Health problems and help-seeking in a nationwide sample of operational Norwegian ambulance personnel

Background To estimate the prevalence of anxiety and depression symptoms, and their association with professional help-seeking, among operational ambulance personnel and a general working population, and to study the symptoms of musculoskeletal pain and disturbed sleep among ambulance personnel. Methods The results of a comprehensive nationwide questionnaire survey of operational ambulance personnel (n = 1180) were compared with the findings of a population-based Norwegian health study of working people (n = 31,987). The questionnaire included measures of help-seeking, the Hospital Anxiety and Depression Scale, the Subjective Health Complaints Questionnaire, the Karolinska Sleep Questionnaire and the Need for Recovery after Work Scale. Results Compared with those in the reference population, the mean of level anxiety symptoms in the ambulance sample was lower for men (3.5 vs. 3.9, P < 0.001) and women (4.0 vs. 4.4, P < 0.05), and the mean level of depression symptoms in ambulance workers was lower for men (2.3 vs. 2.8, P < 0.05) but not for women (2.9 vs. 3.1, P = 0.22). A model adjusted for anxiety and depression symptoms indicated that ambulance personnel had lower levels of help-seeking except for seeing a chiropractor (12% vs. 5%, P < 0.01). In the ambulance sample, symptoms of musculoskeletal pain were most consistently associated with help-seeking. In the adjusted model, only symptoms of disturbed sleep were associated with help-seeking from a psychologist/psychiatrist (total sample = 2.3%). Help-seeking was more often reported by women but was largely unaffected by age. Conclusion The assumption that ambulance personnel have more anxiety and depression symptoms than the general working population was not supported. The level of musculoskeletal pain and, accordingly, the level of help-seeking from a chiropractor were higher for ambulance workers. More research should address the physical strains among ambulance personnel

Innate Immune Responses of Drosophila melanogaster Are Altered by Spaceflight

Alterations and impairment of immune responses in humans present a health risk for space exploration missions. The molecular mechanisms underpinning innate immune defense can be confounded by the complexity of the acquired immune system of humans. Drosophila (fruit fly) innate immunity is simpler, and shares many similarities with human innate immunity at the level of molecular and genetic pathways. The goals of this study were to elucidate fundamental immune processes in Drosophila affected by spaceflight and to measure host-pathogen responses post-flight. Five containers, each containing ten female and five male fruit flies, were housed and bred on the space shuttle (average orbit altitude of 330.35 km) for 12 days and 18.5 hours. A new generation of flies was reared in microgravity. In larvae, the immune system was examined by analyzing plasmatocyte number and activity in culture. In adults, the induced immune responses were analyzed by bacterial clearance and quantitative real-time polymerase chain reaction (qPCR) of selected genes following infection with E. coli. The RNA levels of relevant immune pathway genes were determined in both larvae and adults by microarray analysis. The ability of larval plasmatocytes to phagocytose E. coli in culture was attenuated following spaceflight, and in parallel, the expression of genes involved in cell maturation was downregulated. In addition, the level of constitutive expression of pattern recognition receptors and opsonins that specifically recognize bacteria, and of lysozymes, antimicrobial peptide (AMP) pathway and immune stress genes, hallmarks of humoral immunity, were also reduced in larvae. In adults, the efficiency of bacterial clearance measured in vivo following a systemic infection with E. coli post-flight, remained robust. We show that spaceflight altered both cellular and humoral immune responses in Drosophila and that the disruption occurs at multiple interacting pathways

IL-10 from CD4+CD25−Foxp3−CD127− Adaptive Regulatory T Cells Modulates Parasite Clearance and Pathology during Malaria Infection

The outcome of malaria infection is determined, in part, by the balance of pro-inflammatory and regulatory immune responses. Failure to develop an effective pro-inflammatory response can lead to unrestricted parasite replication, whilst failure to regulate this response leads to the development of severe immunopathology. IL-10 and TGF-β are known to be important components of the regulatory response, but the cellular source of these cytokines is still unknown. Here we have examined the role of natural and adaptive regulatory T cells in the control of malaria infection and find that classical CD4+CD25hi (and Foxp3+) regulatory T cells do not significantly influence the outcome of infections with the lethal (17XL) strain of Plasmodium yoelii (PyL). In contrast, we find that adaptive IL-10-producing, CD4+ T cells (which are CD25−, Foxp3−, and CD127− and do not produce Th1, Th2, or Th17 associated cytokines) that are generated during both PyL and non-lethal P. yoelii 17X (PyNL) infections are able to down-regulate pro-inflammatory responses and impede parasite clearance. In summary, we have identified a population of induced Foxp3− regulatory (Tr1) T cells, characterised by production of IL-10 and down regulation of IL-7Rα, that modulates the inflammatory response to malaria

Neck disorder influenced by occupational reward type: Results from effort-reward imbalance model based on IPWS

Effort-Reward Imbalance model is known as one of the survey method of occupational stress and also as an effective element on health condition according to its parameters. Due to types of rewards generally, and reward subscales in this model specifically, each one can have a distinctive effect on health perception, current study is aimed at determination of the most effective reward subscale for managing work-related neck disorder in industries. All of workers who participated in IPWS study (N = 1126), were entered in the statistical analysis stage. After completing personal and organizational information, they responded to Van Vegchel et al. Effort-Reward Imbalance and also Dutch questionnaires for their musculoskeletal disorders. Chi-square and t-test comparisons were performed and the final regression model was presented with a significance level of 0.05. The mean (Standard deviation) age of workers and musculoskeletal disorders prevalence in neck were 33.21 (7.63) years and 34 percent respectively. Also in workers with neck pain, odds ratio between effort and monetary reward, between effort and respect reward, and between effort and security reward in their jobs were 1.35, 2.07 and 1.32 respectively. After elimination of confounders in final regression model, significant correlation was remained only between effort and job respect reward. According to high prevalence of musculoskeletal disorders in neck and also large amount of effort-reward imbalance in Iranian workers, implementing interventions are recommended. Based on results of present study, it is suggested that main intervention must be focused on respect and esteem reward in jobs. © Springer Nature Switzerland AG 2019

Why Functional Pre-Erythrocytic and Bloodstage Malaria Vaccines Fail: A Meta-Analysis of Fully Protective Immunizations and Novel Immunological Model

Background: Clinically protective malaria vaccines consistently fail to protect adults and children in endemic settings, and at best only partially protect infants. Methodology/Principal Findings: We identify and evaluate 1916 immunization studies between 1965-February 2010, and exclude partially or nonprotective results to find 177 completely protective immunization experiments. Detailed reexamination reveals an unexpectedly mundane basis for selective vaccine failure: live malaria parasites in the skin inhibit vaccine function. We next show published molecular and cellular data support a testable, novel model where parasite-host interactions in the skin induce malaria-specific regulatory T cells, and subvert early antigen-specific immunity to parasite-specific immunotolerance. This ensures infection and tolerance to reinfection. Exposure to Plasmodium-infected mosquito bites therefore systematically triggers immunosuppression of endemic vaccine-elicited responses. The extensive vaccine trial data solidly substantiate this model experimentally. Conclusions/Significance: We conclude skinstage-initiated immunosuppression, unassociated with bloodstage parasites, systematically blocks vaccine function in the field. Our model exposes novel molecular and procedural strategies to significantly and quickly increase protective efficacy in both pipeline and currently ineffective malaria vaccines, and forces fundamental reassessment of central precepts determining vaccine development. This has major implications fo