Sleep, age, and shiftwork experience

The effects of age and shiftwork experience (never, past, present) on sleep were studied in a sample of 3236 wage earners and retired workers by means of a questionnaire. The sample was composed of 32-, 42-, 52-, and 62-year-old subjects, and included both sexes and various occupational statuses. Age resulted in a continuously increasing frequency of sleep disturbances and hypnotic use, except for difficulty getting back to sleep and early awakening, which peaked at 52 years and then decreased at 62 years, thus suggesting a 'retirement effect'. Current and past shiftworkers reported more problems with falling asleep and early awakening than subjects who had never worked on shifts. This is a likely explanation of why the effect of age was massive in the latter group and much less pronounced in the former groups. There were no clear effects of the length or recency of shiftwork experience. This finding does not support the hypothesized permanent effect of shiftwork experience on subsequent sleep. Females had higher complaint rates at every age. There was little interaction between age and sex, but women were affected more by shiftwork as they got older, particularly as to hypnotic consumption. Some of the results support the hypothesis that a selection process excludes workers who are no longer able to cope with the demands of shiftwork.     

Prospective relations of body image,eating, and affective disturbances to smoking onset in adolescent girls: how Virginia slims

This study tested whether body image, eating, and affective disturbances prospectively predicted onset of cigarette smoking in adolescent girls (N = 496). Elevated body dissatisfaction and eating pathology, as well as elevated negative affectivity, showed significant univariate relations to subsequent onset of smoking. In the multivariate model, the effect for body image and eating disturbances remained significant, but the effect for negative affectivity did not. Results support the theory that body image and eating disturbances markedly increase risk for smoking initiation in adolescent girls and further establish the clinical significance of these disturbances. Results also support the theory that negative affect is a risk factor for smoking initiation but suggest that the self-medication model may have less predictive power than previously concluded.     

Shiftwork, job type, and the work environment as joint predictors of health-related outcomes.

This article examines the potential confounding of observed relations between shiftwork and health outcomes by differences in the jobs typically carried out by shiftworkers and dayworkers. Objective factors (daywork vs. day/night shiftwork and job type) and work perceptions (job demand, discretion, social support, and physical stressors) were analyzed as joint predictors of psychosomatic complaints (headaches and musculoskeletal, gastric, and sleep problems), affective distress, and work-related injuries in data from oil industry personnel (N = 1,462). Logistic regression showed that, after control for individual differences (including age and negative affectivity), shiftwork and job type each predicted specific health outcomes when evaluated simultaneously. Work perceptions also contributed significantly to each outcome, partially mediating relations between job type and health.     

Shiftwork and environment as interactive predictors of work perceptions

Evidence suggests that the work environment may play a role in the elevated risk of adverse health outcomes among shiftworkers compared with dayworkers. Perceived work environment measures (physical stressors, job demand, job control, skill discretion, supervisor support, and safety perceptions) from UK oil industry personnel (N=1,867) were analyzed in relation to shiftwork (day/night rotation vs daywork) and objective work environment (onshore vs offshore). Age, education, job type, and negative affectivity were also included. The Environment * Shiftwork interaction was significant in multivariate tests and in 5 of the 6 univariate analyses. Onshore, shiftworkers perceived their environment significantly less favorably than dayworkers, but differences were less marked offshore. Results are discussed in relation to the demand-control-support model of work stress.     

Caregiver's distress is associated with delusions in Alzheimer's patients

Behavioral disturbances in Alzheimer's (AD) patients might be caused by environmental factors. The authors tested the hypothesis that delusions in AD might be a result of caregiver's distress. Participants were 22 delusional and 21 nondelusional mild AD patients and their caregivers. Those who cared for nondelusional patients, compared with the delusional patients' caregivers, reported higher levels of distress because of behavioral disturbances other than delusions. When patients were stratified into 2 groups according to median distress value, 64% of the delusional patients and 33% of the nondelusional patients showed a high level of caregiver's distress, chi2(1, N = 43) = 3.94, p = .047. Although final conclusions about the causal direction of the association cannot be drawn, these findings are consistent with the hypothesis that distressed caregivers might use inappropriate coping strategies that, in turn, might favor the development of delusions.     

Hormonal and pharmacological manipulation of the circadian clock: recent developments and future strategies

The mammalian circadian oscillator, located in the suprachiasmatic nuclei of the anterior hypothalamus, serves as the principal source of rhythmic temporal information for virtually all physiologic processes in the organism, including the alternating expression of sleep and wakefulness. Recent studies, in both animal models and human subjects, have demonstrated the important modulation of sleep and wakefulness mediated by the circadian clock. Independent of other factors, notably prior sleep-wake history, the circadian clock potentiates wakefulness (and alertness) at one phase of the diurnal cycle, while facilitating sleep and its attendant processes at the opposite phase. The adaptive advantage of synchronizing sleep-wake behaviors with the daily changes in the external environment is clear. But in a modern world where the constraints of environmental time are less and less important, the circadian clock still imposes rigid boundaries on the timing of sleep and alert wakefulness that are increasingly perceived as limitations on human performance. This conflict underlies the sleep "disorders" of jet lag and shiftwork sleep disruption, problems that are not really diseases at all, but instead reflect normal function of circadian timing in the context of extraordinary demands on sleep-wake scheduling. Whatever their proper classification, both jet lag and shiftwork insomnia represent important societal problems deserving of public health and medical attention. Barring a worldwide rejection of air-travel, jet lag will continue to afflict tens of thousands of people annually. The effects of jet lag on human performance, while typically transient, can nonetheless be significant, affecting commerce, government, and even the outcome of professional sports contests. More important, only a global regression to an agrarian economy will eliminate the problem of tens of millions of workers in this country who regularly attempt to work at night and sleep during the day. In contrast to jet lag, shiftwork produces chronic sleep disruption lasting for the duration of shiftwork exposure. For while individual differences in the ability to adjust to a nocturnal work schedule clearly exist, recent studies suggest that few if any night workers regularly experience restful and restorative day sleep equivalent to that considered normal at night. This chronic sleep limitation is associated with significant increases in a number of consequent problems including sleepiness-related accidents, social disruption, and psychiatric disturbances. In addition, chronic exposure to shiftwork has now been shown to be an independent risk factor for the development of both cardiovascular and gastrointestinal diseases. While these epidemiological studies have not identified the specific aspect of shiftwork that is associated with increased risk of these disorders, the chronic limitation and disruption is foremost among plausible factors. The most important aspect of human circadian physiology that limits adaptation to the extreme schedules inherent in shiftwork and jet travel is the primacy of light among entraining signals, or zeitgebers. Exposure to sunlight for night shiftworkers, or for jet travelers at their destination, results in maintenance (or resetting) of the clock to environmental time. This response can be prevented or overridden with extraordinary avoidance of sunlight or with provision of artificial light of sufficient duration and intensity to negate the sunlight signal, an approach shown to be effective in the treatment of shiftwork sleep disruption. Practical issues sharply limit the application of artificial lighting to all shiftwork settings, however, and the role for a pharmacological chronobiotic agent capable of accomplishing the same end is potentially very large (Copinschi et al., 1995; Jamieson et al., 1998). For example, the effects of zolpidem vs. placebo on sleep, daytime alertness, and fatigue in travelers who complain of jet lag was co     

The sleep-wake cycle and sleeping pills

Sleeping pills are drugs which are used world-wide to combat sleep disturbances, and to prevent symptoms due to maladjustment to shiftwork or jet-lag. Today, benzodiazepines and the so-called "non-benzodiazepines", such as zolpidem, which both act on benzodiazepine receptors, are drugs of first choice and they are substitutes for barbiturates. Their use as sleeping pills in insomniacs is established after appropriate medical diagnosis. Symptoms from shiftwork or jet-lag are due to an internal desynchronisation of biological rhythms, and there is ample evidence that benzodiazepines are not effective in preventing these symptoms. Cabin crews in particular should never take sleeping pills, in order not to impair cognitive functions or to reduce the reactivity needed to fly an aircraft safely. The biological clock(s) cannot be reset instantaneously by any drug.     

Validation of an Embryotoxicity Assay

PROBLEM : Culture of mouse blastocysts has served as a tool for identifying various embryotoxic factors in human serum. While inactivated, sera from recurrently aborting women inhibit mouse blastocyst development in vitro. Variation in results from individual serum samples has limited the usefulness of this assay in establishing a new classification of idiopathic recurrent spontaneous abortion (RSA). METHOD : Two-cell embryos were collected from superovulated mated CB6F1/J mice and cultured in Ham's F-10 media supplemented with 10% fetal bovine serum (FBS) or tested human serum at 37°C with 5% CO₂ and high humidity. Each sample was assayed in triplicate using three mice with at least five embryos from the same mouse per dish. Development was evaluated at 72 h and the frequency of atretic embryos was recorded. RESULTS : Intrasample (interassay) variation yielded a coefficient of variation of 9%. When repeated, samples from a given individual were evaluated and the coefficient of variation was 8.7%. Interoperator variability was 4% interassay and 2% intraassay. Atresia of embryos was 23% when incubated with FBS (N=122), 21% in FC (N=122), and in the sera of patients with RSA 34.6% (N=95). Results of percentage of atresia from the fertile control group had a nonparametric distribution. Using 2.2 multiples of the median to determine the 95% confidence interval, a threshold at 44.0% of atresia was established. CONCLUSIONS : The critical step in maintaining low variability in this bioassay is to control mouse variability by averaging the percentage atresia from different mice as embryo donors for each tested serum. A subgroup of 24% (23/95) RSA patients who displayed embryotoxic activity was identified with a specificity of 95% and positive predictive value of 83%, P=0.001.     

Use of PGMY primers in L1 consensus PCR improves detection of human papillomavirus DNA in genital samples

The novel PGMY L1 consensus primer pair is more sensitive than the MY09 and MY11 primer mix for detection and typing with PCR of human papillomavirus (HPV) DNA in genital specimens. We assessed the diagnostic yield of PGMY primers for the detection and typing of HPV by comparing the results obtained with PGMY09/PGMY11 and MY09/MY11/HMB01 on 299 genital samples. Amplicons generated with PGMY primers were typed with the line blot assay (PGMY-line blot), while HPV amplicons obtained with the degenerate primer pool MY09/MY11/HMB01 were detected with type-specific radiolabeled probes in a dot blot assay (standard consensus PCR test). Cervicovaginal lavage samples (N = 272) and cervical scrape samples (N = 27) were tested in parallel with both PCR tests. The PGMY-line blot test detected the presence of HPV DNA more frequently than the standard consensus PCR assay. The concordance for HPV typing between the two assays was 84.3% (214 of 255 samples), for a good kappa value of 0.69. Of the 177 samples containing HPV DNA by at least one method, 40 samples contained at least one HPV type detected only with PGMY-line blot, whereas positivity exclusively with the standard consensus PCR test was found for only 7 samples (P < 0.001). HPV types 45 and 52 were especially more frequently detected with PGMY than MY primers. However, most HPV types were better amplified with PGMY primers, including HPV-16. Samples with discordant results between the two PCR assays more frequently contained multiple HPV types. Studies using PGMY instead of MY primers have the potential to report higher detection rates of HPV infection not only for newer HPV types but also for well-known genital types.     

创伤后成长量表在汶川地震灾民中的修订与初步应用

目的:旨在5.12汶川地震灾民群体中修订创伤后成长量表,探索其因子结构,进行信效度分析。方法:研究1采用方便取样,在四川省国家级一般灾区的某个灾后安置点中,抽取了来自4个板房区的两组样本。样本群体包括工人、农民、商人和无业人员等。用创伤后成长量表施测。样本1(n=195)进行探索性因素分析,样本2(n=294)进行验证性因素分析。研究2在四川多所中学的学生中对所得创伤后成长量表进行效标效度检验(n=339)。结果:3因素(个人改变、人际改变和具体改变)模型在地震灾民群体中的拟合性(χ2=312.74,df=101,χ2/df=3.089,RMSEA=0.084,NN-FI=0.93,CFI=0.94,GFI=0.88,AGFI=0.84)优于5因素模型(χ2=667.8,df=178,χ2/df=3.752,RMSEA=0.097,NNFI=0.92,CFI=0.94,GFI=0.82,AGFI=0.77)。修订版创伤后成长量表的信度指标良好(α=0.87)。量表与抑郁、生活满意度指数、正性情绪有中等程度的显著相关,具有良好的效标效度。结论:创伤后成长量表在创伤相关群体中使用具有较好的信效度。     

GOLPH3 overexpression correlates with tumor progression and poor prognosis in patients with clinically N0 oral tongue cancer

ABSTRACT: BACKGROUND: Overexpression of GOLPH3 (Golgi phosphoprotein 3, 34 kDa) is associated with the progression of many solid tumor types leading to an unfavorable clinical outcome. We aimed to investigate the clinical significance of GOLPH3 expression in the development and progression of clinically N0 (cN0) oral tongue cancer. METHODS: Real-time PCR and Western blotting analyses were employed to examine GOLPH3 expression in four oral tongue cancer cell lines, primary cultured normal tongue epithelial cells (TEC), eight matched pairs of oral tongue cancer samples and adjacent noncancerous tissue samples from the same patient. Immunohistochemistry (IHC) was performed to examine GOLPH3 protein expression in paraffin-embedded tissues from 179 cN0 oral tongue cancer patients. Statistical analyses were applied to evaluate the diagnostic value and the associations of GOLPH3 expression with clinical parameters. RESULTS: GOLPH3 mRNA and protein was up-regulated in oral tongue cancer cell lines and cancerous tissues compared with that in primary cultured normal tongue epithelial cells (TEC) and adjacent noncancerous tissue samples. GOLPH3 protein level was positively correlated with clinical stage (P = 0.001), T classification (P = 0.001), N classification (P = 0.043) and recurrence (P = 0.009). Patients with higher GOLPH3 expression had shorter overall survival time, whereas those with lower GOLPH3 expression had longer survival time. CONCLUSION: Our results suggest GOLPH3 overexpression is associated with poor prognosis for cN0 oral tongue cancer patients and may represent a novel and useful prognostic indicator for cN0 oral tongue cancer.     

Age,smoking, and negative affectivity as predictors of sleep patterns among shiftworkers in two environments

Although adaptation to shiftwork has been widely studied, little is known about how individual and environmental factors combine to influence sleep among shiftworkers. This study examined age, smoking, and negative affectivity (NA) as predictors of sleep duration and quality for 3 work phases (day shifts, DS; night shifts, NS; and leave periods, LP). Data were collected from personnel working 12-hr shifts, onshore (n = 330) or offshore (n = 456). Individual factors predicted patterns of sleep measures across the DS, NS, and LP phases onshore, but not offshore; onshore, work phase interacted with smoking and with age to predict sleep duration and with NA to predict sleep quality. The role of the offshore environment in shiftwork adaptation is discussed.     

Prospective relations between bulimic pathology, depression, and substance abuse: unpacking comorbidity in adolescent girls

To elucidate the processes that contribute to the comorbidity between bulimic pathology, depression, and substance abuse, the authors tested the temporal relations between these disturbances with prospective data from adolescent girls (N = 496). Multivariate analyses indicated that depressive symptoms predicted onset of bulimic pathology but not of substance abuse, bulimic symptoms predicted onset of depression but not of substance abuse, and substance abuse symptoms predicted onset of depression but not of bulimic pathology. Results suggest that the comorbidity arises because certain disorders are risk factors for the other disorders. Findings also provide support for select etiologic theories and further establish the clinical significance of these conditions by showing that they increase risk for onset of other psychiatric disturbances.     

Comparison of two real-time RT-PCR-based systems for the detection and typing of the pandemic influenza A virus, 2009

During the 2009 pandemic the Virology Laboratory of L. Spallanzani, Rome, Italy, adopted a real-time RT-PCR developed by the Centers for Disease Control and Prevention (CDC), Atlanta, Georgia to diagnose pandemic influenza A/H1N1 (H1N1pdm). A new multiplex real-time RT-PCR distributed by Astra Diagnostics, coupled with the extraction system developed and commercialized by Siemens Healthcare Diagnostics (referred to as the RealStar system), was tested for the ability to detect and type influenza A in clinical samples, with particular emphasis on influenza A-positive samples untyped by the CDC method. Seventy-six nasopharyngeal swabs, resulting by the CDC method H1N1pdm (n = 7), H3N2 (n = 3), and not subtyped (n = 66), were re-analysed with the RealStar system. All H3N2 and H1N1pdm-positive samples were correctly identified; among the untyped samples, the RealStar system detected 24/66 (36.4%) H1N1pdm and 1/66 (1.5%) seasonal influenza A. In conclusion, the RealStar system confirmed the results of all the influenza A-positive samples subtyped by the CDC method, and was able to type 37.9% of samples untyped by the CDC method. However, 62.1% of samples, detected as influenza A-positive but not subtyped by the CDC method, were found to be negative by the RealStar system. Further investigation is needed to explain this latter, unexpected, finding.     

Psychometric properties of the Beck Depression Inventory-II in nonclinical adolescent samples

This study examined the factor structure and psychometric properties of the Beck Depression Inventory-II (BDI-II; A. T. Beck, Steer, & Brown, 1996) in samples of high-school adolescents (N=414; 210 boys and 204 girls, ages 14-18 years). Confirmatory factor analyses provided satisfactory fit estimates for the two- and three-factor oblique solutions reported frequently in the extant literature. The solution to a general factor with domain-specific somatic and cognitive-affective factors was examined as an alternative model to previously established models for the current high-school sample data. Results provided stronger support for the general factor model. Estimates of internal consistency for scores on this instrument were high (coefficient alpha=.92, average interitem correlation=.35). The mean BDI-II total score for the nonclinical samples (M=12.50, SD=10.50) was compared with the mean scores reported for various adolescent normative samples in the extant literature. The BDI-II total score correlated moderately and significantly with scores on self-report measures of hopelessness (r=.63), anxiety (r=.53), and suicide-related behaviors (r=.57), providing support of adequate correlates for the BDI-II. Estimates of known-groups validity were evaluated using data from a small sample of 167 clinical adolescent inpatients. Specific study findings, limitations, and recommendations are discussed.     

Attentional and mnemonic deficits associated with infectious disease in humans

BACKGROUND: Infectious diseases are accompanied by behavioural and psychological changes that suggest the implication of the central nervous system. Among them, cognitive alterations have been reported, but their specificity and implication in everyday life are still largely unclear. The purpose of the present study was to evaluate and specify the everyday memory disturbances in sick human subjects and to determinate the role of fever in the appearance of these alterations. METHODS: The study was carried out in a military training centre for naval recruits. Ninety-one volunteer subjects, healthy (N = 30) or suffering from flu-like syndrome, with (N = 29) or without fever (N = 32), participated in this experiment and were administered a cognitive test (the ERBMT) according to a cross-sectional design for assessing various aspects of everyday memory. RESULTS: Sick subjects were specifically impaired in daily memory tasks that require the temporary management of a large amount of information. This impairment was similar for the feverish and apyretic sick subjects who both differed from the controls. CONCLUSION: These findings suggest that infectious disease disturbs the complex cognitive processes that might be associated with attentional functions. Moreover, these results show that fever is not a necessary condition for the appearance of these cognitive disturbances.     

呼吸道合胞病毒抗原酶联免疫吸附测定检测方法的建立及应用

目的建它呼吸道合胞病毒抗原酶联免疫吸附测定(ELISA)检测方法,应用其对来源于本院的临床样本进行检测.方法建立ELISA方法,检测标本中的呼吸道合胞病毒,与呼吸道合胞病毒细胞培养检测方法进行对照,并利用该方法进行该病毒2007年在广州市的流行性分析.结果本方法的灵敏度略高于呼吸道合胞病毒的细胞培养检测方法,对甲型流感病毒(H3N2亚型、H1N1亚型)、乙型流感病毒、副流感病毒(Ⅰ型、Ⅲ型)、呼吸道腺病毒(Ⅲ型、Ⅶ型)无特异性反应.结论本呼吸道合胞病毒抗原ELISA检测方法可用于呼吸道合胞病毒感染的临床诊断和鉴别诊断.