Developing an Intervention Toolbox for the Common Health Problems in the Workplace

Development of the Health ↔ Work Toolbox is described. The toolbox aims to reduce the workplace impact of common health problems (musculoskeletal, mental health, and stress complaints) by focusing on tackling work-relevant symptoms. Based on biopsychosocial principles this toolbox supplements current approaches by occupying the zone between primary prevention and healthcare. It provides a set of evidence-informed principles and processes (knowledge + tools) for tackling work-relevant common health problems. The toolbox comprises a proactive element aimed at empowering line managers to create good jobs, and a ‘just in time’ responsive element for supporting individuals struggling with a work-relevant health problem. The key intention is helping people with common health problems to maintain work participation. The extensive conceptual and practical development process, including a comprehensive evidence review, produced a functional prototype toolbox that is evidence based and flexible in its use. End-user feedback was mostly positive. Moving the prototype to a fully-fledged internet resource requires specialist design expertise. The Health ↔ Work Toolbox appears to have potential to contribute to the goal of augmenting existing primary prevention strategies and healthcare delivery by providing a more comprehensive workplace approach to constraining sickness absence

AMPK regulates basal skeletal muscle capillarization and VEGF expression, but is not necessary for the angiogenic response to exercise

5 -AMP-activated protein kinase(AMPK)is a metabolic fuel sensor that monitors cellular energy charge, while the vasculature is important for maintaining cellular energy homeostasis. Mice with muscle-specific inactive AMPK (AMPK DN) were used to investigate if AMPK regulates skeletal muscle capillarization and the angiogenic responses to exercise. Two hours of the AMP analogueAICAR(1.0 g kg - 1)or systemichypoxia (6%O2) increased vascular endothelial growth factor (VEGF) mRNA in wild-type (WT), but not in AMPK DN mice. In contrast, the increase in VEGF mRNA with acute exercise (1 h at 20m min - 1, 10% gradient) was greater in AMPK DN compared to WT mice. Nuclear run-on assay demonstrated that exercise increased VEGF transcription, while hypoxia decreased VEGF transcription. There was no difference in VEGF transcription between WT and AMPK DN. There was a strong correlation between VEGF transcription and VEGF mRNA at rest and with exercise. Resting capillarization was lower in AMPK DN compared to WT. Wheel running (28 days) increased capillarization and this response was AMPK independent. Significant correlations between VEGF protein and muscle capillarization are consistent with VEGF being an important determinant of skeletal muscle capillarization. These data are to our knowledge the first to demonstrate in skeletal muscle in vivo that: (1) AMPK is necessary for hypoxia-induced VEGF mRNA stabilization, (2) acute exercise increases VEGF transcription, (3) inhibition of AMPK augments the VEGF mRNA response to acute exercise, and (4) AMPK regulates basal VEGF expression and capillarization, but is not necessary for exercise-induced angiogenesis. Originally published Journal of Physiology, Vol. 586, No. 24, Dec 200

The role of temperate treed swamps as a carbon sink in southwestern Nova Scotia

Accepted VersionForested wetlands may represent important ecosystems for mitigating climate change effects through carbon (C) sequestration because of their slow decomposition and C storage by trees. Despite this potential importance, few studies have acknowledged the role of temperate treed swamps in the C cycle. In southwestern Nova Scotia, Canada, we examined the role of treed swamps in the soil C cycle by determining C inputs through litterfall, assessing decomposition rates and soil C pools, and quantifying C outputs through soil greenhouse gas (GHG) emissions. The treed swamps were found to represent large supplies of C inputs through litterfall to the forest floor. The swamp soils had substantially greater C stores than the swamp–upland edge or upland soils. We found growing season C inputs via litterfall to exceed C outputs via GHG emissions in the swamps by a factor of about 2.5. Our findings indicate that temperate treed swamps can remain a C sink even if soil GHG emissions were to double, supporting conservation efforts to preserve temperate treed swamps as a measure to mitigate climate change

Six-Year Incidence of Blindness and Visual Impairment in Kenya: The Nakuru Eye Disease Cohort Study.

PURPOSE: To describe the cumulative 6-year incidence of visual impairment (VI) and blindness in an adult Kenyan population. The Nakuru Posterior Segment Eye Disease Study is a population-based sample of 4414 participants aged ?50 years, enrolled in 2007-2008. Of these, 2170 (50%) were reexamined in 2013-2014. METHODS: The World Health Organization (WHO) and US definitions were used to calculate presenting visual acuity classifications based on logMAR visual acuity tests at baseline and follow-up. Detailed ophthalmic and anthropometric examinations as well as a questionnaire, which included past medical and ophthalmic history, were used to assess risk factors for study participation and vision loss. Cumulative incidence of VI and blindness, and factors associated with these outcomes, were estimated. Inverse probability weighting was used to adjust for nonparticipation. RESULTS: Visual acuity measurements were available for 2164 (99.7%) participants. Using WHO definitions, the 6-year cumulative incidence of VI was 11.9% (95%CI [confidence interval]: 10.3-13.8%) and blindness was 1.51% (95%CI: 1.0-2.2%); using the US classification, the cumulative incidence of blindness was 2.70% (95%CI: 1.8-3.2%). Incidence of VI increased strongly with older age, and independently with being diabetic. There are an estimated 21 new cases of VI per year in people aged ?50 years per 1000 people, of whom 3 are blind. Therefore in Kenya we estimate that there are 92,000 new cases of VI in people aged ?50 years per year, of whom 11,600 are blind, out of a total population of approximately 4.3 million people aged 50 and above. CONCLUSIONS: The incidence of VI and blindness in this older Kenyan population was considerably higher than in comparable studies worldwide. A continued effort to strengthen the eye health system is necessary to support the growing unmet need in an aging and growing population

The incidence of diabetes mellitus and diabetic retinopathy in a population-based cohort study of people age 50 years and over in Nakuru, Kenya.

BACKGROUND: The epidemic rise of diabetes carries major negative public health and economic consequences particularly for low and middle-income countries. The highest predicted percentage growth in diabetes is in the sub-Saharan Africa (SSA) region where to date there has been no data on the incidence of diabetic retinopathy from population-based cohort studies and minimal data on incident diabetes. The primary aims of this study were to estimate the cumulative six-year incidence of Diabetes Mellitus (DM) and DR (Diabetic Retinopathy), respectively, among people aged ≥50 years in Kenya. METHODS: Random cluster sampling with probability proportionate to size were used to select a representative cross-sectional sample of adults aged ≥50 years in 2007-8 in Nakuru District, Kenya. A six-year follow-up was undertaken in 2013-14. On both occasions a comprehensive ophthalmic examination was performed including LogMAR visual acuity, digital retinal photography and independent grading of images. Data were collected on general health and risk factors. The primary outcomes were the incidence of diabetes mellitus and the incidence of diabetic retinopathy, which were calculated by dividing the number of events identified at 6-year follow-up by the number of people at risk at the beginning of follow-up. Age-adjusted risk ratios of the outcomes (DM and DR respectively) were estimated for each covariate using a Poisson regression model with robust error variance to allow for the clustered design and including inverse-probability weighting. RESULTS: At baseline, 4414 participants aged ≥50 years underwent complete examination. Of the 4104 non-diabetic participants, 2059 were followed-up at six-years (50 · 2%). The cumulative incidence of DM was estimated at 61 · 0 per 1000 (95% CI: 50 · 3-73 · 7) in people aged ≥50 years. The cumulative incidence of DR in the sample population was estimated at 15 · 8 per 1000 (95% CI: 9 · 5-26 · 3) among those without DM at baseline, and 224 · 7 per 1000 (116.9-388.2) among participants with known DM at baseline. A multivariable risk factor analysis demonstrated increasing age and higher body mass index to be associated with incident DM. DR incidence was strongly associated with increasing age, and with higher BMI, urban dwelling and higher socioeconomic status. CONCLUSIONS: Diabetes Mellitus is a growing public health concern with a major complication of diabetic retinopathy. In a population of 1 · 6 million, of whom 150,000 are ≥50 years, we estimated that 1650 people aged ≥50 develop DM per year, and 450 develop DR. Strengthening of health systems is necessary to reduce incident diabetes and its complications in this and similar settings

Preventing Plasmon Coupling between Gold Nanorods Improves the Sensitivity of Photoacoustic Detection of Labeled Stem Cells in Vivo

© 2016 American Chemical Society.Gold nanorods are excellent contrast agents for imaging technologies which rely on near-infrared absorption such as photoacoustic imaging. For cell tracking applications, the cells of interest are labeled with the contrast agent prior to injection. However, after uptake into cells by endocytosis, the confinement and high concentration in endosomes leads to plasmon band broadening and reduced absorbance. This would limit the potential of multispectral optoacoustic tomography in terms of spectral processing and, consequently, sensitivity. Here, we show that steric hindrance provided by silica coating of the nanorods leads to the preservation of their spectral properties and improved photoacoustic sensitivity. This strategy allowed the detection and monitoring of as few as 2 × 104 mesenchymal stem cells in mice over a period of 15 days with a high spatial resolution. Importantly, the silica-coated nanorods did not affect the viability or differentiation potential of the transplanted mesenchymal stem cells

Extensive crustal extraction in Earth’s early history inferred from molybdenum isotopes

Estimates of the volume of the earliest crust based on zircon ages and radiogenic isotopes remain equivocal. Stable isotope systems, such as molybdenum, have the potential to provide further constraints but remain underused due to the lack of complementarity between mantle and crustal reservoirs. Here we present molybdenum isotope data for Archaean komatiites and Phanerozoic komatiites and picrites and demonstrate that their mantle sources all possess subchondritic signatures complementary to the superchondritic continental crust. These results confirm that the present-day degree of mantle depletion was achieved by 3.5 billion years ago and that Earth has been in a steady state with respect to molybdenum recycling. Mass balance modelling shows that this early mantle depletion requires the extraction of a far greater volume of mafic-dominated protocrust than previously thought, more than twice the volume of the continental crust today, implying rapid crustal growth and destruction in the first billion years of Earth’s history

HPV status and favorable outcome in vulvar squamous cancer

It is universally accepted that high-risk human papillomavirus (HR-HPV) is the cause of cervical dysplasia and cancer. More recently, it has been shown that HPV is also a marker of clinical outcome in oropharyngeal cancer. However, contemporary information is lacking on both the prevalence of HPV infection in vulvar cancer (VSCC), its precursor lesion, vulvar intraepithelial neoplasia (VIN) and the influence of HPV-status on the prognosis of this malignancy. We have conducted a detailed population-based study to examine rates of progression of VIN to VSCC, type-specific HPV prevalence in vulvar disease and the influence of HPV status on clinical outcome in VSCC. We observed that the age at which women are diagnosed with VSCC is falling and there is a significant time gap between first diagnosis of VIN and progression to invasive disease. HR-HPV infection was detected in 87% (97/112) cases of VIN and 52% cases (32/62) of VSCC. The presence of HR-HPV in squamous intraepithelial lesion was associated with lower rates of progression to invasive cancer (hazard ratio, 0.22, p = 0.001). In the adjusted analysis, HR-HPV was associated with improved progression-free survival of VSCC compared to those with HPV negative tumours (hazard ratio, 0.32, p = 0.02)

HPV status and favorable outcome in vulvar squamous cancer

It is universally accepted that high-risk human papillomavirus (HR-HPV) is the cause of cervical dysplasia and cancer. More recently it has been shown that HPV is also a marker of clinical outcome in oropharyngeal cancer. However, contemporary information is lacking on both the prevalence of HPV infection in vulvar cancer (VSCC), its precursor lesion, vulvar intraepithelial neoplasia (VIN) and the influence of HPV-status on the prognosis of this malignancy. We have conducted a detailed population-based study to examine rates of progression of VIN to VSCC, type-specific HPV prevalence in vulvar disease and the influence of HPV status on clinical outcome in VSCC. We observed that the age at which women are diagnosed with VSCC is falling and there is a significant time gap between first diagnosis of VIN and progression to invasive disease. HR-HPV infection was detected in 87% (97/112) cases of VIN and 52% cases (32/62) of VSCC. The presence of HR-HPV in squamous intraepithelial lesion was associated with lower rates of progression to invasive cancer (hazard ratio, 0.22, p=0.001). In the adjusted analysis, HR-HPV was associated with improved progression-free survival of VSCC compared to those with HPV negative tumours (hazard ratio, 0.32, p=0.02)