Increased glutamate in type 2 diabetes in the Korean population is associated with increased plasminogen levels.

BACKGROUND: Glutamate is a major neurotransmitter, although it causes cytotoxicity and inflammation in nonneuronal organs. This study aimed to investigate the metabolic disorders in which glutamate, associated with type 2 diabetes onset, is induced in the liver. METHODS: An analysis of Korean community-based Ansan-Ansung cohort study data as well as functional research using in vitro and mouse models were performed. RESULTS: Groups with high plasma glutamate levels (T2, T3) had a significantly increased risk of diabetes incidence after 8 years, compared to the group with relatively low glutamate levels (T1). Analysis of the effect of glutamate on diabetes onset in vitro showed that glutamate induces insulin resistance by increasing glucose-related protein 78 (GRP78) and phosphoenolpyruvate carboxykinase (PEPCK) expression in SK-Hep-1 human liver cells. In addition, three different genes, FRMB4B, PLG, and PARD3, were significantly associated with glutamate and were identified via genome-wide association studies. Among glutamate-related genes, plasminogen (PLG) levels were most significantly increased in several environments in which insulin resistance was induced, and was also upregulated by glutamate. Glutamate-induced increase in PLG in liver cells was caused by metabotropic glutamate receptor 5 activation, and PLG levels were also upregulated after extracellular secretion. Moreover, glutamate increased the expression of plasminogen activator inhibitor-1 (PAI-1). Thus, extracellular secreted PLG cannot be converted to plasmin (fibrinolytic enzyme) by increased PAI-1. CONCLUSIONS: Increased glutamate is closely associated with the development of diabetes, and it may cause metabolic disorders by inhibiting the fibrinolytic system, which plays an important role in determining blood clots, a hallmark of diabetes.

Cultural factors affecting the self-care of cancer survivors: An integrative review.

PURPOSE: For cancer survivors, self-care is an important factor that can improve health and quality of life. Cultures known to inform human behavior can influence self-care, such as prioritizing various self-care practices or utilizing other resources. The impact of culture on cancer survivors' self-care has not been adequately investigated to date. The purpose of this integrative review is to summarize and synthesize the past empirical literature examining cultural factors affecting cancer survivors' self-care. DESIGN: An integrative review was conducted. METHODS: This study was performed in accordance with Whittemore and Knafl's stages of an integrative review (problem identification, literature search, data evaluation, data analysis, and presentation of the results). A literature search was conducted using PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Embase, Web of Science (WOS), and the International Bibliography of the Social Sciences (IBBS) computerized databases with the guidance of a medical librarian. RESULTS: The review incorporated 16 articles. Cultural values, cultural beliefs, fatalism, social norms, faith/religion, sexual roles, and customs were identified as cultural factors affecting the self-care of cancer survivors. These cultural factors were found to influence the behaviors of cancer survivors' health maintenance (healthy life and psychological well-being), self-care monitoring (physical symptoms and complication symptoms), and self-care management (coping with symptoms and response to symptoms). CONCLUSION: The results of this study provide valuable insights into the cultural influence of cancer survivors on self-care behaviors, and healthcare providers can promote self-care behaviors if they understand cultural factors and develop nursing interventions that take cultural influences into account.

A Structural Model of Quality of Life in Patients after Colorectal Cancer Surgery.

BACKGROUND: This study was conducted to determine a hypothetical model for the factors affecting the quality of life of postoperative colorectal cancer patients. METHODS: We collected data from 209 patients that was analyzed using SPSS 22.0 and AMOS 25. RESULTS: Predictive variables of the hypothesis model included an exogenous variable, social support, as well as endogenous variables self-efficacy, symptoms, health promotion behavior, and quality of life. Testing of the correction model showed that significant paths directly affecting quality of life of patients after colorectal cancer surgery included health promotion behavior, symptoms, and self-efficacy and also showed an explanation power of 58.7%. Social support was found to have a significant impact on the quality of life indirectly through self-efficiency. CONCLUSIONS: To improve the quality of life of colorectal cancer patients, it is necessary to develop a nursing intervention program that strengthens patients' health promotion behaviors to alleviate their symptoms and improve their social support and self-efficacy.

Experience of Conflict in Three Shift Nurses Rearing more than Two Kids: Phenomenological Study.

PURPOSE: To understand the essentials of rearing conflict experience by three shift nurses in advanced general hospitals. METHODS: The design was a qualitative research of phenomenology. Participants were 7 shift nurses working in advanced general hospitals who were rearing young children. Data were collected individually through in-depth interview on their life experiences. Data were analyzed by Colaizzi's phenomenological methodology. RESULTS: Eighteen themes were drawn from 256 meaningful experiences and these themes were integrated to six theme clusters. The most influencing themes were 'Regret that I cannot satisfy even the slightest wish', 'Fail to care for kids', and 'Mutual feeling to care giver between appreciation and inconvenience'. Other themes were as follows: 'Body and mind are broken', 'The need for a three-shift system to support nurses who are rearing children', 'Doing my best for work and child rearing'. CONCLUSION: The nature of three-shift nurses working in advanced hospital and caring kids is explained as 'lives with conflict' between work and home. This study suggests it is necessary to establish a 24-hour care center for 3-shift nurses to keep working while rearing their children.

Association between Nutrient Intake and Metabolic Syndrome in Patients with Colorectal Cancer.

The purpose of this study was to investigate the difference of nutritional status according to metabolic syndrome in colorectal cancer patients. The subjects were divided into 2 groups (metabolic syndrome group and normal group) according to the presence or absence of metabolic syndrome in 143 patients diagnosed with colorectal cancer, and their lifestyle and nutritional status were analyzed. Recall method was used for the dietary survey, and metabolic syndrome was defined as the presence of 3 or more of waist circumference, fasting blood glucose, triglyceride, high-density lipoprotein (HDL)-cholesterol, and blood pressure. This study showed that the metabolic syndrome group had a low age, a high body mass index (BMI), and a high drinking rate. The intake of energy, protein, fat, calcium, and phosphorus was significantly higher in the metabolic syndrome group than in the normal group, and the intake of ß-carotene, vitamin C, and folic acid was significantly low. The intake of cholesterol, fatty acid, saturated fatty acid, and polyunsaturated fatty acid was also higher in the metabolic syndrome group. Higher BMI, alcohol consumption, intake of fat, total fatty acid or saturated fatty acid increased the risk of metabolic syndrome, but fiber, vitamin C, or folic acid intake lowered the risk.Weight management and balanced nutritional intake should be emphasized to prevent metabolic syndrome and to improve the condition in patients with colorectal cancer.