Efficacy and costs of a workplace wellness programme

BACKGROUND

Research investigating the efficacy of workplace wellness programmes to promote exercise, and by extension, reduce obesity and increase productivity has proliferated in recent years. Although preliminary work is encouraging, more work is needed.

AIMS

To evaluate the effects and overall cost of a workplace exercise programme on multiple physical outcomes, including body mass index, aerobic fitness and muscular fitness.

METHODS

Data from the Bruin Health Improvement Programme .5 (BHIP) between August 2013 and July 2018 were analysed. BHIP is a 12-week workplace wellness programme that assesses multiple areas of physical and mental health. For this study, changes in weight, waist-to-hip ratio, aerobic fitness and muscular endurance were analysed using paired samples t-tests and chi-squared tests. Using results from a prior analysis of Medical Expenditure Panel Survey, the estimated medical expenditure savings associated with weight loss were also analysed.

RESULTS

A total of 518 participants (84% female) took part in the BHIP programme (mean age = 41 years, SD = 1.17). There were significant decreases in all anthropometric indices and significant increases in all fitness outcomes (P < 0.01) from baseline to follow-up. Estimated programme cost per participant, per session was $473 US Dollars (USD), and weight loss is estimated to reduce annual medical care costs by ~$2200 USD.

CONCLUSIONS

Results showed significant improvements in all physical outcomes of interest. Additionally, there appears to be an inverse relationship between improvements in employee health and employer healthcare costs. Strengths, limitations and future directions are discussed.

IntraperitonealInsulin: A Protocol for Administration during CAPD and Review of Published Protocols

For many diabetics in end-stage renal failure, the initial therapy they receive will be continuous ambulatory peritoneal dialysis (CAPD) together with i.p. insulin. To date, all published protocols rely on empirical dosages based upon predialysis insulin requirements. A practical regimen for the institution of i.p. insulin administration during CAPD is described. The only endpoints used to determine insulin dosage were fasting plasma glucose 5 to 10 mmol/L and 2 h postprandial plasma glucose 8 to 15 mmol/L. An initial protocol related to body weight, dextrose content, volume, and timing of dialysate was based on a retrospective analysis of the results in our first 10 patients. Subsequently, a prospective assessment in an additional 22 patients confirmed the effectiveness of the regimen. The following protocol is recommended for the institution of i.p. insulin therapy in patients undergoing CAPD: Preprandial exchanges 1.36% dextrose-0.175 U/L dialysate/kg body weight 3.86% dextrose-0.25 U/L/kg Overnight exchanges 1.36% dextrose-0.1 U/L/kg 3.86% dextrose-0.15 U/L/kg Further adjustment of insulin dosage is then made on the basis of four hourly plasma glucose profiles. Self-monitoring of capillary blood glucose is recommended.

Predicting pathogen-specific CD8 T cell immune responses from a modeling approach

The primary CD8 T cell immune response constitutes a major mechanism to fight an infection by intra-cellular pathogens. We aim at assessing whether pathogen-specific dynamical parameters of the CD8 T cell response can be identified, based on measurements of CD8 T cell counts, using a modeling approach. We generated experimental data consisting in CD8 T cell counts kinetics during the response to three different live intra-cellular pathogens: two viruses (influenza, vaccinia) injected intranasally, and one bacteria (Listeria monocytogenes) injected intravenously. All pathogens harbor the same antigen (NP68), but differ in their interaction with the host. In parallel, we developed a mathematical model describing the evolution of CD8 T cell counts and pathogen amount during an immune response. This model is characterized by 9 parameters and includes relevant feedback controls. The model outputs were compared with the three data series and an exhaustive estimation of the parameter values was performed. By focusing on the ability of the model to fit experimental data and to produce a CD8 T cell population mainly composed of memory cells at the end of the response, critical parameters were identified. We show that a small number of parameters (2-4) define the main features of the CD8 T cell immune response and are characteristic of a given pathogen. Among these parameters, two are related to the effector CD8 T cell mediated control of cell and pathogen death. The parameter associated with memory cell death is shown to play no relevant role during the main phases of the CD8 T cell response, yet it becomes essential when looking at the predictions of the model several months after the infection.

Capability maturity models for offshore organisational management

The goal setting regime imposed by the UK safety regulator has important implications for an organisation's ability to manage health and safety related risks. Existing approaches to safety assurance based on risk analysis and formal safety assessments are increasingly considered unlikely to create the step change improvement in safety to which the offshore industry aspires and alternative approaches are being considered. One approach, which addresses the important issue of organisational behaviour and which can be applied at a very early stage of design, is the capability maturity model (CMM). The paper describes the development of a design safety capability maturity model, outlining the key processes considered necessary to safety achievement, definition of maturity levels and scoring methods. The paper discusses how CMM is related to regulatory mechanisms and risk based decision making together with the potential of CMM to environmental risk management.

Inhibition of proteolysis by a cyclooxygenase inhibitor, indomethacin

The effect of indomethacin, a non-steroidal anti-inflammatory drug upon purified calpain has been studied. Also, its effects upon Ca2+-mediated degradation of cytoskeletal proteins (neurofilament) in spinal cord homogenate has been investigated. A dose-dependent inhibition of purified calpain activity was observed. A 50% inhibition of 14C-caseinolytic activity was obtained with less than 1.1 mM of indomethacin while the activity was completely inhibited at 3.3 mM concentration. The inhibitory effect of ketorlac, another non-steroidal anti-inflammatory drug, upon calpain was weaker than that of indomethacin. The degradation of myelin basic protein (MBP) by cathepsin B, a lysosomal cysteine protease, was significantly inhibited by indomethacin. It also inhibited the Ca2+-mediated degradation of neurofilament protein (NFP) in spinal cord homogenate. The extent of NFP degradation was analyzed by SDS-PAGE and the inhibition shown by indomethacin was weaker than that observed with leupeptin and the calpain inhibitor E64-d. The inhibitory effect of indomethacin on the activity of multicatalytic proteinase complex was negligible. These results suggest that indomethacin, a non-steroidal anti-inflammatory drug and cyclooxygenase inhibitor also inhibits proteinases, including cathepsin B and calpain.

Explaining demographic trends in teenage fertility, 1980-1995

CONTEXT

The teenage birthrate rose sharply in the late 1980s and early 1990s, and then declined in the 1990s. Attempts to explain these changes have failed to account for the changing environment in which adolescents live.

METHODS

Data from the 1995 cycle of the National Survey of Family Growth are used to compare the experiences of three cohorts of teenage females in the 1980s and 1990s. A life-course framework is used to examine trends in characteristics of adolescents and adolescent mothers over time, and event-history analyses are conducted to determine which characteristics are associated with the risk of a teenage birth in each cohort. A comparison of the predicted probabilities from hazard analyses shows how changes in the context of adolescence across the cohorts help explain changes in the probability of a teenage birth over time.

RESULTS

Factors associated with the increase in the teenage birthrate in the 1980s include negative changes in family environments (such as increases in family disruption) and an increase in the proportion of teenagers having sex at an early age. Factors associated with the recent decline in the teenage birthrate include positive changes in family environments (such as improvements in maternal education), formal sex education programs and discussions with parents about sex, stabilization in the proportion of teenagers having sex at an early age and improved contraceptive use at first sex. Sexually experienced teenagers in the mid- 1990s were younger, on average, at first sex than were their counterparts in the 1980s, and thus are at an increased risk of a teenage birth. Partner factors, including nonvoluntary first sexual experiences, were not associated with the risk of a adolescent birth in any cohort.

CONCLUSIONS

Programs to further reduce the teenage birthrate should take into account the role of family stability, parent-child communication, sex education programs and engagement in school, as well as attempt to reduce the proportion of adolescents having sex at an early age and to improve contraceptive use. The increasing risk levels among sexually experienced teenagers suggest that current programs may be reducing sexual activity among adolescents already at a low risk of a teenage birth, without addressing the needs of those at highest risk.

A new mechanism of methylprednisolone and other corticosteroids action demonstrated in vitro: inhibition of a proteinase (calpain) prevents myelin and cytoskeletal protein degradation

The affect of methylprednisolone (MP), an anti-inflammatory drug upon purified calpain and the Ca2+-mediated degradation of endogenous proteins of spinal cord homogenate in vitro has been examined. Activity of calpain purified from rabbit muscle was greatly inhibited in a dose-dependent fashion by MP. A 50% inhibition was obtained with 3.2 mM MP concentration and the activity was inhibited further (80%) at 8.1 mM. More potent inhibition of the purified enzyme (70-80%) was produced by dexamethasone (3.9 mM) and prednisolone (4.1 mM). Calpain-mediated degradation of myelin basic protein (MBP) was also inhibited by MP as was cathepsin B-mediated MBP breakdown. The effect of MP and other steroids upon calcium-mediated degradation of spinal cord homogenate was also evaluated. SDS-PAGE analysis revealed significant inhibition of neurofilament protein breakdown by MP and other corticosteroids. This inhibitory effect was much less than that exerted by the calpain inhibitors calpeptin and/or E64-d. These results indicate that MP acts as a proteinase (calpain) inhibitor and define a new mechanism for its actions.

Early Winter Habitat Use by Mountain Caribou in the North Cariboo and Columbia Mountains, British Columbia

Winter habitat use was compared between two mountain caribou (Rangifer tarandus caribou) populations in British Columbia. Regional differences were apparent during November and December. Radio-collared caribou inhabiting the gentle plateaus of the northern Cariboo Mountains, near Prince George, B.C. primarily used mid-elevation balsam-spruce stands on moderate slopes (&lt;30%). In contrast, radio-collared caribou in the North Columbia Mountains, near Revelstoke, B.C. used low elevation hemlock-cedar stands and relatively steeper slopes (&gt;30%). To adequately address habitat requirements of caribou, forest management plans should incorporate varying regional and seasonal habitat use patterns. Hypotheses on observed differences in habitat use are discussed.

Susceptibility of myelin proteins to a neutral endoproteinase: the degradation of myelin basic protein (MBP) and P2 protein by purified bovine brain multicatalytic proteinase complex (MPC)

Multicatalytic proteinase complex (MPC) was isolated from bovine brain and the susceptibility of myelin basic protein (MBP) and P2 protein of bovine central and peripheral nervous system was examined. SDS-polyacrylamide electrophoretic analysis of purified MPC revealed protein bands of molecular weight ranging from 22-35 kDa. The enzyme is activated by SDS at a concentration less than 0.01%. Upon incubation with MPC, purified MBP and P2 proteins were degraded into smaller fragments. There was a 57% and 100% loss of MBP at 2 and 6 hours of incubation. The P2 protein which is not susceptible to any endogenous non-lysosomal enzyme thus far studied was digested into small peptide fragments only in the presence of SDS (0.01%) and not in its absence. These results indicate that MPC which is active at physiological conditions may have a role in the turnover of myelin proteins and in demyelinating diseases.

Molecular comparison of mouse Thy-1 and its human homologue

Physicochemical techniques were used to verify previous immunochemical studies showing homology of the human Thy-1 (formerly p25) antigen and the murine Thy-1 or theta antigen. Peptide maps and amino acid compositions showed close similarity between these two proteins; however, they were not identical. These data confirm that the p25 antigen is the human homologue of mouse Thy-1.