Sexuality and the satisfaction of sexual needs. A study on the attitudes of aged home-nursing clients

This article discusses conceptions of sexuality and the satisfaction of sexual needs in a sample of aged home nursing patients (N = 50) in a small rural town in Finland. The purpose of the study, which was carried out as part of a nursing development project in the form of action research, was to gain a deeper understanding of the satisfaction of basic human needs and problems of need-satisfaction in aged people, particularly in the domain of sexual needs. The data were collected using a semi-structured questionnaire, which was designed primarily on the basis of the need theories of Yura & Walsh and Orem. Negative attitudes towards sexual needs were found in more than half of the aged respondents; they did not consider it proper for aged people to have an active sex life. One-quarter felt that sexual needs and desires were shameful and sinful. Only less than one-quarter had positive attitudes towards sex. The majority of the respondents felt that they could freely and confidently talk about sex with the nursing staff, but only less than one-quarter were willing to do so. Almost all had some need to show affection to another person. The majority accepted their own self-image, but half were not satisfied with their physical appearance.     

Sociodemographic differences in myocardial infarction risk perceptions among people with coronary heart disease

This study examines sociodemographic differences in myocardial infarction (MI) risk perceptions among people with coronary heart disease (CHD) (N = 3130). Two variables for comparative risk perceptions were computed: (1) own risk compared to that of an average person; and (2) own risk compared to that of an average person with CHD. Comparative optimism in MI risk perceptions was common, particularly among men and those with higher education. CHD severity and psychosocial resources mediated these sociodemographic differences. These results suggest challenges for secondary prevention in CHD, particularly regarding psychosocial interventions for communicating risk information and supporting lifestyle adjustments.     

Avian influenza risk perception, Europe and Asia

During autumn 2005, we conducted 3,436 interviews in European and Asian countries. We found risk perceptions of avian influenza to be at an intermediate level and beliefs of efficacy to be slightly lower. Risk perceptions were higher in Europe than in Asia; efficacy [corrected] beliefs were lower in Europe than in Asia.     

Radiographic progression is getting milder in patients with early rheumatoid arthritis. Results of 3 cohorts over 5 years

OBJECTIVE: There is a common impression, rarely documented, that the outlook of patients with rheumatoid arthritis (RA) is different today compared to previous decades. We investigated the 5-year radiographic progression of 3 cohorts of patients with early RA enrolled in the 1980s and 1990s. METHODS: Patients with early RA were enrolled into 3 separate studies in 1983-85 (n = 58; Cohort A), 1988-89 (n = 77; Cohort B), and 1995-96 (n = 62; Cohort C) at one rheumatology center; all were subsequently treated actively with disease-modifying antirheumatic drugs according to the "sawtooth strategy" to control inflammation, and monitored regularly to collect data for evaluation of longterm outcome. Evaluation over 5 years included disease activity measures and medications. Radiographs of hands and feet taken at baseline and at 2 and 5 years were analyzed by Larsen score (0-100). RESULTS: Larsen score increased by a median of 12, 6, and 4 points by Year 5 in cohorts A, B, and C, respectively (p = 0.001), adjusted for age, sex, rheumatoid factor (+/-), and the baseline values for Larsen score and erythrocyte sedimentation rate. RF positivity and persistent high disease activity over 5 years were associated with greater progression of radiographic damage. CONCLUSION: Radiographic progression was greatest in the earliest cohort and mildest in the most recent cohort, a phenomenon that was also seen in the literature review. The reasons for the observation may include (1) improved therapy, (2) milder disease, and (3) patient selection.     

Acute central nervous system toxicity during treatment of pediatric acute lymphoblastic leukemia: phenotypes,risk factors and genotypes

Central nervous system (CNS) toxicity is common at diagnosis and during treatment of pediatric acute lymphoblastic leukemia (ALL). We studied CNS toxicity in 1,464 children aged 1.0–17.9 years, diagnosed with ALL and treated according to the Nordic Society of Pediatric Hematology and Oncology ALL2008 protocol. Genome-wide association studies, and a candidate single-nucleotide polymorphism (SNP; n=19) study were performed in 1,166 patients. Findings were validated in an independent Australian cohort of children with ALL (n=797) in whom two phenotypes were evaluated: diverse CNS toxicities (n=103) and methotrexate-related CNS toxicity (n=48). In total, 135/1,464 (9.2%) patients experienced CNS toxicity for a cumulative incidence of 8.7% (95% confidence interval: 7.31–10.20) at 12 months from diagnosis. Patients aged ≥10 years had a higher risk of CNS toxicity than had younger patients (16.3% vs. 7.4%; P<0.001). The most common CNS toxicities were posterior reversible encephalopathy syndrome (n=52, 43 with seizures), sinus venous thrombosis (n=28, 9 with seizures), and isolated seizures (n=16). The most significant SNP identified by the genome-wide association studies did not reach genomic significance (lowest P-value: 1.11x10^-6), but several were annotated in genes regulating neuronal functions. In candidate SNP analysis, ATXN1 rs68082256, related to epilepsy, was associated with seizures in patients <10 years (P=0.01). ATXN1 rs68082256 was validated in the Australian cohort with diverse CNS toxicities (P=0.04). The role of ATXN1 as well as the novel SNP in neurotoxicity in pediatric ALL should be further explored.     

Infants sleeping outdoors in a northern winter climate: skin temperature and duration of sleep

Aim: The aim of the study is to describe the relationships among thermal environment, skin temperatures and infants’ daytime outdoor sleep duration in northern winter conditions. Methods: This study is a cross‐over observational study. Skin temperatures of three‐month‐old infants were recorded from seven skin sites continuously throughout outdoor (n = 34) and indoor sleep (n = 33) in the families’ homes. The duration of the sleep was observed, and temperature and the air velocity of the environment were recorded. Results: Skin temperatures increased towards the end of indoor sleeping, whereas they decreased during outdoor sleeping. The cooling rate of mean skin temperature (T_sk) increased in lower outdoor temperatures (r_s = 0.628, p < 0.001) in spite of increased clothing. On some occasions, cold extremities were observed, suggesting slight deviations from thermoneutrality. Sleep time was 92 min longer in outdoors than in indoors. However, outdoor sleep duration was shortened when the cooling rate of T_sk increased (r_s = 0.611, p < 0.001). Conclusion: The longest sleep was recorded outdoors when the cooling rate of T_sk was minimal. Restriction of movements by clothing probably increases the length of sleep, and a cold environment makes swaddling possible without overheating. A decrease in ambient temperature increased the cooling rate, suggesting that the cold protection of the clothing compensated only partly for the increased heat loss.     

Promoting participation of informal caregivers in the hospital care of the elderly patient: informal caregivers' perceptions

A study to identify informal caregivers' perceptions of factors promoting or inhibiting their participation in the care of elderly patients was conducted An open-ended questionnaire was completed by 369 informal caregivers during 2-month periods in late 1991,1992 and 1993 Several factors related to the patient, informal caregiver, nurse and environment were identified The findings and implications for nursing are discussed The data presented here are from a larger study which is reported in earlier issues of the Journal of Advanced Nursing