Saturday, December 28, 2019

Offreds Narrative - What is the purpose and function of...

Offreds Narrative - What is the purpose and function of the Historical Notes and how do they assist your interpretation of the novel? The historical notes are not part of Offred’s narrative, they are a transcript of a symposium held at a university in 2195 – two hundred years from where we left the end of Offred’s harrowing tale. The purpose of these notes if any, is to put Offred’s narrative into a historical purpose to help these academics understand the life of Gilead. It seems to me that another purpose of these historical notes is to provoke a very strong reaction in the readers who have followed the emotional journey with the narrator Offred. The significance of the university name ‘Denay, Nunavit’ is that Atwood†¦show more content†¦All of this is now being analysed and retold by those who made her feel so powerless in the first place. This section of the novel can also be functioned to create a light mockery towards the current academic practice and language, the male perspective used here is typical of the historical male dominance and perspective in academic research who also completely miss the point, like Pieixto with Offred’s narrative. I believe that the readers who have just finished agonising with Offred through her tormented times to suddenly come across the Historical Notes will find themselves offended and shocked, as I am convinced Atwood means it to be allowing another purpose for the historical notes, to hear Offred’s tragic life discussed in front of an amused audience of academics who joke about it as if it was an unusual memento. At the beginning of his speech we learn it was a man called Professor Wade who gave the title of Offred’s story ‘The Handmaid’s Tale’ partly in homage to the great Geoffrey Chaucer who had wrote the Canterbury tales between 1380 and 1400. This is significant because he only had two female characters and one of those characters was the Wife of Bath who’s prologue argues the importance of female experience over male authority, the significance of Offred’s experience is invalidated by the power of the male authority in 2195 plus

Friday, December 20, 2019

National Health And Nutrition Survey - 2625 Words

Government Involvement in Obesity It is evident today in society that obesity levels have increased throughout the years. According to the National Health and Nutrition Survey, more than two out of three adults are considered to be overweight or obese, and one-third of children from ages six to nineteen are considered to be overweight or obese (â€Å"Overweight and Obesity Statistics†). This is a dramatic increase since the 1960’s, almost doubled. There is not enough awareness in the United States on the issue. We are one of the most overweight countries of the world. The government must obtain a more positive and enlightened role in America’s obesity levels. Why has the obesity rated doubled in adults and tripled in children since the 1960’s? There is a very simple explanation. Americans are not aware of the severity of the problems with being overweight. The government and media do not emphasize the importance of being healthy and in shape. Obesity has been defined as a culture-bound phenomenon. In the United States, many have just accepted this epidemic to be normal. As the years fly by, we begin to not take notice on people’s body weights. This may because the media is starting to portray a new slogan of â€Å"everybody is beautiful- no matter the size and shape.† Although this is a very positive message, it allows the public to believe that being overweight is acceptable. In reality, being overweight affects your heath in numerous, horrible ways. Being overweight means youShow MoreRelatedNational Health And Nutrition Examination Survey940 Words   |  4 Pagesbeneficial to physicians, health care providers, and people in the community. It provides data that can be used to establish prevalence in different categories. It provides evidence and allows for issues to be prioritized. This is extremely important because different nations, states, counties, and cities are able to factors pertinent to their areas. The Un ited States uses the National Health and Nutrition Examination Survey (NHANES) to gather information about the health and nutritional status fromRead MoreAnalysis Of The National Health And Nutrition Examination Survey1764 Words   |  8 PagesPublicly available data from three waves 2009-2010, 2011-2012, and 2013-2014 of the National Health and Nutrition Examination Survey (NHANES) were used for this analysis. These waves were selected because they correspond to the most recent time periods with available data for public use at the time of this analysis between 2017-2018. NHANES is a repeated, cross-sectional survey with a multi-stage probability sample of non-institutionalized population of the United States.27 Demographic variablesRead MoreA Study Conducted By National Health And Nutrition Examination Survey764 Words   |  4 PagesThe study conducted by National Health and Nutrition Examination Survey (NHANES) found that the commonness of hypertension among US residents in the year 2003-2004 was 7.3 ±0.9%, 32.6 ±2.0%, and 66.3 ±1.8% in the 18 to 39, 40 to 59, and ≠¥60 age groups, respectively and 29.3% overall. Not everyone is aware of hypertension and its risk. There were numerous studies and researches conducted to learn and understand more about hypertension and its connection with obesity, hyperuricemia, eplerenone and otherRead MoreCoffee And Depression : The Fifth Korean National Health And Nutrition Examination Survey Essay700 Words   |  3 PagesCoffee and depression in Korea: the fifth Korean National Health and Nutrition Examination Survey (3) Introduction The article â€Å"Coffee and depression in Korea: the fifth Korean National Health and Nutrition Examination Survey† was published in the European Journal of Clinical Nutrition in 2015. The question the authors looked at was whether there was a correlation between coffee consumption and the prevalence of depression among South Korean adults. There had been no previous studies examiningRead MoreMalnutrition : A Common Problem1480 Words   |  6 PagesNepal Nutrition Section, CHD, DoHS, MoHP. (2004,p.5 ). Malnutrition is a very common problem in children under five years of age in Nepal and is a significant contributor to morbidity and mortality– accounting for more than half of all child deaths. The process of stunting occurs between conception and two years of age, and is an irreversible process. Furthermore, the population of Nepal, especially women and children, are affected by major micronutrient deficiencies. Malnutrition increases theRead MoreEssay about Nutritio n in Public Health 1165 Words   |  5 PagesNutrition in public health: Objectives: Ensure that students acquire specific knowledge for the analysis of food and nutrition problems in population groups. Identify the causal factors of the state of nutrition in communities. Be able to take part in the planning and programming for prevention and control activities within the field of nutrition in public health. Program: I. Concept of public health: Historical evolution. Population and food. Quality of life and socioeconomic developmentRead MoreGovernment Should Design Effective Child Nutritional And Health Program757 Words   |  4 PagesFor the government: Government should design effective child nutritional and health program for the community to reduce malnutrition (stunting, underweight and wasting). Above half of the community gets Water from unprotected sources such as dug well, spring river/surface water which results child diarrhea and illness therefore, government should facilitate clean water supply for the community. Women/mothers education should be promoted as it has been proved that it is the key to reduce both chronicRead MoreThe Natural Form Of Vitamin B91478 Words   |  6 Pagesprocessed more efficiently in the body. Availability of folic acid is estimated to be about twice that of food folate. Folate deficiency has been linked to several adverse health outcomes. Neural tube defects are one of the commonest side effects of folate deficiency among women in childbearing age. Other adverse health effects include preterm birth, other congenital anomalies, megaloblastic anemia, cancer, and cardiovascular diseases. There are several studies that link folate deficiency to cognitiveRead MoreThe Effects Of Malnutrition On Indi The Facts Essay1419 Words   |  6 Pagesin five deaths in the world. More than half of these deaths could be prevented if children were well nourished . Malnutrition is a serious condition in which the body does not get the right balance of nutrients and calories needed to sustain good health and development. It has two sides - undernutrition and obesity/overweight. Undernutrition arises mainly as a result of inadequate or unbalanced diets, but is also caused by poor nutrient absorption or a loss of nutrients due to illness (2000, SmithRead MoreEssay On Clinical Data746 Words   |  3 PagesUniversity of Washington reduces them to six categories: Electronic health records: This type of clinical data resides generally at the point of care such as a hospital or office clinic. Best known as the Electronic Health Record â€Å"EHR†, and opened to healthcare providers, it has a restricted access to researchers. These data come in part from verbal patient interviews and take the form of narrative inserted in the EHR. The electronic health record contains almost all data regarding a patient visit or encounter

Thursday, December 12, 2019

The Lasting Impresion of Reality Tv and Its Lack of Moral free essay sample

So in order to keep up ratings shows were forced to show what people wanted to see. As our country has slowly let go of morals and standards, its people have been forced to adapt. Reality television has been forced to diminish all possibilities for ever being labeled as moral. It has taken a direction for the worse and shows today lack little meaning or value. In its most current state, television shows force its younger viewers to grow up faster, making younger and younger kids do adult things. These reality shows exemplify things such as sex, drugs, violence, and self-harm. Television producers these days simply have no problem exposing the youth to this rubbish. In fact, the producers are specifically targeting the youth with their unmoral and controversial shows. They often reward the rebel characters with extra TV time or book them for another reality show, while the moral and respectable characters are made out to be boring and hardly ever get rewarded. We will write a custom essay sample on The Lasting Impresion of Reality Tv and Its Lack of Moral or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page America keeps asking what is making each generation less and less moral, but they fail to recognize what kinds of examples are being set. Children have not become more influential, they simply have been influenced by worse things. In the past few years, there has been a major change to reality television that diminishes its moral teaching reputation. From music videos of half naked women to reality shows full of betrayal, lies, and more vulgar than most can handle, the state of American television is in trouble. So where can you turn to when you want to avoid these unmoral shows and watch something good for a change? Well there is no clear-cut answer. Sadly, even some of the biggest networks such as CBS and NBC have started targeting the young crowd with shows that are completely inappropriate. The only solution to this problem is to simply search around a bit to find the perfect show for you. Use sites such as TVguide. com and Amazon. com to check out some reviews and customers opinions on the show before you start getting into it..

Wednesday, December 4, 2019

Objective Structured Clinical Examination Method

Question: Discuss about the Objective Structured Clinical Examination Method. Answer: Introduction: Mr. Harry Jones is 68-year-old man and is admitted to the medical ward suffering from Rapid Atrial Fibrillation. He has allergy with penicillin , and has a past medical history of asthma and hypertension. Mr. Jones is currently on Salbutamol 5mg two puffs four times per day and, oral cardiprin 100mg once a day and oral enalapril 10mg daily. He has a known family history of acute myocardial infarction, migraines in mother , and cancer of the colon in his father.This report includes pathophysiology of atrial fibrillation, and the rationale of administrating amiodarone as his initial medical management, and action and the therapeutic benefits of both the drugs warfarin and dabigatran as well as the side effects to decide which drug most suitable for him. Mr. Jones was prescribed aspirin to prevent the heart stroke, which can occur due atrial fibrillation since he has an age of 68 years. This drug was given because of low risk of bleeding, easy to use and monitoring is not required while giving this drug(Lip, 2013).The Mode of action of aspirin involves inhibiting the activation and aggregation of platelets and also the inhibition of enzyme cyclo xygenase that is platelet dependent. This leads to the inhibition of prostaglandin synthesis. The side effects of aspirin involves fever that lasts for 3 days, vomiting, pain in the stomach and nausea. Cardiprin is used for thinning of blood during heart strokes and atrial fibrillation. It has an active ingredient as aspirin and functions by the suppression of the production of prostaglandins hormones. There are various side effects of Cardiprin such as nausea, vomiting(Ng Ho, 2017). Asthma and problems related to digestion. Nursing interventions for administering Cardiprin involves proper knowledge about the current medicaments the patient is taking, allergic responses and any future surgery and pregnancy. The patient should inform the doctor about any issues of asthma, high blood pressure, heartburn or any other cardiac diseases. The nurse should give the medicine to the patient by checking on the outer packaging and as prescribed by the clinician. It can also lead to irritation in the stomach so it should be taken along with milk. The pathophysiology of atrial fibrillation involves pathological changes such as fibrosis in the artria that is progressive in nature. The fibrosis occurs due to the ageing process, dilation of the chamber, genetic reasons and inflammation. Atria gets dilated due to various structural abnormalities in them heart such as high blood pressure, valvular heart disease or a congestive failure of the heart (Heitner, 2013).Atrial fibrosis can also occur due to the mutation in the lamin AC gene. The renin-aldosterone angiotensin pathway is activated by the atrial dilatation due to stretch and this in turn increases the protein disintegrin and matrix metaproteinase in the walls of the atria. This pathway leads to the release of cytokines, oxidative stress and the formation of factors that lead to growth and promote fibrosis(Wakili, Voigt, Kb, Nattel, 2014). It also initiates various cell-signalling processes that increase the level of calcium inside the cells. The Renin aldosterone angiotensin system (RAAS) includes various enzymes such as Angiotensin 2, aldosterone and angiotensin converting enzyme and they are increased during atrial fibrillation as they are synthesized on a local level in the atrial myocardium. The increase in the level of these enzymes leads to fibrosis and atrial remodeling and results in the loss of muscle mass of atria.There are two types of fibrosis that is Reactive interstitial fibrosis, which helps in the separation of muscle bundles, and Reparative fibrosis that helps in replacing the cardiomyocytes. Fibroblasts can be coupled to the cardiomyocytes in an electrical manner and help in promoting the ectopic activities when their number is increased(Dan Camm, 2013). Amiadarone is given to Mr Jones to prevent myocardial infarction since his mother had a past medical history of the same disease. Amiadarone is also used to help the heart to beat in a normal manner as he is suffering from atrial fibrillation. It may lead to side effects if given to Mr Jones since he is allergic to pencillin and is suffering from asthma and serious heart issues(Barber Blundell, 2013).It should also be not given to patients suffering from thyroid diseases, implantation of pacemaker, eyesight issues, low balance of electrolyte and low or high blood pressure. There are various side effects of amiodarone such that it can have a negative effect on the liver and lungs in Mr Jones. The nursing interventions include various measures after administering this drug to the patient such as continuous monitoring of ECG and rhythm and heart rate and keeping a check if the patient suffers from jaundice, pain in the chest and stomach breathing issues, dark coloured urine and blood i n the cough(Schalij, 2014). Amiodarone should not be given to females who are pregnant as it can have a negative effect on the health of the baby because it passes to the mothers milk. Anticoagulants such as warfarin and dabigatran are used to reduce the risk of blood clotting and hence the heart stroke. The most common medicine is warfarin but it has a disadvantage that it can interact with foods, medicines and alcohol. But dabigatran has an advantage that it has a low interaction rate with medicaments, alcohol and food items .Warfarin requires regular blood tests to check the clotting time of blood in the body and dabigatran does not require regular blood tests(Wislff Klemp, 2014). According to, the National Institute for Health and Care Excellence (NICE), warfarin is used to decrease the risk of heart stroke. Its main disadvantage is heavy bleeding so to avoid it, a Vitamin K injection is given to stop the bleeding. Dabigatran blocks the effect of thrombin and helps in preventing the blood clots. Thrombin is a protein which is formed in the body for the formation of blood clots. Dabigatran gets collected in the blood of the patients who suffer from kidney probl ems as the kidney is not able to remove the drug from the body(Giugliano, Ruff, Braunwald, Murphy, Wiviott, Ruzyllo, 2013). There are various precautions while taking the drug dabigatran such as the capsule should not be opened before giving then dose to the patient that will lead to an increase in the concentration of drug in the body of the patient and hence lead to an increase in the risk of bleeding. Another disadvantage of this drug is that it is degraded when comes in contact with moisture and hence precautionary measures should be followed to keep the bottle closely tight. It should be used within 30 days after the bottle is opened. A side effect of dabigatran is that it leads to indigestion and stomach upset in patients if it is discontinued because the drug needs an acidic environment to get absorbed in the body(Mooney, 2013).It can also lead to heart stroke or heart attack if this medicine is stopped from taking. The side effects of warfarin are fever, bleeding from the gums, pain and swelling, irritation and diarrhea. Warfarin is more effective and safer than dabigatran and dabigatran should no t be taken by patient suffering from kidney and liver problems as it lead to increase in bleeding. Salbutamol is used in the treatment of asthma by providing relaxation to the muscles in the walls of airways present in the lungs. The normal dose for patients is 1-2 inhalations those who are adults and one puff for children in the age group of 6-11 years. It should be used only after prescribed by the doctor. (Salvi, 2013). Mr Jones will be instructed to remove the cover from the mouthpiece and shake the inhaler profusely then hold the inhaler and breathe out in a gentle manner. Then the mouthpiece should be immediately kept on the mouth. He will be advised to seal the mouthpiece totally with lips and start to breathe slowly with the mouth. After breathing slowly, press the inhaler firmly to release the medication and continued to breathe in(Zhang, Liu, Hu, Tan, 2015). If the patient misses the dose he should continue with the regular dosage schedule. It should be store at a room temperature and kept out of reach from children. It should be kept away from hot devices such as stove and heater. The patients who are allergic to salbutamol and milk proteins such as lactose should not take salbutamol puffers. Side effects of this medication include drowsiness, dizziness, fatigue, coughing and faster rate of heartbeat(Lahiri, 2017). It can be concluded that Mr Jones has a high risk of heart stroke since he is an elderly person. He should take proper care of himself and follow the medicaments prescribed by his clinician properly. He should take a well balanced diet and exercise daily that will decrease the chances of heart stroke. He should take warfarin that will help to decrease the risk of heart stroke and it is more effective and safer as compared to other drugs such as dabigatran. He should follow proper nursing interventions and follow precautionary measures to recover from Rapid Atrial Fibrillation. Bibliography Barber, Blundell, P. . (2013). Further Esstentials of Pharmocology For Nurses. Maidenhead: McGraw-Hill Education . Dan, Camm, B. d. (2013). Atrial fibrillation therapy. . Giugliano, Ruff, Braunwald, Murphy, Wiviott, Ruzyllo, H. . (2013). Edoxaban versus warfarin in patients with atrial fibrillation. New England Journal of Medicine , 369(22), 2093-2104. Heitner, H. . (2013). Cardiology in Family Practice. A practical guide . Lahiri. (2017). vidence behind use of levosalbutamol over salbutamol to prevent cardiac side effects. . International Journal of Contemporary Pediatrics , 4(3), 674-678. Lip, . L. (2013). Stroke prevention with oral anticoagulation therapy. Circulation Journal, Volume 77(6), pp1380-1388. . Mooney. (2013). Use of dabigatran to prevent stroke in patients with atrial fibrillation. .Nursing standard, Volume 27(27), , pp 35-41. Ng, Ho, C. . (2017). Comprehension by older people of medication information with or without supplementary pharmaceutical pictograms. Applied Ergonomics , 58, 167-175. Salvi, B. . (2013). Aspirin and asthma. CHEST Journal Volume118 (5 , p1470-1476.doi:10.1378/chest.118.5.1470. Schalij, V. E. (2014). Amiodarone: an effective antiarrhythmic drug with unusual side effects. Heart, Volume , 96(19). Use of dabigatran to prevent stroke in patients with atrial fibrillation. (2013). Nursing standard, , Volume 27(27), pp 35-41.41. Van Erven, L., Schalij, M. J. (2010)Amiodarone: an effective antiarrhythmic drug with unusual side effects. . (2013). Heart, Volume 96(19) , 96(19). Wakili, Voigt, Kb, Nattel, D. (2014). Reccent advances in the molecular pathophysiology of atrial fibrillation. Journal of clinical investigation , p2955-2968. Wislff, Klemp, H. . (2014). conomic evaluation of warfarin, dabigatran, rivaroxaban, and apixaban for stroke prevention in atrial fibrillation. . Pharmacoeconomics , 32(6), 601-612. Zhang, Liu, Hu, Tan, X. (2015). An aerosol formulation of R-salbutamol sulfate for pulmonary inhalation., . Acta Pharmaceutica Sinica B , 4(1), 79-85.