Experiential health knowledge from the perspective of Finnish adults.

The article describes how Finnish adults understand health. The data were collected by means of free-form thematic interviews and analyzed on the basis of an interpretive approach, representing the phenomenological research tradition. From the interviewees' responses, there emerged two different types of experiential health knowledge, namely institutional and individual health knowledge. Institutional health knowledge found expression in the following themes: knowledge about health as normalcy, knowledge about proper health care, knowledge about factors that may cause illness, knowledge about diseases observed in oneself, and knowledge about obtaining help. Individual health knowledge found expression in the following themes: knowledge about being healthy and feeling well, knowledge about how to produce well-being and how to deal with not feeling well, and knowledge about being ill and not feeling well. The results of the study provide conceptual tools for the further analysis of health knowledge from the perspective of people themselves and at the same time deeper knowledge about the ways in which people perceive health and in which they seek to maintain good health.

What is expected of the nurse-client interaction and how these expectations are realized in Finnish health care.

The purpose of this paper is to describe what clients using health care services and nurses themselves expect of nursing, the role of patient, and also how these expectations are met. This article is based on qualitative research where both clients and nurses have been interviewed and their own perspectives have been revealed. Expectations expressed by both nurses and clients differ from each other. The clients described a good interactive relationship in a much more diverse and many-sided manner than nurses. Interactive situations seem to be taken for granted by nurses. The results show the starting points of good nursing care and the need to continue nursing development in the client-centred direction.

Self-directed health care among Finnish adults and its implementation in daily life.

This article describes self-directed health care based on people's everyday experiences from their own perspective. A total of 120 people (aged 30 and 50 years) participated in thematic interviews. Data were analyzed using a phenomenological, interpretive approach. Three types of self-directed health care emerged. Sixty percent attributed their self-directed health care to self-knowledge. Twenty-six percent attributed their self-directed health care to information of health as normalcy. Health and self-directed health care were distant or insignificant issues to 14%. The motives for own health care were identified in each type of self-directed health care. The strategies of self-care varied according to the revealed motives. The results increase understanding of the individual as the participant in question, related to his or her own health and health care, and can be used to develop health education programs and measurements that are meaningful from the viewpoint of people's experiential world and their daily life.

Mycotoxin production of Fusarium langsethiae and Fusarium sporotrichioides on cereal-based substrates.

The present study investigated and compared the mycotoxin production of two Fusarium species, F. sporotrichioides and F. langsethiae, isolated from grain samples. Fusarium strains were cultivated at 25°C for 7 days on two types of solid media, i.e. rice-flour and cereal-flour agar. Toxins produced were measured after the incubation period with a multi-mycotoxin method based on liquid chromatography-tandem mass spectrometry (LC-MS/MS). Both F. sporotrichioides and F. langsethiae synthesised type-A trichothecenes, i.e. T-2 and HT-2 toxins, diacetoxyscirpenol (DAS) and neosolaniol (NEO). In addition, both species could be verified as beauvericin producers. The toxin production occurred in both cereal-based assays but was more predominant on the carbohydrate-rich rice-flour medium. The two species were potent producers of T-2 toxin, the highest amounts measured being at a level of 20,000 µg/kg after 7 days' incubation. Differences between the species were observed regarding the quantitative production of the other trichothecenes: F. sporotrichioides was a more prolific producer of HT-2 toxin and beauvericin, whereas F. langsethiae produced higher amounts of DAS and NEO. On rice-flour assay, the toxin production was monitored during the growth period. The production started rapidly at an early growth phase and several toxins could be detected already after the 1st day of incubation, the highest concentrations being at mg/kg level. The results also indicated that the biosynthesis by F. sporotrichioides and F. langsethiae shifted towards the other type-A trichothecenes at the expense of T-2 toxin at the end of the cultivation.

Bran fermentation as a means to enhance technological properties and bioactivity of rye.

Response surface methodology was applied to study the effects of fermentation on the levels of phytochemicals (folates, phenolic compounds, alkylresorcinols) and on the solubilization of pentosans in rye bran from native and peeled grains. Furthermore, the microbial composition of the brans before and after fermentation was studied. Peeling reduced the microbial load and lower microbial counts were detected in the fermentation experiments carried out with the bran from peeled grains. High temperature and long fermentation time favoured the growth of indigenous lactic acid bacteria (LAB), and a diverse microbial community was detected. The brans contained low levels of aerobic spore-forming bacteria, but their number was not increased during the fermentations. Fermentation of both brans increased the levels of folates, easily extractable total phenolics and free ferulic acid. During fermentation of bran from native grains, the levels of alkylresorcinols slightly increased but during fermentation of bran from peeled grains they decreased. Significant increase in soluble pentosans was established in both types of rye bran fermentations. Enhanced bioactivity and solubilization of pentosans with limited microbial growth were obtained after 12-14 h fermentation at 25 degrees C. The results suggest that fermentation is a potential bioprocessing technology for improved technological properties and bioactivity of rye bran.

Yeasts in an industrial malting ecosystem.

The malting ecosystem consists of two components: the germinating cereal grains and the complex microbial community. Yeasts and yeast-like fungi are an important part of this ecosystem, but the composition and the effects of this microbial group have been largely unknown. In this study we surveyed the development of yeasts and yeast-like fungi in four industrial scale malting processes. A total of 136 malting process samples were collected and examined for the presence of yeasts growing at 15, 25 and 37 degrees C. More than 700 colonies were isolated and characterized. The isolates were discriminated by PCR-fingerprinting with microsatellite primer (M13). Yeasts representing different fingerprint types were identified by sequence analysis of the D1/D2 domain of the 26S rRNA gene. Furthermore, identified yeasts were screened for the production of alpha-amylase, beta-glucanase, cellulase and xylanase. A numerous and diverse yeast community consisting of both ascomycetous (25) and basidiomycetous (18) species was detected in the various stages of the malting process. The most frequently isolated ascomycetous yeasts belonged to the genera Candida, Clavispora, Galactomyces, Hanseniaspora, Issatchenkia, Pichia, Saccharomyces and Williopsis and the basidiomycetous yeasts to Bulleromyces, Filobasidium, Cryptococcus, Rhodotorula, Sporobolomyces and Trichosporon. In addition, two ascomycetous yeast-like fungi (black yeasts) belonging to the genera Aureobasidium and Exophiala were commonly detected. Yeasts and yeast-like fungi produced extracellular hydrolytic enzymes with a potentially positive contribution to the malt enzyme spectrum. Knowledge of the microbial diversity provides a basis for microflora management and understanding of the role of microbes in the cereal germination process.

[Evaluation criteria of quality of care]. / Hyvän hoidon arviointiperusteet.

In this article there is described a study, where 60 persons who had been patients were asked to tell their conceptions of good care and experiences of its implementation. Information was collected by theme interviews. The basic idea in the research was to extend knowledge of peoples experiences in the health care system by a research design, where peoples' conceptions could be described and understand according to the experiences which were really meaningful to patients. In previous research patients' experiences have been described based on foreordained criterions. Most of the people studied regarded pertinence, friendliness, individuality, giving of information, conversation, safeguarding of privacy, safety, comfort, waiting as the evaluation criteria of good care. Administrative or organisational things were not regarded as meaningful. According to these results the implementation of good care preconceives that the conceptions of professions must be broaden. It also preconceives that different health professional groups together engage themselves to patient-centered goals.

Health as an individual's way of existence.

This paper examines health from the viewpoint of Finnish individuals. The goal of the study was to understand and describe the human being's health as an individual way of existence on the basis of life descriptions. The methodology of the study were based on the existentialist phenomenological conception of a human being's existence and the essence of knowledge. The study answers the research question: How do Finnish adults who have been cared for in hospital experience health? The data were collected from 60 persons via free form thematic interviews. The data were analysed by applying the grounded theory method. The analysis led to the identification of five different ways to experience health. To the interviewees, health meant independent coping, drifting with the current of life, developing one's personal existence, avoiding threats in one's life situation and taking care of the components of one's life situation. The results provide a deeper understanding of health within daily life and of a human being as a nursing client.

[Images and experiences of being a patient through the viewpoint of persons who have visited the health care system]. / Terveydenhuollossa asioineiden mielikuvia ja kokemuksia potilaana olemisesta.

This article describes the images and experiences of being patient by the viewpoint of persons who have visited health care system. The purpose is to expand knowledge of the starting points and improvement of good care. The description of the subject is based on the data gathered by focused interviews (N = 60) during the spring 1989. The data was analysed in two phases. Images and experiences of being patient were identified and classified to establish concepts, which describe data as a whole. Analyses were carried out according to Grounded theory-method. Those who were interviewed expected a person as a patient to be active and to take care of her rights during the care or to be obedient. They named many reasons why patients are passive and shy. They also described patients' troublesome behaviour in many different ways. Those who were interviewed had been patients in five different styles. Styles were connected with peoples' individual ways of being healthy and their basic belief of life control. According to the study the goodness of care is partly affected by the norms of being patient in health care system and partly by the human being's own choices to be patient. It seems that patients who were active were heard better during the care than the passive ones. According to the study the development of good nursing care requires the analyses of good nursing care requires the analyses and the expanding of the norms of being a patient and the establishing of the data gathering methods describing a patient as a person.

The authenticity and ethics of phenomenological research: how to overcome the researcher's own views.

This article is based on the assumption that the researcher cannot detach from his or her own view in phenomenological research. The researcher is assumed to be able to understand the experiences of an individual only through the points of departure created by the researcher's own view. The goal of this article is to describe practical aspects and their theoretical grounds that are of crucial importance in overcoming a researcher's views in data gathering and analysis. Its purpose is to clarify the authenticity and ethical standards concerning the views of the researcher in phenomenological research.

Good nursing practice as perceived by clients: a starting point for the development of professional nursing.

This paper presents clients' experiences of health care and nursing services in the Finnish primary health care and hospital system. These are described to find evaluation criteria for good nursing care and to point out challenges for development of the nursing profession.

Life situation of aged home-nursing clients.

We describe the life situation of elderly Finnish home-nursing clients (N = 50) on the basis of their own experiences and opinions of need-satisfaction. The purpose of the study, which was carried out as part of a nursing development project in the form of action research, was to gain a deeper understanding of the satisfaction of human needs and problems of need-satisfaction in aged people and on this basis to develop forms of nursing that support self-care. The data were collected using a semistructured questionnaire, which was designed primarily on the basis of the need theories of Yura and Walsh and Orem. The specific areas of inquiry included the clients' experiences of need-satisfaction in the promotion of physical health, emotional life, relations of communality, personal growth and development, and spiritual life. Overall the aged clients were relatively satisfied. However, in certain areas there were also unmet needs, notably in getting adequate nutrition, rest, and sleep, as well as in secretory activity. In addition, it seemed that loneliness caused considerable anxiety to the elderly home-nursing clients.

[Sexuality and the satisfaction of sexual needs]. / Iäkkäiden näkemyksiä seksuaalisuuteen liittyvien tarpeiden tyydyttämisestä.

The article discusses conceptions of sexuality and the satisfaction of sexual needs in a sample of aged home nursing patients (N = 50) in small rural town in Finland. The purpose of the study, which was carried out as part of a nursing development project in the form of action research, was to gain a deeper understanding of the satisfaction of basic human needs and problems of need-satisfaction in aged people, particularly in the domain of sexual needs. Negative attitudes towards sexual needs were found in more than half of the aged respondents; they did not consider it proper for aged people to have an active sex life. One quarter felt that sexual needs and desires were shameful and sinful. Only less than one quarter had positive attitudes towards sex. The majority of the respondents felt that they could freely and confidentially talk about sex with the nursing staff, but only less than one quarter were willing to do so. Almost all had some need to show affection to another person. The majority accepted their own self-image, but half were not satisfied with their physical appearance.

Life control and health in view of qualitative and quantitative research.

In this paper the experiences of life control and health of Finnish people are described and compared by reference to two studies with different methodologies. The goal of the qualitative study was to describe and understand the human being's health as an individual way of existence on the basis of life descriptions. The qualitative data were gathered through thematic interviews (n = 60, men and women, aged 30-50 years). The data were analyzed with the grounded theory method. The analysis showed life control to be a core category that characterizes health experiences. On the basis of the analysis, the content of concept of life control was defined to describe the data. The goal of the quantitative study was to produce information on life control among young males, their health, health behaviour, experiences of stress and life situations as well as the associations between these dimensions. The definition of life control was based on Antonovsky's theory of sense of coherence and on the study of Söderqvist and Bäckman. The quantitative data were gathered with questionnaires from 2500 (response rate 60%). The data were processed using cross-tabulation and multivariate data analysis (discriminant analysis). The connections between life control and health were obvious in both studies. To a certain extent the results were parallel, but there were also some differences which are discussed here as a starting point for developing further the research on life control and health in the nursing science context.

Sexuality and the satisfaction of sexual needs. A study on the attitudes of aged home-nursing clients.

This article discusses conceptions of sexuality and the satisfaction of sexual needs in a sample of aged home nursing patients (N = 50) in a small rural town in Finland. The purpose of the study, which was carried out as part of a nursing development project in the form of action research, was to gain a deeper understanding of the satisfaction of basic human needs and problems of need-satisfaction in aged people, particularly in the domain of sexual needs. The data were collected using a semi-structured questionnaire, which was designed primarily on the basis of the need theories of Yura & Walsh and Orem. Negative attitudes towards sexual needs were found in more than half of the aged respondents; they did not consider it proper for aged people to have an active sex life. One-quarter felt that sexual needs and desires were shameful and sinful. Only less than one-quarter had positive attitudes towards sex. The majority of the respondents felt that they could freely and confidently talk about sex with the nursing staff, but only less than one-quarter were willing to do so. Almost all had some need to show affection to another person. The majority accepted their own self-image, but half were not satisfied with their physical appearance.

[Life control, the core of being healthy. Theoretical-empirical definition of the concept "life control"]. / Elämänhallinta terveenä olemisen perustana. Elämänhallinta käsitteen teoreettis-empiiristä määrittelyä.

In this article the concept 'life control' is being analysed and defined. A need to define the concept 'life control' emerged during a research that deat with a human being's descriptions being healthy. 'Life control' turned out to be the central category and the main concept organising the whole data. The data were collected by focused interviews (N = 60). Those interviewed represented five different styles of 'life control'. One of these styles that were discovered in the research was chosen as the basis of the conceptual analysis. This style was characterised by 'laissez faire' attitude towards life. Hybrid model was used as the theoretical frame of reference in the conceptual analysis. Thorough study of Finnish and foreign literature about 'life control' leads into an explicit definition of 'life control' describing the data collected by focused interviews: 'Life control' is an individual's basic belief concerning the possibilities to control the course of human life and the extent of this control. An individual either controls his/her life quite independently and completely or only to a certain extent, or it is controlled by factors beyond the influence of a human being. The definition of the 'life control' -concept in the sense that it displays basic beliefs should be examined by studying people's way of thinking with the help of interviews, essays, questionnaires or analysis of autobiographies.

Antifungal activities of two Lactobacillus plantarum strains against Fusarium moulds in vitro and in malting of barley.

AIMS: The Lactobacillus plantarum strains VTT E-78076 (E76) and VTT E-79098 (E98) were studied for their antifungal potential against Fusarium species. METHODS AND RESULTS: In vitro screening with automated turbidometry as well as direct and indirect impedimetric methods clearly showed Lact. plantarum cell-free extracts to be effective against Fusarium species including Fusarium avenaceum, F. culmorum, F. graminearum and F.oxysporum. However, great variation in growth inhibition was observed between different Fusarium species and even between strains. The antifungal potential of Lact. plantarum E76 culture, including cells and spent medium, was also examined in laboratory-scale malting with naturally contaminated two-rowed barley from the crops of 1990-96. The growth of the indigenous Fusarium flora was restricted by the addition of Lact. plantarum E76 to the steeping water. However, the antifungal effect was greatly dependent on the contamination level and the fungal species/strains present on barley in different years. CONCLUSIONS: Lactobacillus plantarum strains E76 and E98 had a fungistatic effect against different plant pathogenic, toxigenic and gushing-active Fusarium fungi. SIGNIFICANCE AND IMPACT OF THE STUDY: The present study indicates that Lact. plantarum strains with known and selected characteristics could be used as a natural, food-grade biocontrol agent for management of problems caused by Fusarium fungi during germination of cereals.

New types of antimicrobial compounds produced by Lactobacillus plantarum.

New types of antimicrobial compounds were identified in the culture filtrate of Lactobacillus plantarum VTT E-78076. Activity was detected in the low molecular mass fraction separated by gel chromatography. This fraction totally inhibited the growth of the Gram-negative test organism, Pantoea agglomerans (Enterobacter agglomerans) VTT E-90396. Characteristic compounds from this fraction were identified by GC/MS-analysis and the identification was confirmed using pure commercial reference compounds in identical chromatographs and in antimicrobial tests. The active fraction included benzoic acid (CAS 65-85-0), 5-methyl-2,4-imidazolidinedione (CAS 616-03-5, methylhydantoin), tetrahydro-4-hydroxy-4-methyl-2H- pyran-2-one (CAS 674-26-0, mevalonolactone) and 3-(2-methylpropyl)-2,5-piperazinedione (CAS 5845-67-0, cyclo(glycyl-L-leucyl)). These compounds in concentrations of 10 ppm inhibited growth of the test organism by 10-15% when acting separately, but 100% when all were applied together with 1% lactic acid. The inhibition was 40% by 1% lactic acid alone. The compounds were also active against Fusarium avenaceum (Gibberella avenacea) VTT-D-80147. The inhibition was 10-15% by separate compounds in concentrations of 10 ppm and maximally 20% in combinations. Fungal growth was not inhibited by lactic acid. Inhibition by unfractionated Lact. plantarum culture filtrate was 37% and by the low molecular mass fraction, 27%.

Protein modification by fermentation: effect of fermentation on the potential allergenicity of pea.

The effect of fermentation on components of potential significance for the allergenicity of pea was analyzed. Pea flour was fermented with three lactic acid bacteria, Pediococcus pentosaceus, Lactococcus raffinolactis, and Lactobacillus plantarum, and two fungi, Rhizopus microsporus, var. oligosporus and Geotrichum candidum. Residual antigenicity against antipea antibodies was reduced to 10% by the three lactic acid bacteria and R. microsporus. Reactions to anti-pea profilin and anti-Bet v 1 were still detectable after fermentation. The contents of lectin and pea protease inhibitor were not reduced by the microorganisms.

Adhesion of bifidobacteria to granular starch and its implications in probiotic technologies.

Adhesion of 19 Bifidobacterium strains to native maize, potato, oat, and barley starch granules was examined to investigate links between adhesion and substrate utilization and to determine if adhesion to starch could be exploited in probiotic food technologies. Starch adhesion was not characteristic of all the bifidobacteria tested. Adherent bacteria bound similarly to the different types of starch, and the binding capacity of the starch (number of bacteria per gram) correlated to the surface area of the granules. Highly adherent strains were able to hydrolyze the granular starches, but not all amylolytic strains were adherent, indicating that starch adhesion is not a prerequisite for efficient substrate utilization for all bifidobacteria. Adhesion was mediated by a cell surface protein(s). For the model organisms tested (Bifidobacterium adolescentis VTT E-001561 and Bifidobacterium pseudolongum ATCC 25526), adhesion appeared to be specific for alpha-1,4-linked glucose sugars, since adhesion was inhibited by maltose, maltodextrin, amylose, and soluble starch but not by trehalose, cellobiose, or lactose. In an in vitro gastric model, adhesion was inhibited both by the action of protease and at pH values of < or =3. Adhesion was not affected by bile, but the binding capacity of the starch was reduced by exposure to pancreatin. It may be possible to exploit adhesion of probiotic bifidobacteria to starch granules in microencapsulation technology and for synbiotic food applications.