'A good person does not feel envy': envy in a nursing community

The definition of envy is commonly based on psychoanalytical views of organizational culture. The purpose of this paper is to describe envy in a nursing community. The population study consisted of random sample of 120 subjects drawn from among the employees of one central hospital in Finland. The study material consisted of data collected by questionnaires (response rate 65%). The data were processed by various statistical methods. Open-ended questions were analysed by inductive content analysis. The results of this study indicated that the employee's view of his/her official position in the nursing community, his/her relationships with his/her fellow workers and the management as well as relationships with other nursing communities are all related to envy. The employee's view of his/her official position intensified his/her feelings of envy, if he/she had other negative feelings, anxiety, dissatisfaction with him/herself, and negative feelings towards fellow workers. The major object of envy was fellow workers' salaries. Envy towards other nursing communities was generated by alleged differences in the amount of labour, or by the charge nurse's greater interest in other sections. Employees coped with envy by hiding these feelings and being modest. Women coped with envy by being silent, while men denied the value of the object of envy.     

Tubal patency and fertility outcome after expectant management of ectopic pregnancy

Objective: To study tubal patency and fertility outcome of patients with expectantly managed ectopic pregnancy (EP).

Design: A prospective study.

Setting: Department of Obstetrics and Gynecology, Turku University Central Hospital, Turku, Finland.

Patient(s): Thirty patients who wanted to become pregnant again were treated successfully by expectant management of EP.

Intervention(s): Patients were examined with posttreatment hysterosalpingography, and they filled out a questionnaire about their subsequent pregnancies.

Main Outcome Measure(s): Free passage through open lumen showing tubal patency; number of full-term pregnancies and EPs revealing relative rate of subsequent fertility.

Result(s): A free passage through the diseased tube was seen in 93% of the cases (28 of 30). Two of the 24 patients (8.4%) who wanted to become pregnant had an obstruction in the diseased tube. One (4.2%) of them had a normal opposite tube and later had a normal pregnancy. The other (4.2%) had an obstruction in both tubes and subsequently had a repeat EP. One of the 6 patients had an EP (this patient did not want to become pregnant and did not use contraception). However, her posttreatment hysterosalpingography was normal. In total, the subsequent pregnancy rate was 88% (21 of 24), and the rate of repeat EP was 4.2% (1 of 24).

Conclusion(s): Patients who are treated with expectant management have a good long-term fertility outcome. Spontaneous regression of EP does not lead to increased harm or damage to the tube, i.e., the risk for repeat EP is low.     

The life situation of a long-term psychiatric patient: some restrictions in, and possibilities of, open care

This paper describes and analyses, from a sociocultural viewpoint, the ways of life of discharged long-term psychiatric patients in northern Finland The paper focuses on subjectivity control of life and fundamental experiences in life The data consist of interviews with 25 outpatients who have moved to live in residential homes, rehabilitation centres or their own homes after receiving preparatory training in the psychiatric hospital The findings suggest that the way of life of the outpatients did not significantly differ from that of other people belonging to the same generation of Finns With respect to control of life, a conspicuous feature was the strong tendency to let themselves be led by others, and to self-sacrifice for the good of others For the patients, independence was the best aspect of open care Fear for being branded as a psychiatric case or as a former mental patient threatened the patients'external control of life The central element of control of life of the Finns is work The outpatients thought work a matter of honour and they did not find their present, inactive way of life satisfactory     

Incidence and survival in patients with pharyngeal cancer in northern Finland

A population-based survey was conducted in northern Finland in order to study the incidence rate and survival in patients with pharyngeal cancer diagnosed between 1986 to 1996. A total of 95 new patients with hypopharyngeal, oropharyngeal or nasopharyngeal cancers were identified. The overall age-adjusted incidence rates (per 100,000 years) were 1.28 in men and 0.60 in women, giving an overall incidence rate of 0.89. Most of the tumours were diagnosed at stage IV, and the median disease-specific survival times were 27.6 months for the patients with oropharyngeal cancer, 13.5 months for nasopharyngeal cancer and 17.7 for hypopharyngeal cancer. The most important factors that were associated with a poor prognosis were stage IV in oropharyngeal [Hazard ratio (HR) 3.68, 95% confidence interval (CI) 0.97-13.92] and hypopharyngeal cancer (HR 3.99, CI 1.51-10.67) and age over 65 years in nasopharyngeal cancer (HR 9.28, CI 1.79-47.99).     

Risk factors for recurrences of febrile convulsions

Risk factors for predicting recurrences of febrile seizures were studied in an unselected series of 169 children after their first febrile seizure. Follow-up data covering 2.1–6.8 (mean 3.8) years from the first febrile seizure were available from 167 of them (98.8%) including 72 girls. Altogether 35/167 (21.0%, 95% confidence intervals (CI) 14.6% to 29.1%) had further febrile seizures, and multivariate logistic regression analysis showed the number of febrile episodes (p = 0.011) and the occurrence of such seizures among first degree relatives (p = 0.015, relative risk 3.75, CI 1.22 to 11.5) to be significant risk factors for recurrences. Our findings indicate that more emphasis should be placed on preventing febrile episodes rather than concentrating only on preventing seizures with antiepileptic therapy.     

Lens opacity in patients with hypercholesterolemia and ischaemic heart disease

Lens opacity studies were performed using an electronic Lens Opacity Meter (Interzeag Opacity Lensmeter 701) in a population (n = 321) with ischaemic heart disease. These patients are participating in a trial targetting at the reduction of mortality and incidence of myocardial infarction using a cholesterol-lowering drug, simvastatin. A separate study to evaluate the reliability of the method showed good reproducibility. Repeated measurements after a short time-interval (2–10 days) gave statistically lower opacity values either due to a change in lens transparency or perhaps a change in pigment and cell dispersion in the acqueous caused by repeated mydriasis. Lens opacity values showed a highly significant positive correlation to age. Serum cholesterol, systolic blood pressure and smoking habits showed no significant correlations to the levels of lens opacity when adjustments for age were made.Abbreviations HMG-CoA hydroxy-methylglutarylcoenzyme A - 4S Scandinavian Simvastatin Survival Study - LOM lens opacity meter     

Cardiovascular malformations, work attendance, and occupational exposures during pregnancy in Finland

To explore for associations between occupational factors and cardiovascular malformations, information on the parents of 160 infants with cardiovascular malformations and 160 control parents was studied. The case infants had been reported consecutively to the Finnish Register of Congenital Malformations. All mothers were interviewed identically after delivery, using both open and pro forma questions about detailed work tasks, exposures, and leisure activities during pregnancy. The interview information was evaluated blindly. Neither parental occupational titles nor maternal working per se gave new clues to the teratogenic risk; nor did shift working, wearing of personal protective equipment, or the mother's own opinion on exposures during pregnancy. Identified occupational exposures, as categorized by an industrial hygienist, showed no remarkable associations to cardiovascular malformations. Few mothers were exposed substantially to specific occupational hazards. Comparing mothers who used medications in the first trimester with those who did not showed an odds ratio of 2.2 (95% confidence interval 1.3-3.9) when adjusted for potential confounding by multivariate logistic methods.     

Molecular and biological analysis of echovirus 9 strain isolated from a diabetic child

The full-length infectious cDNA clone was constructed and sequenced from the strain DM of echovirus 9, which was recently isolated from a 6-week-old child at the clinical onset of type 1 diabetes. Parallel with the isolate DM, the full-length infectious cDNA clone of the prototype strain echovirus 9 Barty (Barty-INF), was constructed and sequenced. Genetic relationships of the sequenced echo 9 viruses to the other members of the human enterovirus type B species were studied by phylogenetic analyses. Comparison of capsid protein sequences showed that the isolate DM was closely related to both prototype strains: Hill and Barty-INF. The only exception was the inner capsid protein VP4 where serotype specificity was not evident and the isolate DM clustered with the strain Hill and the strain Barty-INF with echovirus 30 Bastianni. Likewise, the nonstructural protein coding region, P2P3, of isolate DM was more similar to strain Hill than to strain Barty-INF. However, like echovirus 9 Barty, the isolate DM contained the RGD-motif in the carboxy terminus of capsid protein VP1. By blocking experiments using an RGD-containing peptide and a polyclonal rabbit antiserum to the alpha(v)beta(3)-integrin, it was shown that this molecule works as a cellular receptor for isolate DM. By using primary human islets, it was shown that the isolate DM is capable of infecting insulin-producing beta-cells like the corresponding prototype strains did. However, only isolate DM was clearly cytolytic for beta-cells. The infectious clones that were made allow further investigations of the molecular features responsible for the diabetogenicity of the isolate DM.     

Laccase from the white-rot fungus Trametes versicolor: cDNA cloning of lcc1 and expression in Pichia pastoris

A cDNA coding for laccase was isolated from the ligninolytic fungus Trametes versicolor by RNA-PCR. The cDNA corresponds to the gene lcc1, which encodes a laccase isoenzyme of 498 amino-acid residues preceded by a 22-residue signal peptide. The lcc1 cDNA was cloned into the vector pHIL-D2 for expression in Pichia pastoris under the control of the AOX1 promoter. Transformants were found to secrete active recombinant enzyme after induction with methanol. The use of growth medium buffered to pH 6.0 and control of pH during cultivation were found to be important, or even necessary, for obtaining activity in liquid cultures. The effect of exchanging the native secretion signal for the Saccharomyces cerevisiae α-factor pre-pro secretion signal was studied by cloning the portion encoding the mature enzyme into the vector pPIC9. The activity obtained for the construct encoding the native laccase signal sequence was found to be seven-fold higher than for the construct encoding the α-factor secretion signal. Utilisation of the P. pastoris pep4 mutant strain SMD1168 was found to provide a two-fold higher level of activity compared with P. pastoris GS115. Received: 16 May / 8 August 1997