Fatty acid profiles in response to soybean oil lipid emulsion infusions in essential fatty acid-deficient miniature swine

The ability of soybean oil lipid emulsions to affect essential fatty acid deficiency (EFAD) and plasma fatty acid distribution was studied in neonatal pigs. The test animals were maintained on a fat-free diet prior to administration of lipid emulsion. Plasma and red blood cell (RBC) membrane levels of essential [linoleic (C-18:2 omega 6) and arachidonic (C-20:4 omega 6)] and nonessential [palmitic (C-16, palmitoleic (C-16:1 omega 7), stearic (C-18), and oleic (C-18:1 omega 9)] fatty acids and the triene:tetraene ratio [5,8,11-eicosatrienoic acid (C-20:3 omega 9):arachidonic acid (C-20:4 omega 6)] were monitored to ascertain the establishment of EFAD and its correction. Nonessential fatty acids were studied, as these components of lipid therapy have received little attention. Results indicate that soybean oil emulsions are effective in reversing fatty acid profiles found in EFAD, and both essential and nonessential fatty acids are under strict metabolic control.     

Analysis of job-share as a process of change

This paper describes the introduction of a district nursing job-share in a primary health care team. Exploring change theory and different strategies for organizational change, the implications for members of the team are considered. In addition, changes in the balance of power which resulted in conflict within the district nursing team are discussed.     

Recruiting for success--the potential for using occupational personality questionnaires for the assessment of doctors.

OBJECTIVES: to evaluate the Saville and Holdsworth Occupational Personality Questionnaire (OPQ) to assess its potential and validity as a tool in the recruitment of doctors. To determine the range of personality characteristics in a group of general practitioners. DESIGN: an administered commercially available questionnaire. SETTING: general practitioners in North and Mid. Stafftordshire. SUBJECTS: 133 general practitioners or trainees. RESULTS: 44% of general practitioners agreed to participate. The majority found it useful and recognised its potential to increase self-awareness, highlight weaknesses that might be improved and for future recruitment of others to their teams. Doctors' personality traits were similar to those of managerial/professional norms. The validity of the OPQ was supported by (a) significant associations with subjects' previously reported mental health problems and (b) 83% of respondents confirming that their reports correctly described their personalities at work. CONCLUSIONS: OPQs have a place in the recruitment of doctors by identifying appropriate people to strengthen the team.     

Review: deterioration of glucose tolerance with age: the role of insulin resistance.

Glucose tolerance is determined by the balance of insulin secretion and insulin action and deteriorates with age. Insulin secretion does not appear to be reduced with increasing age, but many recent studies have demonstrated insulin resistance in healthy elderly subjects. However, this has not been a universal finding and the reasons for the discrepant results probably include general health, physical training, changes of liver size and delays in carbohydrate absorption. When confounding factors, particularly physical activity, are taken into account there appears to be little or no change in insulin action with age. Delays in monosacharride absorption may play a role. Maintaining physical fitness throughout middle and older age and so reducing hyperinsulinaemia may have benefits on reducing vascular disease.     

Declining blood lead levels in Victorian children

Abstract: To investigate the distribution of blood lead levels in a sample of Victorian children, and to compare current levels with those from a similar survey in 1979, blood was tested for lead in 252 children (123 under five years) attending Royal Children's Hospital as outpatients and having venepuncture blood samples for medical reasons. Blood lead levels were determined by graphite furnace atomic absorption spectrophotometer. The mean blood lead level was 0.26 μmol/L (5.4 μg/dL). In the under-five age group, the mean was 0.28 μmol/L (5.7 μg/dL). Only 1.6 per cent of this group exceeded the National Health and Medical Research Council action level of 0.72 μmol/L (15 μg/dL). Levels in this age group have declined significantly since 1979, when the mean was 0.54 μmol/L (11.1 μg/dL) and 12.9 per cent exceeded 0.72 μmol/L (15 μg/dL). Average blood lead levels have halved since 1979, with likely contributing factors being reduced exposure from lead in diet, reduced access to lead in paint and reduced lead in ambient air. Children with elevated levels had identifiable risk factors such as pica or exposure to lead-based paint, suggesting the need for ongoing public health action to prevent exposure in these groups.     

The effect of cigarette smoking on ovarian function and early pregnancy outcome of in vitro fertilization treatment

A retrospective analysis of the results of the first attempt at in vitro fertilization (IVF) treatment in 447 couples was performed by chart review. In 124 couples the female partners smoked cigarettes, and in 236 couples they did not. A total of 69 pregnancies (19.2%) were achieved, 50 in nonsmokers (21.2% per cycle), and 19 in smokers (15.3% per cycle). There were no significant differences in these cycles between the two groups in peak estradiol level achieved, the number of eggs retrieved, fertilization rate, or implantation rate. The incidence of spontaneous abortion was higher in smokers (42.1%) than in nonsmokers (18.9%). Consequently, the delivery rate per cycle of IVF was significantly lower in the smoking group (11 of 124, 9.6%) than in the nonsmokers (40 of 236, 17.0%). There was no effect when only the husband was a smoker. From these data, smoking appears to significantly reduce the chances of successful pregnancy after IVF treatment.