Journal of Nursing Theory and Practice

[Childhood obesity]

KORMOS-TASI Judit, SZABÓ László, GÁCSI Erika

DECEMBER 31, 2013

Journal of Nursing Theory and Practice - 2013;26(06)

[The obesity is a worldwide problem in all agegroup. In 1998 the WHO gives forth that the obesity is an illness. In Hungary the frequency of obesity today is 7 % at the age of 17. The childhood obesity is a main risk of morbidity in the adulthood. There atre two parts of the prevention: sports and excersises and healthy nutrition. In the health prevention we have to take aim at these two methods, so this is the right way to the successfull results. ]

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[The health care changes affected the everyday lives of nurses ]

NÉMETH Anikó, BETLEHEM József, LAMPEK Kinga

[Aims of the study: To examine the changes inpatient care nurses had to undergo following the reorganization of health care system during the last few years. Sample and methods: This was a cross-sectional study conducted in six teaching hospitals of Hungary involving nurses who worked full-time in inpatient care applying self-developed questionnaires between October and December 2010. Results: Nurses had to face many negative events and the feeling of uncertainty during the reorganization, which also affected the self evaluation of their health status. The fear of relocation, reduced salary or losing the job and the worsened psychic status and bad workplace communication are significant. The six-question uncertainty scale can be divided into a promotional and an environmental subscale. Responders expect significant support from their employers, mainly financially. Conclusions: The reorganization of the health care system caused uncertainty by the nurses. ]

Journal of Nursing Theory and Practice

[Hungary is the cradle of Occupational Health Nursing Education ]

HIRDI Henriett Éva

[Aim of the study: To research the origin and story of the Occupational Health Nursing in Hungary, to present the development of the factory nurse institutions which fell into oblivion by this time. Sample and Method: Collect and work up literature sources and legislation systematically issued between 1840 and 1950. Examine extant correspondence and reports of factories, enterprises and finishing-schools functioned before the socialization. The examined issues were the followings: aspects of the selection of those who fill factory nurse scope of activities, their qualification, role and esteem. Results: It was found that factory nurses were not selected out of working women. The first factory nurse course started in 1933 in Budapest. During ten years 150 students fulfilled the two-years full-time course based on the secondary education. Participants of the course had to suit strict admission requirements. Students of the course learnt about health, social, legal and cultural knowledge from noted professionals at that time. Factory nurses performed their activities basically at two locales: inside and outside of the factory. Qualified factory nurses were hold in great honour socially, even their rights were protected by collective agreement. Conclusions: Occupational Health Nurse Education has a 80-years-old history in Hungary, that throw new light upon theories until now about origin of Occupational Health Nursing. ]

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[One of the potentials of the effective fight against endemic diseases is their exposition and the recognition of their dangers and risk factors. The other possibility is to increase the professional knowledge of the medical and healthcare employees along with the patients’ co-operation. For the prevention of complications and the adequate treatment of hypertension an extensive compliance program, called „Live below 140/90!” was initiated by the Hungarian Society of Hypertension in 2005. The mission was to give knowledge to the non-professional public about the symptoms of the disease and how to get information about it while helping patients’ relatives. The first message was the “Hit the target blood pressure value!”. With careful planning, treatment and taking of medicines the next phase could begin. The ratio of the patients who reached the target blood pressure increased by 5% during the two years of the Program between 2005 and 2007 therefore the message changed to “Hold the blood pressure there!”. The next step in the Program was to prevent the forming of complications and to treat the co-morbidities effectively among patients with pre-diabetes or diabetes and hypertension in 2008. The slogan was “Prevent the complications!”. As part of the Program we organized a roadshow named the “Day of caring!” and we announced the “Conscious Care” substudy focused on the public summoning about the stroke which is the most dangerous complication of hypertension. The year of 2011 is an absolutely new beginning in the communication of the Program since we started to use some very modern tools of the 21st century including YouTube, Facebook and others for the better education of the people. Based on the results of the initial Program we got to know the risks, co-morbidities, complications and the characteristics of the Hungarian hypertensive patients. We have recognized that most of the patients belong to the high and very high risk hypertensive category. Also more than 30 percent of them have a pre-diabetes condition. We have found that increased caring helps to build up the patients’ co-operation which in return improves the decrease of their blood pressure significantly. The Program therefore continues in 2011! Our intention is to enlarge the Hungarian Hypertension Register database and to get to know more and more epidemiologic and therapeutic features of the hypertension disease.]

Clinical Neuroscience

Positive airway pressure normalizes glucose metabolism in obstructive sleep apnea independent of diabetes and obesity

KABELOĞLU Vasfiye, SENEL Benbir Gulçin, KARADENIZ Derya

The relationship among obstructive sleep apnea syndrome (OSAS), type 2 diabetes mellitus (DM2) and obesity is very complex and multi-directional. Obesity and increased visceral fat are important perpetuating factors for DM2 in patients with OSAS. On the other hand, OSAS itself leads to obesity by causing both leptin and insulin resistance as a consequence of activation of the sympathetic nervous system. Risk for developing DM2 further increases in patients with OSAS and obesity. Data regarding effects of positive airway pressure (PAP) therapy, gold standard treatment for OSAS, on glycemic control were inconsistent due to variability in duration of and adherence to PAP therapy. In our cohort study we investigated effects of PAP treatment on glucose metabolism in normal-weighted non-diabetic OSAS patients, in obese non-diabetic OSAS patients, and in OSAS patients with DM2. We prospectively analyzed 67 patients diagnosed with OSAS and documented to be effectively treated with PAP therapy for three months. Apnea-hypopnea index was highest in the diabetic group, being significantly higher than in the normal-weighted group (p=0.021). Mean HOMA values were significantly higher in obese (p=0.002) and diabetic group (p=0.001) than normal-weighted group; the differences were still significant after PAP therapy. HbA1c levels were significantly higher in diabetic group compared to those in normal-weighted (p=0.012) and obese (p=0.001) groups. After PAP treatment, decrease in HbA1c levels were significant in normal-weighted (p=0.008), obese (p=0.034), and diabetic (p=0.011) groups. There was no correlation with the change in HbA1c levels and age (p=0.212), BMI (p=0.322), AHI (p=0.098) or oxygen levels (p=0.122). Our study showed that treatment of OSAS by PAP therapy offers beneficial effect on glucose metabolism, not only in diabetic patients, but also in obese and normal-weighted OSAS patients. Although data regarding overall effects of PAP therapy on glycemic control present contradictory results in the literature, it should be emphasized that duration and adherence to PAP therapy were main determinants for beneficial outcome of treatment.