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[Scientific basis and professional concept of instituting a medical program of active recreation].

Physical activity is essential to health and should be exercised in accordance with one's functional and health state. Among the most advanced forms of programmed physical activity is medically programmed active leisure (MPAL). The implementation of MPAL in practice relies on research and on scientifically based concepts and attitudes which control the selection of persons for and their inclusion in MPAL. In Croatia MPAL is a form of specific care for worker's health, which is conducted in compliance with the health care and health insurance acts.

Exercise

Legal issues in the delivery of worksite health promotion.

Employee health promotion programs typically involve one or more of the following: (1) education programs, (2) cholesterol, blood pressure, diabetes, or other similar screening programs, (3) smoking cessation programs, (4) drug/alcohol testing and counseling programs, (5) exercise facility or activity programs, and (6) recreational activity programs. The authors examine potential legal implications of these activities. This chapter is intended for those attempting to define and establish these programs or to focus and operate them without undue conflict or legal system involvement.

Health Education

Activation of programmed cell death by recombinant human tumor necrosis factor plus topoisomerase II-targeted drugs in L929 tumor cells.

The mechanism of death induced by recombinant human tumor necrosis factor (rHuTNF) in L929 tumor cells of C3H mice was investigated. Treatment with rHuTNF led to fragmentation of DNA into nucleosomal oligomers and to induction of the expression of TRPM-2, a programmed cell death-associated gene. Both events preceded cell death by several hours. Treatment with DNA topoisomerase II inhibitors accelerated both the rHuTNF-mediated DNA fragmentation and the elevation in TRPM-2 messenger RNA levels. These results suggest that rHuTNF exerts its cytotoxicity on L929 cells by activating programmed cell death, leading to apoptosis, and that topoisomerase II inhibitors enhance rHuTNF-mediated cytotoxicity by accelerating this process.

Animals

Challenging residents to assume maximal responsibilities in homes for the aged.

A program for activating residents of homes for the aged to assume maximal responsibilities is described. Promoting maximal physical and mental health through various modalities including activity programs, appropriate exercise and participation in democratic self-government mechanisms, will result in a happier, healthier population of residents in institutions for the aged. The increased demands on staff time and patience will be compensated for by relief of the too-frequent feelings of hopelessness and boredom endemic among the staff of long-term care facilities. Such programs demand constant effort by all staff members, patients, volunteers and relatives because if they succumb to the usual human dislike of persistency, short-term gains can easily be lost.

Aged

Outcome for court-referred drug-abusing male adolescents of an alternative activity treatment program in a vocational high school setting.

This is a report of outcome of an alternative activity treatment program, consisting of off-campus supportive life skill activities, in a private vocational high school for court-adjudicated delinquent boys. A total of 130 adolescent male drug abusing student-clients were evaluated at follow-up, 22 months after admission to the day school treatment program. The determination of graduation vs. dropping out was made 3 years after admission to the study. The sample was 75% white, 21% black, and 4% Hispanic. Eighty-two percent were from 16 to 18 years of age, but only 24% had completed the 10th grade. The mean number of different types of drugs "ever used" was 5.87, and the mean number of drug sale offenses was 4.4. Sixty-one percent had been incarcerated (overnight or longer). A comprehensive assessment was administered at admission and at follow-up. The findings developed by paired t-test, comparing the student-clients' self-reports at follow-up evaluation with their self-reports at pretreatment, indicated significant improvement in numerous problem areas of behavior, adjustment, and attitude measured, except that no significant reduction in illicit drug use occurred. The improvement, however, was more related to the vocational training and job placement program and the general milieu of the school than to the off-campus supportive life skills program. The latter was shown to have a highly significant positive association with outcome as measured by success in graduating from high school and a significant positive association to improvement in "personal adjustment" (reduction in personal problems and increase in interpersonal maturity).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent

Physical activities: teaming up patients and programs.

Physical activities programs are suggested for the average deconditioned individual over 35 years of age. They involve noncontact, noncompetitive aerobic activities which require minimal expense. Their purpose is to delay to some degree the progression of the degenerative diseases associated with aging and inactivity. The best activities are walking, running, bicycling, or other exercise in which a sustained cardiac rate of 70% of the individual's work capacity is achieved.

Adult

Activation-driven programmed cell death and T cell receptor zeta eta expression.

Activation of spontaneously dividing T cell hybridomas induces interleukin-2 (IL-2) production, a cell cycle block, and programmed cell death. T cell hybridomas that express the T cell antigen receptor (TCR) zeta homodimer (zeta 2), but not the TCR zeta eta heterodimer, were studied. The zeta eta- cells produced little or no inositol phosphates (IP) when stimulated with antigen. In most cases the hydrolysis of phosphoinositides was also impaired after stimulation with antibody to CD3, although one zeta eta- cell produced normal concentrations of IP. The zeta eta- cells slowed their growth and secreted IL-2 in response to both stimuli. However, the zeta eta- cells did not die after activation with antigen. Since activated thymocytes also undergo programmed cell death, these results may have important implications for the role of the zeta eta.TCR in negative selection.

Animals

Activation of monocytes--more than one process. Differential effect of cytokines on monocytes.

Monocytes and macrophages respond to a number of exogenous agents by alterations in metabolism and gene expression in a process loosely called 'activation'. The question arises whether these alterations in cellular activity are the pleiotropic effects of one programmed activation process or result from separately programmed activation pathways. We report that certain cytokines (interleukin 1 (IL-1 alpha, IL-1 beta) and interleukin 2 (IL-2] which all activate monocytes, induce the synthesis of thromboplastin (TPL) and (IL-1 beta only) factor VII. Interferon-gamma (IFN-gamma) and tumour necrosis factor alpha (TNF alpha) do not induce monocyte procoagulant activity, although they both activate monocytes in several respects. Our data thus show that different states of activation are induced. Similar observations have been made by others using different systems.

Biological Products

Growth factors and membrane depolarization activate distinct programs of early response gene expression: dissociation of fos and jun induction.

A set of early response genes has been identified whose transcription in fibroblasts is rapidly induced in response to growth factors. Prototype members of this group, c-fos and c-jun, encode products that form a heterodimer and have been implicated in the regulation of gene expression and cell growth. It is thought that other early response genes also encode critical mediators of the cell's response to external stimuli. We have used PC12 pheochromocytoma cells as a model system to test the hypothesis that different extracellular signals induce distinct patterns of expression of early response genes. Our results indicate that membrane depolarization, induced either by potassium chloride or by the neurotransmitter analog nicotine, activates a program of gene expression distinct from that activated by nerve growth factor or epidermal growth factor. Notably, c-fos and c-jun activation can be dissociated; whereas c-jun is coinduced with c-fos and jun-B after growth factor stimulation, membrane depolarization activates c-fos and jun-B without stimulating c-jun. Fos may therefore form transcription complexes with alternative cofactors under different stimulation conditions. nur/77 and zif/268, which encode putative transcription factors, also show markedly different responses to growth factors and depolarization. We conclude that multiple nonconvergent signal transduction pathways control early response gene expression. Our findings also indicate that the diversity and specificity of cellular response to environmental change can be accounted for by the differential combinatorial induction of a relatively small number of early response genes.

Animals

The Veterans Administration Northwest Regional Health Services Research and Development Field Program: organization, activities, and early outcomes.

In 1982, the Veterans Administration established Health Services Research field programs in each of the six VA regions. Herein, we describe the historical origins, organization, responsibilities, activities, and early accomplishments of one of these programs--the Northwest Regional HSR&D field program. Special reference is made to this program's commitment to health services research relevant to geriatrics and gerontology, including the development of a system-wide agenda for research, information syntheses in geriatrics-relevant health services research topics, and the conduct of funded projects pertinent to care of the elderly. The importance of a medical center location for the field programs is discussed, and early indications of institutional impact are described.

Aged

Activation of programmed cell death in the rat ventral prostate after castration.

The rapid involution of the rat ventral prostate after castration is an active process initiated by removal of the inhibitory effects of androgen on prostatic cell death. The present studies demonstrate that after castration-induced androgen deprivation a series of temporally discrete biochemical events are activated which result in the rapid programmed death of the subset of androgen-dependent cells within the rat ventral prostate. These biochemical steps involve 1) rapid loss of nuclear androgen receptor retention; by 12 h after castration, androgen receptors are no longer detectable in ventral prostatic nuclei; 2) an initial fragmentation of nuclear DNA into low mol wt (less than 1000 basepairs) nucleosomal oligomers which lack intranucleosomal break points; and 3) eventual complete digestion of these nucleosomal oligomers into component nucleotides. Additional studies demonstrate that activation of a Ca2+-Mg2+-dependent endonuclease is associated with this DNA fragmentation. By 4 days after castration, maximal DNA fragmentation is obtained, with 15% of the total nuclear DNA extractable as low mol wt fragments. Proteolytic enzymes are apparently not involved initially in this process, suggesting that DNA fragmentation is a discrete event in, rather than a result of, cell death. Flow cytometric analysis of nuclear DNA content demonstrated that each day after castration, a subpopulation of androgen-dependent cells in rat ventral prostate fragmented all of their genomic DNA, as opposed to the whole population of cells fragmenting an increasing portion of their DNA daily.

Animals