Association of the fatty acid profile of serum lipids with glucose and insulin metabolism during 2 fat-modified diets in subjects with impaired glucose tolerance

BACKGROUND: Both the amount and quality of dietary fat can modify glucose and insulin metabolism. OBJECTIVE: The objective was to examine the relation between serum lipid fatty acids and glucose metabolism before and after the consumption of a diet enriched in either monounsaturated (Mono diet) or polyunsaturated (Poly diet) fatty acids. DESIGN: After consuming a high-saturated-fat run-in diet for 3 wk, 31 subjects with impaired glucose tolerance were randomly counseled to consume the Mono [40% fat; 11%, 19%, and 8% of energy as saturated, monounsaturated, and polyunsaturated fatty acids (S:M:P), respectively] or the Poly (34% fat; S:M:P of 11%:10%:10%) diet for 8 wk. Serum lipid fatty acids were measured, and an intravenous-glucose-tolerance test was performed at baseline and at 8 wk. RESULTS: At baseline, a higher glucose effectiveness (S(G)) was associated with higher proportions of oleic (r = 0.57, P = 0.04) and alpha-linolenic (r = 0.64, P = 0.01) acids in phospholipids. An increase in the proportions of oleic and alpha-linolenic acids in phospholipids was associated with a decrease in fasting plasma glucose [r = -0.53 (P = 0.002) and r = -0.47 (P = 0.009), respectively]. An increase in the S(G) was associated with an increase in the proportion of oleic acid (r = 0.55, P = 0.004) and with a decrease in that of arachidonic acid (r = -0.40, P = 0.04) in phospholipids. CONCLUSIONS: The beneficial changes in fasting plasma glucose and in the S(G) during the Mono diet were associated with alterations in the proportions of oleic, alpha-linolenic, and arachidonic acids in phospholipids.     

The coping of an adolescent who has been in psychiatric inpatient care and her mother in everyday life

The purpose of this study was to describe the coping of an adolescent girl who had been psychiatric inpatient care and her mother in everyday life. The case study design was used to gain intimate knowledge of the persons' condition, thoughts, feelings, actions, intentions and environment. The data were collected by interviewing the adolescent and her mother during 1999-2001. The informants were interviewed three times. The data were analysed by inductive content analysis. Six categories were formulated to describe the coping demands faced by the adolescent who had been in psychiatric inpatient care. They were: suicidal behaviour, failing mental health, narrow social network, weakening sense of reality, low self-esteem and negative feedback from others. Her coping strategies were hobbies, praying and occasionally withdrawal into a fantasy world. Emotional support was her most important coping resource. The coping demands faced by the mother concerned her daughter's aggressive behaviour, withdrawal from personal relationships and inability to concentrate. The mother worried about her daughter's unstable mental health and future. She was also extremely concerned about the relationships between the family members. On top of everything else, the mother developed new somatic diseases. The mother took care of herself by studying and doing handiwork. Social life was very important to her. Her main coping resource was emotional support. She got emotional support from friends and members of the family. The family had previously kept in touch with friends, but the husband had broken off all contacts.     

Accumulation of silver from drinking water into cerebellum and musculus soleus in mice

In spite of the general toxicity, ecotoxicity and sparsely known metabolism of silver, WHO allows silver ions (Ag) up to 0.1 mg/l in drinking water disinfection. In order to determine the accumulation and distribution of silver in a mammalian body, mice were given for 1 and 2 weeks drinking water containing a 3-fold lower concentration, namely 0.03 mg/l silver ions as silver nitrate labelled with 110mAg. The silver concentrations in different tissues were analysed by gamma radioactivity. The saturation of tissues with silver seems to occur quickly, as there were no statistical differences between silver contents of mice tissues in spite of the study design that mice were administered silver for 1 or 2 weeks. The highest concentrations were found in musculus soleus (m. soleus), cerebellum, spleen, duodenum, and myocardial muscle in the rank order. Concentrations of silver in musculus gastrocnemius (m. gastrocnemius) were found to correlate negatively with cerebrum and positively with blood and kidneys. The accumulation of silver into organs and tissues important in motor functions may be of relevance especially in emergency and catastrophe situations in which accurate motor functions may be critical. A re-evaluation of the present recommendations on the use of silver salts for disinfection of drinking water might be necessary.     

The development of an instrument to measure the compliance of adolescents with a chronic disease

The purpose of this paper was to describe the process of developing an instrument for measuring the compliance of adolescents with a chronic disease. The aim was to develop an instrument that could be used in a clinical setting to evaluate the compliance of young people with a chronic disease and to test a theoretical model of compliance, which had been developed along with the instrument. The instrument was originally developed to measure the compliance of adolescents with diabetes and later adjusted to measure the compliance of adolescents with asthma, rheumatoid arthritis and epilepsy. To test and develop the instrument, face and criterion validity, factor analyses, linear structural relations (LISREL) analyses, correlation coefficients and Cronbach's alpha were used. The instrument has 13 background questions and 41 items to measure compliance and factors connected to it.     

Coping with the onset of cancer: coping strategies and resources of young people with cancer

A chronic illness, such as cancer, causes permanent changes in a person's way of life and their way of adapting to changes. The purpose of this study was to describe the coping strategies and resources of adolescents and young adults with cancer. The data were collected by interviewing adolescents and young adults aged 16–22 ( n  = 14) who had had cancer for more than 2 months and who came to a university hospital for treatment or control check ups. The interview material was analysed by content analysis. Emotion-focused, appraisal-focused and problem-focused coping strategies were used. The major coping strategies were social support, belief in recovery and getting back to normal life as soon as possible. The subjects discussed with health care providers their disease, its treatment and how they could cope with everyday life as well as their energy and will-power to cope. The family was the most important source of emotional support. Also, gaining knowledge about cancer and its treatment was a good coping strategy. Moreover, a positive life attitude, belief in one's own resources, belief in God, earlier life experiences and willingness to fight against the disease were resources for coping with cancer.     

The relationship between multidimensional leadership and burnout among nursing staff

AIM AND BACKGROUND: The purpose was to explore the relationship between multidimensional leadership and burnout among nursing staff. There exists little research evidence of the relation between these phenomena. METHOD: The study used a non-experimental survey design. The sample consisted of 601 nurses and nurse managers working in different health care organizations. RESULTS: Rewarding transformational leadership seems to protect particularly from depersonalization. Active management-by-exception protected from depersonalization and increased personal accomplishment. Passive laissez-faire leadership functioned as an exposing factor for emotional exhaustion as well as a decreasing factor for personal accomplishment. However, the employment status and the character of work tasks affected the connection between leadership and burnout. CONCLUSIONS: The relation between leadership and burnout is complex, affected by situational factors of leadership and the ambiguous nature of burnout. Nurses of various ages, at different stages of career development and participating in different work tasks require different kinds of leadership.     

Coping and social support of parents with a diabetic child

The purpose of this study is to describe and understand the parental coping and the social support received by the parents of diabetic children. The parental coping process was followed for a 4-week period after the diagnosis of diabetes. The parents of two girls, whose diabetes was diagnosed in early childhood, served as study subjects. Data were collected by interviewing and observing the parents over four separate periods. The data were analyzed by the time series and content analysis methods. Six phases of parental coping were identified: disbelief, lack of information and guilt, learning to care, normalization, uncertainty and reorganization. In the different phases of parental coping, the parents' experience of stress, coping strategies and sense of control varied. In the phase of disbelief, the parents tried to reject the child's diabetes by questioning the diagnosis. The initial information given to the parents regarding their child's diabetes proved to be important for parental coping. In the phase of lack of information and guilt, the parents sought reasons for their child's diabetes and felt guilty about it. As coping responses, the parents sought support from each other and from people who had experienced the same. In the learning to care phase, they recognized the demands caused by diabetes and took responsibility for the child's care. The parents appreciated supervision based on their problems. In the normalization phase, the parents prepared to return home with the diabetic child. Getting back to normal life was one of the most effective parental coping responses. In the uncertainty phase, the care to be given to the diabetic child changed the daily routines of the family. In the reorganization phase, the parents adapted to the diagnosis of diabetes and to the care of their diabetic child. The parents felt that the life of the family normalized and was able to be controlled.     

Conceptual analysis of compliance

Compliance has been studied from a wide range of scientific perspectives including medicine, nursing, psychology and health economics. There is no agreement regarding a commonly accepted definition. Lack of consistency in the definition and measurement of compliance is a major problem in research which becomes more complicated in an international study. The response to the confusion over the term compliance has been to suggest and use alternative terms such as adherence, co-operation, mutuality and therapeutic alliance. These terms are ill-defined and often are used as synonyms. The purpose of this paper is to analyse definitions of the concept of compliance. Abstracts from MEDLINE have been analysed in order to identify the types of compliance research that have been carried out.     

Meaning attached to compliance with self-care, and conditions for compliance among young diabetics

This paper presents a hypothetical model of the compliance with self-care of young diabetics, its features, its meaning to them and the preconditions for compliance with self-care The aim of this research was to develop a model to clarify and expand existing knowledge concerning compliance with self-care among young diabetics and to produce new ideas for planning and implementing this care Four categories of behavioural pattern were identified Those young people with good compliance experienced a sense of well-being, health, and freedom They were responsible, active, and well motivated in voluntarily implementing self-care The second group were those whose actions deviated only slightly from health regimens but who had undergone many negative experiences with self-care Their actions were guided only by compulsion The third group were consciously non-compliant Their constant neglect of health regimens was associated with feelings of poor health, fears and indifference They were not motivated to comply, felt that the aims set were too high and the self-care programme too tightly regimented They felt that they received no encouragement The young people belonging to the fourth group frankly refused to pursue self-care Their non-compliance was seen by them as an issue of freedom In effect, their friends controlled their lives, and they felt that their self-care was all the more unnecessary since nobody encouraged them to keep to it