Andean indigenous food crops: nutritional value and bioactive compounds

The Andean area of South America is a very important center for the domestication of food crops. This area is the botanical origin of potato, peanut and tomato. Less well- known crops, such as quinoa (Chenopodium quinoa), kañiwa (Chenopodium pallidicaule) and kiwicha (Amaranthus caudatus), were also domesticated by ancient Andean farmers. These crops have a long history of safe use with the local populations and they have contributed to the nutrition and wellbeing of the people for centuries. Several studies have reported the nutritional value of Andean grains. They contain proteins with a balanced essential amino acid composition that are of high biological value, good quality oil and essential minerals, for example iron, calcium and zinc. They are potential sources of bioactive compounds such as polyphenols and dietary fiber. The main objective of the practical work was to assess the nutritional value of Andean native grains with a special emphasis on the bioactive components and the impact of processing. The compounds studied were phenolic acids, flavonoids, betalains and dietary fiber. The radical scavenging activity was measured as well. Iron, calcium and zinc content and their bioavailability were analyzed as well. The grains were processed by extrusion with the aim to study the effect of processing on the chemical composition. Quinoa, kañiwa and kiwicha are very good sources of dietary fiber, especially of insoluble dietary fiber. The phenolic acid content in Andean crops was low compared with common cereals like wheat and rye, but was similar to levels found in oat, barley, corn and rice. The flavonoid content of quinoa and kañiwa was exceptionally high. Kiwicha did not contain quantifiable amounts of these compounds. Only one variety of kiwicha contained low amounts of betalains. These compounds were not detected in kañiwa or quinoa. Quinoa, kañiwa and kiwicha are good sources of minerals. Their calcium, zinc and iron content are higher than the content of these minerals in common cereals. In general, roasting did not affect significantly mineral bioavailability. On the contrary, in cooked grains, there was an increase in bioavailability of zinc and, in the case of kañiwa, also in iron and calcium bioavailability. In all cases, the contents of total and insoluble dietary fiber decreased during the extrusion process. At the same time, the content of soluble dietary fiber increased. The content of total phenolics, phytic acid and the antioxidant activity decreased in kiwicha varieties during the extrusion process. In the case of quinoa, the content of total phenolic compounds and the radical scavenging activity increased during the extrusion process in all varieties. Taken together, the studies presented here demonstrate that the Andean indigenous crops have excellent potential as sources of minerals, flavonoids and dietary fiber. Further studies should be conducted to characterize the phenolic compound and antioxidant composition in processed grains and end products. Quinoa, kañiwa and kiwicha grains are consumed widely in Andean countries but they also have a significant, worldwide potential as a new cultivated crop species and as an imported commodity from South America. Their inclusion in the diet has the potential to improve the intake of minerals and health-promoting bioactive compounds. They may also be interesting raw materials for special dietary foods and functional foods offering natural sources of specific health-promoting components.

Expectations of elderly people on the nurse-client relationship and interaction in home care : "When I see the nurse's smiling face it feels likes sunshine on a rainy and gloomy day"

The purpose of the thesis was to explore expectations of elderly people on the nurse-client relationship and interaction in home care. The aim is to improve the quality of care to better meet the needs of the clients. A qualitative approach was adopted. Semi-structured theme interviews were used for data collection. The interviews were conducted during spring 2006. Six elderly clients of a private home care company in Southern Finland acted as informants. Content analysis was used as the method of data analysis. The findings suggest that clients expect nurses to provide professional care with loving-kindness. Trust and mutual, active interaction were expected from the nurse-client relationship. Clients considered it important that the nurse recognizes each client's individual needs. The nurse was expected to perform duties efficiently, but in a calm and unrushed manner. A mechanic performance of tasks was considered negative. Humanity was viewed as a crucial element in the nurse-client relationship. Clients expressed their need to be seen as human beings. Seeing beyond the illness was considered important. A smiling nurse was described to be able to alleviate pain and anxiety. Clients hoped to have a close relationship with the nurse. The development of a close relationship was considered to be more likely if the nurse is familiar and genuine. Clients wish the nurses to have a more attending presence. Clients suggested that the work areas of the nurses could be limited so that they would have more time to transfer from one place to another. Clients felt that they would benefit from this as well. The nurses were expected to be more considerate. Clients wished for more information regarding changes that affect their care. They wished to be informed about changes in schedules and plans. Clients hoped for continuity from the nurse-client relationship. Considering the expectations of clients promotes client satisfaction. Home care providers have an opportunity to reflect their own care behaviour on the findings. To better meet the needs of the clients, nurses could apply the concept of loving-kindness in their work, and strive for a more attending presence.

Church and people in Britain and Scandinavia -konferenssi Yorkissa

Hanna-Maija Ketola & Mika Nokelainen

Loneliness of Older People and Elements of an Intervention for its Alleviation

Ikääntyneiden yksinäisyys ja intervention elementit sen lievittämisessä Ikääntyneiden yksinäisyys on yleistä ja hoitotyöntekijöillä on vähän keinoja sen lievittämiseen. Tutkimus oli kaksiosainen. Ensimmäisen osan tavoitteena oli saada tietoa yksinäisyyden käsitteestä, sen yhteydestä sosiaaliseen eristäytyneisyyteen ja yleiseen turvattomuuden tunteeseen sekä kotona asuvien ikääntyneiden (≥75 v.) yksinäisyyden yleisyydestä ja siihen yhteydessä olevista tekijöistä sekä selvittää ikääntyneiden itsensä kokemia yksinäisyyden syitä. Toisessa osassa tavoitteena oli tunnistaa yksinäisyyden lievittämiseen pyrkivän psykososiaalisen ryhmäkuntoutus (PRK) –intervention elementit sekä kuvata ryhmiin osallistuneiden kokemuksia interventiosta. Ensimmäisessä osassa tutkimusaineosto kerättiin postikyselyllä, joka lähetettiin eri puolilla Suomea kotona tai palvelutalossa asuville satunnaisotannalla valituille ikääntyneille henkilöille (N=6 786). Vastausprosentti oli 72 % (n=4113). Vastaajien keski-ikä oli 81 vuotta. Tutkimuksen toisessa osassa aineisto koostui PRK intervention ryhmänvetäjien (N=14) kirjoittamista päiväkirjoista, tutkijoiden vapaista muistiinpanoista ryhmätoiminnasta (N=32) sekä ryhmäläisten intervention jälkeen täyttämistä palautekyselystä (n=103). Tulosten mukaan yksinäisyys, sosiaalinen eristäytyneisyys ja yleinen turvattomuuden tunne näyttävät olevan eri asioita. Vastanneista 39 % kärsi yksinäisyydestä vähintään joskus. Useat demografiset ja terveyteen liittyvät tekijät, psyykkisen hyvinvoinnin ulottuvuudet kuten myös sosiaalisiin suhteisiin kohdistetut odotukset olivat yhteydessä yksinäisyyden kokemiseen. Vanhempien menettäminen lapsuudessa ei ollut yhteydessä yksinäisyyden kokemiseen. Yksinäisyyden kokemuksiin oli useita syitä. Aineistosta tunnistettiin elementtejä, joiden katsottiin olevan tärkeitä yksinäisyyden lievittämiseen pyrkivän PRK-intervention toteutuksessa. Nämä voitiin jakaa ennalta määriteltyihin elementteihin, ryhmäläisten sisäisiin ja välisiin suosiollisiin prosesseihin sekä välittäviin tekijöihin. Ennalta määritellyt elementit liittyivät ryhmäläisiin, ryhmän vetäjiin ja ryhmätoimintaan. Ryhmäläiset kokivat ryhmät erittäin merkityksellisiksi, ja 95 % koki, että yksinäisyys oli lievittynyt ryhmän aikana. Ikääntyneiden henkilöiden yksinäisyys on haaste hoitotyön tekijöille. Tutkimuksessa kuvattu PRK-interventio auttaa hoitajia tunnistamaan ikääntyneiden yksinäisyyden lievittämiseen liittyviä elementtejä.

Surgically-treated Hip Fracture in older People. With Special Emphasis on Mortality Analysis

Hip fractures are associated with significant morbidity and mortality. Cervical and trochanteric fractures have a different morphometry, surgical treatment, and outcome. Polypharmacy, common in older people, is associated with increased mortality. The risk factors for mortality can be identified based on cause-of-death analysis. In this population-based study, 461 older, surgically in 1999-2000 treated hip fracture patients were enrolled. Incidence, morphometry, medication, mortality, and cause-of-death were analysed. Hip fractures were most commonly sustained by women, occurred mostly indoors, and often in institutions. One in four patients had sustained a previous fracture. Routine clinical radiographs revealed no differences in the hip geometry between hip fracture types. Age-adjusted mortality was higher in men than in women during the follow-up. Chronic lung disease and male sex were predictors of mortality after cervical fracture. In men, potent anticholinergics were associated with excess age-adjusted mortality. Men were more likely to die from circulatory disease and dementia after hip fracture than women. Mortality after hip fracture was 3-fold higher than that of the general population, including every cause-of-death class. Fracture prevention in institutions and homes, indoor safety measures, and treatment of chronic lung diseases should be encouraged. Hip morphometry analyses require more accurate measures than that provided by routine radiographs. Careful use of potent anticholinergics may reduce mortality. Compared to the general population, excess mortality after hip fracture was evident up to 9 years after hip fracture. Cause-of-death analysis indicates that all major comorbidities require optimal treatment after hip fracture surgery.

The history of Lapland : wherein are shewed the original manners, habits, marriages, conjurations, &c. of that people : written by John Scheffer, professor of law and rhetoric at Upsal in Sweden.

Added engraved title page: The history of Lapland.

Fractures in older people - incidence, predictors and consequences

In older populations, fractures are common and the consequences of fractures may be serious both for an individual and for society. However, information is scarce about the incidence, predictors and consequences of fractures in population-based unselected cohorts including both men and women and a long follow-up. The objective of this study was to analyse the incidence and predictors of fractures as well as functional decline and excess mortality due to fractures, among 482 men and 695 women aged 65 or older in the municipality of Lieto, Finland from 1991 until 2002. In analyses, Poisson’s, Cox proportional Hazards and Cumulative Logistic regression models were used for the control of several confounding variables. During the 12-year follow-up with a total of 10 040 person-years (PY), 307 (26%) persons sustained altogether 425 fractures of which 77% were sustained by women. The total incidence of fractures was 53.4 per 1000 PY (95% confidence intervals [95% CI]: 47.9 - 59.5) in women and 24.9 per 1000 PY (95% CI: 20.4 - 30.4) in men. The incidence rates of fractures at any sites and hip fractures were associated with increasing age. No significant changes in the ageadjusted incidence rates of fractures were found in either gender during the 12-year follow-up. The predictors of fractures varied by gender. In multivariate analyses, reduced handgrip strength and body mass index (BMI) lower than 30 in women and a large number of depressive symptoms in men were independent predictors of fractures. A compression fracture in one or more thoracic or upper lumbar vertebras on chest radiography at baseline was associated with subsequent fractures in both genders. Lower body fractures independently predicted both short- (0-2 years) and long-term (up to 8 years) functional decline in mobility and activities of daily living (ADL) performance during the 8-year follow-up. Upper body fractures predicted decline in ADL performance during longterm follow-up. In the 12-year follow-up, hip fractures in men (Hazard Ratio [HR] 8.1, 95% CI: 4.4-14.9) and in women (HR 3.0, 95% CI: 1.9-4.9), and fractures at the proximal humerus in men (HR 5.4, 95% CI: 1.6-17.7) were independently associated with excess mortality. In addition, leisure time inactivity in physical exercise predicted independently both functional decline and excess mortality. Fractures are common among older people posing serious individual consequences. Further studies about the effectiveness of preventing falls and fractures as well as improving care and rehabilitation after fractures are needed.

Social capital, coping and information behaviour of long-term unemployed people in Finland

Avhandlingen studerar hur långtidsarbetslösa klarar av sin situation, hurdant socialt kapital och informationsbeteende de har, samt granskar hur de ovannämnda faktorerna är relaterade till varandra. Därtill undersöks om det finns skillnader mellan finsk- och svenskspråkiga långtidsarbetslösa på de här tre livsområdena. I undersökningen består socialt kapital av sociala relationer, deltagande i organisatoriska aktiviteter samt känslan av tillhörighet med olika grupper och samfund. Gällande informationsbeteende är fokus på vardaglig informationssökning, vilka källor som används, och hurdana problem man stöter på när man söker information. Som mest påfrestande upplevdes arbetslösheten av män, som var i början eller mitten av sin arbetskarriär. De äldre (över 55 år) verkade på många sätt klara av arbetslöshetssituationen bättre än de yngre, som drabbades hårdare av ekonomiska problem och stress. Kvinnor kunde bättre än män bibehålla en positiv inställning, de hade t.ex. starkare sociala nätverk som stöd, medan mäns sociala relationer i högre grad verkade vila på en arbetsgemenskap, som blev allt svagare i och med utdragen arbetslöshet. Yngre män upplevde också ofta att deras hälsa hade försämrats, när den för kvinnor och äldre arbetslösa i genomsnitt blev bättre. När arbetslösas bemästring av arbetslöshetssituationen, sociala relationer och informationssökning granskades, framgick att människor som var aktiva på ett livsområde också var aktiva på andra livsområden. I de flesta fall framkom inte några större skillnader mellan finsk- och svenskspråkiga arbetslösa. Beträffande informationssökning var de upplevda problemen ändå av diametralt motsatt karaktär – för svenskspråkiga åsamkade för lite tillgänglig information ofta problem, medan problemet för de finskspråkiga var att hitta det väsentliga i informationsflödet. Finskspråkiga kände sig också mera fast anknutna till sin boendemiljö och det finska samhället i stort, svenskspråkiga hade däremot i genomsnitt bredare och tätare sociala nätverk.