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
M3 ch12 discussionConnecting Eligible Immigrant Families to Heal.docxjeremylockett77
M3 ch12 discussion
Connecting Eligible Immigrant Families to Health Coverage
Instructions:
Read the report
Connecting Eligible Immigrant Families to Health Coverage and Care
.
Write a one page post offering solutions to the problem from the nurse's standpoint.
.
Loudres eats powdered doughnuts for breakfast and chocolate that sh.docxjeremylockett77
Loudres eats powdered doughnuts for breakfast and chocolate that she can get out of the vending machines before class. Between classes , she grabs some chips and a caffine drink for lunch. By the end of the day, she is exhauted and cannot study very long before she falls asleep for a few hours. Then, she stays up untils 2.A.M to finish her work and take care of things she could not do during the day. She feels that she has to eat sugary foods and caffeinated drinks to keep her schedule going and to fit in all her activities. What advice would you give her?
.
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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
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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.
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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.
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M3 ch12 discussionConnecting Eligible Immigrant Families to Heal.docxjeremylockett77
M3 ch12 discussion
Connecting Eligible Immigrant Families to Health Coverage
Instructions:
Read the report
Connecting Eligible Immigrant Families to Health Coverage and Care
.
Write a one page post offering solutions to the problem from the nurse's standpoint.
.
Loudres eats powdered doughnuts for breakfast and chocolate that sh.docxjeremylockett77
Loudres eats powdered doughnuts for breakfast and chocolate that she can get out of the vending machines before class. Between classes , she grabs some chips and a caffine drink for lunch. By the end of the day, she is exhauted and cannot study very long before she falls asleep for a few hours. Then, she stays up untils 2.A.M to finish her work and take care of things she could not do during the day. She feels that she has to eat sugary foods and caffeinated drinks to keep her schedule going and to fit in all her activities. What advice would you give her?
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Lori Goler is the head of People at Facebook. Janelle Gal.docxjeremylockett77
Lori Goler is the head
of People at Facebook.
Janelle Gale is the head
of HR Business Partners
at Facebook. Adam Grant
is a professor at Wharton,
a Facebook consultant,
and the author of Originals
and Give and Take.
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HBR.ORG
Let’s Not Kill
Performance
Evaluations Yet
Facebook’s experience shows
why they can still be valuable.
BY LORI GOLER, JANELLE GALE, AND ADAM GRANT
November 2016 Harvard Business Review 91
LET’S NOT KILL PERFORMANCE EVALUATIONS YET
tThe reality is, even when companies get rid of performance evaluations, ratings still exist. Employees just can’t see them. Ratings are done sub-jectively, behind the scenes, and without input from the people being evaluated.
Performance is the value of employees’ contribu-
tions to the organization over time. And that value
needs to be assessed in some way. Decisions about
pay and promotions have to be made. As research-
ers pointed out in a recent debate in Industrial and
Organizational Psychology, “Performance is always
rated in some manner.” If you don’t have formal
evaluations, the ratings will be hidden in a black box.
At Facebook we analyzed our performance man-
agement system a few years ago. We conducted fo-
cus groups and a follow-up survey with more than
300 people. The feedback was clear: 87% of people
wanted to keep performance ratings.
Yes, performance evaluations have costs—but
they have benefits, too. We decided to hang on
to them for three reasons: fairness, transparency,
and development.
Making Things Fair
We all want performance evaluations to be fair. That
isn’t always the outcome, but as more than 9,000
managers and employees reported in a global sur-
vey by CEB, not having evaluations is worse. Every
organization has people who are unhappy with their
bonuses or disappointed that they weren’t pro-
moted. But research has long shown that when the
process is fair, employees are more willing to accept
undesirable outcomes. A fair process exists when
evaluators are credible and motivated to get it right,
and employees have a voice. Without evaluations,
people are left in the dark about who is gauging their
contributions and how.
At Facebook, to mitigate bias and do things sys-
tematically, we start by having peers write evalua-
tions. They share them not just with managers but
also, in most cases, with one another—which reflects
the company’s core values of openness and transpar-
ency. Then decisions are made about performance:
Managers sit together and discuss their reports
face-to-face, defending and championing, debating
and deliberating, and incorporating peer feedback.
Here the goal is to minimize the “idiosyncratic rater
effect”—also known as personal opinion. People
aren’t unduly punished when individual managers
are hard graders or unfairly rewarded when they’re
easy graders.
Next managers write the performance reviews.
We have a team of analysts who examine evalua-
tions f.
Looking for someone to take these two documents- annotated bibliogra.docxjeremylockett77
Looking for someone to take these two documents- annotated bibliography and an issue review(outline)
to conduct an argumentative paper about WHY PEOPLE SHOULD GET THE COVID-19 VACCINE
Requirements:
Length: 4-6 pages (not including title page or references page)
1-inch margins
Double spaced
12-point Times New Roman font
Title page
References page
.
Lorryn Tardy – critique to my persuasive essayFor this assignm.docxjeremylockett77
Lorryn Tardy – critique to my persuasive essay
For this assignment I’ll be workshopping the work of Lisa Oll-Adikankwu. Lisa has chosen the topic of Assisted Suicide; she is against the practice and argues that it should be considered unethical and universally illegal.
Lisa appears to have a good understanding of the topic. Her sources are well researched and discuss a variety of key points from seemingly unbiased sources. Her sources are current, peer reviewed and based on statistical data.
Lisa’s summaries are well written, clear and concise. One thing I noticed is that the majority of her writing plan is summarized and cited at the end of each paragraph. I might suggest that she integrate more synthesis of the different sources, by combining evidence from more than one source per paragraph and using more in text citations or direct quotes to reinforce her key points.
I think that basic credentialing information could be provided for Lisa’s sources, this is something that looking back, I need to add as well. I think this could easily be done with just a simple “(Authors name, and their title, i.e. author, statistician, physician etc.…)”, when the source is introduced into the paper might provide a reinforced credibility of the source.
As far as connection of sources, as previously mentioned, I think that in order to illustrate a stronger argument, using multiple sources to reinforce a single key point would solidify Lisa’s argument. I feel that more evidence provided from a variety of different sources, will provide the reader with a stronger sense of credibility and less room for bias that could be argued if the point is only credited to one source.
One area that stuck out to me for counter argument, being that my paper is in favor of this issue, is in paragraph two where Lisa states that “physicians are not supposed to kill patients or help them kill themselves, and terminally ill patients are not in a position of making rational decisions about their lives.” I’d like to offer my argument for this particular statement. In states where assisted suicide (or as I prefer to refer to it, assisted dying) is legal, there are several criteria that a patient has to meet in order to be considered a candidate. These criteria include second, even third opinions to determine that death is imminent, as well psychological evaluation(s) and an extensive informed consent process that is a collaborative effort between the patient, the patient’s family, physicians, psychologists and nurses. It is a process that takes weeks to months. Patients that wish to be a candidate, should initiate the process as soon as they have been diagnosed by seeking a second opinion. As an emergency room nurse, I have been present for a substantial amount of diagnoses that are ‘likely’ terminal. Many of these patients presented to the emergency for a common ailment and have no indication that they don’t have the capacity to make such a decision. Receiving a terminal diagnos.
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M450 Mission Command: System
General forum instructions: Answer the questions below and provide evidence to support your claims (See attached slides). Your answers should be derived primarily from course content. When citing sources, use APA style. Your initial posts should be approximately 150-500 words.
1. Describe and explain two of the Warfighting Functions.
2. How do commanders exercise the Command and Control System?
.
Lymphedema following breast cancer The importance of surgic.docxjeremylockett77
Lymphedema following breast cancer: The importance of
surgical methods and obesity
Rebecca J. Tsai, PhDa,*, Leslie K. Dennis, PhDa,b, Charles F. Lynch, MD, PhDa, Linda G.
Snetselaar, RD, PhD, LDa, Gideon K.D. Zamba, PhDc, and Carol Scott-Conner, MD, PhD,
MBAd
aDepartment of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA, USA.
bDivision of Epidemiology and Biostatistics, College of Public Health, University of Arizona,
Tucson, AZ, USA.
cDepartment of Biostatistics, College of Public Health, University of Iowa, Iowa City, IA, USA.
dDepartment of Surgery, College of Medicine, University of Iowa, Iowa City, IA, USA.
Abstract
Background: Breast cancer-related arm lymphedema is a serious complication that can
adversely affect quality of life. Identifying risk factors that contribute to the development of
lymphedema is vital for identifying avenues for prevention. The aim of this study was to examine
the association between the development of arm lymphedema and both treatment and personal
(e.g., obesity) risk factors.
Methods: Women diagnosed with breast cancer in Iowa during 2004 and followed through 2010,
who met eligibility criteria, were asked to complete a short computer assisted telephone interview
about chronic conditions, arm activities, demographics, and lymphedema status. Lymphedema was
characterized by a reported physician-diagnosis, a difference between arms in the circumference
(> 2cm), or the presence of multiple self-reported arm symptoms (at least two of five major arm
symptoms, and at least four total arm symptoms). Relative risks (RR) were estimated using
logistic regression.
Results: Arm lymphedema was identified in 102 of 522 participants (19.5%). Participants treated
by both axillary dissection and radiation therapy were more likely to have arm lymphedema than
treated by either alone. Women with advanced cancer stage, positive nodes, and larger tumors
along with a body mass index > 40 were also more likely to develop lymphedema. Arm activity
level was not associated with lymphedema.
*Correspondence and Reprints to: Rebecca Tsai, National Institute for Occupational Safety and Health, 4676 Columbia Parkway,
R-17, Cincinnati, OH 45226. [email protected] Phone: (513)841-4398. Fax: (513) 841-4489.
Authorship contribution
All authors contributed to the conception, design, drafting, revision, and the final review of this manuscript.
Competing interest
Conflicts of Interest and Source of Funding: This study was funded by the National Cancer Institute Grant Number: 5R03CA130031.
All authors do not declare any conflict of interest.
All authors do not declare any conflict of interest.
HHS Public Access
Author manuscript
Front Womens Health. Author manuscript; available in PMC 2018 December 14.
Published in final edited form as:
Front Womens Health. 2018 June ; 3(2): .
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Love Beyond Wallshttpswww.lovebeyondwalls.orgProvid.docxjeremylockett77
Love Beyond Walls
https://www.
lovebeyondwalls
.org
Provide a brief background of your chosen nonprofit entity using evidence from their publications or any other published materials. Then evaluate the factors, which may include economic, political, historic, cultural, institutional conditions, and changes that contributed to the creation and growth (decline) of the nonprofit organization. Justify your response.
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Longevity Presentation
The purpose of this assignment is to examine societal norms regarding aging and to integrate the concepts of aging well and living well into an active aging framework that promotes longevity.
Using concepts from the Hooyman and Kiyak (2011) text and the Buettner (2012) book, consider the various perspectives on aging.
Identify the underlying values or assumptions that serve as the basis for longevity, including cultural, religious, and philosophical ideas.
Present an overview of three holistic aging theories.
Integrate the values, assumptions, and theories to indicate what is necessary for an active aging framework where individuals both live well and age well.
Presentations should be 10-15 minutes in length, use visual aids, and incorporate references from the course texts and 5 additional scholarly journal articles.
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Look again at the CDCs Web page about ADHD.In 150-200 w.docxjeremylockett77
Look again at the
CDC's Web page about ADHD
.
In 150-200 words, please analyze the document’s purpose and audience. Who, for example, is the CDC's audience? What are the CDC's beliefs about ADHD, and how does the CDC's Web page relate itself to those beliefs? Why would the federal government post a Web page about ADHD? What role does the general public expect the government to play regarding disorders such as ADHD?
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M8-22 ANALYTICS o TEAMS • ORGANIZATIONS • SKILLS .fÿy' ÿ,oÿ ()V)g
The Strategy That Wouldn't Travel
by Michael C. Beer
It was 6:45 P.M. Karen Jimenez was reviewing the
notes on her team-based productMty project tbr
what seemed like the hundredth time. I31 two days,
she was scheduled to present a report to the senior
management group on the project's progress. She
wasn't at all sure what she was going to say.
The project was designed to improve productiv-
it3, and morale at each plant owned and operated by
Acme Minerals Extraction Company. Phase one--
implemented in early 1995 at the site in Wichita,
I(amsas--looked like a stunning, success by the mid-
dle of 1996. Productivity and mo[ÿale soared, and
operating and maintenance costs decreased signifi-
cantly. But four months ago, Jimenez tried to
duplicate the results at the project's second
target--the plant in Lubbock, Texas--and some-
thing went wrong. The techniques that had worked
so well in Wichita met with only moderate success
in Lubbock. ProductMty improved marginally and
costs went down a bit, but morale actually seemed
to deteriorate slightl): Jimenez was stumped,
approach to teamwork and change. As it turned
out, he had proved a good choice. Daniels was a
hands-on, high-energy, charismatic businessman
who seemed to enjoy media attention. Within his
first year as CEO, he had pretty much righted the
floundering company by selling oft:some unrelated
lines of business. He had also created the share-
services deparnnent--an internal consulting organ-
ization providing change management, reengineer-
ing, total quailB, management, and other
services--and had rapped Jimenez to head the
group. Her first priority Daniels told her, would be
to improve productiviB, and morale at the com-
pany's five extraction sites. None of them were
meeting their projections. And although Wichita
was the only site at which the labor-management
conflict was painfiflly apparent, Daniels and Jimenez
both thought that morale needed an all-around
boost. Hence the team-based productivity project.
She tried to "helicopter up" and think about
the problem in the broad context of the com-
pany's history. A few ),ears ago, Acme had been in
bad financial shape, but what had really brought
things to a head--and had led to her current
dilemma--was a labor relations problem. Acme
had a wide variety of labor requirements For its
operations. The company used highly sophisti-
cated technologB employing geologists, geophysi-
cists, and engineers on what was referred to as the
"brains" side of the business, as well as skilled and
semi-skilled labor on the "brawn" side to run the
extraction operations. And in the summer of
1994, brains and brawn clashed in an embarrass-
ingly public way. A number of engineers at the
Wichita plant locked several union workers out of
the offices in 100-degree heat. Although most
Acme employees now felt that the incident had
been blown out of propo,'tion by the press, .
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Lombosoro theory.
In week 4, you learned about the importance of theory, the various theoretical perspectives and the ways in which theory help guide research in regards to crime and criminal behavior.
To put this assignment into context, I want you to think about how Lombroso thought one could identify a criminal. He said that criminals had similar facial features. If that was the case you would be able to look at someone and know if they were a criminal! Social theories infer that perhaps it is the social structures around us that encourage criminality. Look around your city- what structures do you think may match up to something you have learned about this week in terms of theory? These are just two small examples to put this assignment into context for you. The idea is to learn about the theories, then critically think about how can one "show" the theory without providing written explanation for their chosen image.
Directions: With the readings week 4 in mind, please do the following:
1. Choose a theoretical perspective (I.e., biological, psychological sociological)
2. Look through media images (this can be cartoons, magazines, newspapers, internet stories, etc...) and select 10 images that you think depict your chosen theory without written explanation.
3. Provide a one paragraph statement of your theory, what kinds of behavior it explains and how it is depicted through images. Be sure to use resources to support your answer.
4. You will copy and paste your images into a word document, along with your paragraph. You do not need to cite where you got your images, but you do need to cite any information you have in number 3.
Format Directions:
Typed, 12 point font, double spaced
APA format style (Cover page, in text citations and references)
.
Looking over the initial material on the definitions of philosophy i.docxjeremylockett77
Looking over the initial material on the definitions of philosophy in
the course content section, which definition (Aristotle, Novalis,
Wittgenstein) would you say gives you the best feel for philosophy? What
is it about the definition that interests you? do you find there to be any problems with the definition? what other questions do you have regarding the meaning of philosophy?
ARISTOTLE :
Definition 1: Philosophy begins with wonder. (Aristotle)
Our study of philosophy will begin with the ancient Greeks. This is not because the Greeks were necessarily the first to philosophize. They were the first to address philosophical questions in a systematic manner. Also, the bodies of works which survive from the Greeks is quite substantial so in studying philosophy we have a lot to go on if we start with the Greeks.
Philosophy is, in fact, a Greek word. Philo is one of the Greek words for love: in this case the friendship type of love. (What other words can you think of that have "philo" as a part?) Sophia, has a few different uses in Greek. Capitalized it is the name of a woman or a Goddess: wisdom. Philosophy, then, etymologically, (that is from its roots) means love of wisdom.
But what exactly is wisdom? Is it merely knowledge? Intelligence? If I know how to perform a given skill does this necessarily imply that I also have wisdom or am wise?
The word "wise" is not in fact a Greek word. Remember for the Greeks that's "Sophia". Wise is Indo-European and is related to words like "vision", "video", "Veda" (the Indian Holy scriptures). The root has something to do with seeing. Wisdom then has to do with applying our knowledge in a meaningful and practically beneficial way. Perhaps this is the reason why philosophy is associated with the aged. Aristotle believes that philosophy in fact is more suitably studied by the old rather than the young who are inclined to be controlled by the emotions. Do you think this is correct? Nevertheless, whether Aristotle is correct or not, typically the elderly are more likely to be wise as they have more experience of life: they have seen more and hopefully know how to respond correctly to various situations.
Philosophy is not merely confined to the old. Aristotle also says that philosophy begins with wonder and that all people desire to know. Children often are paradigm cases of wondering. Think about how children (perhaps a young sibling or a son or daughter, niece or nephew of your acquaintance) inquistively ask their parents "why" certain things are the case? If the child receives a satisfying answer, one that fits, she is satisfied. If not there is dissatisfaction and frustration. Children assume that their elders know more than they do and thus rely on them for the answers. Though there is a familiar cliche that ignorance is bliss, (perhaps what is meant by this is that ignorance of evil is bliss), Aristotle sees ignorance as painful, a wonder that I would rather fill with knowledge. After all wha.
Lucky Iron Fish
By: Ashley Snook
Professor Phillips
MGMT 350
Spring 2018
Table of Contents
Executive Summary
Introduction
Human Relations Theory
Communications Issues
Intercultural Relations
Ethics Issues
Conclusion
Works Cited
Executive Summary
The B-certified organization that I chose is Lucky Iron Fish Enterprise which is located in Guelph, Ontario Canada. The company distributes iron fish that are designed to solve iron deficiency and anemia for the two billion people who are affected worldwide.
The human relations model is comprised of McGregor’s Theory X and Theory Y, Maslow’s Hierarchy of Needs, and theories from Peters and Waterman. These factors focus on the organizational structure of the company as it relates to the executives, the staff, and the customers. The executives provide meaningful jobs for the staff which gives them high levels of job satisfaction. Together, they are able to provide a product that satisfies the thousands of customers they have already reached.
Communication in this company flows smoothly. They implement open communication, encourage participation, and have high levels of trust among employees. Each of their departments are interconnected through teamwork.
Their intercultural relations, although successful, require a significant amount of time. They need to emphasize to the high context cultures that they are willing to understand their culture and possibly adopt some aspects of it. Additionally, they face barriers such as language dissimilarity and lack of physical store locations.
Ethics remains a top priority for this organization. They have high ethical standards that are integrated into their operations. They make decisions that do the most good for the most people, they do not take into consideration financial or political influence, and they strive to protect the environment through their sustainability measures.
Every employee is dedicated to improving the lives of those who suffer from iron deficiency
and anemia. As their organization grows, they continue to impact thousands of lives around the world. They are on a mission to put “a fish in every pot” (Lucky Iron Fish).
Introduction
Lucky Iron Fish, located in Guelph Canada, is a company that is dedicated to ending worldwide iron deficiency and anemia. They do this by providing families with iron fish that release iron when heated in food or water. They sell this product in developed countries in order to support their business model of buy one give one. Each time an iron fish is purchased, one is donated to a family in a developing country. They designed their product to resemble the kantrop fish of Cambodia; in their culture this fish is a symbol of luck. Another focus of theirs is to remain sustainable, scalable, and impactful (Lucky Iron Fish). Each of their products is made from recycled material and their packaging is biodegradable. Their organization has a horizontal stru.
Lucky Iron FishBy Ashley SnookMGMT 350Spring 2018ht.docxjeremylockett77
Lucky Iron Fish
By: Ashley Snook
MGMT 350
Spring 2018
https://www.youtube.com/watch?v=G6Rx3wDqTuI
Table of Contents
Case Overview
Introduction
Human Relations
Communications
Intercultural Relations
Ethics
Conclusion
Works Cited
https://www.youtube.com/watch?v=iY0D-PIcgB4
Video ends at 1:45
2
Case Overview
Company located in Guleph, Ontario Canada
Mission is to end iron deficiency and anemia
A fish in every pot
Gavin Armstrong, Founder/CEO
Introduction
Idea originated in Cambodia
Distribute fish through buy one give one model
Sustainable, scalable, impactful
Human Relations
McGregor’s Theory X and Y
-X: employees focused solely on financial gain
-Y: strive to improve worldwide health
Maslow’s Hierarchy of Needs
-Affiliation: desire to be part of a unit, motivated by connections
-Self-esteem: recognition for positive impact
Peters and Waterman
-Close relations to the customer
-Simple form & lean staff
Communications
Time and Distance
-Make product easily and quickly accessible
Communication Culture
-Encourages active participation
Teamwork
-Each role complements the overall mission
Gavin Armstrong Kate Mercer Mark Halpren Melissa Saunders Ashley Leone
Founder & CEO VP Marketing Chief Financial Officer Logistics Specialist Dietician
Intercultural Relations
High/Low Context
-Targets high context cultures
Barriers
-Language dissimilarity
Overcoming Barriers
-Hire a translator
Ethics
Utilitarianism
-Targets countries where majority of people will benefit
Veil of Ignorance
-Not concerned with financial influence
Categorical Imperative
-Accept projects only if environmentally friendly
Conclusion
Buy one give one model
Expansion
Sustainability
Works Cited
Guffey, Mary. “Essentials of Business Communication.” Ohio: Erin Joyner. 2008. Print.
“Lucky Iron Fish.” Lucky Iron Fish. Accessed 30 May 2018. https://luckyironfish.com/
“Lucky Iron Fish Enterprise.” B Corporation.net. Accessed 30 May 2018. https://www.bcorporation.net/community/lucky-iron-fish-enterprise
Lucky Iron Fish. “Lucky Iron Fish: A Simple
Solution
for a global problem.” Youtube. 28 October 2014. Accessed 4 June 2018. https://www.youtube.com/watch?v=iY0D-PIcgB4
“Lucky little fish to fight iron deficiency among women in Cambodia.” Grand Challenges Canada. Accessed 6 June 2018. http://www.grandchallenges.ca/grantee-stars/0355-05-30/
Podder, Api. “Lucky Iron Fish Wins 2016 Big Innovation Award.” SocialNews.com. 5 February 2016. Accessed 4 June 2018. http://mysocialgoodnews.com/lucky-iron-fish-wins-2016-big-innovation-award/
Zaremba, Alan. “Organizational Communication.” New York: Oxford University Press Inc. 2010. Print.
Lucky Iron Fish
By: Ashley Snook
Professor Phillips
MGMT 350.
look for a article that talks about some type of police activity a.docxjeremylockett77
look for a article that talks about some type of police activity and create PowerPoint and base on the history describe
-What is the role of a police officer in society? (general statement )
-how are they viewed by society?
what is the role of the police in this case?
how it is seems by society?
Article
An unbelievable History of Rape
An 18-year-old said she was attacked at knifepoint. Then she said she made it up. That’s where our story begins.
by T. Christian Miller, ProPublica and Ken Armstrong, The Marshall Project December 16, 2015
https://www.propublica.org/article/false-rape-accusations-an-unbelievable-story
.
Look at the Code of Ethics for at least two professional agencies, .docxjeremylockett77
Look at the Code of Ethics for at least two professional agencies, federal agencies, or laws that would apply to Health IT professionals. In two pages (not including the reference list), compare and contrast these standards. How much overlap did you find? Is one reference more specific than the other? Does one likely fit a broader audience, etc... Would you add anything to either of these documents?
.
Locate an example for 5 of the 12 following types of communica.docxjeremylockett77
Locate
an example for 5 of the 12 following types of communication genres:
Business card
Resume/CV
Rules and regulations
Policy handbook
Policy manual
Policy guide
Policy or departmental memorandum
Public policy report
Government grant
Government proposal
Departmental brochure or recruitment materials
Governmental agency social media (Twitter, Facebook, etc...)
Write
a 1,050- to 1,400-word paper in which you refer to your examples for each of the above listed communication genres. Be sure to address the following in your paper:
How does the purpose of the communication relate to the particular communication genre? In what ways does the genre help readers grasp information quickly and effectively? In what way is the genre similar or different than the other genres you chose?
What role has technology played in the development of the genre? How is it similar or different than the other genres you chose?
How does the use of these conventions promote understanding for the intended audience of the communication? How is it similar or different than the other genres you chose?
Is the communication intended for external or internal distribution? Describe ethical and privacy considerations used for determining an appropriate method of distribution. How is it similar or different than the other genres you chose?
Cite
at least three academic sources in your paper.
Format
your paper consistent with APA guidelines.
.
Locate and read the other teams’ group project reports (located .docxjeremylockett77
Locate and read the other teams’ group project reports (located in Doc Sharing).
Provide some comments for two reports in terms of what you think they did right, what you learned from these reports, as well as what else they could have done.
In addition, read the comments that other students made about your team’s report and respond to at least one of them.
Review ATTACHMENTS!!!!
.
2024.06.01 Introducing a competency framework for languag learning materials ...Sandy Millin
http://sandymillin.wordpress.com/iateflwebinar2024
Published classroom materials form the basis of syllabuses, drive teacher professional development, and have a potentially huge influence on learners, teachers and education systems. All teachers also create their own materials, whether a few sentences on a blackboard, a highly-structured fully-realised online course, or anything in between. Despite this, the knowledge and skills needed to create effective language learning materials are rarely part of teacher training, and are mostly learnt by trial and error.
Knowledge and skills frameworks, generally called competency frameworks, for ELT teachers, trainers and managers have existed for a few years now. However, until I created one for my MA dissertation, there wasn’t one drawing together what we need to know and do to be able to effectively produce language learning materials.
This webinar will introduce you to my framework, highlighting the key competencies I identified from my research. It will also show how anybody involved in language teaching (any language, not just English!), teacher training, managing schools or developing language learning materials can benefit from using the framework.
How to Make a Field invisible in Odoo 17Celine George
It is possible to hide or invisible some fields in odoo. Commonly using “invisible” attribute in the field definition to invisible the fields. This slide will show how to make a field invisible in odoo 17.
The French Revolution, which began in 1789, was a period of radical social and political upheaval in France. It marked the decline of absolute monarchies, the rise of secular and democratic republics, and the eventual rise of Napoleon Bonaparte. This revolutionary period is crucial in understanding the transition from feudalism to modernity in Europe.
For more information, visit-www.vavaclasses.com
Embracing GenAI - A Strategic ImperativePeter Windle
Artificial Intelligence (AI) technologies such as Generative AI, Image Generators and Large Language Models have had a dramatic impact on teaching, learning and assessment over the past 18 months. The most immediate threat AI posed was to Academic Integrity with Higher Education Institutes (HEIs) focusing their efforts on combating the use of GenAI in assessment. Guidelines were developed for staff and students, policies put in place too. Innovative educators have forged paths in the use of Generative AI for teaching, learning and assessments leading to pockets of transformation springing up across HEIs, often with little or no top-down guidance, support or direction.
This Gasta posits a strategic approach to integrating AI into HEIs to prepare staff, students and the curriculum for an evolving world and workplace. We will highlight the advantages of working with these technologies beyond the realm of teaching, learning and assessment by considering prompt engineering skills, industry impact, curriculum changes, and the need for staff upskilling. In contrast, not engaging strategically with Generative AI poses risks, including falling behind peers, missed opportunities and failing to ensure our graduates remain employable. The rapid evolution of AI technologies necessitates a proactive and strategic approach if we are to remain relevant.
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
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.
Acetabularia Information For Class 9 .docxvaibhavrinwa19
Acetabularia acetabulum is a single-celled green alga that in its vegetative state is morphologically differentiated into a basal rhizoid and an axially elongated stalk, which bears whorls of branching hairs. The single diploid nucleus resides in the rhizoid.
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.
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?
Welcome to TechSoup New Member Orientation and Q&A (May 2024).pdfTechSoup
In this webinar you will learn how your organization can access TechSoup's wide variety of product discount and donation programs. From hardware to software, we'll give you a tour of the tools available to help your nonprofit with productivity, collaboration, financial management, donor tracking, security, and more.
Read| The latest issue of The Challenger is here! We are thrilled to announce that our school paper has qualified for the NATIONAL SCHOOLS PRESS CONFERENCE (NSPC) 2024. Thank you for your unwavering support and trust. Dive into the stories that made us stand out!
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.
11
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.
13
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
Running head:…….. Comment by JoAnn Ferguson: Put your
25. running head and page numbers at the top in the header section
format like this:
Running head: RESEARCH Comment by JoAnn Ferguson:
Do not forget to include a title page
Title of Paper
Part 1:
Criterion One
In this section you want to discuss the patient you are using
from the patient profiles. You will discuss his/her current diet
and how they are in excess or deficient in carbs, protein and
fats. Be specific and provide examples for each macronutrient.
Comment by JoAnn Ferguson: Make sure you follow the
APA format. You can use these headers for your paper
Be specific on your information. Just think that you are writing
a paper to someone who has no idea of the information you are
providing. Do not be vague.
Look up basic diets for the type of diet mentioned. For example,
if taking about a fast food diet, lookup a common meal at
Burger King, MacDonald’s or your favorite fast food restaurant.
There are sample diets for atkins or look up a basic 1200 calorie
diet.
You can use My fitness pal to plug in the foods but do not add
the chart to the paper. This should be analyzed in paragraph
form.
Criterion Two
In this section you want to discuss at least 5 micronutrients
your patient is either deficient in or in excess of. Explain the
micronutrient (what it is, why important and RDA) and provide
examples on how they are deficient or in excess of the
micronutrient. Give examples, again look at the nutrition
guidelines for the diet you looked up in criterion one, but do not
26. include the charts. This should be in paragraph form only.
Part 2:
Criterion One:
In this section discuss the pathophysiology of the patients
disease processes (ex. HTN, diabetes, etc). After the
pathophysiology discuss how the foods the patient is consuming
will affect these disorders. Provide at least 3 examples of the
foods this patient should avoid and foods they should consume
to prevent further problems. Explain why.
Criterion Two
In this section discuss the patient’s medications. Discuss what
the meds are and what foods should be avoided or any other
patient education regarding the patient’s medications and diet.
Be sure to include all medications the patient is taking.
Part 3:
Criterion One:
Based on the information in the patient profile calculate the
patients: BMI, BMR, CHO, Protein and fat needs. These are not
RDA %, they are actual specific client needs based on their
weight and height. Include all of the actual calculations for each
section.
Please see the web site below and it will give you the formulas
on how to calculate carbohydrates, proteins and fats. Determine
the fat intake based on your patient's comorbidities. In the
assignment directions you will also find out how to calculate
each calculation.
You can find how to calculate the BMR and your BMI in your
textbook.
http://mybodymykitchen.com/calculate-your-macronutrients-
protein-fats-carbs/
Criterion Two:
Develop a nutritional educational plan based on the nutritional
needs for this patient. What diet would you put this patient on?
Include three SMART goals and provide 2-3 specific nursing
strategies, these are nursing strategies or interventions for this
patient to help him/her reach the goals. This is not strategies the
27. patient should do. Give rationales for the strategies.
SMART goal:
S-specific
M-measurable
A-attainable
R-realistic
T-timed
Example of a SMART goal
By December 12, 2017(timed), the client will write three diet
(measurable and specific) modifications to decrease the amount
of sodium he consumes (specific, realistic and attainable)
Then you will provide 3 nursing strategies to help this patient
achieve his goal.
Page | 1
Final Research Paper: Disease & Nutrition
Signature Assignment Details
Part I The Diet
Include the following in Part I:
• Criterion 1: Determine if the person’s diet is deficient or in
excess of CHO, PRO, and fat
and explain why.
• Criterion 2: Explain in detail how the person’s diet meets or
28. does not meet the RDA for
five or more micronutrients.
Part II Disease and Nutrition
Include the following in Part II:
• Criterion 1: Explain how the person’s diet would affect the
patient’s disease symptoms
and progression. Provide a minimum of three examples of how
specific foods affect the
disease pathophysiology. Provide examples of foods the person
should avoid, and those
he/she should consume.
• Criterion 2: Explain how food interacts with the medications
this patient takes. What are
the nutrient-related side effects of the medication? What are the
nutrient restrictions and
recommendations for the medications?
o Example: Iron supplements cause constipation, so people are
advised to increase fiber foods; however, if a person is taking
fiber
with iron, the fiber will reduce the absorption of the iron thus
decreasing the effectiveness of the iron.
29. Part III Patient Education
Include the following in part III:
• Criterion 1: Calculate the following for the patient: BMI,
BMR, CHO, PRO, and fat
needs and any other relevant calculations that will help you
develop a nutritional plan for
your patient.
• Criterion 2: Develop an evidence-based nutritional education
plan with three SMART
goals for your patient. Provide specific nursing strategies and
examples for the patient,
and consider all aspects of the patient’s lifestyle.
Page | 2
Rev 02/14/17
Getting Started Tips
Some common diets in the United States:
• Paleo diet
• DASH
30. • Diabetic
• Hemodialysis
• Vegetarian
• Atkins
A few recommended peer-reviewed journals:
• Journal of American Medical Association
• Lancet
• Journal of American Dietetic Association
* You may not use WebMD or any Wiki sources. Check with
your instructor or librarian to
confirm that your sources are credible and scholarly. Your
librarians are here to help you with
your research questions!