Prävention von psychosozialen Gesundheitsrisiken in Betrieben. Qualitative Interventionsforschung : Forschungsbericht

Das Staatssekretariat für Wirtschaft SECO hat Anfang 2014 einen neuen Vollzugsschwerpunkt lanciert, um die Prävention im Bereich der psychosozialen Risiken am Arbeitsplatz zu verstärken. In einer ersten Phase wurden gute Praxisbeispiele gesucht. Die Forschungsstudie setzte sich zum Ziel, eine Wirkungsanalyse der im Rahmen des KTI-Projektes VitaLab erfolgten Massnahmen des Betrieblichen Gesundheitsmanagements zu erstellen und die Kriterien guter Praxis in Kleinbetrieben (KU) zu überprüfen. Im Projekt wurden 32 BGM-Dienstleistungen angeboten. Zielgruppe waren die Unternehmerinnen und Unternehmer der KU. Das Forschungsteam konnte je 10 Interviews mit Geschäftsleitenden und Mitarbeitenden aus 12 Betrieben durchführen, die BGM-Dienstleistungen bezogen hatten. Für die Auswertung wurde die inhaltlich strukturierende qualitative Inhaltsanalyse gewählt. Die Frage nach den erfolgten Veränderungen aufgrund der BGM-Dienstleistungen konnte über die Hälfte Interviewpartner positiv beantworten. Diese lagen insbesondere in der Verbesserung der sozialen Beziehungen und der physischen Arbeitsumwelt. Zudem gaben Führungspersonen an, eine höhere Sensibilität für ihren Einfluss auf die Gesundheit der Mitarbeitenden gewonnen zu haben. Beim spezifischen Einfluss auf die Reduktion der psychosozialen Belastungen sahen Geschäftsleiter insbesondere Verbesserungen aufgrund von Rollenklärungen, Stellvertretungsregelungen und Verbesserungen der internen Abläufe. Die Ermittlung der Gesundheitsgefährdung versuchen die Befragten über regelmässige und spontane Gespräche umzusetzen. Auffallend war die Tatsache, dass die Mehrheit der Mitarbeitenden vermehrt regelmässige und/oder standardisierte Gespräche wünscht. Die Früherkennung von Gesundheitsproblemen hängt letztlich stark von der Sozialkompetenz der Geschäftsleitenden ab. Entsprechend wird u.a. empfohlen, Gesprächsleitfäden oder eLearning-Tools zur Verbesserung ihrer Kommunikationskompetenzen anzubieten. Alle Massnahmen sollen KU unterstützen und möglichst wenig Zusatzaufwand geben

Quantitative PCR for the diagnosis of cutaneous leishmaniasis from formalin-fixed and paraffin-embedded skin sections.

The present report describes a real-time PCR-based procedure to reliably determine the quantity of Leishmania amastigotes in relation to the amount of host tissue in histological skin sections from canine and equine cases of cutaneous leishmaniasis. The novel diagnostic Leishmania-PCR has a detection limit of <0.02 amastigotes per μg tissue, which corresponds well to the detection limit of immunohistochemistry and is far beyond that of conventional histology. Our results emphasise the importance of PCR to complement routine histology of cutaneous leishmaniasis cases, particularly in laboratories in which no immunohistochemical assay is available

The brown hare (Lepus europaeus) as a novel intermediate host for Echinococcus multilocularis in Europe

A typical multivesiculated metacestode tissue has been found in the liver of a European brown hare (Lepus europaeus) originating from a northern area of Switzerland. In this study, the causative species was identified as Echinococcus multilocularis by appropriate histological and molecular analyses and corresponding DNA sequencing. This is the first confirmation of larval E. multilocularis from hares in central Europe. The metacestode tissue contained protoscolices, suggesting that the hare may contribute to the transmission of E. multilocularis in Switzerland

Genetic identification of an oxyurid from a captive, black-handed spider monkey—implications for treatment and control

Parasites are of major clinical significance in captive primates in zoos, particularly those with direct life cycles. Oxyurid nematodes can be a persistent problem, as infection intensity and environmental contamination with infective eggs are usually high. Observations at the Basel Zoo in Switzerland have revealed that particularly black-handed spider monkeys (Ateles geoffroyi) exhibit continuous oxyurid nematode infection(s), despite regular deworming with anthelmintics. In the present study, using a molecular approach, we were able to identify the nematode (Trypanoxyuris atelis) causing this ongoing problem, and we are now evaluating a practical treatment and control regimen to tackle this parasite problem

Immunoblotting for the serodiagnosis of alveolar echinococcosis in alive and dead Eurasian beavers (Castor fiber)

A novel species-specific anti-beaver-IgG-alkaline-phosphatase conjugate was synthesized for the development of a new serological test for echinococcosis in beavers. Two different ELISAs conventionally used for human Echinococcus multilocularis serology (Em18-ELISA and Em2-ELISA) yielded diagnostic sensitivities of 0% and 46%, respectively. In contrast, the subsequently developed immunoblotting assay gave an 85% diagnostic sensitivity (11 out of 13 beavers with alveolar echinococcosis were immunoblotting-positive, i.e. showed reactivity with a specific 21 Mr band), and maximal specificity. In conclusion, this immunoblotting assay should be the method of choice for use in serological studies on E. multilocularis in Eurasian beavers, and the test proved suitable to investigate both animals alive and post-mortem

A Solve-RD ClinVar-based reanalysis of 1522 index cases from ERN-ITHACA reveals common pitfalls and misinterpretations in exome sequencing

Purpose Within the Solve-RD project (https://solve-rd.eu/), the European Reference Network for Intellectual disability, TeleHealth, Autism and Congenital Anomalies aimed to investigate whether a reanalysis of exomes from unsolved cases based on ClinVar annotations could establish additional diagnoses. We present the results of the “ClinVar low-hanging fruit” reanalysis, reasons for the failure of previous analyses, and lessons learned. Methods Data from the first 3576 exomes (1522 probands and 2054 relatives) collected from European Reference Network for Intellectual disability, TeleHealth, Autism and Congenital Anomalies was reanalyzed by the Solve-RD consortium by evaluating for the presence of single-nucleotide variant, and small insertions and deletions already reported as (likely) pathogenic in ClinVar. Variants were filtered according to frequency, genotype, and mode of inheritance and reinterpreted. Results We identified causal variants in 59 cases (3.9%), 50 of them also raised by other approaches and 9 leading to new diagnoses, highlighting interpretation challenges: variants in genes not known to be involved in human disease at the time of the first analysis, misleading genotypes, or variants undetected by local pipelines (variants in off-target regions, low quality filters, low allelic balance, or high frequency). Conclusion The “ClinVar low-hanging fruit” analysis represents an effective, fast, and easy approach to recover causal variants from exome sequencing data, herewith contributing to the reduction of the diagnostic deadlock

Combined cross-sectional and case-control study on Echinococcus multilocularis infection in pigs in Switzerland.

The canid tapeworm Echinococcus multilocularis causes alveolar echinococcosis (AE) in humans and other intermediate hosts. Depending on the permissiveness of the intermediate host, the larval form of E. multilocularis (metacestode) may be either fertile, e.g. in rodents, and thus supporting the life cycle of the parasite, or infertile, e.g. in pigs, and thus interrupting the life cycle. Pigs have been shown to act as aberrant hosts for the metacestode and consequently develop liver lesions but represent a dead-end for the parasite. Routine liver inspection at slaughter provided the basis for a large-scale surveillance study on E. multilocularis infection in pigs. The aim of this combined cross-sectional and case-control study was to estimate the minimal prevalence of E. multilocularis in pigs in Switzerland, to find factors associated with infection, and to assess potential regional clusters of infection. During the 12-month-study period, approximately 85% of all pigs slaughtered in Switzerland were assessed. In total, 450 pig livers with macroscopic lesions suggestive of E. multilocularis infection were analysed. Of those, 200 samples were positive by E. multilocularis-PCR. Thus, the overall minimal prevalence detected by molecular means was 0.009% in all slaughter pigs (200 of 2'143'996), 0.008% in finishing pigs (177 of 2'123'542), and 0.11% in breeding pigs (22 of 20'454). Histology revealed the unique presence of a laminated layer in 105 cases, and an additional germinal layer detected in a single case. Protoscoleces could not be observed in any of the lesions. Factors positively associated with infection were "foxes seen in the pig shed", "foxes on premises", "presence of other animals in the shed", "absence of a hygiene barrier", "outdoor feeding", "feeding grass", "lack of rodent control", "not having own dogs on the farm" and "infrequent deworming of sows". Infection was present in all regions sampled and was representative of the important pig rearing areas of Switzerland, without evidence of any obvious geographical cluster. Conclusively, our study provided further evidence of widespread environmental contamination with E. multilocularis eggs in Switzerland. Furthermore, the absence of protoscoleces in any of the lesions supported the concept that pigs act only as a dead-end host and thus do not contribute to the life cycle of the parasite. Factors associated with E. multilocularis infection were in-line with parasite biology, and many can be addressed by increasing hygiene and management standards

Leishmaniasis manifesting as osteomyelitis and monoarthritis in a dog and outcome following treatment with mitefosine and allopurinol.

A nine-year-old male, neutered, mixed-breed dog was presented with chronic left pelvic limb lameness, moderate muscular atrophy and pain on palpation of the lateral femoral condyle. No other clinical abnormalities were found except for two subcutaneous tarsal nodules. Radiographs and CT revealed severe stifle monoarthropathy and distal femoral osteolysis without periosteal proliferation, mild popliteal lymphadenopathy and several small splenic nodules. Leishmaniosis was diagnosed on cytology of the lymph nodes and spleen, serology and PCR of the synovial membrane, and bone biopsies. Complete clinical remission was achieved with oral miltefosine and allopurinol. The areas of distal femur bone loss remained radiographically and on CT. Monarthritis and osteomyelitis without systemic clinical signs or clinicopathological alterations have rarely been reported with canine leishmaniosis. Leishmaniosis should be considered even if radiographic signs are atypical. Treatment with miltefosine and allopurinol was successful in achieving clinical remission. Previous areas of bone loss remained quiescent without bone infilling