Sjuksköterskans omändertagande av anhöriga för att minska risken för posttraumatiskt stressyndrom : Omvårdnad och krishanteringEn systematiskt litteraturstudie

Syftet med denna studie var att undersöka hur anhöriga upplever det när närstående befinner sig i ett allvarligt sjukdomstillstånd, samt hur sjuksköterskan upplever mötet med anhöriga och hur sjusköterskan kan påverka deras krisbearbetning. Metod: Studien genomfördes som en systematisk litteraturstudie. Vetenskapliga artiklar söktes via databaserna ELIN@Dalarna och PubMed. Artiklarna som användes var tillgängliga i fulltext, skrivna på engelska och publicerade mellan 2000-2008. Resultat: Anhöriga kan ha svårt att ta in och bearbeta den information som de fått om patientens sjukdomstillstånd. Anhöriga som upplevde att de fick otillräcklig information om patientens sjukdomstillstånd hade en ökad risk att senare utveckla PTSD. Oavsett ålder på patienter med allvarligt sjukdomstillstånd så upplever de anhöriga stress och ett behov av att få vara nära patienten. Anhöriga upplever situationer olika och är därför i olika behov av hjälp och stöd. Diskussion: För att kunna bemöta anhöriga i deras upplevelse av att ha en närstående i ett allvarligt sjukdomstillstånd, behöver sjuksköterskan mer utbildning och praktisk övning av dessa situationer för att kunna ge adekvat vård. Både patient och anhöriga behöver information och stöd för att kunna gå vidare i sin krisbearbetning.

Kivy on justifying music in liberal education

Within analytical aesthetic circles, Peter Kivy is best known for re-igniting the debate inaugurated by Eduard Hanslick over the issue of whether or not music of the purely instrumental or absolute kind can be said to express a content, and, if so, whether or not listeners' emotional responses to it bear any relation to that content. Kivy's particular contribution countenances the possibility of interpreting the appearance of a musical work as expressive - be it the percussive Allegro barbara [1911] by Bela Bartok or the lyrical Adagio for Strings {1936] by Samuel Barber - without having to presume that music itself, being non-sentient by nature, possesses any emotional, subjective state.  This short essay, however, will critically examine a rather neglected facet of Kivy's prolific writings. In a relatively recent attempt to justify the place of purely instrumental music in liberal education without drawing upon the above-mentioned notion of expressiveness, Kivy reconceptualizes the matter in a manner that significantly shifts us from the dominant epistemological arena of debate. No longer are we to dispute the place of music within the terms set by the highly influential forms-of-knowledge approach revived by P.H. Hirst a generation ago and currently under revision by Jim McKenzie in terms of forms of argumentative discourse. But before first surveying and then critically assessing Kivy's proposal, perhaps we should briefly remind ourselves of the contrasting frame of reference associated with Hirst.

Taste sensitivity to NaCl is associated with liking of salty foods and BMI

Background – It is widely acknowledged that sodium is consumed in excess in most developed countries. Sodium (Na) consumption has been a target of public health interventions in recent years due to its link to numerous adverse health affects such as hypertension and cardiovascular disease. While much of the current research is directed at strategies to reduce sodium in foods and the diet, little is known about the factors which determine salt consumption and preference. Currently, there is no research relating NaCl taste sensitivity and liking of food, or if NaCl taste sensitivity may manifest in changes in BMI.
Objective – Establish whether a relationship exists between NaCl taste sensitivity, preference for salty foods and BMI.
Design – Taste sensitivity to NaCl was determined for 119 subjects (104 female) according to the procedure laid out by “ISO 3972:1991 – Method of investigating sensitivity of taste”. In a separate session subjects rated their liking of generic biscuit with 2 levels of added NaCl [low (2.9g/100g) & high (19.1g/100g)] using the 9-point hedonic scale. BMI was calculated from self reported height and weight data collected. Spearman’s rank order correlation was used to determine whether an association existed between NaCl taste sensitivity, preference for salty foods and BMI.
Outcomes – A significant positive correlation was found between BMI and NaCl taste sensitivity (r=0.204, p<0.05). In addition there was a significant positive correlation between BMI and liking of low NaCl biscuits (r=0.267, p<0.01). No significant associations were identified between the high NaCl cracker and NaCl taste sensitivity or BMI. A paired t-test showed there was no significant difference in liking of the low and commercial NaCl crackers (p=0.078).
Conclusion – This study revealed that individuals with a higher BMI have a greater liking of low NaCl biscuits, and this may be due to their increased NaCl taste sensitivity. The results suggest that NaCl taste sensitivity may be a factor in foods consumed by an individual which in turn may influence weight status.

The influence of heat on biological activity and concentration of oleocanthal - a natural anti-inflammatory agent

Background – The olive oil phenolic, oleocanthal is a natural non-steroidal anti-inflammatory compound that irritates the oropharynx in a dose-dependent manner. It has been proposed that the biological activity of oleocanthal is partially responsible for the beneficial health effects of the Mediterranean diet. Virgin olive oil containing oleocanthal is often added as an ingredient in a number of cooked dishes and therefore it is of great importance to understand how best to preserve the putative health promoting benefits of this compound, as olive oil phenolics are
subject to heat degradation.

Objective – To investigate if oleocanthal is thermally degraded or its biological activity reduced during cooking.

Design – One extra virgin olive oil containing 54mg/kg oleocanthal was heated at varying temperatures (100°C, 170°C and 240°C) for set time periods (0, 1, 5, 20, 60, 90 min). Oleocanthal concentrations were quantified using HPLC and its biological activity determined with a taste bioassay measuring the intensity of throat irritation.

Outcomes – Results demonstrated that oleocanthal was heat stable compared with other olive oil phenolics, with a maximum loss of 16% as determined by HPLC analysis. In contrast, there was a significant decrease of up to 38% (p<0.05) in the biological activity of oleocanthal as determined by the taste bioassay.

Conclusions – Minimal degradation of oleocanthal concentration was observed upon heating however a significant decrease in the biological activity of this compound was noted with extended heating time. This has important implications for health in that, consumers may be unable to reap all of the putative health benefits associated with oleocanthal when adding virgin olive oil as an ingredient to dishes requiring prolonged heat treatment.

The relationship betwen NaCl concentration and taste perception of saltiness in bread

Background – Sodium (Na+ ) is present in food in the form of sodium chloride (NaCl). There is strong evidence that high dietary Na+ intakes increase the risk of developing various adverse health conditions. Many international organisations encourage Na+ reduction in both the diet and the food supply. One of the major dietary sources of NaCl is bread, where NaCl has the essential function of imparting flavour. At present, no literature has been published examining taste interactions that may play a role in limiting the maximum saltiness perception in bread.
Objective – To determine the extent the physical structure of bread inhibits salty taste perception. Additionally, to determine whether common commercial bread additives suppress saltiness of bread.
Design – Subjects (n=14, 12 females) tasted and rated samples with varying NaCl concentrations in water (0 – 1724 mg NaCl/100 g) and bread (125 – 1550 mg NaCl/100 g) using the general Labelled Magnitude Scale. Psychophysical curves plotting NaCl concentration against NaCl intensity were constructed for water and bread. Breads of fixed NaCl concentration (1125 mg NaCl/100 g) and various common additives (sucrose, soya flour, canola oil, gluten) were also rated to assess perceived saltiness.
Outcomes – There was a significant difference between Na+ psychophysical curves in water and bread (P<0.05) with the bread matrix suppressing maximum possible saltiness by 25% to 70%. Suppression of saltiness was observed after the addition of sucrose (55% decrease) or soya flour (60% decrease) during bread production compared to prototypical bread (both P<0.05).
Conclusions – The physical structure of bread and some common additives have a major influence on perceptual saltiness of bread. The removal of additives that suppress saltiness combined with strategies to modify the texture of bread could lead to significant reduction in dietary Na+, whilst maintaining optimal salty taste.

The role of fatty acids in satiation and satiety

Background – Satiation and satiety describe the events which lead to meal termination and the maintenance of hunger induced by physical and metabolic events following food ingestion. Fatty acids, components of dietary fat (triglyceride) may be important, if not essential components of satiation and satiety. Emerging evidence suggests fatty acid now constitutes a sixth taste modality and orally sensed fatty acids mediate unique cephalic and hormonal responses priming the body for fat digestion, and may contribute to sensory specific satiety. Once ingested, fatty acids are sensed in the gastrointestinal tract (GIT) where they cause the release of hormones, stimulate the vagus and enter the blood stream where they act a number of organs (brain, liver) to influence satiety.
Objective – To review the role of fatty acids in sensory and metabolic satiation and satiety.
Design – Literature search and review of papers from the past decade on satiety, satiation, fat taste and fatty acids.
Outcomes – The physiological significance of gustatory fat detection is still unclear, but it may signal the nutritious content of fat similar to the tastes of sweet or umami which signal the presence of carbohydrate or proteins. Like other tastants, fatty acid taste sensitivity is thought to vary in the population and differences in sensitivity may influence dietary choice and fat intake. Fatty acid taste may contribute to sensory specific satiety as foods are eaten. Animal models have observed an inverse relationship between oral fatty acid sensitivity and fat consumption, which leads to obesity. Observations that the obese have heightened preferences for, and consume more fat than lean individuals questions whether such a relationship may also be apparent in humans. At the GIT, fatty acids are sensed by enterocytes and bind to receptors, transporters or ion channels where they initiate gut-brain communication over nutrient status through the vagus and cause the release of satiety hormones which lead to meal termination. Inefficient fatty acid sensing at either or both locations is thought to accompany the aetiology of obesity.
Conclusion – Variations in sensitivity to fatty acids may alter preferences and consumption of fats or hormonal responses to fat ingestion which influence sensory-specific, metabolic and subjective satiety.