Resizing hospital nursing organizations, an alternative to downsizing.
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Cost-Benefit Analysis↗
Biomedical subjects
A Bruce
Publications and source records attributed to A Bruce.
Dietary recommendations in cancer prevention.
In order to prevent diet-induced cancer, many countries regulate the use of food additives (e.g. nitrites) and control the level of harmful substances, such as pesticide residues and mycotoxins in food. In most affluent countries therefore, these factors play a minor role in cancer causation. The dietary intake of agents preventing cancer, such as nutrients, dietary fibre and some natural components in plants is probably of much greater importance in cancer prevention. So far there are only general recommendations promoting increased consumption of food rich in these substances. Some international and national organizations have published dietary guidelines specifically intended to decrease the risk of cancer. In many respects, the recommendations given in these guidelines do not differ from those published during the last decades with the aim of preventing, for example, cardiovascular diseases. They all stress the need to decrease the intake of fat and sodium and to increase the consumption of foods rich in dietary fibre and nutrients such as vitamins A, C and E.
Carcinogens↗
Retention of linoleic acid in carcass lipids of rats fed different levels of essential fatty acids.
Rats of an inbred Sprague-Dawley strain were fed purified diets with low (0.3% of total energy), normal (3%) or high (10%) content of essential fatty acids (EFA) for at least three generations. Two 30-day-old rats with similar weights were chosen from one litter. One was killed; weight increase and food consumption of the other rat was measured for 15 days. Total lipid content and fatty acid composition in total lipid and lipid classes were determined in both rats. Seven pairs of rats from each group were treated in the same way. Calculations based on amount of linoleic acid ingested and retained in the carcass lipids showed that 50% of the ingested linoleic acid was retained in the low EFA rats compared to 10-15% in the normal and high EFA rats.
Animals↗
Food habits and nutrient intake in childhood in relation to health and socio-economic conditions. A Swedish Multicentre Study 1980-81.
In Sweden a multicentre nutritional survey was performed in 1980-81 in four different parts of Sweden. The total number of children investigated was 1109, of whom 92 were two years old, 332 four years, 338 eight years and 347 thirteen years. The 24-hour recall method was used in all children. In addition 7-day record was used in the 2-, 4- and 8-year-olds and the dietary history method in the 13-year-olds. During the weekdays the 2-, 4-, 8- and 13-year-old children had 5.9, 5.8, 5.4 and 5.2 meals and snacks per day, respectively. During weekends these respective numbers decreased to 5.7, 5.6, 5.1 and 5.0. The mean number of light meals and snacks was almost the same on all days and varied between 2.4 and 3.3 in the different age groups. The part of the energy intake deriving from snacks has increased during the last 15 years. The mean daily energy intakes for the 2-, 4-, 8- and 13-year-old boys and girls were 5.8 and 5.6, 6.9 and 6.5, 8.9 and 7.9 and 12.1 and 9.7 MJ respectively. These values are below the recommendations for all age groups except the 2-year-old boys. The mean daily intakes of protein, retinol, ascorbic acid, thiamin, riboflavin, niacin, vitamin B12 and calcium were almost invariably higher or much higher than the recommendations, while those of vitamin D and zinc were below the recommended values. The iron intake fulfilled the recommendations except for the 2-year-olds and the 13-year-old girls. The intake of protein and fat expressed in per cent of the total energy intake was very similar in all age groups, about 14 per cent and 35-37 per cent respectively. The mean ratio between polyunsaturated and saturated fatty acids (P/S ratio) was also the same in all age groups, i.e. 0.22-0.23. This low ratio is explained by a high consumption of dairy products. Furthermore, the nutrient density of the food did not change appreciably with age. The only exception was found for the 2-year-old children, who had slightly higher nutrient density values on account of a relatively high consumption of fortified follow-up formula. In all age groups the mean nutrient densities of vitamins D and B6 and of iron were below the recommendations to varying degrees. No clinical signs of nutritional deficiencies, iron deficiency included, were found in any age group.(ABSTRACT TRUNCATED AT 400 WORDS)
Adolescent↗
Swedish views on selenium.
For a long time selenium was known only for its toxic characteristics. During the last few decades selenium deficiency has been recognized as an important agricultural problem in Sweden. On average, grains and pastures only contain one tenth of the amount of selenium considered necessary to avoid symptoms of deficiency. However, the incidence of muscle degeneration among the animals has been low, probably due to imported animal feed. Since 1980 selenium has been added to animal feed, but only minor changes in the selenium content of Swedish food stuffs have been recorded. Some studies have shown that the average Swedish dietary intake of selenium is 10-70 micrograms/day. The lowest levels were found in vegan diets, based on locally-grown products. Swedish studies have found depressed glutathione peroxidase (GSH-Px) levels in patients with various skin disorders, including acne; myotonic dystrophy and rheumatic arthritis. Clinical trials with selenium supplementation have given positive results in some of these disorders as well as in some patients with disabling muscular and joint pains. Today there is a large sale of selenium tablets sometimes with additional vitamin E. The marketing of these tablets, however, is often based on unsubstantiated claims.
Animal Feed↗
Autoradiographic studies with fatty acids and some other lipids: a review.
In this review, we have mainly included studies in which whole-body autoradiography was used. In lipid research, most studies have been done with fatty acids. These studies showed some common characteristics in the pattern of tissue distribution. A major uptake was seen in the brown fat, liver and adrenal cortex but also to some extent in other tissues with a high metabolic activity or high cell turn-over, e.g. the gastric and intestinal mucosa, diaphragm, kidney cortex and bone marrow. Low levels of radioactivity were generally found in the brain, testes, thymus, white fat, skeletal muscles, lungs and spleen. Most fatty acids showed some specific features, e.g the strong uptake of erucic, arachidonic and docosahexaenoic acid in myocardium and of eicosapentaenoic acid in the adrenal cortex. Studies with PGE1 and LTC3 showed that the liver and kidney and to a lesser degree the lungs were the major sites of metabolism. The distribution of free cholesterol and triolein emulsion labelled in the fatty acid moieties did show some similarities with respect to the general pattern found with most fatty acids. Specific for cholesterol was a very strong uptake in the adrenal cortex. There was also a significant uptake in the spleen whereas the uptake in the brown fat was not as marked as for most fatty acids. Specific for triolein was a marked uptake in the spleen and myocardium, in fed animals also in the white adipose tissue. These studies show that whole-body autoradiography can give much valuable information of the uptake and distribution of lipids that would be rather difficult to obtain with conventional methods. Combined with electron-microscopy, autoradiography can be used to study cellular and even subcellular distribution, and thus given further data on the metabolism of lipids in the body.
Autoradiography↗
The effect of vitamin and mineral supplements and health foods on physical endurance and performance.
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Adolescent↗
Changes in lipoprotein metabolism during a supplemented fast and an ensuing vegetarian diet period.
The effect on lipoprotein metabolism of a 2-week modified fast and an immediately ensuing 3-week period on a vegetarian diet was studied under metabolic ward conditions in 21 non-obese female and 6 male patients. The very low calorie diet induced reductions of the cholesterol concentration in all serum lipoprotein classes. In the female patients, who were all normolipoproteinaemic, the triglycerides in serum showed a slight increase during the fast, reflecting small changes in very low (VLDL) and low density lipoprotein triglycerides. This may probably be explained partly by simultaneous significant reductions of both the adipose tissue and skeletal muscle tissue lipoprotein lipase activities (LPLA). In contrast, in the male patients who had a higher VLDL level at admission, the VLDL triglycerides decreased without significant changes of high density lipoprotein (HDL) cholesterol and of LPLA in muscle. The female patients, whose weights were stable during the vegetarian diet, ended up with a lower HDL cholesterol than at the start of the trial. This effect was probably partly due to the high content of polyunsaturated fatty acids in the vegetarian diet. It is concluded that the changes of lipoprotein metabolism during supplemented fasting are quantitatively and qualitatively different in several respects in females and males.
Adult↗
Intake of thiocyanate by way of milk and its possible effect on thyroid function.
The keeping quality of milk can be improved if the lactoperoxidase system is activated. To make such an activation efficient the thiocyanate concentration has to be increased. Since, however, thiocyanate has a potent antithyroid effect, thyroid function has been studied in 37 healthy individuals during 12 wk of daily intake of 8 mg thiocyanate by way of milk. The thiocyanate increased significantly in serum and reached a maximum value after 4 wk (+3.8 mg/1). The increased serum levels coincided with an increased excretion in urine (+ 4.8 mg/g creatinine). The levels of thyroxine, triiodothyronine, and thyrotropic hormone were all in the normal range at the beginning of the investigation and no significant changes were found during the experimental period. In conclusion, a daily intake of 8 mg thiocyanate by way of milk does not have any apparent effect on the thyroid function.
Adolescent↗
Sodium in nutrition policy.
Salt once was a scarce commodity and for some governments salt tax was an important income. The Na content of a diet without any processed foods or added salt would be approximately 400-500 mg. Food industry contributes substantial amounts of salt. A nutrition policy on Na should include regulation of the Na content in infant formulas and a decreased Na intake to reduce the risk of hypertension and possibly also gastric cancer. Iodized salt is an important source of iodine in many countries. Recommendations regarding Na intake have been given in some recommended dietary intakes and in several dietary guidelines. During the last years a few Western countries have published action programmes regarding Na and hypertension. Very few countries have standards regulating the salt content of certain products but in case any claims are made related to the Na content, this usually has to be declared. Special dietary foods with low Na content and salt substitutes are available in many countries. Standards for such products have been published by the FAO/WHO Codex Alimentarius Commission.
Adult↗
How hypertension redevelops after cessation of long-term therapy.
Long-term therapy (1.5-27 years, average 7.5 years) was ceased in 11 patients with essential hypertension. The return of supine hypertension during the ensuing 10 weeks was slow and incomplete, contrasting with previous studies when blood pressure (BP) had been lowered for shorter periods. After prolonged therapy in these patients, non-autonomic total peripheral resistance index (TPRI) was near normal, but left ventricular mass index (LVMI) was still high in six of the 11 patients. The latter was directly related to duration of effective treatment of BP and to BP when therapy was stopped. These findings may indicate that with antihypertensive therapy, structural changes in the peripheral vasculature regress more quickly than cardiac hypertrophy.
Adult↗
Autoradiographic studies with albumin-bound 1-14C-linoleic acid in normal and essential fatty acid-deficient rats. A pilot study.
Young rats fed a diet providing 0.3, 3 or 10% of the energy as essential fatty acids (EFA) were given a single intravenous dose of albumin-bound 1-14C-linoleic acid. 1 animal from each group was killed at 1 and 18 h, respectively, after the injection and submitted to whole-body autoradiography. In general, the activities in the tissues were higher in the 0.3% group than in the other groups, whereas the differences between the 3% and the 10% group were small. In all groups the highest activity occurred in the brown fat. High activities were also noted in the liver, the adrenal cortex, the diaphragm, and the gastric and intestinal mucosa. The higher activities in the tissues of the rats fed 0.3% than in the tissues of those fed 3% or 10% EFA probably reflect a higher incorporation of fatty acids of the linoleic acid series into structural and other lipids in the former group due to the lack of EFA.
Adipose Tissue, Brown↗
Changes in metabolism during a fasting period and a subsequent vegetarian diet with particular reference to glucose metabolism.
During an investigation on the effect of fasting and a vegetarian diet on the symptoms and signs in chronic cutaneous and arthritic diseases studies were made of glucose metabolism, liver function and the plasma concentration and urine excretion of some minerals. The study was performed on 27 patients who stayed as in-patients on a metabolic ward for five weeks. After the fasting period the blood glucose and serum insulin concentrations were lower (p less than 0.01) than before the fast. At the end of the period on the vegetarian (vegan) diet (three weeks) the insulin/glucose ratio was lower than at the start of the fast. Serum enzyme concentrations reflecting liver function increased during the fast, but normalized during the vegan diet. The intake of vitamin B12 and of selenium due to the vegan diets was very low, which may give reason for some concern during long-term use of this type of vegetarian diet.
Adult↗
A fasting and vegetarian diet treatment trial on chronic inflammatory disorders.
Twenty patients with arthritis and various skin diseases were studied on a metabolic ward during a 2-week period of modified fast followed by a 3-week period of vegetarian diet. During fasting, arthralgia was less intense in many subjects. In some types of skin diseases (pustulosis palmaris et plantaris and atopic eczema) an improvement could be demonstrated during the fast. During the vegan diet, both signs and symptoms returned in most patients, with the exception of some patients with psoriasis who experienced an improvement. The concentrations of lactoferrin in serum reflect the turnover and activity of neutrophil leukocytes. When this protein was initially increased it fell to normal values in most cases. The improvement or impairment of signs and symptoms was related to the lactoferrin levels in serum.
Adult↗
Campylobacter enteritis associated with foodborne transmission.
During an outbreak of gastrointestinal illness at a boys summer camp in Connecticut in June-July 1980, Campylobacter jejuni was isolated from 16 of 41 ill persons but from none of 63 controls (P less than 0.001). When the indirect fluorescent antibody assay was used, cross-titering serum and isolates from five patients showed all isolates to be identical. Lack of serologic response in culture-negative ill persons suggested that a second etiologic agent may have been involved. Ten convalescent carriers treated with erythromycin had clearance of Campylobacter from their stools within 72 hours. Among 26 camp staff members affected, two clusters of illness were seen, each one week after a birthday party, one party on June 26 and the other on July 2. Eating cake at the parties was significantly associated with illness (p = 0.0002 and p = 0.019, respectively). Eating an edge or corner piece with more icing at one party was associated with illness (p = 0.024). The source of the contamination of the icing was not found. None of 15 ill campers had eaten birthday cake. Although rates of eating salad were not significantly different when ill campers were matched with healthy campers, the relative risk associated with eating salad was 5. Campylobacter was isolated from the hands of an infected staff member who, while ill, prepared salad for the campers.
Adolescent↗
Longitudinal studies of anthropometric data and body composition. The population study of women in Götenberg, Sweden.
Anthropometric data and body composition, estimated from total body potassium and total body water determinations, were studied in 1968 to 1968 and 1974 to 1975 in a population sample of middle-aged women. Altogether 1302 women participated in the anthropometric studies and 79 women in the body composition studies on both occasions. Body height decreased with age both secularly and biologically. The reduction of body height was greater at higher ages. Body weight increased with age, the change being partly a cohort effect and partly an effect of age. Evidence of a reduced muscle mass in the arms with age was found. Body cell mass increased with age in some age strata. There was an increase in subcutaneous fat with age, both in the arms and in the trunk. Body fat did not change significantly with age in the age strata studied. A change in body weight was accompanied by a smiliar change in both body fat and body cell mass.
Adult↗
Body composition. Prediction of normal body potassium, body water and body fat in adults on the basis of body height, body weight and age.
In 134 males and 242 females, aged 20-70 years, most of them randomly selected from population studies, the body composition was estimated from the measurements of body height (BH), body weight (BW), total body potassium (TBK) and total body water (TBW). TBK was measured with isotope dilution technique using 42K or determined as 40K in a whole body counter. TBW was determined with an isotope dilution technique using tritiated water, assayed in urine or plasma. From these data, body cell mass (BCM), intra- and extra-cellular water (ICW and ECW, resp.) and body fat (BF) were calculated for each individual. Significant correlations were found between age versus TBK, ECW, BF and ECW/ICW; between BW versus TBK, TBW, ECW, BF and ECW/ICW; (females only) and between BH versus TBK, TBW, ECW (females only) and ECW/ICW. For the prediction of TBK, TBW and BF, multiple regression equations based on BW, BH and age are given. These equations are also presented diagrammatically. The problems with the methods used are considered as well as the applicability of the formulas for the calculation of BCM etc. The predictive value of the results when both TBW and TBK are used for the calculation of body composition data is discussed and compared with similar results, based on TBW or TBK only. It is concluded, that the most reliable method for calculation of BF is to estimate both TBW and TBK.
Adult↗