Experiences of persons with type II diabetes receiving health coaching: an exploratory qualitative study.

INTRODUCTION: The objective of this exploratory qualitative study was to examine the experience of persons living with type II diabetes who participated in a health coaching intervention. METHODS: The researchers used a qualitative phenomenological hermeneutic research design to explore the experiences of people undergoing health coaching for self-management of their diabetes. RESULTS: Qualitative data analysis resulted in three themes that best described participants' experience of health coaching for diabetes: (1) "the driving force," which described how health coaches helped clients to find powerful motivators for change; (2) "I'm not a child," which described how people wanted to be treated by the health coaches; and (3) "meeting the inner coach," which described how health coaches helped clients develop their own inner wisdom. DISCUSSION: The participants' descriptions of coaching challenge a more traditional paradigm of expert-driven and information-laden diabetes education practices. The findings suggest that the process of health coaching may help persons with diabetes become confident self-managers of their diabetes.

Acute and chronic effects of ethanol on secretion of alpha-tocopherol from primary cultures of rat hepatocytes.

Primary cultures of rat hepatocytes were used to study the effect of acute and chronic ethanol exposure on alpha-tocopherol content in cells and media. Cells treated acutely with 60 mM ethanol secreted 74.5 +/- 18.0% (P less than 0.05), and their cellular alpha-tocopherol content was 85.7 +/- 15.4% (not significant) of controls after 20 h incubation. At this time total recovery of alpha-tocopherol was significantly reduced in ethanol-exposed cells (43.1 +/- 8.4%) as compared to control cells (52.8 +/- 5.0%, P less than 0.05). Hepatocytes isolated from chronic ethanol-fed rats (35% of total energy intake as ethanol for 5 weeks) secreted 41.9 +/- 12.7% less alpha-tocopherol than did cells of pair-fed controls during 20 h incubation (P less than 0.05). The amount of alpha-tocopherol secreted was then 15.6 +/- 4.2 and 19.8 +/- 3.8% of cell-associated alpha-tocopherol at start of incubation for chronic ethanol-fed and control rats, respectively (P less than 0.05). When 60 mM ethanol was added to the incubation medium, hepatocytes of control rats secreted significantly less alpha-tocopherol (about 30%, P less than 0.05), whereas alpha-tocopherol secretion was not significantly reduced in hepatocytes of chronic ethanol-fed rats. We conclude that both acute and chronic ethanol exposure reduce alpha-tocopherol secretion from rat hepatocytes.

Reduced hepatic alpha-tocopherol content after long-term administration of ethanol to rats.

We have studied the effects of long-term administration of ethanol on the distribution and pharmacokinetics of alpha-tocopherol. In rats fed ethanol (35% of total energy) for 5-6 weeks concentration of alpha-tocopherol in whole liver was reduced by 25% as compared to the pair-fed controls (P less than 0.003). This reduction was significant in the parenchymal cells (28%, P less than 0.004), whereas no significant difference was observed for the nonparenchymal cells. Mitochondrial alpha-tocopherol content was reduced by 55% in the ethanol-treated rats as compared to the controls (P less than 0.002), whereas no significant difference was observed in microsomes, light mitochondria or cytosol. The serum levels of alpha-tocopherol showed no significant difference between the groups. When in vivo labeled chylomicron alpha-[3H]tocopherol was injected intravenously to anesthetized rats, we found a significant increase in serum half-life of alpha-tocopherol in the ethanol-treated group as compared to the controls (P less than 0.025). Hepatic alpha-[3H]tocopherol content was similar in the two groups 24 h after injection.

Transport and distribution of alpha-tocopherol in lymph, serum and liver cells in rats.

Rats were cannulated in the major mesenteric lymph duct and given an intraduodenal bolus of unlabeled and alpha-[3H]tocopherol, and [14C]oleic acid in soybean oil. The appearance of alpha-tocopherol in lymph was negligible during the first 2 h and peaked 4-15 h after feeding, whereas no detectable amount was recovered in the portal vein. Intestinal absorption via the lymphatic pathway was 15.4 +/- 8.9% (n = 10) and 45.9 +/- 10.8% (n = 4) for alpha-tocopherol and [14C]oleic acid, respectively. About 99% of alpha-tocopherol in lymph was associated with the chylomicron fraction (d less than 1.006 g/ml). In non-fasting rats, 51% of serum alpha-tocopherol was associated with chylomicrons/VLDL (very-low-density lipoprotein, d less than 1.006 g/ml) and 47% with HDL (high-density lipoprotein, 1.05 less than d less than 1.21 g/ml). Our study revealed that the liver, skeletal muscle and adipose tissue contain approx. 92% of the total mass of alpha-tocopherol measured in ten different organs. Parenchymal and nonparenchymal liver cells contributed to 75% and 25% of the total mass of alpha-tocopherol in the liver, respectively.

Secretion of alpha-tocopherol from cultured rat hepatocytes.

Primary cultures of rat hepatocytes and rat liver perfusions were used to study hepatic secretion of alpha-tocopherol. The secretion of alpha-tocopherol from hepatocytes in culture was linear with time for 4 h. Ultracentrifugation of the medium revealed that 89.4 +/- 2.1% of alpha-tocopherol secreted during 4 h incubation was associated with the very-low density lipoprotein fraction (VLDL, d less than 1.006 g/ml). Oleic acid had no significant effect on the secretory rate of alpha-tocopherol, whereas eicosapentaenoic acid reduced the amount of alpha-tocopherol secreted to 48.4 +/- 12.7% of the control value after 20 h incubation (P less than 0.01). Monensin, a known inhibitor of VLDL secretion, reduced the secretion of alpha-tocopherol to 14.1 +/- 4.3% of the control value (P less than 0.02). Colchicine and chloroquine inhibited the secretion of alpha-tocopherol in the same order of magnitude as monensin. Hepatic perfusion after intravenous injection of in vivo labeled alpha-[3H]tocopherol lymph, showed that about 75% of the secreted radioactivity was in the VLDL fraction. From these results we conclude that most alpha-tocopherol is secreted from the liver associated with nascent VLDL in rats.

A model assay to demonstrate how intrinsic factors affect diffusion of bacteriocins.

A rapid and simple method to elucidate how intrinsic factors in a given food product affect bacteriocin diffusion and efficacy is described. The basic idea of this assay is to help predict which bacteriocin or other inhibitory substance to select for a given product, where increased security towards specific microorganisms is wanted. In an agar plate model system the effect of five factors (number of indicator cells, pH and concentration of NaCl, agar and soy oil) on the diffusion of the bacteriocins sakacin A, sakacin P, pediocin PA-1, piscicolin 61 and nisin was studied. An experimental design permitting simultaneous evaluation of the effect of all factors was used. The results indicated that each bacteriocin has a characteristic intrinsic factor effect profile. However, pH and load of indicator cells affect all the bacteriocins.

Meat starters have individual requirements for Mn(2+).

The effect of different Mn(2+) concentrations on sausage fermentation was evaluated. A screening experiment was carried out with six lactobacilli starters in a sausage model. To further investigate the effects found, two selected lactobacilli strains were tested in pilot-scale sausage production. For all starters an increased fermentation rate was observed after Mn(2+) addition. Differences in the development of microbial, textural and sensory parameters were observed in the sausages. For one of the cultures these differences levelled out during sausage production yielding identical end products with and without Mn(2+), for the other strain the differences due to Mn(2+) addition in the sausages remained throughout the production process yielding sausages with different properties. Knowing a starter culture's requirements for Mn(2+) will allow optimisation of dry fermented sausage production in order to increase reliability and reproducibility of production decrease fermentation time and ensure microbial safety of the final product.

Accelerated production of dry fermented sausage.

The scope of this paper is to review work connected with accelerated ripening of dry fermented sausages by addition of proteolytic enzymes. An overview of the following topics is given: practical sausage experiments with addition of various proteinases of bacterial origin, including data from sensory, biochemical and gc/ms analyses; biochemical and genetic characterization of the enzyme shown to be most useful in these experiments, the serine proteinase from Lactobacillus paracasei subsp. paracasei NCDO 151; experiments to transform starter cultures with the genes for production of this proteinase and proposals for future work in this field.

When caring leaves bruises: the effects of staff education on resident aggression.

1. Physical aggression toward nursing staff by confused elderly residents is a very common and frustrating clinical nursing problem in long-term care facilities. 2. Some physical aggression may be associated with a lack of knowledge about dementia, therefore staff inservice education may be one way of reducing some forms of physical aggression. 3. The authors found a 50% reduction in reported physical aggression from elderly residents after a staff education program on dementia and aggression was implemented.

Might within the madness: solution-focused therapy and thought-disordered clients.

Nurses working with thought-disordered clients in inpatient psychiatric settings may find that much of their role is defined by the administration and monitoring of antipsychotic medications. Therefore, a challenge for these nurses can be to find other nursing interventions for these clients that are effective, efficient, and clearly and uniquely within the scope of nursing. In response to this challenge, this article presents the use of solution-focused therapy (SFT) to help thought-disordered clients better cope with some of their negative experiences and symptomatology. The article provides an overview of SFT, with a focus on how these techniques might be used on an inpatient psychiatry setting with clients experiencing thought disorders. The authors include three case studies demonstrating the use of SFT with clients experiencing thought disorders, and conclude with some of the lessons they have learned using SFT techniques with these kinds of clients in inpatient psychiatric settings.

Effect of chronic ethanol consumption on the content of alpha-tocopherol in subcellular fractions of rat liver.

The effects of long-term administration of ethanol (35% of total energy for 6-8 weeks) on the distribution and concentration of alpha-tocopherol in subcellular fractions of rat liver have been studied. Marker enzymes were measured in all fractions. The highest concentration of alpha-tocopherol was found in the light mitochondrial fraction both in ethanol-fed and control rats, 754 +/- 104 and 1127 +/- 126 pmol/mg protein, respectively. The microsomal, heavy mitochondrial, and nuclear fractions also had high concentrations of alpha-tocopherol, whereas the cytosolic fraction contained minor amounts. In the light mitochondrial fraction we found the highest concentration of alpha-tocopherol in lysosomes, whereas small amounts were detected in peroxisomes. In the microsomal fraction the highest concentration was found in the Golgi apparatus. The content of alpha-tocopherol in the light mitochondrial fraction was reduced by 33% (p less than 0.02) in the ethanol-fed group as compared to the controls. In the other fractions no significant differences between the two groups were observed. Long term administration of ethanol promoted, however, a further enrichment of alpha-tocopherol (178% higher than controls) in the Golgi apparatus, possibly due to reduced secretion of very low density lipoprotein-associated alpha-tocopherol.

Effect of dietary deficiency and supplementation with all-rac-alpha-tocopherol on hepatic content in rats.

We studied the effect of dietary deficiency and supplementation with vitamin E in the form of all-rac-alpha-tocopherol in relation to the content of alpha-tocopherol in parenchymal and nonparenchymal liver cells. The cells were isolated by centrifugal elutriation from rats fed diets containing normal, low or high amounts of vitamin E. The parenchymal cells contained about 90% of total hepatic alpha-tocopherol content in rats fed a nonpurified diet (reference group). However, the Kupffer and the endothelial/stellate cells contained four and two times more alpha-tocopherol, respectively, than the parenchymal cells per milligram of cell protein. When the rats were deprived of vitamin E for 8 wk, the content of alpha-tocopherol in parenchymal cells was reduced to 30% of values obtained from rats fed the nonpurified diet, and nonparenchymal cells contained very low levels of alpha-tocopherol (less than 5% of reference values). A diet enriched in vitamin E resulted in a sixfold increase in the content of alpha-tocopherol in parenchymal cells but in small changes in nonparenchymal cells compared to the reference diet. Accordingly, the parenchymal cells may have storage capacity for alpha-tocopherol. The light mitochondrial and microsomal fractions contained high amounts of alpha-tocopherol. These fractions were subdivided by density gradient centrifugation to examine the alpha-tocopherol content in different cell organelles. The lysosomes and the Golgi apparatus were found to contain high levels of alpha-tocopherol, whereas peroxisomes contained small amounts.