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Zagreb, Croatia

Tate M.D.,University of Melbourne | Brooks A.G.,University of Melbourne | Reading P.C.,University of Melbourne | Reading P.C.,Collaborating Center
Immunology and Cell Biology | Year: 2011

Host-mediated recognition of mannose-rich glycans on the surface of pathogens represents an ancient mechanism of innate immune defence. In this study, we demonstrate that the virus strains that differ in the degree of N-linked glycosylation on the globular head of their hemagglutinin glycoprotein also differed in their (i) sensitivity to neutralization by a mannose-specific lectin in mouse lung fluids and (ii) ability to infect (and, therefore, to be destroyed) by airway macrophages. Virus strain BJx109 (H3N2), but not PR8 (H1N1), was sensitive to neutralization by mouse lung fluids and infected airway macrophages efficiently in vitro and these antiviral activities were blocked by mannan, a complex polymer of mannose residues. Although intranasal (i.n.) infection of mice with PR8 led to severe disease and mortality, mice infected with an equivalent dose of BJx109 displayed no signs of disease. However, i.n. treatment of BJx109-infected mice with mannan led to viral pneumonia, severe disease and death characterized by excessive virus replication, pulmonary inflammation, vascular leak and lung edema. Thus, when mannose-specific innate defences were inhibited in vivo, virus strain BJx109 induced severe viral pneumonia similar to that of PR8. Together, these findings highlight the importance of N-linked glycans as a target for recognition and destruction of influenza viruses by the innate immune system. Moreover, soluble and cell-associated lectins coordinate to modulate disease severity following influenza virus infection of mice. © 2011 Australasian Society for Immunology Inc. All rights reserved. Source

Jorgensen L.D.,Copenhagen University | Dahl B.,Copenhagen University | Pedersen T.,Copenhagen University | Tonnesen H.,Collaborating Center
Clinical Rehabilitation | Year: 2010

Objective: To evaluate the outcome after spinal surgery when adding prehabilitation to the early rehabilitation. Design: A randomized clinical study. Setting: Orthopaedic surgery department. Subject: Sixty patients scheduled for surgery followed by inpatient rehabilitation for degenerative lumbar disease. Interventions: The patients were computer randomized to prehabilitation and early rehabilitation (28 patients) or to standard care exclusively (32 patients). The intervention began two months prior to the operation. The prehabilitation included an intensive exercise programme and optimization of the analgesic treatment. Protein drinks were given the day before surgery. The early postoperative rehabilitation included balanced pain therapy with self-administered epidural analgesia, doubled intensified mobilization and protein supplements. Main measures: The outcome measurements were postoperative stay, complications, functionality, pain and satisfaction. Results: At operation the intervention group had improved function, assessed by Roland Morris Questionnaire (P = 0.001). After surgery the intervention group reached the recovery milestones faster than the control group (1-6 days versus 3-13, P =0.001), and left hospital earlier (5 (3-9) versus 7 (5-15) days, P =0.007). There was no difference in postoperative complications, adverse events, low back pain and radiating pain, timed up and go, sit-to-stand or in life quality. Patient satisfaction was significantly higher in the intervention group compared with the control group. Conclusion: The integrated programme of prehabilitation and early rehabilitation improved the outcome and shortened the hospital stay - without more complications, pain or dissatisfaction. Source

Lahiri S.,University of Massachusetts Lowell | Low C.,Collaborating Center | Barry M.,University of Massachusetts Lowell
Journal of Occupational and Environmental Medicine | Year: 2011

Objective: This article provides a convenient tool for companies to determine the costs and benefits of alternative interventions to prevent noise-induced hearing loss (NIHL). Methods: Contextualized for Singapore and in collaboration with Singapore's Ministry of Manpower, the Net-Cost model evaluates costs of intervention for equipment and labor, avoided costs of productivity losses and medical care, and productivity gains from the employer's economic perspective. Results: To pilot this approach, four case studies are presented, with varying degrees of economic benefits to the employer, including one in which multifactor productivity is the main driver. Conclusion: Although compliance agencies may not require economic analysis of NIHL, given scarce resources in a market-driven economy, this tool enables stakeholders to understand and compare the costs and benefits of NIHL interventions comprehensively and helps in determining risk management strategies. Copyright © 2011 by American College of Occupational and Environmental Medicine. Source

Makanjuola V.,University of Ibadan | Doku V.,Institute of Psychiatry | Jenkins R.,Collaborating Center | Jenkins R.,Institute of Psychiatry | Gureje O.,University of Ibadan
Mental Health in Family Medicine | Year: 2012

Background: There is a huge unmet need for mental health services in low- and middle-income countries such as Nigeria. It has been suggested that one way of bridging the service gap is to plan for the effective integration of mental health services into primary care. We present the impact of a one-week training workshop on attitudes to and knowledge of mental health issues among the tutors of community health workers. Method: An intensive one-week training workshop was organised for 24 trainers of community health officers from eight Nigerian states. The package was designed for the training of primary care workers in low-income countries by one of the authors (RJ). Participants completed a questionnaire designed to assess knowledge of and attitudes to mental health issues before and on completion of the training. Results: There were 24 participants with a mean age of 47 years (SD ± 4.89). Eighteen (75%) of the participants were female. The overall assessment of knowledge of mental health issues increased from a mean score of 60.4% before training to a mean score of 73.7% after the training (t-test = 4.48, P = 0.001). Conclusion: We reported a significant improvement in the knowledge and attitudes of tutors of community health workers following an intensive one-week training workshop. This, we believe, should improve the quality of pre-service mental health training for community health workers and hopefully impact on mental health service delivery at the primary healthcare level. © 2012 Radcliffe Publishing. Source

Bavdaz B.,Collaborating Center
Psychiatria Danubina | Year: 2011

The purpose of this project is to optimize early detection and early intervention in psychosis, in adolescents and young adults. The goal is to reduce DUP (Duration of Untreated Psychosis) through the integrated work of trans-disciplinary teams and youth-friendly (health and social) services. This should lead to a reduction of stigma and an improved accessibility to appropriate care. The aim we wish to achieve is a reduction of the incidence and prevalence of psychosis in the area covered by the Department of Mental Health of Trieste. © Medicinska naklada. Source

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