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1.
Cynthia M. Bulik Rachael Flatt Afrouz Abbaspour Ian Carroll 《Psychiatry and clinical neurosciences》2019,73(9):518-525
Anorexia nervosa (AN) has one of the highest mortality rates of any psychiatric disorder. Treatments are often ineffective and relapse is common. Most research attempting to understand the underlying causes and maintenance factors of AN has focused on environmental contributions, yet there is much to be explored in terms of biological risk and maintenance factors. In this paper, we focus primarily on AN research related to genetics and the complex microbial community in the gut (intestinal microbiota), and how these impact our conceptualization of this disorder. Emerging research identifying significant negative genetic correlations between AN and obesity suggests that the conditions may represent ‘metabolic bookends’. The identification of underlying biological mechanisms may provide both insight into extreme weight dysregulation on both ends of the spectrum and new possible points of entry for AN treatment. Additionally, the reported microbial imbalance (dysbiosis) in the gut microbiota in AN patients, potentially due to a nutrient‐ and energy‐deprived gut environment, implies alterations in functional and metabolic capacity of the gut microbiome. The extent to which AN and obesity can also be considered to be ‘microbiome bookends’ requires further investigation. Finally, we discuss ongoing and future AN projects exploring the interplay between host genomics, the environment, and cumulative microbial genomes (microbiome) as well as interventions at the microbial and gut level. 相似文献
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The midwifery art has emphasised the uniqueness of human beings throughout its Nordic history. The educated Nordic midwife has in the last decade celebrated several hundred years of memories. This article studies how the key ideas of the midwifery art and patterns of ideas become evident in the zeitgeist from the beginning of the 19th century to the millennium in the Nordic countries. The legacy and pattern of ideas of the art of midwifery are interpreted in relation to the texts of the selected historical sources and based on Ricoeur's phenomenological-hermeneutic approach to the text and further to the dedication of understanding and interpretation. The historical sources refer to unprinted primary sources from historical archives and printed secondary and tertiary sources. The patterns of ideas include a tripartite whole: the true cultivation of the head, the philosophy and aesthetics of the hand, the strength of the heart and the drive of calling. These ideas open for unique visions and attest to the evident in modern midwives. Today's midwives have academic training with examinations, and the education is based on scientific evidence. The midwife profession is authorised by the state and supervised by the authorities. 相似文献
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Elizabeth R. Hoffman Margaret E. Bentley Robert M. Hamer Eric A. Hodges Dianne S. Ward Cynthia M. Bulik 《Maternal & child nutrition》2014,10(3):360-372
This preliminary study surveyed the feeding practices of mothers with eating disorder histories through evaluation of mothers' reported feeding styles, child diet composition and restrictive special approaches to feeding. For this non‐randomised cohort study, 25 mothers with eating disorder histories and 25 mothers with no history of an eating disorder with children ages 6–36 months were selected such that the groups were similar based on child age group and child sex. Mothers were compared on self‐reported feeding style using the Infant Feeding Styles Questionnaire and on child diet composition and special feeding approaches using a modified version of the Toddler Diet Questionnaire from the Women, Infants, and Children program. Mothers with eating disorder histories scored lower on the restrictive feeding style subscale than controls. No significant differences were detected between groups in child diet including the percentage of mothers who breastfed, duration of breastfeeding, age at solid food introduction, daily number of meals or snacks or daily frequency of consumption of fruits, vegetables or protein foods. Mothers with eating disorder histories were more likely to report taking a restrictive special approach to feeding such as limiting processed foods or feeding organic foods only. Although mothers with eating disorder histories may not differ greatly from control mothers in terms of child diet composition (smaller effects may not have been detected due to limited sample size), they may be more likely to take restrictive special approaches to feeding which mirror dietary rules common in individuals with eating disorders. 相似文献
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Lesley M Wilkes RN CM BSc GradDipEd MHPEd PhD Barbara Beale RN CM BAppSc MNurs 《International journal of nursing practice》2001,7(5):306-313
Nurses often experience positive and negative dimensions of caring for dying clients and their families. This project aimed to compare stress experienced by urban and rural community nurses working with palliative-care clients in the home. Participants included five nurses working in rural Australia and seven nurses working in an urban area. Transcribed data from unstructured audio-taped interviews were coded for common and contrasting themes, and a comparison was made of the stress experienced by the two groups of nurses. The major themes were role conflict and definition, family dynamics, time and workload. For both groups of nurses, the impact of family relationships and role conflict within the community impacted significantly to the stress they experienced. Debriefing opportunities for nurses to discuss stress, including educational and support sessions, is an essential component of best practice. Rural nurses had the additional stress of trying to provide a 24 h service over vast distances with a lack of financial resources. 相似文献
8.
Trichinella infection and clinical disease 总被引:1,自引:0,他引:1
Clausen MR; Meyer CN; Krantz T; Moser C; Gomme G; Kayser L; Albrectsen J; Kapel CM; Bygbjerg IC 《QJM : monthly journal of the Association of Physicians》1996,89(8):631-636
Trichinellosis is caused by ingestion of insufficiently cooked meat
contaminated with infective larvae of <it>Trichinella</it>
species. The clinical course is highly variable, ranging from no apparent
infection to severe and even fatal disease. We report two illustrative
cases of trichinellosis. Returning to Denmark a few days after having eaten
roasted pork in the Republic of Serbia, a female patient suffered from
severe vomiting, epigastric pain, diarrhoea, and later myalgia, generalized
oedema, and prostration. A biopsy showed heavy infestation with
<it>Trichinella spiralis</it>, 2000 larvae/g of muscle.
Life-threatening cardiopulmonary, renal and central nervous system
complications developed. The patient recovered after several months. Her
husband, who also ate the pork, did not have clinical symptoms, but an
increased eosinophil count and a single larva in a muscle biopsy confirmed
infection. The epidemiology, clinical manifestations, diagnosis, treatment
and prevention of trichinellosis are reviewed.
相似文献
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Autoantibodies against bactericidal/permeability-increasing protein in patients with cystic fibrosis 总被引:5,自引:0,他引:5
Zhao MH; Jayne DR; Ardiles LG; Culley F; Hodson ME; Lockwood CM 《QJM : monthly journal of the Association of Physicians》1996,89(4):259-265
Cystic fibrosis (CF), a genetic disorder, is characterized by chronic
pulmonary infection/inflammation which leads to respiratory failure. The
presence of anti-neutrophil cytoplasmic autoantibodies (ANCA) has
previously been observed in the sera of patients with CF. In view of the
known relationship of ANCA with primary vasculitis and of their putative
pathogenetic role in these disorders, we studied the presence, specificity
and isotype of ANCA and their clinical associations in 66 adult CF
patients. None of the 66 CF samples had autoantibodies to the major ANCA
antigens, proteinase 3 or myeloperoxidase. However, 60/66 (91%) CF samples
contained IgG and 55/66 (83%) IgA, autoantibodies to
bactericidal/permeability increasing protein (BPI), a recently
characterized ANCA specificity. All the IgA anti-BPI-positive samples were
also IgG anti-BPI-positive. The autoantibody specificity was confirmed by
inhibition assay and immunoblotting of CF sera against a neutrophil granule
preparation. Furthermore, in this cross-sectional study, anti-BPI levels
were inversely correlated with the observed reductions in FEV1 and FVC (IgA
anti-BPI and FEV1: r = 0.508, <it>p</it> < 0.0001), and
both IgG and IgA anti-BPI levels were higher in CF patients with secondary
vasculitis (<it>n</it> = 6) than in those without
(<it>p</it> < 0.05). ANCA with specificity for BPI were
present in the majority of CF sera in this study and autoimmune processes
may be associated with the development of pulmonary injury in CF.
相似文献