1
Running head: NUTRITION FINAL RESEARCH PAPER
HCG Diet and Cystic Fibrosis
West Coast University
Orange County
Your Name Here
NURS 225: Nutrition in Health and Disease
2017
2
NUTRITION FINAL RESEARCH PAPER
Topic # 1: HCG Diet
Part I, Criteria # 1: Identification of Nutrients
According to the Dudek (2016), the RDAs represent the average daily-recommended
intake to meet the nutrient requirements of 97% to 98% of healthy individuals by life stage and
gender. When estimating the nutritional needs of people with health disorders, health
professionals use the RDA’s as a starting point and adjust them according to the individual’s
need (Dudek, 2013). Even though HCG is a hormone injection program, there are extremely
strict and limited food choice to their diet plan such as: 500 calories limit per day, no cosmetic
products that contain fat in them, 2 small apples are not an expectable exchange for 1 apple.
Table 1 below lists some foods that patients are allowed to choose from for daily intake
(Simeons, 2016).
Table 1 The Original HCG Diet Protocol by Dr. Simeons
3
NUTRITION FINAL RESEARCH PAPER
Due to such strict rules and limitation on food selection, patients would end up with deficiency in
two important macronutrients such as carbohydrate and fat. As we can see, if we plug in some
foods from Table 1 above into MyFitnessPal website we would end up with 509 calories, which
is very close to what the HCG program requires (Lose weight with MyFitnessPal. Retrieved
from http://www.myfitnesspal.com/). However, if we look at the amount of carbohydrate
remaining, it is obvious that patients only consume 50% of their daily-recommended calories.
Carbohydrate is a macronutrient that is important in providing energy for the daily living.
Clearly, patients using HCG program are very limited on fat consumption. According to
example below, if we follow The Original HCG Diet Protocol by Dr. Simeons, we would end up
with only 5 grams from fat when the daily-recommended intake is 40 grams. Fats come in
multiple different forms. While some are bad and should be limited, some are essential for the
body; therefore, limiting the amount of fat consumption to almost completely nothing is not a
good diet plan. On the other side, this program provides a very sufficient amount of protein to
the patients. As we can see from Table 2 below, patient fulfilled the amount of daily-
recommended requirement, 60 grams, with the additional 4 grams. This might be also the key
element to the program that claims that by injecting HCG, patients will not feel hungry. It might
be because the high amount of protein patients consume that make them feel less hungry.
4
NUTRITION FINAL RESEARCH PAPER
Table 2 Patient Food Diary from MyFitnessPal Showing Daily Intake Goals versus RDAs.
Part I, Criteria # 2: RDA Approval Analysis
As mentioned previously, Recommended Dietary Allowa.
Approximately 35% to 60% of all patients with head and neck cancer are malnourished at the
time of their diagnosis because of tumor burden and obstruction of intake or the anorexia and cachexia
associated with their cancer. The purpose of this presentation is to provide a contemporary review of the
nutritional aspects of care for patients with head and neck cancer.
The Mediterranean Kidney Diet, the DASH diet, the Nordic diet, and the vegan and vegetarian diet have all been linked to improved kidney function. Following these dietary guidelines has been linked to a lower risk of developing chronic kidney disease. In addition, the course of CKD is generally slowed when patients adopt certain dietary behaviors.
Geriatric nutrition- nutrition for optimal health, energy, and longevity in o...SriramNagarajan16
The over-sixties make up the fastest growing segment of the population in most countries. Although life expectancy
has also increased dramatically over the last 100 years, this segment of the population is susceptible to many health
risks from a poor diet. Evidence from various sources indicates that many older people fail to get the amounts and
types of food necessary to meet essentialenergy and nutrient needs. There are numerous reasons why older people
might not be getting the most nutritious diet Assessment of nutritional status is essential for preventing or maintaining
a chronic disease and for healing. Knowing the causes of changing nutritional needs and dietary preferences is needed
to understand a patient’s nutritional status. The nutrient requirements for older adults include increased in take of
vitamins D,B 12 ,and B 6and calcium. An old Age individual needs to balance energy intake with his or her level of
physical activity to avoid storing excess body fat. Dietary practices and food choices are related to wellness and affect
health, fitness, weight management, and the prevention of chronic diseases such as osteoporosis, cardiovascular
diseases, cancer , and diabetes.the present Article Reviews the role of balanced Nutrition for old Age Persons
Presentation by Sam Blamires, registered dietician and Senior Medical Affairs Advisor at Nutricia. Part of the PLAN Summer meeting 2016. A review of the latest evidence and guidelines on supporting nutrition in COPD, including the causes and consequences of malnutrition in COPD, the use of screening tools, the NICE guidelines on supplementation, and putting theory into practice.
Approximately 35% to 60% of all patients with head and neck cancer are malnourished at the
time of their diagnosis because of tumor burden and obstruction of intake or the anorexia and cachexia
associated with their cancer. The purpose of this presentation is to provide a contemporary review of the
nutritional aspects of care for patients with head and neck cancer.
The Mediterranean Kidney Diet, the DASH diet, the Nordic diet, and the vegan and vegetarian diet have all been linked to improved kidney function. Following these dietary guidelines has been linked to a lower risk of developing chronic kidney disease. In addition, the course of CKD is generally slowed when patients adopt certain dietary behaviors.
Geriatric nutrition- nutrition for optimal health, energy, and longevity in o...SriramNagarajan16
The over-sixties make up the fastest growing segment of the population in most countries. Although life expectancy
has also increased dramatically over the last 100 years, this segment of the population is susceptible to many health
risks from a poor diet. Evidence from various sources indicates that many older people fail to get the amounts and
types of food necessary to meet essentialenergy and nutrient needs. There are numerous reasons why older people
might not be getting the most nutritious diet Assessment of nutritional status is essential for preventing or maintaining
a chronic disease and for healing. Knowing the causes of changing nutritional needs and dietary preferences is needed
to understand a patient’s nutritional status. The nutrient requirements for older adults include increased in take of
vitamins D,B 12 ,and B 6and calcium. An old Age individual needs to balance energy intake with his or her level of
physical activity to avoid storing excess body fat. Dietary practices and food choices are related to wellness and affect
health, fitness, weight management, and the prevention of chronic diseases such as osteoporosis, cardiovascular
diseases, cancer , and diabetes.the present Article Reviews the role of balanced Nutrition for old Age Persons
Presentation by Sam Blamires, registered dietician and Senior Medical Affairs Advisor at Nutricia. Part of the PLAN Summer meeting 2016. A review of the latest evidence and guidelines on supporting nutrition in COPD, including the causes and consequences of malnutrition in COPD, the use of screening tools, the NICE guidelines on supplementation, and putting theory into practice.
Efficacy of Dietary Intervention in END STAGE RENAL DISEASEJunaid Nazar
Chronic kidney disease (CKD), a major global public health problem, has been recognized as one of the eleven important causes of death (WHO, 2009). This review explores wide range of barriers related to patients and health systems involved in controlling the prevalence of CKD at the primary health care level.
This pilot study describe the malnutrition with its double burden ( overweight and under weight ) among Egyptian population and its effect on public health.
This poster published in Duphat conference in Dubai
Nutrition in complete denture Patients /certified fixed orthodontic courses b...Indian dental academy
Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
DIETARY INTAKE AND NUTRITIONAL STATUS IN HEMODIALYSIS PATIENTSNeeleshkumar Maurya
This study was conducted on 50 CKD-5 patients during the year 2016-17, considered stable from, 3 months of regular dialysis at least 2 times in a week dialysis centre in MLB, Medical College Jhansi. Dietary intake was estimated by 24-hour recall and analysed after 30 days three times the average dietary intake of 1580.5±164 kcal/day; carbohydrate 204.3±19.0 gm/day; lipid, 49.0±4.6 gm/day, protein 54.0±4.8 gm/day. The significant prevalence was observed for the inadequacy of calories intake and other nutrients. Hemodialysis patients had a lower intake of fruit (77%), vegetable (56%) and dairy products (70%) exchange whereas they had normal intake of oils/fats (95%) and sugars/sweets (97%). This study the reveals that the patient suffered from CKD with dialysis phase were observed loss of appetite and inadequate dietary intake than the recommended, lead to malnutrition, susceptible to various life style diseases and high risk of morbidity.
Keywords: Dialysis, inadequate, dietary intake, malnutrition, morbidity.
Diabetes is a rapidly and serious health problem in Pakistan. This chronic condition is associated with serious long-term complications, including higher risk of heart disease and stroke. Aggressive treatment of hypertension and hyperlipideamia can result in a substantial reduction in cardiovascular events in patients with diabetes 1. Consequently pharmacist-led diabetes cardiovascular risk (DCVR) clinics have been established in both primary and secondary care sites in NHS Lothian during the past five years. An audit of the pharmaceutical care delivery at the clinics was conducted in order to evaluate practice and to standardize the pharmacists’ documentation of outcomes. Pharmaceutical care issues (PCI) and patient details were collected both prospectively and retrospectively from three DCVR clinics. The PCI`s were categorized according to a triangularised system consisting of multiple categories. These were ‘checks’, ‘changes’ (‘change in drug therapy process’ and ‘change in drug therapy’), ‘drug therapy problems’ and ‘quality assurance descriptors’ (‘timer perspective’ and ‘degree of change’). A verified medication assessment tool (MAT) for patients with chronic cardiovascular disease was applied to the patients from one of the clinics. The tool was used to quantify PCI`s and pharmacist actions that were centered on implementing or enforcing clinical guideline standards. A database was developed to be used as an assessment tool and to standardize the documentation of achievement of outcomes. Feedback on the audit of the pharmaceutical care delivery and the database was received from the DCVR clinic pharmacist at a focus group meeting.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats
1. 1250 Words (min) - 1450 Words (max), Bibliography and Titles no.docxkarisariddell
1. 1250 Words (min) - 1450 Words (max), Bibliography and Titles not counted.
2. It is a comparison essay.
3. 3+ outside academic sources (blogs, wikis, pop websites are permitted, but do not count for these 3 scholarly sources). Sources should be good journal articles or academic books.
4. Avoid Google. For academic articles, search https://onesearch.library.utoronto.ca/research/articles-databases Links to an external site.
Writing Tips:
—MLA or APA format required: quotes and paraphrasing need page numbers APA: (Smith, 2000, p. 235). MLA (Smith 235). Quotes are best. Avoid footnotes in any form, or the Chicago style of citation.
—State your thesis at the end of Paragraph 1 -- what will you claim?--Include a copy of small image as an Appendix after your Works Cited, if you analyze an ad or other visual item you want me to see (if I haven't likely seen it).
"Quote" if you can. Paraphrase secondarily. Introduce/integrate quotes. As Smith suggests, “Ads are a system...” that can “educate us...” (Smith, 2005, p. 5)
Quotes cannot stand alone.
Begin each paragraph with a topic sentence and address that topic. The topic sentence tells readers what the topic is. For example: “Historically, ads were outdoors...” OR you can use a question “How did we move from a needs society to a wants society?...”
Use transitions between paragraphs. “But Farnsworth was not only the creator of TV, he also…”
Block quotes (more than 3 full lines) should NOT be used, or only in rare cases when you cannot summarize the gist, and almost never in short papers.
Topic:
DIGITAL MEDIA. Select 1 Historical or Current Example of Social Media being blamed for a social problem (ex: the cyber bullying of Amanda Todd), and 1 Example of Social Media being credited with improving life (ex: social movements). (See Chapter 2). Many people who examine ‘social media’ (such as Facebook and Twitter) say that these tools distract us from the important things in life. Similar things were said about television, and telephones, and the radio, and even of writing. Any communication technology can be used in a variety of ways, depending on who has access to them, and how creative they are. In your Compare and Contrast Essay, discuss one case or way in which social media get blamed for negative events or outcomes (loneliness, competitiveness, bullying, boasting, narcissism). Compare this side with the positive things people accomplish with social media (MeToo, BLM, organizing events, socializing, reading the day’s news). Give specific examples, and support your claims with research. You may also mention your own experiences, if relevant. For the negative side, a case study may be wise: the Grossman cyber bullying case, for example, or the BC politician who lost an election due to an old Facebook photo. Or you could identify a common criticism of social media, and explore it. For example: Are social media affecting news and political views based on this news today negatively? Examples.
1-Why is it the case that single men are prominently represented in .docxkarisariddell
1-Why is it the case that single men are prominently represented in the homeless? Is there a primary prevention program that could be a part of a public health initiative that would address this cohort specifically?
2- APA Style
3- 3 paragraphs 3 sentences each
4- 2 references
.
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Similar to 1 Running head NUTRITION FINAL RESEARCH PAPER HCG D.docx
Efficacy of Dietary Intervention in END STAGE RENAL DISEASEJunaid Nazar
Chronic kidney disease (CKD), a major global public health problem, has been recognized as one of the eleven important causes of death (WHO, 2009). This review explores wide range of barriers related to patients and health systems involved in controlling the prevalence of CKD at the primary health care level.
This pilot study describe the malnutrition with its double burden ( overweight and under weight ) among Egyptian population and its effect on public health.
This poster published in Duphat conference in Dubai
Nutrition in complete denture Patients /certified fixed orthodontic courses b...Indian dental academy
Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
DIETARY INTAKE AND NUTRITIONAL STATUS IN HEMODIALYSIS PATIENTSNeeleshkumar Maurya
This study was conducted on 50 CKD-5 patients during the year 2016-17, considered stable from, 3 months of regular dialysis at least 2 times in a week dialysis centre in MLB, Medical College Jhansi. Dietary intake was estimated by 24-hour recall and analysed after 30 days three times the average dietary intake of 1580.5±164 kcal/day; carbohydrate 204.3±19.0 gm/day; lipid, 49.0±4.6 gm/day, protein 54.0±4.8 gm/day. The significant prevalence was observed for the inadequacy of calories intake and other nutrients. Hemodialysis patients had a lower intake of fruit (77%), vegetable (56%) and dairy products (70%) exchange whereas they had normal intake of oils/fats (95%) and sugars/sweets (97%). This study the reveals that the patient suffered from CKD with dialysis phase were observed loss of appetite and inadequate dietary intake than the recommended, lead to malnutrition, susceptible to various life style diseases and high risk of morbidity.
Keywords: Dialysis, inadequate, dietary intake, malnutrition, morbidity.
Diabetes is a rapidly and serious health problem in Pakistan. This chronic condition is associated with serious long-term complications, including higher risk of heart disease and stroke. Aggressive treatment of hypertension and hyperlipideamia can result in a substantial reduction in cardiovascular events in patients with diabetes 1. Consequently pharmacist-led diabetes cardiovascular risk (DCVR) clinics have been established in both primary and secondary care sites in NHS Lothian during the past five years. An audit of the pharmaceutical care delivery at the clinics was conducted in order to evaluate practice and to standardize the pharmacists’ documentation of outcomes. Pharmaceutical care issues (PCI) and patient details were collected both prospectively and retrospectively from three DCVR clinics. The PCI`s were categorized according to a triangularised system consisting of multiple categories. These were ‘checks’, ‘changes’ (‘change in drug therapy process’ and ‘change in drug therapy’), ‘drug therapy problems’ and ‘quality assurance descriptors’ (‘timer perspective’ and ‘degree of change’). A verified medication assessment tool (MAT) for patients with chronic cardiovascular disease was applied to the patients from one of the clinics. The tool was used to quantify PCI`s and pharmacist actions that were centered on implementing or enforcing clinical guideline standards. A database was developed to be used as an assessment tool and to standardize the documentation of achievement of outcomes. Feedback on the audit of the pharmaceutical care delivery and the database was received from the DCVR clinic pharmacist at a focus group meeting.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats
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1. 1250 Words (min) - 1450 Words (max), Bibliography and Titles no.docxkarisariddell
1. 1250 Words (min) - 1450 Words (max), Bibliography and Titles not counted.
2. It is a comparison essay.
3. 3+ outside academic sources (blogs, wikis, pop websites are permitted, but do not count for these 3 scholarly sources). Sources should be good journal articles or academic books.
4. Avoid Google. For academic articles, search https://onesearch.library.utoronto.ca/research/articles-databases Links to an external site.
Writing Tips:
—MLA or APA format required: quotes and paraphrasing need page numbers APA: (Smith, 2000, p. 235). MLA (Smith 235). Quotes are best. Avoid footnotes in any form, or the Chicago style of citation.
—State your thesis at the end of Paragraph 1 -- what will you claim?--Include a copy of small image as an Appendix after your Works Cited, if you analyze an ad or other visual item you want me to see (if I haven't likely seen it).
"Quote" if you can. Paraphrase secondarily. Introduce/integrate quotes. As Smith suggests, “Ads are a system...” that can “educate us...” (Smith, 2005, p. 5)
Quotes cannot stand alone.
Begin each paragraph with a topic sentence and address that topic. The topic sentence tells readers what the topic is. For example: “Historically, ads were outdoors...” OR you can use a question “How did we move from a needs society to a wants society?...”
Use transitions between paragraphs. “But Farnsworth was not only the creator of TV, he also…”
Block quotes (more than 3 full lines) should NOT be used, or only in rare cases when you cannot summarize the gist, and almost never in short papers.
Topic:
DIGITAL MEDIA. Select 1 Historical or Current Example of Social Media being blamed for a social problem (ex: the cyber bullying of Amanda Todd), and 1 Example of Social Media being credited with improving life (ex: social movements). (See Chapter 2). Many people who examine ‘social media’ (such as Facebook and Twitter) say that these tools distract us from the important things in life. Similar things were said about television, and telephones, and the radio, and even of writing. Any communication technology can be used in a variety of ways, depending on who has access to them, and how creative they are. In your Compare and Contrast Essay, discuss one case or way in which social media get blamed for negative events or outcomes (loneliness, competitiveness, bullying, boasting, narcissism). Compare this side with the positive things people accomplish with social media (MeToo, BLM, organizing events, socializing, reading the day’s news). Give specific examples, and support your claims with research. You may also mention your own experiences, if relevant. For the negative side, a case study may be wise: the Grossman cyber bullying case, for example, or the BC politician who lost an election due to an old Facebook photo. Or you could identify a common criticism of social media, and explore it. For example: Are social media affecting news and political views based on this news today negatively? Examples.
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1-Why is it the case that single men are prominently represented in the homeless? Is there a primary prevention program that could be a part of a public health initiative that would address this cohort specifically?
2- APA Style
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4- 2 references
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1-Holding everything else constant, an increase in the growth rate of the money supply will cause the AD curve to
not shift at all.
shift outward.
shift randomly.
shift inward.
2-In the AD-AS model, which curve would be irrelevant if prices and wages were perfectly flexible?
A. Long-Run Aggregate Supply
B. Long-Run Aggregate Demand
C. Short-Run Aggregate Supply
D. Aggregate Demand
3-An increase in the expected inflation rate will cause the LRAS curve to:
A. do nothing.
B. shift right.
C. flatten out.
D. shift left.
4-When consumers suddenly become more pessimistic about the economy, the stock shifts the:
A. LRAS curve outward, reducing the real growth rate in the short run.
B. AD curve inward, reducing the real growth rate in the short run.
C. AD curve outward, reducing the real growth rate in the short run.
D. LRAS curve inward, reducing the real growth rate in the short run.
5-Which of the following would cause the AD curve to shift to the left?
A. lower growth rate of output
B. decreased government purchases
C. higher government budget deficits
D. lower taxes
6-A temporary decrease in consumer spending causes:
A. a decrease in the economy's long-run potential growth rate
B. a decrease in velocity growth
C. an upward shift of the SRAS curve.
D. a decrease in money growth
7-Which of the following best describes the conditions of the Great Depression?
A. Real GDP growth was negative while inflation was very high.
B. Both real GDP growth and inflation were historically high.
C. Real GDP was high while inflation was negative.
D. Both real GDP growth and inflation were negative.
8- Menu costs are the costs associated with changing:
A. jobs.
B. wages.
C. prices.
D. expected inflation.
9-A temporary positive shock to spending growth will lead to an increase in:
A. output and inflation in the short run, but no change in either in the long run.
B. output in both the short and long run.
C. both inflation and output in the short run, but only output in the long run.
D. both inflation and output in the short run, but only inflation in the long run.
10- Which of the following describes the process through which a major decline in the stock market leads to a change in Aggregate Demand?
A. Banking panics lead to a removal of deposit insurance and a negative AD shock.
B. A stock market bubble bursts, and this leads to a negative supply shock.
C. Reductions in consumer wealth produce a negative AD shock.
D. Increase in net exports produce a negative AD shock.
11-
A. 10%
B. 4%
C. 7%
D. 3%
12-
A. 3%
B. 7%
C. 4%
D. 10%
13-
A. -0.5%
B. 6.5%
C. 7%
D. 3%
14-
A. 6.5%
B. -0.5%
C. 0.5%
D. 2%
15-
A. Workers increase their inflationary expectations so that the economy moves to point A.
B. Workers decrease their inflationary expectations so that the economy moves to point C.
C. Workers increase their inflationary expectations so that the economy moves to point C.
D. Workers decrease their inflationary expectations so that the economy moves to point .
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Everett
Overall what occurred in 2015 following the information of Volkswagen cheating the consumers, the market, and the EPA was fairly little in the grand scheme of things. The background surrounding Volkswagen essentially getting away with mass pollution and hoodwinking the industry for years is that a defeat device was installed within the vehicle’s engine that programmed it to run in a cleaner mode when hooked up to a test (Poeir, 2020). This obviously did not restrict the vehicle when performing on an open road. The device was eventually discovered and Volkswagen was billed for 25 billion dollars (Poier, 2020). However, the market share gained from this deception may have been worth it, as the vehicles outperformed all other competition in power and fuel economy that it resulted in the vehicles being ranked top in their respective classes that year (Poier, 2020).
However, what might Volkswagen do now to build back some of the trust within the corporate world? How can they redeem themselves economically? The first step arguably is to regain the trust of their shareholders and instill a set of ethics the likes of which cannot be questioned. Obviously, a drop in stock price is bad news, however, the company is by no means insolvent, and they quickly recovered following the incident. However ethics the company needs to advertise and explain to investors and to staff some sort of new ethical guidance that can convince people to purchase their products once again.
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Andrea
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1-2 paragraphs
apa format
references
need in 8 hours!
Select one moral philosophy (teleology, deontology, relativist perspective, virtue ethics, or justice) that has influenced the outcome of an ethical dilemma that you have witnessed.
Provide one example of the way in which this moral philosophy influenced the outcome of an ethical dilemma in a past or present organization.
Note
: Please do not identify workplaces or leaders by name.
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1. A:
In your viewpoint, what are the Humanities
? Formulate a definition of the Humanities.
B:
What is the relationship between Humanities and be nurse
?
This can be answer in one paragraph with 6 sentence.
2- What is the contribution of Philosophy to Humanities and humanity? Please explain by writing a well-developed paragraph of at least five sentences.
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1-2 PAGES
Identify an ethical consideration besides establishing culturally relevant efforts that are consistent with recognizing that primary prevention is an act of premeditated intrusion into the lives and setting of individuals and groups and ask a question about this ethical consideration.
Suggest an additional mechanism or strategy to increase culturally relevant prevention programming and planning with African American teenagers, ages 13 through 21, spreading sexually transmitted infections.
Provide your colleague with feedback about how prevention as an act of premeditated intrusion into the lives and setting of individuals and groups on Diversity and Ethical Considerations could help bring about positive social change.
Learning Resources
Required Readings
Hage, S., & Romano, J. L. (2013). Best practices in prevention. In R. K. Conyne & A. M. Horne (Eds.). Prevention practice kit: Action guides for mental health professionals (pp. 32-46). Thousand Oaks, CA: SAGE.
Vera, E. M., & Kenny, M. E. (2013). Social justice and culturally relevant prevention. In R. K. Conyne & A. M. Horne (Eds.). Prevention practice kit: Action guides for mental health professionals (pp. 1-59). Thousand Oaks, CA: SAGE.
American Counseling Association (2014). 2014 ACA Code of Ethics. Retrieved from https://www.counseling.org/Resources/aca-code-of-ethics.pdf
County Health Rankings & Roadmaps (2018). How healthy is your community? Robert Wood Johnson Foundation. Retrieved from http://www.countyhealthrankings.org/.
Required Media
Walden Scholars of Change (2016). Giving incarcerated women a second chance. https://www.waldenu.edu/connect/video-and-multimedia/social-change/scholars-of-change/2016-winners/giving-incarcerated-women-a-second-chance
Be sure to support your postings and responses with specific references to the Learning Resources.
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INTRODUCTION should contain:
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*The literature review is current (within 5 years)
A logical sequence from what we know (the literature review) to what we don't know (the unanswered questions raised by the review and what this study intended to answer)
* the purpose of the present study
*the hypothesis/research questions
*State the overall purpose of the paper
*What new ideas or info were communicated in the paper
*Why was it important to publish these ideas?
METHODS. The methods section has three subsections. It should contain:
* The participants and population they intended to represent
* The number of participants and how they were selected
*A description of the tools/measures used and research design employed
RESULTS: The results should contain a thorough summary of results of all analyses
DISCUSSION: The discussion is where the author "wraps up the research."
* A simple and easy to understand summary of what was found.
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sellers will offer less on the market at lower prices.
consumers will buy more at lower prices.
sellers will offer more on the market at higher prices.
consumers are not responsive to price changes.
2. An increase in the demand for gasoline today caused by concerns that gasoline prices will be
higher tomorrow is most likely attributable to a change in:
consumer preferences.
consumer expectations.
income.
prices of other goods.
3. If the price of hamburger decreased, it would probably result in _____ in the demand for
hamburger buns.
random fluctuations
no change
an increase
a decrease
4. A decrease in supply is caused by:
an advancement in the technology for producing the good.
an increase in the price of goods that are used in production.
an increase in the number of producers.
suppliers' expectations of lower prices in the future.
5. Figure: The Demand and Supply of Wheat
Reference: Ref 3-6
(Figure: The Demand and Supply of Wheat) Look at the figure The Demand and Supply of
Wheat. If a price of $8 temporarily exists in this market, a _____ of _____ bushels will
result.
surplus; 6,000
surplus; 4,000
shortage; 2,000
shortage; 4,000
6. If the market for buffalo meat is in equilibrium, the price of buffalo meat will probably
_____ in the near future.
decrease
increase considerably
increase
not change
7. Figure: Four Markets for DVDs
Reference: Ref 3-9
(Figure: Four Markets for DVDs) Look at the figure Four Markets for DVDs. Which of the
graphs illustrates what may happen in the market for DVDs if D1 or S1 is the original curve
and D2 or S2 is the new curve and if the cost of producing DVDs falls?
C
D
A
B
8. Figure: Shifts in Demand and Supply II
Reference: Ref 3-11
(Figure: Shifts in Demand and Supply II) Look at the figure Shifts in Demand and Supply II.
The graph shows how supply and demand might shift in response to specific events. Suppose
scientists discover that eating pomegranates causes aging. Which panel BEST describes how
this will affect the market for pomegranates?
panel C
panel B
panel D
panel A
9. Figure: Shifts in Demand and Supply III
Reference: Ref 3-12
(Figure: Shifts in Demand and Supply III) Look at the figure Shifts in Demand and Supply
III. The figure shows how supply and demand might shift in response to specific events.
Suppose consumer incomes increase. Which panel BEST describes how this will affect the
market for designer boots, a normal good?
panel B
panel C
panel A
panel D
10. For consumers, pizza and hamburgers are substitutes. A rise in the price of a pizza causes
_____ in the equilibrium price of a hamburger and _____ in the equilibrium quantity of
hamburgers.
a rise; a decrease
a fall; an increase
a rise; an increase
a fall; a decrease .
1-2 page critique of the film after selecting a character in the mov.docxkarisariddell
1-2 page critique of the film after selecting a character in the movie (main character most of the time) and completing a diagnostic impression as it best reflects the character’s clinical syndrome and how the character(s) meets the diagnostic criteria for the particular disorder(s).
Main Character: Ben Sanderson
**** Use the DSM-5 to develop the character impression. Provide your opinion with supporting details from the movie and the DMS-V. Share your overall critique of the movie. Share your overall critique o the movie
.
1. Which of the following changes will result in a shift of the agg.docxkarisariddell
1. Which of the following changes will result in a shift of the aggregate demand curve, and which will result in a movement along the curve? If there is a shift, or a movement, be sure to explain in which direction, and why (either up or down, or, right or left). 1 pt each
a. The Fed lowers interest rates.
b. The price level in the economy falls.
c. Wealth decreases.
d. A foreign trading partner’s national income increases.
2. With a two panel diagram –one panel showing the aggregate expenditure diagram, and the other showing the AD curve – show how a decrease consumption shifts the AD curve.
2 pts
3. What will happen to the aggregate supply curve if the price of foreign oil decreases? Will it cause a movement along the curve or a shift of the curve? Explain clearly. 2 pts
4. Is there any difference between the aggregate demand curve and the demand curve for good x? Explain .
.
1-2 page critique of the film after analyzing the main character (Jo.docxkarisariddell
1-2 page critique of the film after analyzing the main character (Jones) and completing a diagnostic impression as it best reflects the character’s clinical syndrome and how the character meets the diagnostic criteria for the particular disorder(s).
**** Use the DSM-5 to develop the character impression. Provide your opinion with supporting details from the movie and the DMS-V. Share your overall critique of the movie. Share your overall critique o the movie.
.
1. John, a 15 year old who loves skateboarding, wants to buy th.docxkarisariddell
1. John, a 15 year old who loves skateboarding, wants to buy the new hyped magenta 3000 skateboard. He finds the last one on-line at his local sports store. He uses his debit card to purchase the board and the $500 is taken directly from his bank account. In order to avoid a delivery fee, he selects “pick up” as his shipping option.
When he arrives at the store to pick up the skateboard, the manager tells him he has canceled the transaction because another customer has promised to pay $600 for the board. John offers to pay an additional $150 for the skateboard and the manager agrees. John pays the $150 by credit card and takes the board. As soon as John gets home, he calls the credit card company and cancels the transaction.
The store sues John for the $150 or the return of the skateboard. What result?
A. The store will win. John has to return the skateboard because he is a minor without the capacity to contract.
B. John will win. There was no consideration given in exchange for John’s payment of the $150.
C. The store will win under the doctrine of promissory estoppel.
D. The store will win because the store’s website did not create a valid offer.
B. John will win. There was no consideration given in exchange for John’s payment of the $150.
2. Rob, an elderly man, is dependent on his housekeeper, Larry, to care for him. Larry persuades Rob to withdraw $100,000 from the bank and make an interest free loan to him. Rob’s daughter, Erica, sues Larry on behalf of her father to avoid the transaction. Erica’s best claim is:
A. Unilateral mistake.
B. Undue Influence
C. Economic duress
D. Misrepresentation
B. Undue influence
3. Elise took out an ad in the newspaper to sell her car, fully described, for $17,000. Franklin saw the ad and called Elise, saying that he would like to see the car. Franklin met Elise, drove the car and said, “Okay, I’ll buy it.” Which of the following is true?
A. Elise made an offer, which Franklin accepted.
B. Franklin made an offer, which Elise may accept or reject.
C. Elise made an offer which Franklin may accept or reject.
D. Franklin made an offer, which Elise accepted.
B. Franklin made an offer, which Elise may accept or reject.
4. Colleen sold a house to Ben for $300,000. Before selling the house, Colleen forgot to tell Ben about a leaky faucet in a little-used sink in the basement, which would cost about $30 to fix. Ben inspected the house, but didn’t notice the faucet. Later, Ben tries to rescind the deal on the grounds of fraud or misrepresentation because of the leaky faucet. Which of the following is the best reason why Ben cannot rescind?
A. Because Colleen made no statement about the faucet.
B. Because Ben did not rely on any false statement
C. Because the condition of the faucet is not material to the contract.
D. Because Colleen did not conceal the condition of the faucet.
C. Because the condition of the faucet is not material to the contract
5. Ana, a 19-year-old immig.
1-Read and print the data from the brain.csv file2-Extraxt t.docxkarisariddell
1-Read and print the data from the brain.csv file
2-Extraxt the HeadSzie and the BrainWeight into separate arrays (print as column vectors)
3- Find the average, max, and min values for the 2 data columns.
4- Plot the head size verses the brain weight
Please find the attachment for brain.csv file
.
1. Duncan Fisher (2019, march). Children of Divorce The Key Rol.docxkarisariddell
1. Duncan Fisher (2019, march). Children of Divorce: The Key Role of Self-Esteem in Recovering from The Trauma.
https://www.childandfamilyblog.com/child-development/children-of-divorce-self-esteem/
2. Hal Arkowitz, Scott O. Lilienfeld (2013, March 1). Is Divorce Bad for Children?
https://www.scientificamerican.com/article/is-divorce-bad-for-children/
3. Judith S. Wallerstein (1989, Jan 22). CHILDREN AFTER DIVORCE.
https://www.nytimes.com/1989/01/22/magazine/children-after-divorce.html
4. Patrick F. Fagan and Aaron Churchill (2012, January 11). The Effects of Divorce on Children.
https://downloads.frc.org/EF/EF12A22.pdf
5. Wendy Paris (2015, March 17). Yes, You Can Raise Happy Children After Divorce.
https://www.psychologytoday.com/us/blog/splitopia/201503/yes-you-can-raise-happy-children-after-divorce
Rashmitha Anugu
Discussion 7
7 hours ago
Q1. What should Mark have done if Jack still was not able to resolve the problem?
McRoy Aerospace was into building freight planes and refueling tankers. Be that as it may, they needed to contend in a market of building business airplane. McRoy could be an effective rival in the matter of assembling business airplane on the off chance that they could discover an answer for the issue of having a instrument for every one of the four sets of entryways in the airplane.
Jack has been an accomplished specialist and most important asset for McRoy Aerospace, and Mark was persuaded that Jack was the one in particular who could discover an answer for the issue. Mark depended excessively on one representative, which is constantly dangerous and is never suggested while rivaling organizations like Boeing and Airbus. In the event that Jack couldn't think of an answer, Mark could direct or an open test where workers and ongoing alumni can take an interest and take care of the issue independently.
Q2. Would it make sense for Mark to assign this problem to someone else now after Jack could not solve the problem the second time around?
In the wake of giving Jack adequate time, depending on him, and pushing him to concoct an answer, it looks bad to drive Jack further, and it would be a smart thought to relegate this issue to another person. While rivaling solid contenders like Boeing, it's better not to depend on one worker. Mark should locate some other official with exceptional and hands-on understanding, who is happy to respond to the call and is certain to think of an answer.
References
Kerzner, Harold. (2013) Project management: a systems approach to planning, scheduling, and controlling, John Wiley & Sons. 14-600. Newyork, NY.
Thomaz, J. (2014). Knowledge Management on PMO’s Perspective: A Systematic Review. European Conference on Knowledge Management, 1, 233.
Jeevan Manda
Discussion 7
5 days ago
1 reply
Last 3 days ago
What should Mark have done if Jack still was not able to resolve the problem?
Mark has an extensive measure of want on Jack. He figured Jack would think about a blueprint for using all.
1. When Thomas Paine writes about reconciliation, he is referring .docxkarisariddell
1. When Thomas Paine writes about reconciliation, he is referring to (1 point)
the southern Colonies staying peacefully connected to the northern Colonies.
the Colonies staying peacefully connected with Great Britain.
the Colonists staying peacefully connected to Native Americans.
Great Britain staying peacefully connected with Europe.
2. Which of the following statements about Common Sense is NOT true? (1 point)
Common Sense was written the same year as the Declaration of Independence.
Thomas Paine wrote Common Sense to persuade colonists to fight for independence.
The printing press enabled the wide circulation of Common Sense.
Thomas Paine was hanged for treason after writing Common Sense.
3. Thomas Paine believed America should be (1 point)
an asylum, a safe place, for all people.
a British colony.
a continent of many nations.
a city on a hill.
Asylum is a word with multiple meanings. Read the following sentence from Common Sense.
“This new world hath been the asylum for the persecuted lovers of civil and religious livery from every part of Europe.”
4. In this context, does asylum have a positive or negative connotation? (1 point)
positive
negative
5. Thomas Paine wrote Common Sense to (1 point)
Revolutionary War soldiers.
colonists in 1776, prior to the signing of the Declaration of Independence.
the British monarchy.
women seeking the right to vote.
.
1-This discussion question is based on pp. 135-158 ofThe E.docxkarisariddell
1-
This discussion question is based on pp. 135-158 of
The Essential Theater, 10th ed.
, by Oscar G. Brockett and Robert J. Ball.
Topics you should know before answering this question:
1. Neoclassical rules of theater in France (pp. 123-124)
2. The rebellion against neoclassicism and the appreciation of Shakespeare (pp. 136-138)
3. Sturm and Drang movement in Germany (pg. 136)
4. The connection between Romanticism and melodrama (pp. 139-146)
5. Realism and Heinrick Ibsen (pp. 146-158)
6. Realism in acting (Stanislavsky) (pp. 158-160)
Describe the differences between the Romantic movement and the Realism movement in theater. Give specific details and use plays discussed in your book and class as examples. Finally, describe which kind of play you would be more likely to go see and why.
2-
This discussion question is based on pp. 161-250 of
The Essential Theater, 10th ed.
, by Oscar G. Brockett and Robert J. Ball.
Topics you should know before answering this question:
1. Psychological Realism in American theater (pp. 183-188)
2. Stanislavsky method of acting (pp. 175-178)
3. African American theater (pp. 224-228)
4. Latino theater (pp.229-233)
5.
A Raisin in the Sun, Ma Rainey's Black Bottom,
and
Lydia
Compare African American Theater, Latin Theater and Asian-American theater. How are these traditions similar? How are they different? Be specific. Use the names of playwrights and/or their work.
3-
This discussion question is based on pp. 135-158 of
The Essential Theater, 10th ed.
, by Oscar G. Brockett and Robert J. Ball.
Heinrich Ibsen's
A Doll's House
ends with Nora Helmer leaving her husband and children for the purpose of finding out who she is outside the tight confines of her marriage. This ending shocked 19th century audiences, and the play was often changed to have Nora remain with her family. In some places, like Britain,
A Doll's House
was simply banned outright.
In your opinion, what purpose was served by having
A Doll's House
censored, either by being rewritten or banned? Is censorship of a theatrical or cinematic work ever permissible? If so, under what conditions? If not, why not? Explain your position as clearly and thoroughly as you can and defend it against people who might disagree with you.
.
Honest Reviews of Tim Han LMA Course Program.pptxtimhan337
Personal development courses are widely available today, with each one promising life-changing outcomes. Tim Han’s Life Mastery Achievers (LMA) Course has drawn a lot of interest. In addition to offering my frank assessment of Success Insider’s LMA Course, this piece examines the course’s effects via a variety of Tim Han LMA course reviews and Success Insider comments.
Unit 8 - Information and Communication Technology (Paper I).pdfThiyagu K
This slides describes the basic concepts of ICT, basics of Email, Emerging Technology and Digital Initiatives in Education. This presentations aligns with the UGC Paper I syllabus.
Biological screening of herbal drugs: Introduction and Need for
Phyto-Pharmacological Screening, New Strategies for evaluating
Natural Products, In vitro evaluation techniques for Antioxidants, Antimicrobial and Anticancer drugs. In vivo evaluation techniques
for Anti-inflammatory, Antiulcer, Anticancer, Wound healing, Antidiabetic, Hepatoprotective, Cardio protective, Diuretics and
Antifertility, Toxicity studies as per OECD guidelines
Operation “Blue Star” is the only event in the history of Independent India where the state went into war with its own people. Even after about 40 years it is not clear if it was culmination of states anger over people of the region, a political game of power or start of dictatorial chapter in the democratic setup.
The people of Punjab felt alienated from main stream due to denial of their just demands during a long democratic struggle since independence. As it happen all over the word, it led to militant struggle with great loss of lives of military, police and civilian personnel. Killing of Indira Gandhi and massacre of innocent Sikhs in Delhi and other India cities was also associated with this movement.
Macroeconomics- Movie Location
This will be used as part of your Personal Professional Portfolio once graded.
Objective:
Prepare a presentation or a paper using research, basic comparative analysis, data organization and application of economic information. You will make an informed assessment of an economic climate outside of the United States to accomplish an entertainment industry objective.
Francesca Gottschalk - How can education support child empowerment.pptxEduSkills OECD
Francesca Gottschalk from the OECD’s Centre for Educational Research and Innovation presents at the Ask an Expert Webinar: How can education support child empowerment?
Introduction to AI for Nonprofits with Tapp NetworkTechSoup
Dive into the world of AI! Experts Jon Hill and Tareq Monaur will guide you through AI's role in enhancing nonprofit websites and basic marketing strategies, making it easy to understand and apply.
Introduction to AI for Nonprofits with Tapp Network
1 Running head NUTRITION FINAL RESEARCH PAPER HCG D.docx
1. 1
Running head: NUTRITION FINAL RESEARCH PAPER
HCG Diet and Cystic Fibrosis
West Coast University
Orange County
Your Name Here
NURS 225: Nutrition in Health and Disease
2017
2
NUTRITION FINAL RESEARCH PAPER
Topic # 1: HCG Diet
Part I, Criteria # 1: Identification of Nutrients
According to the Dudek (2016), the RDAs represent the average
daily-recommended
intake to meet the nutrient requirements of 97% to 98% of
2. healthy individuals by life stage and
gender. When estimating the nutritional needs of people with
health disorders, health
professionals use the RDA’s as a starting point and adjust them
according to the individual’s
need (Dudek, 2013). Even though HCG is a hormone injection
program, there are extremely
strict and limited food choice to their diet plan such as: 500
calories limit per day, no cosmetic
products that contain fat in them, 2 small apples are not an
expectable exchange for 1 apple.
Table 1 below lists some foods that patients are allowed to
choose from for daily intake
(Simeons, 2016).
Table 1 The Original HCG Diet Protocol by Dr. Simeons
3
NUTRITION FINAL RESEARCH PAPER
Due to such strict rules and limitation on food selection,
patients would end up with deficiency in
two important macronutrients such as carbohydrate and fat. As
3. we can see, if we plug in some
foods from Table 1 above into MyFitnessPal website we would
end up with 509 calories, which
is very close to what the HCG program requires (Lose weight
with MyFitnessPal. Retrieved
from http://www.myfitnesspal.com/). However, if we look at the
amount of carbohydrate
remaining, it is obvious that patients only consume 50% of their
daily-recommended calories.
Carbohydrate is a macronutrient that is important in providing
energy for the daily living.
Clearly, patients using HCG program are very limited on fat
consumption. According to
example below, if we follow The Original HCG Diet Protocol
by Dr. Simeons, we would end up
with only 5 grams from fat when the daily-recommended intake
is 40 grams. Fats come in
multiple different forms. While some are bad and should be
limited, some are essential for the
body; therefore, limiting the amount of fat consumption to
almost completely nothing is not a
good diet plan. On the other side, this program provides a very
sufficient amount of protein to
the patients. As we can see from Table 2 below, patient fulfilled
4. the amount of daily-
recommended requirement, 60 grams, with the additional 4
grams. This might be also the key
element to the program that claims that by injecting HCG,
patients will not feel hungry. It might
be because the high amount of protein patients consume that
make them feel less hungry.
4
NUTRITION FINAL RESEARCH PAPER
Table 2 Patient Food Diary from MyFitnessPal Showing Daily
Intake Goals versus RDAs.
Part I, Criteria # 2: RDA Approval Analysis
As mentioned previously, Recommended Dietary Allowances
(RDAs) is the average
5. daily dietary intake level sufficient to meet the nutrient
requirement of 97% to 98% of healthy
individuals in a particular life stage and gender group (Dudek,
2013). Even though the amount of
intake varies on the individual, HCG program still provides
patient with very little in
micronutrients such as calcium, potassium, iron, fiber, sodium,
vitamin A, and vitamin C.
However, out of these nutrients, there are five nutrients that the
diet is very deficient in: sodium,
potassium, calcium, vitamin A, and iron. These 5 nutrients are
not even at 50% of the daily-
5
NUTRITION FINAL RESEARCH PAPER
recommended intake. Sodium plays an important role in fluid
and electrolyte balance. Even
though deficiency is rare, patient can experience nausea,
dizziness, and/or muscle cramps
(Dudek, 2013). Potassium is also important in fluid and
electrolyte. It also has nerve impulse
transmission function and skeletal and cardiac muscle activity.
Deficiency will lead to muscle
6. weakness, anorexia, confusion, and irregular heartbeats (Dudek,
2013). Calcium involves in bone
and teeth formation, blood clotting, nerve transmission,
contraction and relaxation of muscles,
and blood pressure regulation. Deficiency in this mineral can
lead to impaired growth in children
and osteoporosis in adults (Dudek, 2013). Vitamin A is very
important in formation of visual
purple, normal growth and development of bones and teeth,
healthy skin and hair, and also
important in immune function. Deficiency can result in ceases
of bone growth, dry skin, decrease
saliva production, and impair immune system (Dudek, 2013).
Last but not least, iron is very
important in transporting oxygen. Iron in foods exists in two
forms: heme iron, found in meat,
fish, and poultry, and nonheme iron, found in plants such as
grains, vegetables, legumes, and
nuts. The majority of iron in the diet is nonheme iron (Dudek,
2013).
Part 2, Criteria 1# Nutrition and Pathophysiology
Cystic fibrosis is a genetic disorder where the individual
inherits one defective gene
7. (mutation of the transmembrane conductance regulator gene
[CFTR] located on chromosome 7)
from each parent and is “characterized by abnormally thick
mucus secretions from the epithelial
surfaces that results in progressive lung disease, pancreatic
insufficiency and dysfunction of the
gastrointestinal and genitourinary systems”. Due to the CFTR’s
inability to function properly
leads to obstruction of the ducts and glands of affected organs
such as the lungs and pancreas,
6
NUTRITION FINAL RESEARCH PAPER
digestive tract, liver, skin and reproductive organs (Nahikian-
Nelms, Sucher, & Lacey, 2016, pp.
650).
Patients with cystic fibrosis, enzymes are suppressed and unable
to reach the small
intestines related to pancreatic insufficiency secondary to
obstructed ducts. These patients will
show symptoms such as abdominal distention; frequent bowel
movements that are oily, bulky,
and foul smelling; and even with normal appetite will present
8. with poor growth pattern,
decreased muscle mass and decreased subcutaneous tissue.
These patients, both children and
adults, are also at risk for electrolyte imbalance and dehydration
due to excessive sweating in hot
weather and fever related to the increased levels of chloride and
sodium in their sweat. Other
complications that occur because of the disease process include
varices and cirrhosis of the liver
with portal hypertension; cystic fibrosis related diabetes (10%
to 15% of adults of adults) with
subsequent clinical complications is acquired. Also, patients
with cystic fibrosis have a higher
risk of infection (mainly Staphylococcus aureus and
Pseudomonas aeruginosa) due to defective
or impaired cilia action, which can lead to the inability to clear
mucus from the lungs due to the
defective regulation of the respiratory tract. The major cause of
death (more than 95% of
patients) with cystic fibrosis patients is pulmonary
insufficiency, which in turn leads to
pulmonary failure (Nahikian-Nelms, Sucher, & Lacey, 2016, pp.
650).
To prevent nutritional deficiencies, maintain nutritional status,
9. and maximize growth of
patients with cystic Fibrosis, early detection is of the utmost
importance. Some of these
diagnostic tests to help with early detection include DNA
analysis of the CFTR gene to confirm
mutation, pancreatic function tests, pulmonary function tests,
and a sweat chloride test (usually
done during the newborn screening). “Common nutrition
diagnostic labels for cystic fibrosis
include inadequate energy intake, inadequate oral intake,
increased energy needs, malnutrition,
7
NUTRITION FINAL RESEARCH PAPER
less than optimal intake of fats, inappropriate intake of types of
carbohydrates, inconsistent
carbohydrate intake, inadequate vitamin and mineral intake,
altered GI function, altered
nutrition-related laboratory values, underweight, unintended
weight loss, self-monitoring deficit,
limited adherence to nutrition-related recommendations, and
poor nutrition quality of life”
(Nahikian-Nelms, Sucher, & Lacey, 2016, pp. 653). Most
10. studies show that cystic fibrosis
patients have vitamin and mineral deficiencies including
Vitamin A, Vitamin D, Vitamin E, and
Iron and Zinc (mostly children and adolescence). Although
Vitamin A deficiency is common, it
also can be misleading because during an infection or an acute
illness a patient’s the serum
plasma Vitamin A levels may be decreased. Due to the
increased prevalence of bone fractures
and osteoporosis, Vitamin D needs to be monitored carefully to
ensure they are receiving the
right amount because studies have also shown that CF patients
still have low levels of Vitamin D
concentrations despite intake of supplements (Nahikian-Nelms,
Sucher, & Lacey, 2016, pp. 651-
652).
Part 2, Criteria # 2: Medical and Nutrient Related Interventions
and Dietary Needs
Timely interventions and accurately assessing their nutritional
status is very important
because many cystic fibrosis patients may present with multiple
nutritional diagnoses at any
given time related to the complexity of their disease. Every
11. treatment plan for CF patients will
vary from patient to patient but, also usually include the
“following components; airway
clearance techniques; oral, inhaled and nebulized medications;
nutrition therapies; and a fitness
plan” (Cystic fibrosis Foundation, n.d.); and nutritional-related
medication management with
Pancreatic Enzyme Therapy.
8
NUTRITION FINAL RESEARCH PAPER
“Because a significant number of individuals with CF have
pancreatic insufficiency,
malabsorption of dietary fat, protein, fat-soluble vitamins, and
other nutrients often occurs…
Individuals with CF are prescribed pancreatic enzyme
supplements. These enzymes are
specifically formulated with an enteric coating that allows for
better absorption into the
duodenum. The target dose is 1500 to 2500 unit’s lipase/kg…
[and the] FDA has issued a rule
requiring manufacturers of pancreatic enzyme supplements to
obtain approval for their products
12. [because of the inconsistencies in the formulation].” With this
new FDA ruling in place,
Pancreatic enzyme supplements, like any new drug, must go
through the same standards of
testing before being distributed to the public (Nahikian-Nelms,
Sucher, & Lacey, 2016, p. 652).
Cystic fibrosis patients, especially with pancreatic
insufficiencies, need adequate intake
of calories to help with development and growth and these
needs will vary based on each
individual and their nutritional status. These patients usually
need 1 ½ to 2 times that amount
calories than someone without cystic fibrosis and “if an
individual has significant growth
deficits, lung disease, or malabsorption, energy requirements
may be significantly increased
(110%–200% of the RDA for age)”. Usually caloric intake is
never restricted or minimized due
to the majority of CF patients have difficulty gaining or
maintaining their weight (Nahikian-
Nelms, Sucher, & Lacey, 2016, p. 652). Cystic fibrosis patients
have trouble absorbing fats
related to pancreatic insufficiency and in turn they have trouble
absorbing fat-soluble vitamins
13. such as Vitamin A, Vitamin D, Vitamin E and Vitamin K, which
are critical for normal growth.
Besides taking these fat-soluble vitamins as supplements they
need to ensure they consume
appropriate amount of water-soluble vitamins, such as; Vitamin
C and the B-complex vitamins
(to include biotin and pantothenic acid, and folic acid) (Cystic
fibrosis Foundation, n.d.).
9
NUTRITION FINAL RESEARCH PAPER
One treatment recommended for cystic fibrosis patients include
Airway clearance, which
allows the mucus that is thick and viscous to loosen up and
dislodge from their lungs allowing
for better oxygenation, improve lung function and helps
decrease the risk of lung infections.
Some techniques include: coughing or huffing; chest
physiotherapy (including percussion with
cupped hands or equipment can be prescribed and ordered
through various manufacturers).
Along with these Airway clearance techniques, usually cystic
fibrosis patients are on long term
14. bronchodilators (usually nebulized) that can result in abdominal
pain and anorexia,
corticosteroids, antibiotics like ciprofloxacin may have delayed
absorption when taken with dairy
products, mucus thinners, and “CFTR (cystic fibrosis
transmembrane conductance regulator)
modulator therapies. [They] are designed to correct the function
of the defective protein made by
the CF gene and there are currently [only] two FDA-approved
CFTR modulators: ivacaftor
(Kalydeco®) and lumacaftor/ivacaftor (Orkambi®)” (Cystic
fibrosis Foundation, n.d.).
Part 3, Criteria # 1 Nutrient Calculations
Our patient is a 22-year-old female who is 5'5" (65 inches) and
112 pounds (50.9 kg).
BMI
Using this calculation, the patient’s BMI is 18.6 and according
to the Quick Bite
Interpreting BMI Chart, the patient’s BMI barely meets the
Healthy Weight, which ranged from
18.5 to 24.9 (Dudek 2014, p. 7). “The 2002 Nutrition Consensus
Report states that there is no
perfect method to estimate the calorie needs of a person with
15. CF” (Nahikian-Nelms, et al., 2016,
p.652).
112/ 65 X 65 (4225) = 0.0265 X 703 = 18.6 BMI
BMR
10
NUTRITION FINAL RESEARCH PAPER
Since the patient’s BMI falls under the Healthy Weight category
to estimate her caloric
needs we will use the equation for a healthy adult, which is
(weight in kg) x (30 kcal/kg). Using
this calculation, we estimate that her calorie intake needs would
be roughly be 1527 kcal. The
BMI plus activity and food intake is the calculation documented
below.
112 X 10 = 1120 X 0.20 (activity) = 224 + 1120 = 1344 X
0.1(food) = 134 + 1344 =
1478 calories/day
CHO
For carbohydrate intake, should be individualized and “should
be monitored to achieve
16. glycemic control. Although carbohydrate is not restricted,
patients should be taught to distribute
carbohydrate calories throughout the day and to avoid
concentrated carbohydrate loads”
(Nahikian-Nelms, et al., 2016, p.653).
1478 X 0.45 = 665 calories then/by 4calories/gram = 166
grams/day
1478 X 0.65 = 960 calories then/by 4 calories/gram = 240
grams/day,
Daily range 665-960 calories/day from CHO, 166 - 240
grams/day,
PRO
Protein intake, recommended intake is roughly 1.5 to 2.0 times
the Daily Recommended
Intake (DRI) for that age (Nahikian-Nelms, et al., 2016, p.653).
“The Recommended Dietary
Allowance (RDA) for protein for healthy adults is 0.8 g/kg” and
“the Acceptable Macronutrient
Distribution Range (AMDR) for protein for adults is 10% to
35% of total calories” (Dudek 2014,
p. 54). With a caloric intake of 1527 kcal, minimum protein
intake of 10% and protein equaling 4
kcals/gram, for a healthy patient would need a minimum intake
17. of roughly 38.2 grams. Since a
cystic fibrosis patient needs 1.5 to 2.0 times the normal intake
of protein, at a minimum a cystic
fibrosis patient would need 57.3 grams to 76.4 grams of protein
per day.
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NUTRITION FINAL RESEARCH PAPER
112 lb. / 2.2 kg/lb. = 50.9 kg. X 0.8 gm/kg = 40.7 grams protein
daily, healthy person
Or
40.7 grams X 1.5 times as much, requirement = 61grams/day
protein X 4 calories/gram =
244 calories/day
40.7 grams X 2 times as much, requirement = 81.4 grams/day X
4 calories/gram = 326
calories/day
Daily range 244 - 326 calories/day, or 61 - 81 grams/day
FAT
For patients with cystic fibrosis , there is no restriction on fat
intake because it is essential
18. for weight maintenance. Unlike the 25% to35% recommended
fat intake for the normal
population, cystic fibrosis patients require a greater fat intake
of 35% to 40 % of total kcal
(Nahikian-Nelms, et al., 2016, p.653). With a caloric intake of
1527 kcal, maximum fat intake of
40% and fats equaling 9 kcals/grams, the patient would need a
minimum intake of roughly 67.9
grams of fat per day.
2839 X 0.35 = 568 calories then/by 9 calories/gram = 63
grams/day
2839 X 0.40 = 994 calories then/by 9 calories/gram = 110
grams/day
Daily range 568 – 994 calories/day, or 63 – 110 grams/day
Part 3, Criterion #2 SMART Goals and Patient Care Plan
SMART Goal # 1: Patient will make a menu for two days, 3
meals/day with a heme rich protein
food in two meals, menus will be discussed at the end of the
shift. Patient was able to plan six
meals with four containing heme rich proteins. Goal met
SMART Goal # 2: Patient will consume
75% of 2 meals during this 12—hour shift. Goal met patient
consumed 100% of breakfast and
19. 12
NUTRITION FINAL RESEARCH PAPER
75% of lunch. SMART Goal # 3: Patient will consume a serving
of probiotic rich food, (yogurt)
daily by end of shift. Goal met, patient consumed a Greek
yogurt for lunch.
Patient is a 22-year-old female who’s 5’5” (65 inches) and 112
pounds (50.9 kg), BMI of 18.6
who was diagnosed with cystic fibrosis at two years old. She
came to the ER complaining that she has
trouble breathing. Her blood pressure is 130/86, heart rate 92
beats per minute, temperature of 98.8
degrees Fahrenheit, and oxygen saturation at 88% in room air.
Patient denies any history of smoking or
illicit drug use and occasionally has an alcoholic drink. Patient
states that she is still taking
Ciprofloxacin after having pneumonia about two weeks ago.
As an RN caring for a person with cystic fibrosis, there are
many roles and duties that one
must be responsible for. An RN must ask the patient if they
have any type of food allergies.
20. There are no particular foods that an adult with cystic fibrosis
should really avoid, but you must
take precautions before giving food that a patient may be
allergic to. The RN must assess the
patient for low protein by obtaining the serum prealbumin and
globulin levels. Patient teaching
would include the importance of maintaining a high protein, fat
diet with a daily consumption of
probiotics (Jafir, 2014). Listen to the patient and what she likes
to eat, thus avoiding any
ethnocentricism. Give the patient different options of high
protein meals to choose from in order
to effectively gain the nutrients needed. Advise the patient to
consider what foods she prefers
that are easy to chew that are also high in protein, and fat.
The plan for maintaining nutritional balance throughout the
shift was implemented by first
collaborating with the nutritionist to aid in planning a food
menu that tailored the patient’s needs,
making sure to accommodate the patient’s appetite. After the
menu was provided, the patient decided on
eat hot cereal, with scrambled eggs, and whole wheat toast for
breakfast, lunch included Greek yogurt,
butter lettuce salad and fruit, and for dinner roasted chicken,
21. mashed potatoes with gravy, and edamame.
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NUTRITION FINAL RESEARCH PAPER
Patient was asked what kind of high protein foods she would
like to eat at home and replied with
chicken, salmon, and steak. Patent airway was ensured before
feeding by checking gag reflex and her
ability to swallow. Suction was also readily available by her
bedside. I monitored the patient’s protein
by obtaining labs and assessing her total protein, albumin,
prealbumin and globulin levels.
Due to thick and sticky mucus build up in the lungs, it is very
important that the RN
check the patient’s airways because it can suddenly get clogged.
The nurse must auscultate
breath sounds and recognize wheezing, crackles, or rhonchi.
Assess the patient’s air way and
ensure a patent passage. Teach the patient how to perform
effective coughing and deep breathing
techniques daily in order to help the secretion of sputum. Other
duties include physiotherapy to
aid in secretion of the mucus. The patient should be in a
22. comfortable position with the head
elevated in a semi-fowler position. Thick, sticky mucus also
makes it easier for bacteria to
colonize into the lungs so the RN must assess the patient for
any lung infections. This may also
result in the patient preferring softer foods, for ease of eating
and swallowing. The nurse must
check labs such as blood tests for WBC and platelet count,
ABGs, sputum culture, as well a chest
x-ray. The thick mucus can also block tubes or ducts in the
pancreas (George & Hazle, 2016).
The thick mucus can lead to malnutrition due to digestive
enzymes not being able to reach the
small intestine.
Educate the patient in the importance of physical exercise and
how it helps with
improving GI motility and respiratory muscles (George &
Hazle, 2016).
During patient teaching, she showed willingness to learn as
she stated that she learns better if I
demonstrated techniques. Patient showed understanding as she
demonstrated effective coughing and
deep breathing techniques, preparation of meal plans and
protein sources. She stated that she will
23. 14
NUTRITION FINAL RESEARCH PAPER
practice these techniques daily to excrete her sputum. She also
understood to take her antibiotics
throughout the entire time it is prescribed (Miller & Stoeckel,
2016).
References
Cystic fibrosis Foundation. (n.d.). Treatments and therapies
[website]. Retrieved
https://www.cff.org/Living-with-CF/Treatments-and-Therapies/
Dudek, S. G. (2014). Nutrition essentials for nursing practice
(7th ed.). Philadelphia, PA:
Wolters Kluwer Health/Lippincott Williams & Wilkins.
George, C., & Hazle, L. (2016). Cystic fibrosis: Nurses act as a
healthcare provider, advocate
and educator for CF patients. Advance Healthcare Network for
Nurses. Retrieved from
http://nursing.advanceweb.com/Continuing-Education/CE-
24. Articles/Cystic-Fibrosis.aspx
Miller, M. A., & Stoeckel, P. R. (2016). Client education:
Theory and practice (2nd ed.).
Burlington, MA: Jones & Bartlett Learning.
MyFitnessPal (n.d.). Lose weight with MyFitnessPal. Retrieved
from
http://www.myfitnesspal.com/
Nahikian-Nelms, M., Sucher, K., & Lacey, K. (2016). Nutrition
therapy and pathophysiology
(3rd ed.). Boston, MA: Cengage Learning.
Simeons, W. (2016). The original HCG diet protocol & menu by
Dr. A. T. W. Simeons: An
overview. Retrieved from https://hcgdietinfo.com/Diet-HCG
HCG Diet and Cystic FibrosisTopic # 1: HCG DietPart I,
Criteria # 1: Identification of NutrientsPart I, Criteria # 2: RDA
Approval AnalysisPart 2, Criteria 1# Nutrition and
PathophysiologyPart 2, Criteria # 2: Medical and Nutrient
Related Interventions and Dietary NeedsPart 3, Criteria # 1
Nutrient CalculationsBMRCHO1478 X 0.45 = 665 calories
then/by 4calories/gram = 166 grams/dayPROOrFAT2839 X 0.35
= 568 calories then/by 9 calories/gram = 63 grams/dayPart 3,
Criterion #2 SMART Goals and Patient Care PlanReferences