Paleo-Diet Research Project Paper Example | Topics and Well Written Essays - 1000 words

Paleo-Diet Project - Research Paper Example Refined foods can cause different diseases, i.e. cancer, obesity, diabetes, heart attacks, Parkinson’s, depression, Alzheimer’s, etc. Many scientist researches have proved that the paleo-diet is rich in Monounsaturated and Omega-3 fats to reduce the risk factors of cancer, diabetes, heart diseases, obesity, and the cognitive. Fruits and vegetables have rich vitamins extracts, antioxidants, minerals, etc. to decrease the disease spreading factors in the human body. The critiques of paleo-diet consider it as a nonsensical diet, which can become dangerous because of strict restricting patterns. An evolutionary biologist, Marlene Zuk wrote in the book â€Å"Palefantacy† that the myths of paleo-diet are not relevant to the movements of the common lifestyles. Some experts say that the concept of the paleo-diet is to ban junk foods. The arguments of some experts that they do not like the old patterns of foods rather that modern food recipe by having low calories to live an active life style (Jabar, 2013). Some food experts believe that paleo-diet is not all free from the restricted food items, so the concept of this dietary pattern is just like a folk. Expansion of the vegetarian agenda is also a critic point of the paleo-diet. Men are not conscious for eating only paleo-diet (Wolf, Debunking the Paleo Diet: A Wolf’s Eye View, 2013) . Robb Wolf stated that the Paleo-diet has become one the most favorite diets of Americans (Wolf, Debunking the Paleo Diet: A Wolf’s Eye View, 2013). In a conference of Frankfurt, a census was organized internationally to research for the healthy dietary pattern by many anthropologists, archaeologists, and the molecular biologist. They all agreed on the paleo-diet for a healthy lifestyle. The experts presented the nutritional framework based on human species that these species have not adopted the

Primary Health Care And Improving Polypharmacy Nursing Essay

Primary Health Care And Improving Polypharmacy Nursing Essay Polypharmacy is common in older people around 20% of people over 70 take five or more drugs (Milton, J et al. Prescribing for older people. BMJ 2008; 336: 606-9) With reference to both literature and your CBM experience discuss how the Primary Health Care team can work together to improve both compliance and concordance in relation to medication in patients. Polypharmacy is defined as: the use of a number of different drugs possibly prescribed by different doctors and filled in different pharmacies, by a patient who may have one or several health problems [1]. The World Health Organisation estimates that only 50% of patients who suffer chronic diseases comply with treatment recommendations [2]. During day four entitled A Pill for Every Ill? at our GP practise we discussed and learnt about the issue of polypharmacy and how it effects compliance (The extent to which the patients behaviour matches the prescribers recommendations [3] ) and concordance (a concept in which doctor and patient agree therapeutic decisions that incorporate their respective views [3] ) in patients. I also got the opportunity to interview patients about their medication use. From interviewing two patients I found that they all took a number of different drugs for several health problems not simply for one. All of the patients were over the age of sixty and had initially presented with one health problem. Later, further health complications arose that led to more health conditions/problems and consequently increased polypharmacy. The first patient I interviewed took eleven different tablets and had two inhalers. He had had asthma since his childhood and carried an inhaler with him. He initially presented with type two diabetes mellitus twenty years ago and was prescribed medication to help control his diabetes. However, he had a heart attack ten years ago but was unfortunately not prescribed certain preventative heart medications for nine years and consequently only began to take his full course of heart medications a year ago. He has now been prescribed with GTN spray and eight tablets including beta blockers, statins, aspirin and GTN spray. He takes five of these tablets in the morning and three at night. He is on repeat prescription for all his medications and he picks up a blister pack/ dosette box from the pharmacy every month with his medication in, so that he can remember what to take and when to take it. When asked he said he was very happy with how clearly the tablets, inhalers and the side effects o f both had been explained to him. He does not pay for his medications because he is an old age pensioner. He does not feel he suffers any side effects from the medications. He has regular appointments to have blood taken so that he can be monitored so that if necessary, changes in his medication can be made. The second patient I interviewed took nineteen different tablets. She had presented with angina and was prescribed heart medications (beta blockers, statins, aspirin and GTN spray). She later became hospitalised due to an infection in her leg for which she was prescribed antibiotics which she was still taking at the time. Two years ago she began to suffer from severe pain up her back, at the side of her face and at the back of her head. She consulted because of this pain and after a number of follow ups with a specialist at hospital; it was found that the pain on the side of her face and back of her head, was being caused by a large vein lying on a nerve in her face causing painful muscle spasms. Due to the pain in her back, she found it hard to climb the stairs. She was prescribed codeine for the pain by sticking patches on to her skin (to change every day) to give her a continuous dose over a longer period of time than tablets would. The codeine tablets were prescribed for instance s when the pain became too severe that the dose being administered by the patches wasnt enough. The lady explained that she did not suffer any side effects from the medications she took. She is on repeat prescription for all her medications which she takes daily at different dosages for each medication, apart from the antibiotics for which she is on the last course. She does not have to pay due to her being an old age pensioner. To remember to take her medications, she keeps them all in a box by her bed. She has never been in a situation where she completely ran out of medicine because she has the help of her family who go to the pharmacy to pick up her medicines for her. I found the interviews I conducted very interesting and helpful in understanding the important issues of compliance and concordance with patients that arose from polypharmacy. In relation to compliance and concordance, both patients gave a lot of importance to the fact that every time they were prescribed a medicine, the GP would take time to explain why they were prescribing the drug, explaining the way the drug worked, the dosage required and answering any questions they had about the medicine. Whilst studying literature on the topic, I came across an article about a randomised control trial in patients with heart failure and how the intervention of a pharmacist may possibly increase compliance with the patients [4]. It is a fact that patients with heart failure have several prescriptions and for that reason sometimes have problems being compliant and taking full courses of their medication at prescribed times. The trials objective was specifically to see if pharmacist intervention improves medication adherence and health outcomes compared with usual care for low-income patients with heart failure [4]. 39% of the 314 patients with low income were assigned intervention while the remaining 61% remained with usual care. Both groups were followed for 12 months. The group subject to intervention underwent 9 months of multilevel intervention by the pharmacist with a 3 month follow up period. The intervention was designed by an interdisciplinary healthcare team who helped patients with low health understanding and inadequate resources to manage their medication. The results of this trial showed that during the 9 months of intervention, compliance to take medication in the group with normal care was 67.9% whilst in the intervention group it was 78.8%. This difference of 10.9% was found to be statistically significant; therefore these results prove that intervention by a pharmacist does increase compliance in patients. However, in the 3 month follow up these results dissipated. The rate of compliance reduced to 66.7% in the group with normal care and 70.6% in the group with intervention. The difference of 3.9% between the two groups was found not to be statistically significant meaning there was no lasting effect on compliance. Medication was taken at the correct time 47.2% of the time by the normal care group and 53.1% of the time by the intervention group. This soon lowered to 48.9% and 48.6% in the normal care and intervention group respectively in the 3 mo nth follow up [4]. For there to be a lasting effect on increasing compliance and as a subset, taking the medication at the correct times, it was necessary to continue intervention. This study was useful in helping find a method of increasing compliance; however, it was not clear exactly how this intervention worked. I understood it involved helping patients manage their medication better but not how exactly and also involved educating them better about the drugs. In relation to this essay, this study has these limitations but at the same time it reveals useful methods to increase compliance which I can not ignore. There are proven reasons other than the ones explained above, for non-compliance. These include being male, being a new patient, having a shorter disease period and work and travel pressures [5]. Non-compliance entails the disadvantage of patients not following a strict routine of taking medication which consequently causes further ill health and possible bacterial resistance in the long term. Once these issues have been recognised through discussion between a patient and a practitioner; there are two interventions proven to significantly increase compliance. These methods were proven useful in a study conducted to look at ways in which compliance could be increased in patients with ulcerative colitis [5]. In both instances it is necessary for there to be a good relationship between the patient and practitioner where the patient feels comfortable to talk openly about their problems. Educational intervention can be provided [5]. This is comprised of verbal explanation of the dosage re gime and how the drug itself works. Written information on the drug is also provided to educate the patient further. Once the patient feels they are sufficiently equipped with knowledge on the drug and have agreed to take it, the practitioner and patient draw up a self-management programme collaboratively. However, this method of intervention has its drawbacks due to time constraints many doctors are under. They can not find the time to go through this lengthy process with every patient. This problem could be overcome by having another member of the primary healthcare team take care of this process such as a pharmacist who is qualified to answer questions on medications. The second intervention is based on the patients behaviour [5]. It involves making it easier and more memorable to take their medication. This is done with the use of calendar/blister packs which are made/provided at the pharmacy. The blister packs serve as reminders or cues. They have the day and time at which each tablet should be taken on the back so it becomes harder to get confused and to miss tablets, therefore improving compliance. This is a cheap and cost-effective method which has been proven to improve compliance. The interventions together optimised compliance when they were adapted to individual patient needs in the study involving ulcerative colitis patients. To investigate methods to improve compliance I first need to make clear some of the reasons for poor compliance. For this I will use a study based on the causes of non-compliance to statin therapy as a major challenge in cardiology, as my evidence [6]. This study found that there were a variety of factors that caused non-compliance. These include patient, practitioner and system factors [6]. Patient factors include comorbidities (two or more coexisting medical conditions or disease processes that are additional to an initial diagnosis [7]) which increase polypharmacy which decreases compliance and also financial constraints in being unable to buy prescribed medication. Practitioner factors include poor communication skills, time constraints and poor doctor-patient collaboration. System factors include medication costs, lack of clinical monitoring and drug side effects [6]. These valid points presented by the study highlight where the changes need to be made in the Primary Healthcare team to improve compliance in patients. Some of the causes of decreased compliance above have apparent solutions. Financial constraints on patients could lead to a means tested system where patients that earn less than a certain amount receive medications free. This would eliminate the problem of patients not being able to obtain their medications. Practitioners could be sent on courses to improve their communication skills so that patients feel they are being listened to more and so they feel they understand the drugs and side effects so they feel comfortable being compliant. The idea of communication courses for doctors will also have a good impact on doctor-patient collaboration thereby increasing compliance. Medication costs could only be decreased when patents on specific drugs run out and other drugs companies compete for business thereby decreasing costs. Drug side effects are simply a limitation of the technology companies have at the moment, to formulate drugs. When technology advances, so will mans ability to dec rease the number and severity of side effects. However, doctors can also regularly review medication to reduce side effects by switching a patients medication to another drug with similar effects but fewer side effects. This will increase compliance because drugs will increasingly only have the desired effects and little or no side effects. Many of the system factors that lead to decreased compliance are in fact not in the control of the primary healthcare team, such as controlling the medication costs which are set by the drugs companies and drug side effects. The patient factors leading to decreased compliance are very personal and individual to the patient. However, the primary healthcare team can be useful in helping these problems to be overcome by, for example, sorting medicines into a dosette box for a patient who is very forgetful. The practitioner factors that lead to decreased compliance are indeed the same reasons that cause decreased concordance as well as other reasons. Improving concordance is linked to improving compliance. In fact improved compliance in certain cases is a direct consequence of improving concordance. For this reason tackling the problem of decreased concordance is a key issue in the primary healthcare team. Decreased concordance is a result of intentional non-compliance by patients [8] due to time constraints a doctor is under, poor doctor-patient relationship, poor communication skills of the doctor including poor explanation of the patients conditions [9] and the drugs they are taking and poor appearance/professionalism. Time constraints are a problem because GPs feel pressured to rush everything necessary leaving the patient feeling ill prepared. Government initiatives to set a minimum time limit on how long any consultation should last, could be a possible answer to this problem. This would give doctors more of an opportunity to ask more open questions and more probing questions into how the patients life is affecting their health/compliance. Patients are given the choice of asking to have appointments with doctors they believe they have better relationships with, however, if it is noticed that a pattern is emerging when a certain doctor is consistently not asked for, then a review can take place to investigate why the care given by a particular doctor is not good enough. The doctor can be sent on courses in improving care and be sanctioned if deemed necessary by the General Medical Council through fitness to practise measures. If the NHS makes sure that the doctors are provided with more than enough information to educate them on the drugs they prescribe, the likelihood of poor explanations by doctors to patients on their medications is more unlikely. Doctors should also avoid the use of medical jargon and use simpler language that the patient is likely to understand to improve concordance [9]. If this is the reason for poor communication of doctors then poor concordance is also solved. However, poor communication on the part of the doctor can be due to number of different non-intentional problems including family problems. If this is the case then support services can be made available to the doctor to improve his condition/practise. This has the wider effect of improving appearance/professionalism if this is also suffering. Compliance and concordance are of great importance because a decline in either can lead to an exacerbation of the underlying illness or in many cases of polypharmacy, an exacerbation of comorbidities. In conclusion, there are many simple methods in improving compliance, in certain cases as a result of improving concordance. The doctor-patient relationship is key in improving compliance as it involves a mutual understanding and importantly lends help in listening to complaints of patients and finding methods for them to remain compliant. The simplest methods such as the use of dosette boxes, having doctors that are knowledgeable about the drugs they prescribe and taking the time to explain them to patients, are the most useful methods of improving compliance and concordance.

GHB: Physiological Uses Versus Social Abuses :: Biology Essays Research Papers

GHB: Physiological Uses Versus Social Abuses The human genome is old news. The next generation of thinkers faces the great challenge of establishing how our physiological condition translates into complex thought and behavior. And there has not been a team of researchers more dedicated to empirically finding the answers to these questions than today's experimental teens. As subjects of their own study, these future scientists have quite thoroughly manipulated their mental and physical states through the use of drugs. While drug use may not directly reflect a dedication to science, the devices of these drugs have helped to elucidate the complex functioning of the brain and its effect on one's conscious state. The spirit of this drug culture raises issues important to the neuropsychologist as well as the social psychologist. Negative-effects or side-effects of [recreational] drugs are often considered physiological in nature, and social and political attitudes toward illicit drugs tend to reflect where a drug is presumed to regis ter on the " physically harmful" spectrum. What follows is an explanation of how clinical purposes and recreational uses of a substance may together inform a greater understanding of drug abuse. It appears that issues of over-all health are often connected to both nervous system input, the physiological effects of the drug, and nervous system output, which are the behaviors and alterations in conscious state caused by a drug. The potential advancements in our understanding of the functioning of the nervous system through this "hands-on" research strategy is confounded by the politics that surrounds recreational drug use in the US. Inevitably, the sub-culture of drug experimenters that pops-up as a result of stringent anti-drug enforcement, is not a random sample of the human population. While the DEA and FDA impose upon the research attempts of today's youth, shared information technology has created a space for future scientists to compare their methods and results. Looking up designer drugs on the Internet, I came to a greater understanding of the physiology of the brain as well as the preferences and behavioral patterns of today's youth. Easily manufactured, ubiquitously used, and derived from substances already occurring in the body, GHB is a model drug for addressing these issues. GHB, or gamma-hydroxybutric acid, was first synthesized in 1960 (1). Laborit, a French researcher interested in the effects of GABA on the brain used GHB, a GABA metabolite that can more readily cross the blood brain barrier, in his investigation (2).

Nursing in the Future

Financial issues, healthcare policy changes, scarce resources, political issues and advancing technology on health care affect all areas of nursing, no matter how diverse the field is. In the practice of long term care and assisted living facilities, these issues are of major concern for many people. Trends that are seen in my current practice can help give hints to what is to come in the future. It seems like many health care facilities are always short on money, and so the number of patients per nurse increases so that the facility can make more money by having less nursing staff.When the work load increases on the nurses, there is a higher turn around for the nursing staff, and the facilities run into problems of being short staffed and overworked. In The Resilient Nurse, they explain that â€Å"rising patient acuity, rapid assessments and discharges, and increased service use by clients mean that nurses are dealing with sicker people who are likely to have multiple conditions th at may complicate both the treatment and the recovery† (3-4).A facility that is short staffed comes to the situation where there is more likely to be mistakes when the nurses are being asked to work more hours then they should to compensate. This happens in long term care consistently, it is as if more and more is asked of the staff in order to save a buck somewhere else. It is very hard on the residents as well due to the fact that they are at the end of their lives, can no longer work and usually have no money let. Long term care is very expensive and most of the time it completely wipes out the resident of all of their savings.I think scarce resources and advancing technology can sometimes go hand in hand. Supplies run short and it puts patients at risk if the proper supplies are not being used. Residents run out of things they need, or the facility has to be stingy with how many gloves they use when the really issue is patient safety. It is helpful in long term care when t he facilities develop committees that can the employees advocate for the residents. With the advancing technology through the years, more training on how to use new equipment is needed to ensure that the nurses are providing safe care.In a lot of discipline the nurses that are in practice are getting near retirement, and changes for them are hard to implement because they can be stuck in their ways. Many times it is hard on the nurses when there are policy changes because they are used to doing things a certain way and changing policies has a way of keeping nurses on their toes. Changing policies makes it important for nurses to be up to date on new evidence based practices so that they are able to keep up with the advancing times while maintaining a safe environment for patients.I like how Decision-Making in Nursing: Thoughtful Approaches for Practice sums up the idea that â€Å"without understanding nursing history, decisions are at risk of failing and repeating past errors† (26). Policy changes can be made for many reasons, but many times it is because it was found through evidence based practice that there was a safer and/or better way to go about the policy or that the policy no longer is relevant to the changing times. Times are changing and it has a major affect on long term care residents and nursing in general.Traditionally nursing has been a female dominated profession, but there have been many more men joining the ranks. The time and age were many residents grew up in people were very modest, and the largest population in long term care facilities are women, so it can be hard for them to adjust to a male nurse talking care of them or seeing them in such a vulnerable state. I see the impact of financial issues, healthcare policy changes, scarce resources, political issues and advancing technology on health care all of the time.

Passing: Close Reading

You Ken Tan Christopher Hennessy LI 208 U. S. Multicultural Literature 26 Feb 2013 Passing: An Analysis and Close reading Nella Larsen’s Passing is a story about the tragedy of an African American woman, Clare Kendry, who tried to â€Å"pass† in the white American community. However, while she passes as white, she constantly seeks comfort from her friend Irene Redfield who is a representation of the African American community. Gradually, Clare has become the double image of Irene, due to the similarities of their ethnicity and the contrasting lives they lead.At the end of the story, Clare’s death is a result of the extreme burden on Irene’s shoulder due to the presence of Clare in her life. The death of Clare is very much Irene’s responsibility based upon her suspicious acts at the end of the story. The ending of Passing, and of the life of Clare Kendry, begins on the sixth floor of an apartment complex at a party in the home of Felise and Dave Free land. During the party, Irene says that, â€Å"It seems dreadfully warm in here. Mind if I open this window? † (Larsen 110) However, when Irene opens the window, â€Å"It had stopped snowing some two or three hours back† (Larsen 110).This means that the weather is still rather cold and despite the freezing temperature, Irene still sits beside the window. Another reason why Irene would want to open the window is because she wants to smoke her cigar. She politely uses the warm temperature in the room as her excuse to open the window. Although this action may seem reasonable today, during the 1930s, there was no social etiquette that required opening a window to smoke. The fact that Irene stays by the window after her smoke makes us question exactly what keeps her warm; perhaps it is her anger and rage towards Clare.Later when Irene finishes her cigar, she throws it out and â€Å"watch[es] the tiny spark drop slowly down to the white ground below† (Larsen 110). To Irene, the sense of falling is either giving her an inspiration for her actions against Clare or a practice run before the real deal. In addition, the falling cigar sparks are being described in a very beautiful manner. â€Å"Tiny spark drop† gives us the sense of something small light and shiny which moves in a relatively stable winter air mass. The small shiny bits of cigar also contrasts with the twinkle stars in the clear ky after the snow stops. The action of â€Å"slowly down† is a romanticized version of the falling flakes. As Irene focuses on the falling flakes, she is also picturing the falling of Clare in a very calm and elegant way as if Clare’s fate is justified and beautiful. The separating flakes from the cigar also resemble the feeling of things falling apart. As Irene observes the flakes flying away, she sees Clare’s life being dismantled. In the next scene, Clare’s husband, John Bellew storms into the party after he found out that Clare is actually black and starts to burst out in rage.In the midst of the confrontation, Felise says, â€Å"Careful. You’re the only white man here† (Larsen 111). Felise is stating that John is the only white person in the room, and she does not acknowledge Clare as being white. Although Clare has passed, they do not treat Clare as a white person or an outsider and would not hesitate to help her when she needs them. This demonstrates the strong unity of African American community and one cannot truly be passed and separated from the origin or background he or she comes from. During the confrontation, Irene has a thought in her mind, â€Å"One thought possessed her.She couldn’t have Clare Kendry cast aside by Bellew. She couldn’t have her free† (Larsen 111). Irene is disgust by the thought of Bellew casting Clare away because this would be a great insult to Irene’s life. At the same time, this may be the end of Irene’s life as a â₠¬Å"white† person. She would have to return to who she was before: black, poor and alone. In addition, this would also be an insult to the lives of people in the African American community who are always oppressed and marginalized by the authority the whites.Besides, Irene would not want to set Clare free from Bellew because this would pose a bigger threat to Irene’s life and family. In the middle of the story, there is a mutual attraction between Clare and Irene’s husband, Brian Redfield, and Irene suspects that Brian is having a love affair with Clare. This internal conflict might explain the following scene, which is also Irene’s solution to end all of this – by ending Clare’s life. â€Å"What happened next, Irene Redfield never afterwards allowed herself to remember† (Larsen 111).All the reader is informed of is that â€Å"one moment Clare had been there, a vital glowing thing, like a flame of red and gold† and â€Å"the nex t she was gone† (Larsen 111). What is made clear in these descriptions of Clare’s fall is that it is in some sense out of her own control; the event just happens with no clear explanation. But again this provides a significant parallel with the beginning of this work; as shown in the beginning of the story, â€Å"a man toppled over and became an inert crumpled heap on the scorching cement† (12).Once again someone collapses onto a public street and their falling is hidden in uncertainty. While the cause of the man’s falling is unknown to Irene because she quickly flees the scene, the reason for Clare’s falling being uncertain is because Irene immediately represses this memory. Here, one might argue that in both the beginning and the end of this text the cause of falling is unknown to Irene because she willfully choses to refuse this knowledge, either by rushing away or repression. The connection between the beginning and the end is also reinforced by a syntactic similarity.Additionally, in the beginning of this novel we discover â€Å"what small breeze there was seemed like a breath of a flame fanned by slow bellows† (Larsen 12). These same images are revisited in the conclusion. At the time of her fall, Clare is â€Å"a flame of red and gold (Larsen 111) with an furious John Bellew lurching towards her. Not only does her approaching husband’s name resemble the word bellow, but also at the party he actually â€Å"bellows† to Clare â€Å"So you’re a damned dirty nigger†( Larsen 111). Thus, in both the beginning and end of Passing, we find an imagery of bellows moving towards a flame.In Passing, Clare and Irene are doubles for each other in multiple aspects. The fundamental connection between them is that their roots are from the same racial, social and gender groups. As readers, we are eager to find out why Irene tries to avoid Clare throughout Passing and what is the fear Clare poses upon Ire ne. One reason for this is that the constant appearance of Clare in Irene’s life serves as a constant reminder for Irene’s self. Since they are mirror images of each other, Irene sees herself in Clare in an eerie way.Through Irene’s lens, Clare lives a life she can only image but never engage. It becomes a scary thought for Irene that someone so similar to herself can transform to carry a different identity on the surface. The constant comparison of Clare and Irene has forced Irene to raise questions about her own life. The recurring uncanny doubling effect from Clare presents such a constant pressure on Irene that only death can resolve this conflict. Works Cited Larsen, Nella. Passing. New York: Penguin Books, 2003.