Psychosocial Context of Differences Between Asthmatic and Diabetic Patients in Adaptation to Disease.

A significant rise in the incidence of asthma and diabetes makes the psychosocial underpinnings of these diseases an increasingly important issue. This article examines differences in psychosocial functioning between healthy people and patients suffering from asthma and diabetes, as separate disease entities. Psychological factors seem to play a significant role particularly in the process of recovery and adaptation to the disease. Our assumption was that a time perspective, a sense of belonging, and a hope may be related to the functioning of people with chronic asthma and diabetes. The study involved a total of 90 people assigned to three groups: healthy individuals, asthmatic patients, and diabetic patients. The findings demonstrate that patients suffering from asthma have a different attitude toward the future and a sense of fatalism in the present. Yet there are no significant differences between asthma patients and healthy individuals in the sense of belonging and hope. Diabetic patients perceive the present as more fatalistic than asthmatic patients and healthy individuals, and they are less oriented at setting and achieving future goals. The finding that the type and course of the disease are associated with specific psychosocial adaptation may have functional and therapeutic implications, and thus should get psycho-clinical attention.

Psychological background of pro-health behavior.

In this study, psychological conditions of pro-health lifestyle behavior have been analyzed. A first research group consisted of 88 healthy people (44 males, 44 females) aged 19-39. Psychological analysis showed a positive correlation between the internal locus of control and adherence to healthy diets; a correlation extending to the knowledge about healthy food. Social exclusion appeared to reduce the possibility of reaping new knowledge about healthy diets and was negatively correlated with the tendency of using healthy diet or dietary supplements. A second group consisted of 70 women aged 20-65. The subjects in this group were oriented towards using a diet which reduces body mass; pro-health both physical and psychological objectives other than body mass reduction were secondary in this study. General self-esteem and physical self-esteem were found to be positively correlated with the involvement in physical activities and satisfaction from dietary intervention. These outcomes were negatively correlated with body mass. The study shows that the efficiency of prevention is related to the locus of control, self-efficacy expectation, faith in the result, and self-esteem. The information about the interconnections among these variables may be useful in building preventive behavioral programs.

Toward the clarification of ideas: medical futility, persistent/obstinate therapy and extra/ordinary means.

Despite reluctance of a part of medical society to accept the moral and/or legal permission to euthanasia, there is seemingly a common agreement on the need to resolve the problem of excessive therapy. Several ethical concepts are used to justify decisions to withhold/withdraw such treatment. Three of them are of particular value. The ordinary-extraordinary means distinction has a long tradition deeply-rooted in the Catholic medical ethics. During the last decades the concept of futile (or pointless) treatment has reached popularity within bioethical discourse. Also, slightly less common in use, the term 'obstinate therapy' and the relative concept seems to provide interesting insights into ethical debate. What is however to be emphasized is the ambiguity of meanings attached to these terms/concepts which prompt many bioethicists to reject these terms in favor of other concepts. In the present study a PubMed literature database review is done in order to recognize and then to classify the different ways of interpretation of the three concepts related to withholding/withdrawing excessive treatment. Retrieved interpretations of these concepts are evaluated in the light of an integrated model of moral justification. The undertaken analyses permit reaching the conclusion that the concepts which are the subject matter of this article can be properly defined and used only within the context of the so called holistic ethics and as an example of such i.e., a holistic approach to bioethics, the life's programs approach to bioethics is given.

[Fatty acids in treatment and prevention of depression]. / Kwasy tluszczowe w leczeniu i zapobieganiu depresji.

The increase of incident rates for depression and other psychiatric disorders is a serious threat for all communities. The study presents data verifying the relationship between the level of omega-3 PUFAs in the blood and an increased risk of depression, including the parallel standard therapy with antidepressants or not. There is an increasing number of evidences that fatty acids like DHA, AA and EPA are linked to depression. In epidemiological studies and clinical trials a correlation between the decline of omega-3 PUFA intake and an increasing risk for developing depression is considered.

Metabolic syndrome: a brain disease.

Recent research indicates an association between brain dysfunction and the pathogenesis of metabolic syndrome. To investigate this, we created a Medline search (up to December 2011) of articles in PubMed. The results indicated that refined carbohydrates, saturated and total fat, high levels of ω-6 fatty acids, and low levels of ω-3 fatty acids and other long chain polyunsaturated fatty acids (PUFA), all in conjunction with sedentary behaviour and mental stress can predispose to inflammation. Increased sympathetic activity, with increased secretion of catecholamine, cortisol, and serotonin can cause oxidative stress, which may damage the arcuate nucleus as well as the hypothalamus and macrophages, and the liver may release pro-inflammatory cytokines. These, in conjunction with an underlying deficiency in long chain PUFA, may damage the arcuate nucleus as well as neuropeptide-Y and pro-opiomelanocortin neurons and insulin receptors in the brain, especially during fetal life, infancy, and childhood, resulting in their dysfunction. Of the fatty acids in the brain, 30%-50% are long chain PUFA, which are incorporated in the cell membrane phospholipids. Hence, ω-3 fatty acids, which are also known to enhance parasympathetic activity and increase the secretion of anti-inflammatory cytokines interleukin (IL)-4 and IL-10 as well as acetylcholine in the hippocampus, may be protective. Therefore, treatment with ω-3 fatty acids may be applied for the prevention of metabolic syndrome.

Nutritional aspects of epigenetic inheritance.

The impact of diet and environmental factors on genes concerned with epigenetic inheritance and the mechanism of evolution has grown significantly beyond the Modern Synthesis period. Epigenetic inheritance is the passing of phenotypic change to subsequent generations in ways that are outside the genetic code of DNA. Recently, polymorphisms of the human Delta-5 (fatty acid desaturase, FADS1) and Delta-6 (FADS2) desaturase genes have been described as being associated with the level of several long-chain n-3 and n-6 polyunsaturated fatty acids (PUFAs) in serum phospholipids. Increased consumption of refined starches and sugar increases the generation of superoxide anion in the tissues and free fatty acids (FFA) in the blood. There is an increased amount and activity of nuclear factor-κB (NF-κB), a transcriptional factor regulating the activity of at least 125 genes, most of which are pro-inflammatory. The consumption of glucose may be associated with an increase in 2 other pro-inflammatory transcription factors: activating protein-1 (AP-1), and early growth response protein-1 (Egr-1). AP-1 regulates the transcription of matrix metallo-proteinases and Egr-1 modulates the transcription of tissue factor and plasminogen activator inhibitor-1. It is possible that a complex set of factors, including nutritional factors, come into play during epigenetic inheritance.

Heart rate and blood pressure in the context of nutritional and psychological analysis: a case study.

BACKGROUND: The disturbance of circadian variability helps predict, among others, the occurrence of cardiovascular diseases. Circadian Hyper Amplitude Tension (CHAT) is a psychosomatic disorder related to an inappropriate lifestyle (including unbalanced diet, stress-inducing environment/development) and genetic factors. Blood pressure and heart rate are phenotypes characterized by rhythmic fluctuations over time under influence of environmental/developmental (incl. psychosocial) and genetic conditions. These cardio-/cerebro-vascular fluctuations result from otherwise largely distributed internal biological rhythms regulated via complex and intertwined neuro-hormonal systems. OBJECTIVE: The objective of this study was to identify a potential time-structure relationship between blood pressure/heart rate rhythmic fluctuations and nutritional/psychosocial conditions in a 43-year old woman exposed to new nutritional (omega-3 fatty acids supplementation) and psychosocial (divorce) factors. METHOD: The study involved the use of a non-invasive device (ambulatory blood pressure monitor or ABPM, A&D Ltd, Tokyo, Japan) for continuous (24/7) monitoring of heart functions and rhythms between October 2009 and March 2010, at 30-min intervals. As a result, 16 time-structure profiles (Sphygmochron) were obtained from Halberg Chronobiological Center (Minneapolis, MN, USA), each of them containing detailed analysis and interpretation of stacked data spanning 7-14 days. The study also involved a diary of daily nutritional (omega-3 fatty acids) / psychosocial (PANAS) events and their emotional and cognitive components. RESULTS: Both systolic (SBP) and diastolic blood pressure (DBP) steadily decreased during the time of the study. Three periods of elevated variability in SBP (diagnosed as CHAT) and one period of abnormally low DBP were recorded during the 6-month study at the time of negative affects (NA). CONCLUSION: A comparative analysis of diary records (omega-3 fatty acids & PANAS) and cardiovascular responses (Sphygmochron) showed that a person who is professionally and socially active in middle age can actively reduce her SBP/DBP with omega-3 fatty acids intervention. However, the person also displays disturbances in blood pressure variability predicted by the stress-strain hypothesis, whereby states of strain and relaxation are generated by the persons predetermined standards and objectives.