdl-25984825

ABSTRACT

OBJECTIVE: Organizational justice refers to perceived fairness at the workplace. Low organizational justice has been identified as a major source of distress and a predictor of poor health. Impaired regulation of immunological and inflammatory pathways may, in part, underlie these health effects. The present study investigated the association of organizational justice with leukocyte glucocorticoid sensitivity in vivo. METHODS: Organizational justice was assessed among 541 male factory workers (mean [standard deviation] age = 46 [9] years) by questionnaire. Cortisol release was measured at three time points before blood collection and summed as the area under the curve. Blood was used to assess leukocyte (white blood cell [WBC] count) subsets (neutrophils [%WBC], lymphocytes [%WBC], and the neutrophil/lymphocyte ratio). Glucocorticoid sensitivity was operationalized as the correlation between cortisol release and these hematologic parameters. Associations were adjusted for demographics, work characteristics, and life-style variables. RESULTS: A dose-response relationship between organizational justice and glucocorticoid sensitivity was found. Cortisol and hematologic parameters showed the expected significant association among individuals reporting high (all ß values ≥ |.26|; all p values ≤.001) or medium organizational justice (all ß values ≥ |.15|; all p values ≤.050), but not among those reporting low organizational justice (all ß values ≤ |.04|; all p values > .10). These regression slopes differed significantly between organizational justice groups (p values for interaction < .050). CONCLUSIONS: Low justice at work is associated with an impaired ability of endogenous cortisol to regulate leukocyte distribution in vivo. These findings identify a novel biological pathway by which organizational justice may affect health.


Subject(s)
Employment/psychology , Hydrocortisone/blood , Lymphocytes , Neutrophils , Social Justice , Adult , Cross-Sectional Studies , Humans , Leukocyte Count , Lymphocyte Count , Male , Middle Aged , Workplace
14.
Int J Med Sci ; 12(5): 362-8, 2015.
Article in English | MEDLINE | ID: mdl-26005370

ABSTRACT

OBJECTIVES: Increasing evidence suggests that vitamin D plays a role in the development of chronic diseases including type 2 diabetes (DM). Aim of the study was to explore the association of vitamin D levels with prevalent DM in a sample of predominantly healthy working adults older than 45 years. METHODS: This cross-sectional study (2009-2011) involved 1821 employees of a German engineering company (83.1% male, mean age 51.9 ±5.6 years). Sociodemographics and medical history were assessed by self-report. Clinical characteristics were obtained including blood samples to determine vitamin D levels and diabetes status by fasting plasma glucose (FPG) and glycosylated hemoglobin (HbA1c). Vitamin D was grouped into one of four categories (<10 ng/ml, 10-19.9 ng/ml, 20-29.9 ng/ml, ≥30 ng/ml). Bivariate associations between vitamin D categories and a composite indicator for DM (FPG ≥126 mg/dl or HbA1c ≥6.5% or self-reported diagnosis) were calculated; multivariable models tested this association further, controlling for potential confounders. RESULTS: Severe vitamin D deficiency (<10 ng/ml) was associated with increasing FPG (ß 3.13; 95% CI: 0.78, 5.47; p≤0.01) and HbA1c (ß 0.15; 95% CI: 0.08, 0.23; p≤0.001) values in adjusted linear regression models. In multivariable models, severe vitamin D deficiency was associated with DM (OR 2.55; 95%CI 1.16, 5.62; p≤0.05) after controlling for potential confounders. CONCLUSIONS: Vitamin D deficiency is associated with prevalent DM in working older adults. The findings highlight that the workplace may be a unique location for conducting large-scale health screening to identify those at risk of DM using vitamin D.


Subject(s)
Diabetes Mellitus, Type 2/metabolism , Vitamin D Deficiency/blood , Vitamin D/blood , Blood Glucose/analysis , Cross-Sectional Studies , Diabetes Mellitus, Type 2/epidemiology , Female , Germany , Glycated Hemoglobin/analysis , Humans , Male , Middle Aged , Vitamin D/analogs & derivatives , Vitamin D Deficiency/complications
15.
PLoS One ; 10(2): e0117196, 2015.
Article in English | MEDLINE | ID: mdl-25693164

ABSTRACT

The present study aimed to investigate the possible mechanisms linking a single-item measure of global self-rated health (SRH) with morbidity by comparing the association strengths between SRH with markers of autonomic nervous system (ANS) function, inflammation, blood glucose and blood lipids. Cross-sectional comprehensive health-check data of 3947 working adults (age 42±11) was used to calculate logistic regressions, partial correlations and compare correlation strength using Olkins Z. Adjusted logistic regression models showed a negative association between SRH (higher values indicating worse health) and measures of heart rate variability (HRV). Glycemic markers were positively associated with poor SRH. No adjusted association was found with inflammatory markers, BP or lipids. In both unadjusted and adjusted linear models Pearson's correlation strength was significantly higher between SRH with HRV measures compared to SRH with other biomarkers. This is the first study investigating the association of ANS function and SRH. We showed that a global measure of SRH is associated with HRV, and that all measures of ANS function were significantly more strongly associated with SRH than any other biomarker. The current study supports the hypothesis that the extent of brain-body communication, as indexed by HRV, is associated with self-rated health.


Subject(s)
Diagnostic Self Evaluation , Health Status , Heart Rate , Occupations , Adolescent , Adult , Aged , Autonomic Nervous System/physiology , Biomarkers/blood , Blood Chemical Analysis , Cross-Sectional Studies , Female , Humans , Inflammation/blood , Male , Middle Aged , Multivariate Analysis , Young Adult
16.
Int J Vitam Nutr Res ; 85(5-6): 261-281, 2015 Dec.
Article in English | MEDLINE | ID: mdl-27414419

ABSTRACT

The purpose of this study is to systematically review the published literature reporting vitamin E intake levels and serum concentrations in order to obtain a global overview of α-tocopherol status. Articles published between 2000 and 2012 were considered; 176 articles referring to 132 single studies were included. Applying an RDA (recommended daily allowance) of 15 mg/day and EAR (estimated average requirement) of 12 mg/day to all populations with a minimum age of 14 years, 82 and 61 % of mean and median data points were below the RDA and the EAR, respectively. Regarding serum concentrations, globally 13 % of the included data points were below the functional deficiency threshold concentration of 12 µmol/L, mostly for newborns and children. Several prospective observational studies suggest that a serum α-tocopherol concentration of ≥30 µmol/L has beneficial effects on human health. Of the reported study populations and subpopulations, only 21 % reached this threshold globally. This systematic review suggests that the α-tocopherol status is inadequate in a substantial part of the studied populations.

17.
Neurobiol Dis ; 70: 162-78, 2014 Oct.
Article in English | MEDLINE | ID: mdl-24971933

ABSTRACT

In this study the role of P2Y12 receptors (P2Y12R) was explored in rodent models of inflammatory and neuropathic pain and in acute thermal nociception. In correlation with their activity to block the recombinant human P2Y12R, the majority of P2Y12R antagonists alleviated mechanical hyperalgesia dose-dependently, following intraplantar CFA injection, and after partial ligation of the sciatic nerve in rats. They also caused an increase in thermal nociceptive threshold in the hot plate test. Among the six P2Y12R antagonists evaluated in the pain studies, the selective P2Y12 receptor antagonist PSB-0739 was most potent upon intrathecal application. P2Y12R mRNA and IL-1ß protein were time-dependently overexpressed in the rat hind paw and lumbar spinal cord following intraplantar CFA injection. This was accompanied by the upregulation of TNF-α, IL-6 and IL-10 in the hind paw. PSB-0739 (0.3mg/kg i.t.) attenuated CFA-induced expression of cytokines in the hind paw and of IL-1ß in the spinal cord. Subdiaphragmatic vagotomy and the α7 nicotinic acetylcholine receptor antagonist MLA occluded the effect of PSB-0739 (i.t.) on pain behavior and peripheral cytokine induction. Denervation of sympathetic nerves by 6-OHDA pretreatment did not affect the action of PSB-0739. PSB-0739, in an analgesic dose, did not influence motor coordination and platelet aggregation. Genetic deletion of the P2Y12R in mice reproduced the effect of P2Y12R antagonists on mechanical hyperalgesia in inflammatory and neuropathic pain models, on acute thermal nociception and on the induction of spinal IL-1ß. Here we report the robust involvement of the P2Y12R in inflammatory pain. The anti-hyperalgesic effect of P2Y12R antagonism could be mediated by the inhibition of both central and peripheral cytokine production and involves α7-receptor mediated efferent pathways.


Subject(s)
Cytokines/metabolism , Pain/drug therapy , Pain/physiopathology , Receptors, Purinergic P2Y12/metabolism , Analgesics/pharmacology , Animals , CHO Cells , Cell Line, Tumor , Chimera , Cricetulus , Cyclic AMP/metabolism , Disease Models, Animal , Humans , Hyperalgesia/drug therapy , Hyperalgesia/physiopathology , Male , Mice, Inbred C57BL , Mice, Knockout , Nociception/drug effects , Nociception/physiology , Rats, Wistar , Receptors, Purinergic P2Y12/genetics
18.
Br J Nutr ; 111(1): 23-45, 2014 Jan 14.
Article in English | MEDLINE | ID: mdl-23930771

ABSTRACT

Vitamin D deficiency is associated with osteoporosis and is thought to increase the risk of cancer and CVD. Despite these numerous potential health effects, data on vitamin D status at the population level and within key subgroups are limited. The aims of the present study were to examine patterns of 25-hydroxyvitamin D (25(OH)D) levels worldwide and to assess differences by age, sex and region. In a systematic literature review using the Medline and EMBASE databases, we identified 195 studies conducted in forty-four countries involving more than 168 000 participants. Mean population-level 25(OH)D values varied considerably across the studies (range 4·9-136·2 nmol/l), with 37·3 % of the studies reporting mean values below 50 nmol/l. The highest 25(OH)D values were observed in North America. Although age-related differences were observed in the Asia/Pacific and Middle East/Africa regions, they were not observed elsewhere and sex-related differences were not observed in any region. Substantial heterogeneity between the studies precluded drawing conclusions on overall vitamin D status at the population level. Exploratory analyses, however, suggested that newborns and institutionalised elderly from several regions worldwide appeared to be at a generally higher risk of exhibiting lower 25(OH)D values. Substantial details on worldwide patterns of vitamin D status at the population level and within key subgroups are needed to inform public health policy development to reduce risk for potential health consequences of an inadequate vitamin D status.


Subject(s)
Global Health , Vitamin D Deficiency/epidemiology , Vitamin D/analogs & derivatives , Age Factors , Humans , Risk Factors , Vitamin D/blood , Vitamin D Deficiency/blood , Vitamin D Deficiency/complications
20.
Appl Environ Microbiol ; 79(21): 6730-6, 2013 Nov.
Article in English | MEDLINE | ID: mdl-23995919

ABSTRACT

We describe genetically encoded sensors which transmit elevated cytosolic concentrations of O-acetyl serine (OAS) and O-acetyl homoserine (OAH)-intermediates of l-cysteine and l-methionine synthesis-into an optical output. The sensor pSenOAS3 elicits 7.5-fold-increased fluorescence in cultures of a Corynebacterium glutamicum strain that excrete l-cysteine. Determination of the cytosolic OAS concentration revealed an increase to 0.13 mM, whereas the concentration in the reference strain was below the detection limit, indicating that incorporation of assimilatory sulfur is limited in the strain studied. In another strain, overexpression of metX encoding homoserine acetyltransferase resulted in an 8-fold increase in culture fluorescence at a cytosolic OAH concentration of 0.76 mM. We also assayed for consequences of extracellular sulfur supply and observed a graded fluorescence increase at decreasing sulfur concentrations below 400 µM. Overall, this demonstrates the usefulness of the sensors for monitoring intracellular sulfur availability. The sensors also enable monitoring at the single-cell level, and since related and close homologs of the transcription factor used in the constructed sensors are widespread among bacteria, this technology offers a new possibility of assaying in vivo for sulfur limitation and of doing this at the single-cell level.


Subject(s)
Amino Acids/chemistry , Corynebacterium glutamicum/metabolism , Cytoplasm/metabolism , Single-Cell Analysis/methods , Sulfur/metabolism , Cysteine/metabolism , Homoserine/metabolism , Microscopy, Fluorescence/methods , Serine/analogs & derivatives , Serine/metabolism
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