Schriftenschau

Ohne Zusammenfassung     

The Internet as a Mental Health Advisor in Germany—Results of a National Survey

The internet constitutes a popular source of health information. However, the use of the internet and other modern media in the domain of mental health remains widely unclear. This study aimed at exploring the readiness for seeking information online and making use of online counseling and media-assisted psychotherapy. A representative survey of N = 2411 Germans was conducted. Results indicated that more than one fourth of Germans would consider seeking help online in case of psychic strain. Participants reported that they would use the internet when needing to research about mental health topics and to communicate with persons concerned on internet forums. Only a small number of participants had already used psychological online-counseling. The majority of subjects reported not having known about the possibility of online counseling. However, the willingness to make use of this option in the future was in a medium range. Concerning the treatment of mental disorders, participants showed a clear preference toward conventional face-to-face treatment. Less than 10% of participants considered the use of treatment supported by mobile phones, the internet, or virtual realities as likely. Certainly, readiness was significantly higher in persons who were already using the relevant devices—mobile phones, computers, and the internet. In the future, there will presumably be an increasing demand for media-assisted psychological counseling and interventions. Members of the health care system should therefore prepare for current developments and help enlighten patients with regard to the possibilities, and also the potential risks of e-mental health.     

In vitro binding of estrogens by dietary fiber and the in vivo apparent digestibility tested in pigs.

Within the framework of experiments related to the association between dietary fiber and breast cancer an in vitro test system was used to study the binding of estrogens to various fibers (e.g. cholestyramin, lignin and cellulose) and fiber sources (e.g. wheat bran, cereals, seeds and legumes). Furthermore, the in vivo apparent digestibility of the different fiber sources was tested using a mobile nylon bag technique in intestine-cannulated pigs. Estradiol-17 beta (E2) bound more strongly to the various fibers than did estrone (E1), estriol or estrone-3-glucuronide. At increasing pH (greater than 7) binding of both E1 and E2 to wheat bran decreased significantly. Cholestyramine and lignin bound almost all estrogens present in the medium. Linseed (91%), oats (83%), barley chaff (88%) and wheat bran (82%) are other excellent binders of E2. Corn, rye and white wheat flour showed lower binding capacity with a relatively low affinity. Cereals with the highest percentage of lignin in the fiber (greater than 3%) were also the fiber sources with the lowest apparent digestibility. Estrogens bound with the highest affinity (relative to bovine serum albumin) to these fiber sources. Together with wheat bran and lignin, oats, linseed and soybean seem to be products with good perspectives for in vivo evaluation of the lowering effect of dietary fiber on estrogen exposure of estrogen-sensitive tissues.     

Functional Foods — Lebensmittel der Zukunft?: Maßgeschneiderte Ernährung

Functional foods might be helpful in improving the nutritional status and preventing certain diseases. In order to inform the consumer about the benefit of a product it will be necessary to enable scientifically proved health claims. These health claims have to be supported by studies and should make clear how a product can influence health. Only if there are proven facts, functional foods could establish on the market as foods of the future in the longer term beside the naturally healthful products. It will be of no use neither to the consumer nor to the food industry to promote these product group with exaggerated promises as a kind of miracle cure which can help against all diseases. The acceptance of the consumer will depend on credible product concepts. Another important precondition for functional foods is that there are absolutely no health risks associated with the consumption of these products. Recommendations regarding fortification and intake of functional foods must consider this aspect. Side effects by excessive doses or imbalances are to be avoided. The consumer should know that the point is not to take as much as possible of potentially healthful single substances but to show clearly that physiological dosages, which can also be attained by a higher intake of traditional food are associated with the best benefit‐risk relation, i.e. show the greatest benefit and minimal risk. In general functional foods do not resolve any nutritional problem. The effects are limited, especially if the nutrition is imbalanced (e.g. hyperenergetic, high fat). In these cases the addition of functional foods offers no or only small corrective effects. Functional foods represent no substitute for a fully balanced nourishment with a high amount of naturally healthy foods such as vegetables, fruits, whole grain products as well as milk and milk products.     

Prevalence and determinants of healthcare avoidance during the COVID-19 pandemic: A population-based cross-sectional study

BackgroundDuring the Coronavirus Disease 2019 (COVID-19) pandemic, the number of consultations and diagnoses in primary care and referrals to specialist care declined substantially compared to prepandemic levels. Beyond deferral of elective non-COVID-19 care by healthcare providers, it is unclear to what extent healthcare avoidance by community-dwelling individuals contributed to this decline in routine healthcare utilisation. Moreover, it is uncertain which specific symptoms were left unheeded by patients and which determinants predispose to healthcare avoidance in the general population. In this cross-sectional study, we assessed prevalence of healthcare avoidance during the pandemic from a patient perspective, including symptoms that were left unheeded, as well as determinants of healthcare avoidance.Methods and findingsOn April 20, 2020, a paper COVID-19 survey addressing healthcare utilisation, socioeconomic factors, mental and physical health, medication use, and COVID-19–specific symptoms was sent out to 8,732 participants from the population-based Rotterdam Study (response rate 73%). All questionnaires were returned before July 10, 2020. By hand, prevalence of healthcare avoidance was subsequently verified through free text analysis of medical records of general practitioners. Odds ratios (ORs) for avoidance were determined using logistic regression models, adjusted for age, sex, and history of chronic diseases. We found that 1,142 of 5,656 included participants (20.2%) reported having avoided healthcare. Of those, 414 participants (36.3%) reported symptoms that potentially warranted urgent evaluation, including limb weakness (13.6%), palpitations (10.8%), and chest pain (10.2%). Determinants related to avoidance were older age (adjusted OR 1.14 [95% confidence interval (CI) 1.08 to 1.21]), female sex (1.58 [1.38 to 1.82]), low educational level (primary education versus higher vocational/university 1.21 [1.01 to 1.46), poor self-appreciated health (per level decrease 2.00 [1.80 to 2.22]), unemployment (versus employed 2.29 [1.54 to 3.39]), smoking (1.34 [1.08 to 1.65]), concern about contracting COVID-19 (per level increase 1.28 [1.19 to 1.38]) and symptoms of depression (per point increase 1.13 [1.11 to 1.14]) and anxiety (per point increase 1.16 [1.14 to 1.18]). Study limitations included uncertainty about (perceived) severity of the reported symptoms and potentially limited generalisability given the ethnically homogeneous study population.ConclusionsIn this population-based cross-sectional study, 1 in 5 individuals avoided healthcare during lockdown in the COVID-19 pandemic, often for potentially urgent symptoms. Healthcare avoidance was strongly associated with female sex, fragile self-appreciated health, and high levels of depression and anxiety. These results emphasise the need for targeted public education urging these vulnerable patients to timely seek medical care for their symptoms to mitigate major health consequences.

Marije J. Splinter and colleagues assess the prevalence of healthcare avoidance during the COIVD-19 pandemic and investigate related determinants     

Species distribution and <Emphasis Type="Italic">in vitro</Emphasis> antifungal susceptibility of oral yeast isolates from Tanzanian HIV-infected patients with primary and recurrent oropharyngeal candidiasis

Background  

In Tanzania, little is known on the species distribution and antifungal susceptibility profiles of yeast isolates from HIV-infected patients with primary and recurrent oropharyngeal candidiasis.     

Nazca Booby (Sula granti) inputs maintain the terrestrial food web of Malpelo Island

Most of the known food webs are based on organic compounds provided by photoautotrophic organisms. The terrestrial ecosystem of Malpelo Island (Colombia) seems to be an exception, however, since it supports several trophic guilds without hosting an adequate amount of primary producers. It has been suggested that this apparent paradox might be explained by external inputs provided by seabirds, namely Nazca Boobies (Sula granti), forming a huge colony on Malpelo. This hypothesis has never been tested. Here, we present a first approach to quantify the significance of Nazca Booby inputs into the Malpelo ecosystem via excrement, second eggs/chicks (which are prone to die), and carcasses, respectively, during the major breeding season. The total input was calculated to amount to 171.6 t per breeding season, with excrements accounting for almost 99% (170 t) of this input. Second eggs/chicks contributed approximately 1.1 t (0.64%) and carcasses around 0.1 t (0.06%). These finding support the idea of the Nazca Booby facilitating a food chain that pairs the pelagic primary producers of the open ocean with the terrestrial consumers of an island. Species most strongly profiting from this process include three endemic lizard species (Anolis agassizi, Diploglossus millepunctatus, Phyllodactylus transversalis) and the land crab (Johngarthia malpilensis).     

Changes in land use and habitat availability affect the population genetic structure of Metrioptera roeselii (Orthoptera: Tettigoniidae)

The impact of temporal changes in habitat availability and land use on the present genetic diversity of the grassland katydid species Metrioptera roeselii was investigated in an extensively used agricultural landscape (Lahn-Dill-Bergland, Germany) based on six microsatellite loci. By integrating spatial and temporal dimensions, this study contrasts to conventional approaches that usually record landscape changes at discrete points in time. Molecular data suggest little geographical substructuring of the species. Nevertheless, time-dependent effects on genetic diversity in terms of observed heterozygosity and allelic richness within subpopulations were detected by general linear models (GLM), explaining up to 82 and 13%, respectively. The results indicated that allelic richness was significantly reduced with higher rates of land-use change. Contrastingly, the level of heterozygosity even increased with increasing land-use change, if this rate increase was accompanied by a reduction in grassland amount, while with an increase of grassland amount the level of heterozygosity remained similar. Furthermore, depending on the study site, heterozygosity was differently affected by grassland age of sampled patches and of the surrounding. This is presumably induced by contrasting levels of heterozygosity in combination with differing modes of dispersal due to habitat availability and site-specific matrix effects. The loss of genetic diversity due to frequent land-use change might result in a reduced ability to adapt to landscape change, which is even more relevant in intensively used agricultural landscapes and in the course of climate change.     

Ligand Binding and Crystal Structures of the Substrate-Binding Domain of the ABC Transporter OpuA

Background

The ABC transporter OpuA from Lactococcus lactis transports glycine betaine upon activation by threshold values of ionic strength. In this study, the ligand binding characteristics of purified OpuA in a detergent-solubilized state and of its substrate-binding domain produced as soluble protein (OpuAC) was characterized.

Principal Findings

The binding of glycine betaine to purified OpuA and OpuAC (K_D = 4–6 µM) did not show any salt dependence or cooperative effects, in contrast to the transport activity. OpuAC is highly specific for glycine betaine and the related proline betaine. Other compatible solutes like proline and carnitine bound with affinities that were 3 to 4 orders of magnitude lower. The low affinity substrates were not noticeably transported by membrane-reconstituted OpuA. OpuAC was crystallized in an open (1.9 Å) and closed-liganded (2.3 Å) conformation. The binding pocket is formed by three tryptophans (Trp-prism) coordinating the quaternary ammonium group of glycine betaine in the closed-liganded structure. Even though the binding site of OpuAC is identical to that of its B. subtilis homolog, the affinity for glycine betaine is 4-fold higher.

Conclusions

Ionic strength did not affect substrate binding to OpuA, indicating that regulation of transport is not at the level of substrate binding, but rather at the level of translocation. The overlap between the crystal structures of OpuAC from L.lactis and B.subtilis, comprising the classical Trp-prism, show that the differences observed in the binding affinities originate from outside of the ligand binding site.