The development of an intervention programme to reduce whole-body vibration exposure at work induced by a change in behaviour: a study protocol

<p>Abstract</p> <p>Background</p> <p>Whole body vibration (WBV) exposure at work is common and studies found evidence that this exposure might cause low back pain (LBP). A recent review concluded there is a lack of evidence of effective strategies to reduce WBV exposure. Most research in this field is focussed on the technical implications, although changing behaviour towards WBV exposure might be promising as well. Therefore, we developed an intervention programme to reduce WBV exposure in a population of drivers with the emphasis on a change in behaviour of driver and employer. The hypothesis is that an effective reduction in WBV exposure, in time, will lead to a reduction in LBP as WBV exposure is a proxy for an increased risk of LBP.</p> <p>Methods/Design</p> <p>The intervention programme was developed specifically for the drivers of vibrating vehicles and their employers. The intervention programme will be based on the most important determinants of WBV exposure as track conditions, driving speed, quality of the seat, etc. By increasing knowledge and skills towards changing these determinants, the attitude, social influence and self-efficacy (ASE) of both drivers and employers will be affected having an effect on the level of exposure. We used the well-known ASE model to develop an intervention programme aiming at a change or the intention to change behaviour towards WBV exposure. The developed programme consists of: individual health surveillance, an information brochure, an informative presentation and a report of the performed field measurements.</p> <p>Discussion</p> <p>The study protocol described is advantageous as the intervention program actively tries to change behaviour towards WBV exposure. The near future will show if this intervention program is effective by showing a decrease in WBV exposure.</p

Metabolic consequences of chronic sleep restriction in rats:Changes in body weight regulation and energy expenditure

Epidemiological studies have shown an association between short or disrupted sleep and an increased risk to develop obesity. In animal studies, however, sleep restriction leads to an attenuation of weight gain that cannot be explained by changes in energy intake. In the present study, we assessed whether the attenuated weight gain under conditions of restricted sleep is a consequence of an overall increase in energy expenditure. Adult male rats were subjected to a schedule of chronic sleep restriction (SR) for 8 days with a 4 h window of unrestricted rest per day. Electroencephalogram and electromyogram recordings were performed to quantify the effect of the sleep restriction schedule on sleep-wake patterns. In a separate experiment, we measured sleep restriction-induced changes in body weight, food intake, and regulatory hormones such as glucose, insulin, leptin and corticosterone. To investigate whether a change in energy expenditure underlies the attenuation of weight gain, energy expenditure was measured by the doubly labeled water method from day 5 until day 8 of the SR protocol. Results show a clear attenuation of weight gain during sleep restriction but no change in food intake. Baseline plasma glucose, insulin and leptin levels are decreased after sleep restriction which presumably reflects the nutritional status of the rats. The daily energy expenditure during SR was significantly increased compared to control rats. Together, we conclude that the attenuation of body weight gain in sleep restricted rats is explained by an overall increase in energy expenditure together with an unaltered energy intake. Published by Elsevier Inc

Validity of absolute intake and nutrient density of protein, potassium, and sodium assessed by various dietary assessment methods:An exploratory study

It is suggested that nutrient densities are less affected by measurement errors than absolute intake estimates of dietary exposure. We compared the validity of absolute intakes and densities of protein (kJ from protein/total energy (kJ)), potassium, and sodium (potassium or sodium (in mg)/total energy (kJ)) assessed by different dietary assessment methods. For 69 Dutch subjects, two duplicate portions (DPs), five to fifteen 24-h dietary recalls (24 hRs, telephone-based and web-based) and two food frequency questionnaires (FFQs) were collected and compared to duplicate urinary biomarkers and one or two doubly labelled water measurements. Multivariate measurement error models were used to estimate validity coefficients (VCs) and attenuation factors (AFs). This research showed that group bias diminished for protein and sodium densities assessed by all methods as compared to the respective absolute intakes, but not for those of potassium. However, the VCs and AFs for the nutrient densities did not improve compared to absolute intakes for all four methods; except for the AF of sodium density (0.71) or the FFQ which was better than that of the absolute sodium intake (0.51). Thus, using nutrient densities rather than absolute intakes does not necessarily improve the performance of the DP, FFQ, or 24 hR.</p

Consumption of a recommended serving of wheat bran cereals significantly increases human faecal butyrate levels in healthy volunteers and reduces markers of inflammation ex vivo.

Wheat bran cereals are an important source of dietary fibre. The aim of the study was to investigate if a high intake (120 g) of fibre rich breakfast cereal (which delivers the UK Government guidelines for fibre intake in one serving but is three-fold higher than the manufacturers recommended serving) has additional potential health benefits compared to the recommended serving (40 g, containing 11 g of dietary fibre). To assess this, the study determined the short chain fatty acid (SCFA) profiles in human faecal, urine and plasma samples after consumption of two different servings of fibre-rich cereal. Inhibition of prostanoid production was measured (ex vivo) in human colonic fibroblast cells after cytokine (IL-1β) inflammation stimulation. Eight healthy volunteers, 18-55 years old; BMI (18-30 kg/m2) consumed the wheat bran-rich "ready to eat cereal", at both the high (120 g) serving and recommended (40 g) serving. Faecal, urine and plasma samples were collected at baseline, throughout the five-hour intervention period and approximately 24 hours following consumption. Faecal butyrate showed the largest increase (p < 0.05) of more than a two-fold change following the consumption of the recommended serving of wheat bran cereal (from 13.95 ± 9.17 to 31.63 ± 20.53 mM) and no significant change following the higher serving (from 21.96 ± 11.03 to 22.9 ± 12.69 mM). ANOVA analysis also found a weak serving effect (p = 0.046) of the portion size (high vs. recommended) only for butyrate in urine 24 hours after consumption of the bran cereal. The physiological nutritionally relevant concentrations of faecal SCFAs, as determined in the volunteers' faecal samples showed significant anti-inflammatory activity or the individual faecal SCFAs; acetate (p < 0.001), propionate (p < 0.001) and butyrate (p < 0.01), as well as in combination. Plasma folate was also increased after consumption of both wheat bran servings and was significant (p = 0.037) at the three-hour time point following consumption of the high wheat bran serving. The consumption of the recommended serving (40 g) of wheat bran cereal increased the total microbial SCFAs levels (from 96.88 to 136.96 mM) compared to the higher serving (120 g) (from 110.5 to 117.64 mM) suggesting that the intake of the higher portion size is likely to promote a faecal bulking effect and thereby decrease colonic SCFA levels. These data indicate that consumption of the recommended serving of wheat bran cereal serving would therefore be sufficient to promote microbial butyrate formation, reduce colonic inflammation and increase plasma folate levels in humans

Care provider views on app-based treatment for female urinary incontinence:A mixed-methods study

Objective: To explore the views and preferences of care providers on app use for the treatment of UI and to identify the anticipated barriers to, and facilitators of, implementation.Patients and Methods: We performed an exploratory, two-phase, sequential mixed-methods study. In phase 1, the views of care providers were explored through five focus group sessions with care providers involved in UI: general practitioners (GPs), practice assistants (PAs), pelvic physical therapists (PPTs), and urologists and (uro)gynecologists (UGs). In phase 2, the identified themes and subthemes were quantified in an online survey distributed among different care providers matching these groups.Results: In the focus group sessions, 30 female and two male care providers participated. Survey participants included 351 PAs and 76 PPTs (all females) next to 124 GPs and 183 UGs (70% females). Caregivers generally considered UI treatment apps as having a supportive role, being less convinced about their advantages in the absence of a care provider. Whereas most PPTs (89%) and the majority of participants overall (56%) agreed that app use should be supervised, most GPs considered apps to be suitable alternatives for women who do not visit a care provider. Additionally, caregivers required that the effectiveness of an app should be proven first, and that privacy and safety should be ensured. Contrasting with other research, lack of time and financial compensation were not considered important barriers to implementation. Although care providers shared a positive view of app use for UI treatment, most never to seldom referred their patients to existing tools.Conclusion: Our results add to the existing knowledge about eHealth-related barriers and facilitators. These findings can be used to optimize implementation strategies for other apps and to enhance the uptake of app-based treatment for UI in The Netherlands

SAFEGUI: resampling-based tests of categorical significance in gene expression data made easy

Summary: A large number of websites and applications perform significance testing for gene categories/pathways in microarray data. Many of these packages fail to account for expression correlation between transcripts, with a resultant inflation in Type I error. Array permutation and other resampling-based approaches have been proposed as solutions to this problem. SAFEGUI provides a user-friendly graphical interface for the assessment of categorical significance in microarray studies, while properly accounting for the effects of correlations among genes. SAFEGUI incorporates both permutation and more recently proposed bootstrap algorithms that are demonstrated to be more powerful in detecting differential expression across categories of genes

Bias in protein and potassium intake collected with 24-h recalls (EPIC-Soft) is rather comparable across European populations

Purpose: We investigated whether group-level bias of a 24-h recall estimate of protein and potassium intake, as compared to biomarkers, varied across European centers and whether this was influenced by characteristics of individuals or centers. Methods: The combined data from EFCOVAL and EPIC studies included 14 centers from 9 countries (n = 1,841). Dietary data were collected using a computerized 24-h recall (EPIC-Soft). Nitrogen and potassium in 24-h urine collections were used as reference method. Multilevel linear regression analysis was performed, including individual-level (e.g., BMI) and center-level (e.g., food pattern index) variables. Results: For protein intake, no between-center variation in bias was observed in men while it was 5.7% in women. For potassium intake, the between-center variation in bias was 8.9% in men and null in women. BMI was an important factor influencing the biases across centers (p <0.01 in all analyses). In addition, mode of administration (p = 0.06 in women) and day of the week (p = 0.03 in men and p = 0.06 in women) may have influenced the bias in protein intake across centers. After inclusion of these individual variables, between-center variation in bias in protein intake disappeared for women, whereas for potassium, it increased slightly in men (to 9.5%). Center-level variables did not influence the results. Conclusion: The results suggest that group-level bias in protein and potassium (for women) collected with 24-h recalls does not vary across centers and to a certain extent varies for potassium in men. BMI and study design aspects, rather than center-level characteristics, affected the biases across center

An exploration of socio-economic and food characteristics of high trans fatty acid consumers in the Dutch and UK national surveys after voluntary product reformulation

Trans fatty acids (TFA) increase the risk of mortality and chronic diseases. TFA intakes have fallen since reformulation, but may still be high in certain, vulnerable, groups. This paper investigates socio-economic and food consumption characteristics of high TFA consumers after voluntary reformulation in the Netherlands and UK. Post-reformulation data of adults aged 19–64 was analysed in two national surveys: the Dutch National Food Consumption Survey (DNFCS) collected 2007–2010 using 2*24hr recalls (N = 1933) and the UK National Diet and Nutrition Survey (NDNS) years 3&4 collected 2010/11 and 2011/12 using 4-day food diaries (N = 848). The socio-economic and food consumption characteristics of the top 10% and remaining 90% TFA consumers were compared. Means of continuous data were compared using t-tests and categorical data means using chi-squared tests. Multivariate logistic regression models indicated which socio-demographic variables were associated with high TFA consumption. In the Dutch analyses, women and those born outside the Netherlands were more likely to be top 10% TFA consumers than men and Dutch-born. In the UK unadjusted analyses there was no significant trend in socio-economic characteristics between high and lower TFA consumers, but there were regional differences in the multivariate logistic regression analyses. In the Netherlands, high TFA consumers were more likely to be consumers of cakes, buns & pastries; cream; and fried potato than the remaining 90%. Whereas in the UK, high TFA consumers were more likely to be consumers of lamb; cheese; and dairy desserts and lower crisps and savoury snack consumers. Some socio-demographic differences between high and lower TFA consumers were evident post-reformulation. High TFA consumers in the Dutch 2007–10 survey appeared more likely to obtain TFA from artificial sources than those in the UK survey. Further analyses using more up-to-date food composition databases may be needed

Pitfalls in the diagnosis of acoustic neuroma

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/71894/1/j.1365-2273.1984.tb01490.x.pd