By E. Kalesch. Westwood College of Technology. 2018.

When the asthma goes away cheap pyridium 200mg amex gastritis diet for cats, the confidentiality buy pyridium 200mg otc gastritis diet , and act with purity and discretion. They with contemporary alternative and complementary employ various techniques, including relaxation, medical practices, Hippocrates’ major tenets are guided imagery and visualization, and hypnosis, that physicians should observe all, evaluate hon- along with conventional methods of treatment 56 holistic nursing appropriate to the ailment, and they advocate the went on to develop potentized remedies: each sub- patient’s participation in his or her own healing. Four basic biopsychosocial profile), and treatments that also principles created the foundation of homeopathy include conventional medicine are geared to suit as a healing art and science: (1) similars cure simi- the individual’s needs. Moreover, holistic medicine lars; (2) a single remedy is used (one medication at seeks to prevent physical and emotional illness as a time); (3) the minimal dose is used, and (4) the well as proactively maintain well-being. In general, Western med- Holmes, Ernest Author of The Science of Mind ical treatment is successful when it follows this (New York: G. Putnam’s Sons, 1988), a definitive important Law of Similars (to create a similar [not textbook and motivational reference on how one’s the same] artificial ‘disease’ picture, not the disease attitude and emotions affect health and well-being. As the homeopathy An alternative treatment system body’s vital energy pushes back like a rebound based on the theory that “like cures like,” that if, is effect against the ‘shadow disease’ created by the a substance causes a symptom, it can conversely remedy, it also pushes the actual disease from the cure it when taken in a highly diluted form or in inside to the outside. Remedies are made from plant, to prevent various diseases and allergies engage the animal, and mineral sources and are available at Law of Similars by administering trace amounts of health food stores and pharmacies. Recognized as a a disease component, such as a virus, to promote scientific method of medicine, homeopathy was an antibody-producing immune response in the developed in the late 18th century by the German body. He observed that pathos, “suffering,” may be found in ancient med- symptoms of a disease could be induced in a healthy ical practices and now has a history of more than individual by certain substances. In addition to the Law of Similars (like edy cinchona, for example, could produce malaria- cures like), Hahnemann, who was appalled by cer- like symptoms, Hahnemann observed, and he tain conventional methods of the time such as experimented with numerous plant, mineral, and bloodletting, the use of leeches, and purging with animal substances on himself and other volunteers. Hoxsey therapy 57 Described universally as a humane, low-cost, The Definitive Guide, Celestial Arts, Berkeley, Calif. It is said its thousands of remedies, proponents continue to that the ancient Greek physician Hippocrates believe in its efficacy for relief from a multitude of touted a combination of honey, water, and certain illnesses and conditions. Eating sprigs of parsley dis- premise of a remedy’s “energy imprint,” “essence,” pels bad breath, and mint has long been known as or “memory” of symptoms that calls forth the body’s a remedy for indigestion. Home remedies may also “vital forces” to elicit relief of those symptoms, be based on ethnic traditions and beliefs. In New Orleans, homeopaths treated 1945 amarga, and prickly ash bark—in a potassium victims of the 1879 yellow fever epidemic, with a iodide solution, plus a regimen of nutrition, supple- 5. According to interventions and disciplines, homeopathic treat- reports, the cancer medicines were handed down to ments are “of tremendous value in reversing dis- the Illinois-born Hoxsey from his great-grandfather. When all the humors were balanced, an indi- banned the sale of all Hoxsey tonics, and all vidual maintained health, and the body needed to Hoxsey’s alleged requests for scientific investigation expel any excesses in order to keep the humors in of his formulas went unanswered. Hydrotherapy, largely based on the use of reopened as the Bio-Medical Center in Tijuana, water internally and externally, along with a diet Mexico, under the auspices of Hoxsey’s longtime and exercise regimen, became popular in the 19th clinical nurse, Mildred Nelson, R. Yellow bile was considered warm external use (the topical version was a paste that and dry; black bile was thought of as cold and dry. If the level of one of these humors cer remedy among Lake Superior Native Ameri- became excessive or deficient, illness occurred in cans). Since laboratory studies of its effectiveness three stages: first, the humoral change; second, were conducted, the Hoxsey formula has been fever or what was called “boiling”; third, the dis- reported to reduce tumors, inhibit tumor growth, charge of one of the humors in the form of urine, and provide antioxidant and antiestrogen activities feces, phlegm, bleeding, sweating, vomiting, and so that are known to have a deleterious effect on can- on. It has also been shown that laughter have responded particularly favorably to the stimulates the body’s natural production of endor- Hoxsey therapy. Hoxsey believed that his herbal phins, chemicals almost identical to the painkiller preparations balanced the chemical process in the morphine. In mind-body medicine, laughter, opti- body; his idea was that cancer is a systemic disease mism, and other qualities associated with pleasure that “occurs only in the presence of a profound are believed to have a positive impact in the treat- physiological change in the constituents of body ment of disease. Box 727, 615 General Hydrotheraphy and hydrothermal therapy are Ferreira, Colonia Juarez, Tijuana, B. Hydrothermal therapy involves varying tempera- ture of the water according to need, as in hot baths, humectant A substance used as a moisturizer. Therapeutic water treat- ments have been known and used for centuries as humors, the four The ancient theory that human an all-purpose therapy based on the ancient con- temperament and propensity for disease are based cept of the four bodily humors and the need to hydrotherapy 59 diminish or expel excessive humors such as bath to a still bath because whirlpools had a more phlegm and bile. Water is also a significant compo- direct impact on the ravages of stress and anxiety nent in the traditional Chinese and Native Ameri- than a still bath. A major proponent of A number of hydrotherapy techniques are avail- hydrotherapy was Vincenz Priessnitz (1799–1851), able: baths and showers, neutral baths, sitz baths, whose system of administering water therapeuti- contrast sitz baths, foot baths, cold-mitten friction cally in numerous ways along with an appropriate rub, steam inhalation, hot compresses, cold com- nutrition and exercise regimen sparked the estab- presses, alternating hot and cold compresses, heat- lishment of hydropathic institutions in the United ing compresses, body wrap, wet sheet pack, and States and Europe.

Prednisolone and hydrocorti- ate sulfasalazine and in men who wish to remain fertile cheap pyridium 200mg otc gastritis x estres. Topical therapy in the form of a rectal drip pyridium 200 mg with visa gastritis diet 30, foam or enema of Key points hydrocortisone or prednisolone is very effective in milder Aminosalicylates and blood dyscrasias attacks of ulcerative colitis and Crohn’s colitis; some systemic • Any patient who is receiving aminosalicylates must be absorption may occur. Prednisolone is preferred to hydrocortisone as it has less min- • If there is suspicion of blood dyscrasia, stop aminosalicylates. Also, it is important to remember that many drugs is activated in the intestine of patients with inflammatory can cause constipation (Table 34. This forms the rationale for the use of immuno- In general, patients with constipation present in two ways: suppressive agents in the group of patients who do not respond to therapy with aminosalicylates or glucocorticos- 1. General indications for their use include patients who may be due to decreased colon motility or to dyschezia, or have been on steroids for more than six months despite efforts to a combination of both. It is usually sufficient to reassure to taper them off, those who have frequent relapses, those with the patient and to instruct them in the importance of re- chronic continuous disease activity and those with Crohn’s establishing a regular bowel habit. Patients with ulcerative colitis combined with an increased fluid intake and increased may benefit from a short course of ciclosporin (unlicensed bulk in the diet. Patients with unresponsive or chronically active alternative, non-absorbed bulk substances such as inflammatory bowel disease may benefit from azathioprine or methylcellulose, ispaghula or sterculia are helpful. The mercaptopurine, or (in the case of Crohn’s disease) once- other laxatives described below should only be tried if weekly methotrexate (these are all unlicensed indications). Loaded colon or faecal impaction – sometimes it is nerosis factor (see Chapters 16 and 26) is licensed for the necessary to evacuate the bowel before it is possible to management of severe active Crohn’s disease and moderate to start re-education, particularly in the elderly or those who severe ulcerative colitis in patients whose condition has not are ill. In these cases, a laxative such as senna combined responded adequately to treatment with a glucocorticosteroid with glycerol suppositories is appropriate. Infliximab is also licensed for the management of refractory fistulating Crohn’s disease. It is usually given for a month, but no Iron preparations longer than three months because of concerns about develop- ing peripheral neuropathy. Antimotility drugs such as codeine and loperamide (see below) and antispasmodic drugs may precipitate paralytic ileus and megacolon in active ulcerative colitis; treatment of the inflammation is more logical. There is now a greater know- ledge of intestinal pathophysiology, and of outstanding import- Key points ance is the finding that the fibre content of the diet has a marked regulatory action on gut transit time and motility and Inflammatory bowel disease on defecation performance. Magnesium sulphate (Epsom salts) and other magnesium salts are useful where rapid bowel evacuation is required. Plant fibre Macrogols are inert polymers of ethylene glycol which Plant fibre is the portion of the walls of plant cells that resists sequester fluid in the bowel; giving fluid with macrogols may digestion in the intestine. The main effect of increasing the reduce the dehydrating effect sometimes seen with osmotic amount of fibre in the diet is to increase the bulk of the stools laxatives. It does not increase the Lactulose is a disaccharide which passes through the small effective caloric content of the diet, as it is not digested or intestine unchanged, but in the colon is broken down by absorbed. This By increasing the bulk of the intestinal contents, fibre slowly produces a laxative effect after two to three days. It is effective distends the wall of the colon, and this causes an increase in and well tolerated, but relatively expensive. The main result is a return of value in the treatment of hepatic encephalopathy, as it dis- the large bowel function towards normal. Similar results are courages the proliferation of ammonia-producing organisms obtained in diverticular disease in which there is colon and the absorption of ammonia. These agents were formerly believed to act by softening or The starting ‘dose’ of bran is a dessertspoonful daily and lubricating the faeces, but they act at least in part in a similar this can be increased at weekly intervals until a satisfactory manner to stimulant purgatives by inhibiting intestinal elec- result is obtained. Bran should be avoided in gluten enteropathy and is patients with faecal impaction, and it should not be given over contraindicated in bowel obstruction. However, 5g of magnesium sulphate due to the local irritant action of glycerol and are useful if a would be isotonic in only 130mL and acts within one to two rapid effect is required. Antibiotic treatment is indicated is not clear, but this effect is perhaps due to damage to the for patients with systemic illness and evidence of bacterial intrinsic nerve plexus of the colon. Two main types of drug may be employed, that either Some people, mainly women, take purgatives secretly. This decrease intestinal transit time or increase the bulk and viscos- probably bears some relationship to disorders such as anorexia ity of the gut contents. Codeine is widely used for this purpose in doses of • sodium depletion – hypotension, cramps, secondary 15–60mg.

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If she feels opens up for something more enriching in growth discount 200 mg pyridium with visa gastroenteritis flu, better in this role buy cheap pyridium 200mg line gastritis diet , why not? One good reason why not learning and healing production on the part of the for more and more nurses is that with this increasing patient—you have got a profession. Our intent when trend, patients receive from professional nurses sec- we lay hands on the patient in bodily care is to com- ond class doctoring; and from practical nurses, sec- fort. Seeing the patient through talks out and acts out those things that concern [his or her] medical care without giving up the nur- him—good, bad and indifferent. If nothing more is turing will keep the unique opportunity that personal done with these, what the patient gets is ventilation or closeness provides to further [the] patient’s growth catharsis, if you will. This area empha- beyond—to what I call “nurturer”—someone who fosters learning, someone who fosters growing up sizes the social, emotional, spiritual, and intellec- emotionally, someone who even fosters healing. Through the closeness The second aspect of the nursing process is shared offered by the provision of intimate bodily care, with medicine and is labeled the “cure. Hall (1958) comments on he wants to go and will take or refuse help in get- the two ways that this medical aspect of nursing ting there—the patient will make amazingly more may be viewed. It may be viewed as the nurse rapid progress toward recovery and rehabilitation” assisting the doctor by assuming medical tasks or (Hall, 1958, p. Hall believed that through this process, the patient would emerge as a whole person. The other view of this aspect of nursing is Knowledge and skills the nurse needs in order to to see the nurse helping the patient use self therapeutically include knowing self and through his or her medical, surgical, and learning interpersonal skills. The goals of the inter- rehabilitative care in the role of comforter personal process are to help patients to understand and nurturer. The other view of this aspect of nursing tance of nursing with the patient as opposed to is to see the nurse helping the patient through his nursing at, to, or for the patient. Hall reflected on or her medical, surgical, and rehabilitative care in the value of the therapeutic use of self by the pro- the role of comforter and nurturer. What made the love and trust the patient enough to work with him Loeb Center uniquely different was the model of professional nursing that was implemented under Lydia Hall’s guidance. The center’s guiding philos- The nurse who knows self by the same ophy was Hall’s belief that during the rehabilitation token can love and trust the patient phase of an illness experience, professional nurses enough to work with him professionally, were the best prepared to foster the rehabilitation rather than for him technically, or at him process, decrease complications and recurrences, vocationally. Her goals cease being tied up with She saw this being accomplished by the “where can I throw my nursing stuff around,”or “how special and unique way nurses work with can I explain my nursing stuff to get the patient to do patients in a close interpersonal process what we want him to do,” or “how can I understand with the goal of fostering learning, growth, my patient so that I can handle him better. In She saw this being accomplished by the special and this way, the nurse recognizes that the power to heal unique way nurses work with patients in a close in- lies in the patient and not in the nurse unless she is terpersonal process with the goal of fostering learn- healing herself. At the Loeb Center, ability to help the patient tap this source of power in nursing was the chief therapy, with medicine and his continuous growth and development. A new comes comfortable working cooperatively and con- model of organization of nursing services was im- sistently with members of other professions, as she plemented and studied at the center. Hall stated: meshes her contributions with theirs in a concerted program of care and rehabilitation. She will facilitates the interpersonal process and invited the be involved not only in direct bedside care but she will patient to learn to reach the core of his difficulties also be the instrument to bring the rehabilitation while seeing him through the cure that is possible. Specialists in re- Through the professional nursing process, the pa- lated therapies will be available on staff as resource tient has the opportunity of making the illness a persons and as consultants. The 80-bed unit The Loeb Center for Nursing was staffed with 44 professional nurses employed and Rehabilitation around the clock. Professional nurses gave direct patient care and teaching and were responsible for Lydia Hall was able to actualize her vision of nurs- eight patients and their families. Senior staff nurses ing through the creation of the Loeb Center for were available on each ward as resources and men- Nursing and Rehabilitation at Montefiore Medical tors for staff nurses. The center’s major orientation was rehabil- nurses there was one nonprofessional worker called itation and subsequent discharge to home or to a a “messenger-attendant. Doctors referred patients to the center, and Instead, they performed such tasks as getting linen a professional nurse made admission decisions. Morning and evening shifts were the teachings of Harry Stack Sullivan, Carl Rogers, staffed at the same ratio. Nurses were taught to less; however, Hall (1965) noted that there were use a nondirective counseling approach that em- “enough nurses at night to make rounds every hour phasized the use of a reflective process. Within this and to nurse those patients who are awake around process, it was important for nurses to learn to the concerns that may be keeping them awake” know and care for self so that they could use the self (p. In most institutions of that time, the number therapeutically in relationship with the patient of nurses was decreased during the evening and (Hall, 1965, 1969).

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Practical intelligence represents a type of “street smarts‖ or “common sense‖ that is learned from life experiences purchase pyridium 200mg without prescription gastritis eating plan. Although a number of tests have been devised to measure practical intelligence (Sternberg order 200mg pyridium amex gastritis diet , Wagner, & Okagaki, 1993; [15] Wagner & Sternberg, 1985), research has not found much evidence that practical intelligence is distinct from g or that it is predictive of success at any particular tasks (Gottfredson, [16] 2003). Practical intelligence may include, at least in part, certain abilities that help people perform well at specific jobs, and these abilities may not always be highly correlated with [17] general intelligence (Sternberg, Wagner, & Okagaki, 1993). On the other hand, these abilities or skills are very specific to particular occupations and thus do not seem to represent the broader idea of intelligence. Another champion of the idea of multiple intelligences is the psychologist Howard Gardner [18] (1983, 1999). Gardner argued that it would be evolutionarily functional for different people to have different talents and skills, and proposed that there are eight intelligences that can be differentiated from each other (Table 9. Gardner noted that some evidence for multiple intelligences comes from the abilities ofautistic savants, people who score low on intelligence tests overall but who nevertheless may have exceptional skills in a given domain, such as math, music, art, or in being able to recite statistics [19] in a given sport (Treffert & Wallace, 2004). The idea of multiple intelligences has been influential in the field of education, and teachers have used these ideas to try to teach differently to different students. For instance, to teach math problems to students who have particularly good kinesthetic intelligence, a teacher might encourage the students to move their bodies or hands according to the numbers. On the other hand, some have argued that these “intelligences‖ sometimes seem more like “abilities‖ or “talents‖ rather than real intelligence. Are sense of humor, artistic skills, dramatic skills, and so forth also separate intelligences? Furthermore, and again demonstrating the underlying power of a single intelligence, the many different intelligences are in fact correlated and thus represent, in part, g [20] (Brody, 2003). Measuring Intelligence: Standardization and the Intelligence Quotient The goal of most intelligence tests is to measure g, the general intelligence factor. Good intelligence tests are reliable, meaning that they are consistent over time, and also Attributed to Charles Stangor Saylor. Because intelligence is such an important individual difference dimension, psychologists have invested substantial effort in creating and improving measures of intelligence, and these tests are now the most accurate of all psychological tests. In fact, the ability to accurately assess intelligence is one of the most important contributions of psychology to everyday public life. A 3-year-old who could accurately multiply 183 by 39 would certainly be intelligent, but a 25-year-old who could not do so would be seen as unintelligent. Thus understanding intelligence requires that we know the norms or standards in a given population of people at a given age. Thestandardization of a test involves giving it to a large number of people at different ages and computing the average score on the test at each age level. It is important that intelligence tests be standardized on a regular basis, because the overall level of intelligence in a population may change over time. The Flynn effect refers to the observation that scores on intelligence tests worldwide have increased substantially over the past [21] decades (Flynn, 1999). There are many explanations for the Flynn effect, including better nutrition, increased access to information, and more familiarity with [22] multiple-choice tests (Neisser, 1998). But whether people are actually getting smarter is [23] debatable (Neisser, 1997). Once the standardization has been accomplished, we have a picture of the average abilities of people at different ages and can calculate a person‘smental age, which is the age at which a person is performing intellectually. Most modern intelligence tests are based the relative position of a person‘s score among people of the same age, rather than on the basis of this formula, but the idea of an intelligence “ratio‖ or “quotient‖ provides a good description of the score‘s meaning. It consists of 15 different tasks, each designed to assess intelligence, including working memory, arithmetic ability, spatial ability, and general knowledge about the world (see Figure 9. It also shows significant correlations with measures of everyday functioning among the mentally retarded. The intelligence tests that you may be most familiar with are aptitude tests, which are designed to measure one‘s ability to perform a given task, for instance, to do well in college or in postgraduate training. These tests are useful for selecting students because they predict success in the programs that they are designed for, particularly in the first year of the [25] program (Kuncel, Hezlett, & Ones, 2010). Intelligence tests are also used by industrial and organizational psychologists in the process of personnel selection. Personnel selection is the use of structured tests to select people who are [27] likely to perform well at given jobs(Schmidt & Hunter, 1998). This is normally accomplished by surveying and/or interviewing current workers and their supervisors.

These models have been applied to eating behaviour both as a means to predict eating behaviour and as central to interventions to change eating behaviour discount pyridium 200 mg on line gastritis gerd. For example purchase pyridium 200mg amex gastritis young living, research has explored the extent to which cognitions relate to the intentions to eat biscuits and wholemeal bread (Sparks et al. Similarly, attitudes have also been found to be the best predictor of table salt use (Shepherd and Fairleigh 1986), eating in fast food restaurants (Axelson et al. Research has also pointed to the role of perceived behavioural control in predicting behaviour particularly in relation to weight loss (Schifter and Ajzen 1985) and healthy eating (Povey et al. The social norms component of these models has consistently failed to predict eating behaviour. Adding extra variables Some studies have explored the impact of adding extra variables to the standard frame- work described within the social cognition models. For example, Shepherd and Stockley (1987) examined the predictors of fat intake and included a measure of nutritional knowledge but found that this was not associated with either their measure of attitudes or their participants’ behaviour. Research has also examined the impact of accessing the individual’s hedonic responses to food with a focus on beliefs about the sensory properties of the food concerned. In contrast, Tuorila (1987) asked participants to rate milk which varied in its fat content for its hedonic properties and reported that these ratings of the sensory aspects of the food did not add anything to the basic cognitive model. Shepherd (1989) provided a review of these studies and suggested that the hedonic responses to food may be more important if the food is novel than if it is familiar. The attitudinal research described so far conceptualizes individuals as holding either positive or negative views towards a given object. In terms of eating behaviour it is assumed that people either like or dislike certain foods and that this value-laden attitude predicts food intake. Recent studies, however, have also explored the role of ambivalence in predicting behaviour (Thompson et al. For example, Breckler (1994) defined it as ‘a conflict aroused by competing evalu- ative predispositions’ and Emmons (1996) defined it as ‘an approach – avoidance conflict – wanting but at the same time not wanting the same goal object’. Participants were 325 volunteers who completed a questionnaire including a measure of ambivalence assessed in terms of the mean of both positive and negative evaluations (e. This computation provides a score which reflects the balance between positive and negative feelings. The results also showed that the relationship between attitude and intention was weaker in those participants with higher ambivalence. This implies that holding both positive and negative attitudes to a food makes it less likely that the overall attitude will be translated into an intention to eat it. A cognitive approach to eating behaviour, however, has been criticized for its focus on individual level variables only and for the assumption that the same set of cognitions are relevant to all individuals. The study measured social cognitive variables including self-efficacy, social norms and added additional cognitive variables including preferences and outcome expectations. The results showed that only preferences and outcome expectations pre- dicted actual eating behaviour but that 90 per cent of the variance in eating behaviour remained unaccounted for. Problems with a cognitive model of eating behaviour A cognitive model of eating behaviour highlights the role of cognitions and makes explicit the cognitions which remain only implicit within a developmental perspective. It provides a useful framework for studying these cognitions and highlights their impact upon behaviour. However, there are some problems with this approach as follows: s Most research carried out within a cognitive perspective uses quantitative methods and devises questionnaires based upon existing models. This approach means that the cognitions being examined are chosen by the researcher rather than offered by the person being researched. It is possible that many important cognitions are missed which are central to understanding eating behaviour. This does not adequately address the central role that others play in a behaviour as social as eating. For example is the cognition ‘I am confident I can eat fruit and vegetables’ really distinct from the cognition ‘I intend to eat fruit and vegetables’? In sum, from a social cognitive perspective eating behaviour can be understood and predicted by measuring an individual’s cognitions about food. The research in this area points to a consistently important role for attitudes towards a food (e. There is also some evidence that ambivalence may moderate the association between attitude and intention. However, there is no evidence for either social norms or other hypothesized variables.

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