Dietary intakes differ between renal transplant recipients living in patient hotels versus home.

OBJECTIVE: To compare dietary intake and health-related quality of life approximately 6 to 10 weeks after renal transplantation in patients living at home and at a patient hotel, and how the patients were following a heart-healthy diet according to the current American Heart Association guidelines. DESIGN: Cross-sectional observational study. SETTING: Outpatient clinic at Rikshospitalet University Hospital, Norway. PATIENTS: Forty renal transplant patients, 20 patients (14 men and 6 women) in both groups. There were 4 diabetic patients in each group. METHODS: Dietary intake was assessed by 4-day dietary records. Health-related quality of life was investigated by the SF-36 questionnaire. The main outcome variables were daily energy intake and intakes of protein, total fat, saturated fat, cholesterol, fiber, and fruit and vegetables. The variables were tested by 2-sample t-tests, and significance was set at.05. RESULTS: There was no statistically significant difference in daily energy intake between the groups (P =.08), but there were significantly higher daily intakes of protein (P =.003), total fat (P =.03), monounsaturated fat (P =.02), cholesterol (P =.04), fiber (P =.02), calcium (P =.03), and fruit and vegetables (P =.03) in the group living at the patient hotel. The mean intake of saturated fat was 14.5% of total energy in the group living at home and 14.6% in the group living at the patient hotel. There were no significant differences in health-related quality of life between the groups. CONCLUSION: The results suggest that there are differences in dietary intake in renal transplant patients living at home compared with those at a patient hotel. It seems that neither of the groups follows current guidelines for reducing the risk of cardiovascular disease.     

A Qualitative Study of the Difficulties of Smoking Cessation; Health Care Professionals'' and Smokers'' Pints of View

AbstractObjective: To obtain a deeper understanding of smokers' feelings and to establish co-operative networking groups,the opinions about smoking cessation of health careprofessionals and smokers were studied.Design: Focus group discussions were held in order to gainideas and tools to be used in smoking cessation work, inparticular in network groups. Two focus group discussions forhealth care professionals (n = 7) and one focus groupdiscussion for ex-smokers/smokers (n = 3) were held.Results: The study suggests that problems exist in smokingcessation work among health care professionals. The mainissues among the health care professionals were lack ofmotivation and consistency of approach. Informationconcerning the health risk related to smoking no longerreaches people. New ways of health promotion are desired.Smokers feel that lack of positive support and nicotinedependence are the main problems in their attempts to quit.Conclusions: Society and smokers have the same goal:smoking cessation. However, both parties do not seem toagree on ways of achieving this goal. A local network amonghealth care professionals could motivate and give rise to newmethods of smoking cessation counselling. Positive supportand nicotine replacement therapy could significantlyimprove smokers' success rates. Trained personnel havebetter opportunities for meeting smokers and that is whycessation should be part of the core curriculum and basictraining for health care professionals.     

Occupational well-being of school staff members: a structural equation model

This study aimed to develop a theoretical basis for the promotion of school staff's occupational well-being. The 'Content Model for the Promotion of School Community Staff's Occupational Well-being' describes the four aspects of the promotion of occupational well-being ('working conditions', 'worker and work', 'working community' and 'professional competence') as well as the functionality and structure of the model. The content model was examined empirically by means of a structural equation model. The project was developed with school staff and occupational health nurses and implemented in 2001-2004. The target group consisted of the staff of 12 comprehensive schools in Eastern Finland in 2002 (n = 211) and 2004 (n = 266). The data were collected using a 'well-being at your work index' questionnaire at both times. A structural equation model for the school staff's occupational well-being, i.e. the 'Occupational Well-being of School Staff Model' (baseline OWSS Model: Study I in the year 2002), was produced. The model was tested with the 2004 data. Based on this, the model was further developed into the final OWSS Model (Study II). The theoretical Content Model for the Promotion of School Community Staff's Occupational Well-being can be used as a framework for planning, implementing and evaluating school staff's occupational well-being.     

Comparison of the osteogenic capacity of minipig and human bone marrow‐derived mesenchymal stem cells

Minipigs are a recommended large animal model for preclinical testing of human orthopedic implants. Mesenchymal stem cells (MSCs) are the key repair cells in bone healing and implant osseointegration, but the osteogenic capacity of minipig MSCs is incompletely known. The aim of this study was to isolate and characterize minipig bone marrow (BM) and peripheral blood (PB) MSCs in comparison to human BM‐MSCs. BM sample was aspirated from posterior iliac crest of five male Göttingen minipigs (age 15 ± 1 months). PB sample was drawn for isolation of circulating MSCs. MSCs were selected by plastic‐adherence as originally described by Friedenstein. Cell morphology, colony formation, proliferation, surface marker expression, and differentiation were examined. Human BM‐MSCs were isolated and cultured from adult fracture patients (n = 13, age 19–60 years) using identical techniques. MSCs were found in all minipig BM samples, but no circulating MSCs could be detected. Minipig BM‐MSCs had similar morphology, proliferation, and colony formation capacities as human BM‐MSCs. Unexpectedly, minipig BM‐MSCs had a significantly lower ability than human BM‐MSCs to form differentiated and functional osteoblasts. This observation emphasizes the need for species‐specific optimization of MSC culture protocol before direct systematic comparison of MSCs between human and various preclinical large animal models can be made. © 2012 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 30:1019–1025, 2012     

School staff members' and occupational health nurses' evaluation of the promotion of occupational well-being – with good planning to better practice

This paper describes occupational health nurses' and school staff members' experiences of work ability maintenance carried out at schools and the development of ideas to promote the collaboration between occupational health care and school community and to enhance work ability maintenance. The data were collected in a baseline situation of an action research project to further plan and develop activities. The data were analysed by inductive content analysis. According to the results, school community staff members' work ability maintenance focused on the employee, the school community, school work and the working conditions as well as professional competence. The practical actions involved some individual and school-specific variation, focusing on actions to maintain individual and physical work ability. It seems that the collaboration between the school community and occupational health service for work ability maintenance took place at the individual level, but an obvious need for more structural collaboration emerged by several suggestions made by the participants (e.g. better information exchange between the school and occupational health care, improved collaboration between the school staff and the co-operative partners). The progress in collaboration may lead towards spontaneous collaboration, in which case both actors have the same target and work in a planned, continuous and natural way to ensure work ability maintenance in the school community.     

Dialysate leukocytes, sICAM-1, hyaluronan and IL-6: predictors of outcome of peritonitis?

BACKGROUND/AIMS: Despite effective antibiotic therapy, peritonitis still remains a major problem in peritoneal dialysis (PD). The aim of the present study was to investigate changes of CRP, dialysate leukocytes and IL-6, hyaluronan (HA) and sICAM-1 in dialysate during and after peritonitis and their association to the outcome of peritonitis. METHODS: Dialysate IL-6, HA and sICAM-1 were measured at the onset and on day 4, at the end of the treatment and 2 months after onset of peritonitis. Furthermore, CRP and dialysate leukocytes were measured on days 1-4. RESULTS: All measured soluble factors were higher on the first and fourth day than at the end of the treatment. sICAM-1 and HA were lower at the end of the treatment in patients who later had a relapse/re-infection. IL-6 remained higher 2 months after clinically cured peritonitis. CRP and dialysate leukocytes were higher on day 4 in patients with poor outcome. CONCLUSIONS: Peritonitis causes increased excretion of soluble factors. Low concentrations of sICAM-1 and HA at the end of the treatment were negative prognostic indicators. Higher IL-6 levels after peritonitis could be a sign of ongoing inflammation in the peritoneal membrane. Delayed decrease in CRP and dialysate leukocytes may indicate poor outcome.     

Notch restricts lymphatic vessel sprouting induced by vascular endothelial growth factor

Notch signaling plays a central role in cell-fate determination, and its role in lateral inhibition in angiogenic sprouting is well established. However, the role of Notch signaling in lymphangiogenesis, the growth of lymphatic vessels, is poorly understood. Here we demonstrate Notch pathway activity in lymphatic endothelial cells (LECs), as well as induction of delta-like ligand 4 (Dll4) and Notch target genes on stimulation with VEGF or VEGF-C. Suppression of Notch signaling by a soluble form of Dll4 (Dll4-Fc) synergized with VEGF in inducing LEC sprouting in 3-dimensional (3D) fibrin gel assays. Expression of Dll4-Fc in adult mouse ears promoted lymphangiogenesis, which was augmented by coexpressing VEGF. Lymphangiogenesis triggered by Notch inhibition was suppressed by a monoclonal VEGFR-2 Ab as well as soluble VEGF and VEGF-C/VEGF-D ligand traps. LECs transduced with Dll4 preferentially adopted the tip cell position over nontransduced cells in 3D sprouting assays, suggesting an analogous role for Dll4/Notch in lymphatic and blood vessel sprouting. These results indicate that the Notch pathway controls lymphatic endothelial quiescence, and explain why LECs are poorly responsive to VEGF compared with VEGF-C. Understanding the role of the Notch pathway in lymphangiogenesis provides further insight for the therapeutic manipulation of the lymphatic vessels.     

Cystatin C expression is increased in the hippocampus following photothrombotic stroke in rat

Stroke is a major cause of epilepsy, but the molecular mechanisms underlying post-stroke epileptogenesis are unknown. The expression of cystatin C, a cysteine protease inhibitor, is increased in the hippocampus during status epilepticus (SE)-induced epileptogenesis, and regulates both cell death and birth. To test the hypothesis that increased cystatin C expression represents a common molecular alteration induced by epileptogenic brain insults, we investigated the time course, cellular localization, and association of cystatin C expression with neuronal damage during post-stroke epileptogenesis. Stroke was induced with photothrombosis, which leads to epilepsy in approximately 20-30% of rats. Cystatin C expression was increased in the CA1 area of the hippocampus 4 days after photothrombosis, when the diameter of the lesion was the largest. Double-labeling and confocal analysis indicated that cystatin C was expressed in astrocytes and microglia. Unlike after SE, cystatin C expression did not change in the dentate gyrus. Also, increased cystatin C expression was not associated with neurodegeneration, which was demonstrated as an absence of Fluoro Jade B-positive cells in adjacent sections. The present study provides evidence that cystatin C may be involved in cellular alterations that occur after an epileptogenic insult, not only after SE but also after photothrombotic stroke.