Journal of Nursing Theory and Practice

[Socio-cultural environment as a factor influencing perception of overweight and obesity]

VĚRA Olišarová, VALÉRIE Tóthová, FRANTIŠEK Dolák

DECEMBER 30, 2014

Journal of Nursing Theory and Practice - 2014;27(06)

[The increase of incidence of overweight and obesity is a worldwide problem. Its therapy, as well as prevention, require holistic perception of the issue. The results demonstrate that these diseases cannot be perceived separately but from the perspective of health impact. The socio-economic area, the influences of ethnicity, cultural particularities and a lot of other factors must be considered. This article is focusing on the relation between the socio-cultural environment and perception of overweight and obesity as factors which can be directly reflected with preventive and therapeutic measures. The results show that ethnicity, cultural particularities, acculturation level, social status etc. are factors that influence the incidence of the relevant diseases to some degree. At present, there is lack of sufficient research studies which support the creation and implementation of culturally adequate interventions not only on the territory of the Czech Republic but worldwide. ]



Further articles in this publication

Journal of Nursing Theory and Practice

[Comparative analysis of attitudes during stroke among risk-exposed gypsy and caucasian hungarian population]

SÁNTHA Emese, PAPP László

[Aim of the study: The authors’s aim was to examine causasian and gypsy hungarians attitude towards illness and their knowledge about stroke. Further aim was to study whether the social and financial status and scholastic qualification have an impact on attitude during illness. Sample and methods: A self-made questionnaire was used for data collection. The authors asked 53 gypsy hungarians with a response rate of 85% (45 in total) and 50 causasian hungarians (response rate: 100%, 50 in total). Results: The gypsy persons have less knowledge about stroke than hungarians. The gypsys’ sociodemographic indicators are significantly worse than the other study group. Bad financial conditions and low employment rate seem to sustain the aversive attitude towards illness. Conclusions: If the non-desirable attitude is sustained by low qualification, employment rate and bad financial conditions, then the settlement of these areas could have an effect on the persons’ health. This study expands previous results, since it shows that the attitude towards illness is not only influenced by the knowledge about health and sickness, but also by the level of education. ]

Journal of Nursing Theory and Practice

[Complications and affecting factors of the healing after amputation]

KISS Bernadett Mária

[Aims of the study: To assess whether what complication following primary amputation and what are the chances of the proportion of patients healing who were treated with diabetic foot syndrome and/or lower extremity vascular disease at the Surgical Ward of the Hospital Siofok. Furthermore, to assess the factors that adversely affect the process of healing (addiction, other diseases, type of care after postoperative period and social conditions). Sample and methods: Patients were amputated by reason of diabetic foot syndrome and/or lower extremity vascular disease at the Surgical Ward of the Hospital Siofok between January of 2012 and September of 2013. (N=100) The method of data collection was analysis of the patient’s documentations. Results: 52% of the sample affected by the post-primary lower limb amputation complications. There was no significant correlation between the type of care after postoperative period and conduct of reamputatio. There was no significant correlation between the number of amputations experienced by the patients and the regular appearance of specialized controls. Conclusions: The proposals were formulated based on the following criteria: using for primary, secondary, and tertiary prevention.]

Journal of Nursing Theory and Practice

[Disabled children in the family]

MÓRICZ Lászlóné

[Aim of the study: The arrival of a disabled child at the family is not a happy event at all. The whole life of the family would change and they must face lots of difficulties and impediments. Parents of disabled children become underprivileged financially and socially. They must continuously deal with the structural problems of the social system and the probability of out casting process which are the objects of this study. Sample and methods: Present case study is about a girl suffering from Mucopalysaccharidosis disease and her family. This descriptive study is based on observations, data collecting and analyzing and interviews with the mother. Results: This case is a perfect example to show the structural problems of the social system, which can be latent or not having received the necessary emphasis as most of the time only the parents concerned can see them so they remain unsolved. At the same time it causes great permanent changes having considerable effects on the life of the family. Conclusions: Solutions to the above mentioned problem can be the specialization of the education, the inspection of the nursing districts’ boundaries, the prevention of burning out syndrome of the helpers with proper trainings or if necessary, where there would be only one possible solution, the modification of the legislation.]

All articles in the issue

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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.

Lege Artis Medicinae

[The possibilities of pharmacological treatment of obesity]

PADOS Gyula, SIMONYI Gábor, BEDROS J. Róbert

[There have been attempts to treat obesity with medicines for nearly 100 years, since the discovery of ephedrine. For decades amphetamine derivates and agents stimulating or inhibiting the release of noradrenaline and dopamine have been applied. However, most of theses drugs had to be gradually withdrawn, due to their adverse effects on the cardiovascular and central nervous system or their sympaticotonic effect. Dexfenfluramine (Isolipan), which was introduced in the 90s, did not have such side effects, but it turned out to potentially cause valvular heart disease. Finally, sibutramin (Reductil) was introduced, which again had to be withdrawn in 2010 due to its hypertensive and cardiovascular side effects. After all, we were left without any appetite-suppressant drugs. Orlistat therapy, (Xenical 120 mg, alli 60 mg - OTC), which inhibits the absorption of fat, can eliminate only 30% of the consumed food’s fat content, at the price of gastrointestinal side effects. The latest result of research carried out wordwide is that in 2012 the FDA approved commercial distribution of the selective 5HT2/c serotonin agonist lorcaserin (Belviq), which enhances satiety, in the USA. Unfortunately, in 2013 the EMEA temporarily postponed the lauch of this drug, until certain adverse effects are excluded. For diabetic patients, the GLP-1 agonist exenatid and the GLP-analog liraglutid, which can also reduce body weight, are available in the form of injections.]

Clinical Oncology

[Obesity and cancer]


[The role of obesity in the development of cancer is well-known from ages. However, these days we witness the explosion-like increase of obesity, globally, but mainly in the economically advanced population, and, which is even more alarming, among youngsters. The prognosis of the obesity-related cancer is rather poor, therefore, the prevention, including the screening, have outstanding importance. Unfortunately, the participation of the obes persons, especially obes women, in these programs is very low. The diagnostics and therapies should consider the special features of obesity, which are related to the magnitude, distribution, composition of fatty tissue connected to the changes in pharmacokinetics. Moreover, the problems might be complicated with obesity-associated non-tumorous severe diseases (e.g. cardiovascular, diabetes type 2).This review covers different aspects of obesity-cancer relationships, with an emphasis on everyday oncology.]

LAM Extra for General Practicioners

[Changes in infectology over the past two decades]


[Infectious diseases and various infections are the major causes of morbidity and mortality in developing as well as in industrialised countries. Despite the advances in the past decades in our understanding of microbes, efficient treatment of diseases and preventive approaches, more than 13 million people die every year due to infectious diseases. In the past two decades, more and more new pathogens and infections diseases have been emerging and old diseases that were almost forgotten have re-emerged. There are many new diseases for which we do not have or have hardly any efficient antimicrobial drugs and no efficient vaccines. Despite an increasing frequency of multi- and panresistant microbes, the development of new antibiotics to be used against these infections is unlikely to occur in the near future. The big pharmaceutical companies have stopped the research of antibiotics. In this situation, the only option we have is to use antibiotics rationally and to take prevention and control of infections seriously, both in the outpatient system and in hospitals. Preserving the effectiveness of currently used antibiotics is in everyone’s interest and is everyone’s responsibility]

LAM Extra for General Practicioners



[Various medical associations issue different recommendations for the prevention and treatment of vitamin D deficiency. These significant differences are partly explained by the different definition of normal vitamin D level and the use of completely different mathematical models to predict the increase in vitamin D level as a response to therapy. According to the Institute of Medicine (IOM), the target vitamin D level is 20 ng/ml, whereas the Endocrine Society (ES) recommends 30 ng/m as the miminum target value. According to the ES, a 1 ng/ml increase of vitamin D level can be reached by a daily intake of 100 NE, while the IOM recommends 3.6 ng/ml. Moreover, the IOM states that the effect of therapy on serum level is nonlinear. These differences show that the ES and IOM have different views on the risk of adverse effects. The IOM recommends 400 IU vitamin D daily for children younger than 1 year, 800 IU for those above 70 years and 600 IU/per day for everyone else. The ES recommend 400-1000 IU daily for all infants and 1500- 2000 IU for adults. Screening, however, is not recommended by either society. To decrease uncertainty concerning the side effects of higher-dose vitamin D treatment, it is important to understand, use and support the function of the pharmacovigilance system of the pharmaceutical industry that manufactures and markets various (prescription, over-the-counter) preparations. This is what the author aims to highlight in the second part of this article. Using this system, both the doctor and the patient can help support and accept the justification of higher-dose vitamin D therapy.]