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By Q. Grobock. Lutheran Theological Seminary at Gettysburg.

This shifting perspective is illustrated by contemporary research on the benefits of exercise generic aldactone 25 mg online arrhythmia vs afib symptoms. Aspects of exercise have been defined in different ways according to intention, outcome and location. Some researchers have differentiated between different types of behaviours in terms of the individual’s intentions. Physical activity has been defined as ‘any bodily movement produced by skeletal muscles that results in energy expenditure’. This perspective emphasizes the physical and biological changes that happen both automatically and through intention. Exercise has been defined as ‘planned, structured and repetitive bodily movement done to improve or maintain one or more components of physical fitness’. This perspective emphasizes the physical and biological changes that happen as a result of intentional movements. This distinction illustrates a shift in emphasis from intensive exercise resulting in cardiovascular fitness to moderate exercise resulting in mild changes in health status. It also illustrates a shift towards using a definition of health that includes both biological and psychological changes. For example, Paffenbarger and Hale (1975) differentiated between occupational activity, which was performed as part of an individual’s daily work, and leisure activity, which was carried out in the individual’s leisure time. These definitions are not mutually exclusive and illustrate the different ways exercise has been conceptualized. The results of a survey, in which men and women were asked about their exercise behaviour, are shown in Figure 7. They suggest that the four most common forms of exercise are walking, swimming, snooker/pool/billiards and keep fit/yoga. Research has examined the possible physical and psychological benefits of exercise. They reported the results from a longitudinal study which suggested that individuals with a weekly energy expenditure of more than 2000 kcals on exercise reported as walking, stair climbing and sports, lived for two-and-a-half years longer on average than those with an energy expenditure of less than 500 kcal per week on these activities. The possible reasons for the effects of exercise on longevity are as follows: 1 Reduction in blood pressure: physical activity has an inverse relationship to both diastolic and systolic blood pressure. This effect is particularly apparent in those who have mild or moderately raised blood pressure. Exercise may help promote weight loss/maintenance (see Chapter 15 for details of exercise and obesity). Coronary heart disease The effects of exercise on coronary heart disease have been examined by assessing the consequences of both occupational activity and leisure activity. Regarding occupational activity, Paffenbarger and Hale (1975) followed up 3975 longshoremen for 22 years. The results showed that at the end of this period, 11 per cent had died from coronary heart disease and that those longshoremen who expended more than 8500 kcal per week had a significantly lower risk of coronary heart disease than those in jobs requiring less energy. This difference remained when other risk factors such as smoking and blood pressure were controlled. This relationship between occupational activity and coronary heart disease has also been shown in samples of both men and women (Salonen et al. Research has also evaluated the relationship between leisure-time activity and coronary heart disease. The results showed that those who attempted to keep fit showed less than half the incidence of coronary heart disease at follow-up compared with the other subjects. Exercise may influence coronary heart disease in the following ways: 1 Increased muscular activity may protect the cardiovascular system by stimulating the muscles that support the heart. The physical benefits of exercise have been summarized by Smith and Jacobson (1989) as: (1) improved cardiovascular function; (2) increased muscle size and strength and ligament strength for maintaining posture, preventing joint instability and decreasing back pain; (3) improved work effort; and (4) changing body composition. The psychological benefits of exercise Research also indicates that exercise may improve psychological well-being. These effects are outlined below: Depression Research using correlational designs suggests an association between the amount of exercise carried out by an individual and their level of depression. Much of the reviews into this association have stressed the correlational nature of the research and the inherent problems in determining causality (e.

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This condition may be caused by physical or emotional stress purchase 100 mg aldactone visa blood pressure medication osteoporosis, and hair growth will return to normal as stress is eased. The health of your hair is a reflection of the overall state of your health, so it is im- portant to address hair loss from a multipronged approach that includes both the use of standard medical treatments to slow hair loss, and nutritional and lifestyle changes to address and improve health. Hair loss due to aging and genetics must be treated as early as possible to stabi- lize hair loss and stimulate regrowth. Minoxidil is a vasodilator (a drug that causes the blood vessels in the body to become wider) 254 and was originally introduced as a blood pressure–lowering drug. When it was found to have an added benefit on hair loss and regrowth, it was reformulated as a topical 2 percent solution and is now sold over the counter. It has been shown to benefit approximately 40 percent of people who use it for hair loss as early as two months after the initial application. Studies show hair weight and hair counts increase with the 2 percent solution, and more so with the 5 percent solution where hair weight increased by 45 percent. Another recommended treatment for hair loss is finasteride (Propecia), an oral prescription medication taken once daily for life. It has been shown to stop hair loss in 83 percent of cases and to stimulate regrowth in 66 percent of cases. While there are no foods that directly stimulate increased hair growth, choose foods that supply the body with a rich supply of vitamins, minerals, antioxidants, fibre, and protein. Foods to include: • Ensure adequate protein intake as protein is necessary for hair growth. Choose lean sourc- es of protein (fish, poultry, lean cuts of meat, beans, nuts, seeds, and soy). Meat, poultry, and fish also contain iron, which is required for proper hair growth. Foods to avoid: • Caffeine and alcohol can deplete the body of nutrients and also raise adrenal levels, which can trigger hair loss. Foods high in salt include processed and snack foods, deli meats, and the salt shaker. When the body is deprived of sufficient protein, through strict dieting and calorie restriction, it will shut down all production of hair in order to divert all of its energies toward conserving vital body organs. The body will save protein by shifting healthy hairs that are in a normal growth phase (anagen) into a sudden rest- ing phase. Lifestyle Suggestions • Regular exercise and healthy sleep habits will increase circulatory and overall health, pro- moting healthy hair. According to one report, smokers were four times more likely to have grey hair than non-smokers and were more prone to hair loss. Supplements of biotin may strengthen hair, stimulate new hair growth, slow hair loss, and prevent greying, particularly in those who are deficient in this nutrient. Essential fatty acids: A deficiency can cause hair loss; supplements can help improve the health of scalp and hair. Orthosilicic acid: Enhances collagen formation and makes hair stronger and thicker. Taking silicon supplements will not yield the same results as silicon is poorly absorbed. Orthosilicic acid is the bioavailable (usable) form of silicon and is available in Canada under the name BioSil. In this study, half of the participants massaged a combination of 256 essential oils of thyme, rosemary, lavender, and cedarwood onto their scalps each day. After seven months, 44 percent of the patients using the essential oils showed significant improvement in hair growth com- pared to only 15 percent improvement in the placebo group (Archives of Dermatology, 1998: 134; 1349–1352). Complementary Supplements Grape seed extract: A potent antioxidant that has been shown in preliminary research to stimulate hair growth. Minerals: Iron, selenium, and zinc are essential for hair growth; a deficiency can cause hair loss. Eat lots of vegetables, fruits, whole grains, fish, nuts, seeds, and ensure adequate protein intake.

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Nursing has the capacity to make creative and Through “authentic conscience” (Harmon discount aldactone 25mg with visa arrhythmia technologies institute greenville sc, 1998) moral choices for a preferred future. Spiritual/ethical caring is both a part and a whole, and every part secures its Social- purpose and meaning from each of the parts that Physical Cultural can also be considered wholes. It brings with it a spirit of repentance, hended within as intimacy and spirit (Harmon, seeing in a new way, a change of heart. Because of the crisis of our rela- As the twenty-first century is evolving, nurs- tionship to work, we are challenged to reinvent it. As the Theory of Bureaucratic Caring in touch with others, not only in terms of personal has demonstrated, caring is the primordial gain, but also at the level of service to humanity or construct and consciousness of nursing. Reenvisioning the theory as holographic Work must be spiritual, with recognition of the shows that through creativity and imagina- creative spirit at work in us. Thus, nurses must be tion, nursing can build the profession it the “custodians of the human spirit” (Secretan, wants. The ethical imperatives of caring that join with The new scientific and spiritual approach the spiritual relate to questions or issues about our to nursing theory as holographic will have moral obligations to others. The union of science, ethics, edifying the good through communication and in- and spirit will engender a new sense of teraction involve never treating people simply as a hope for transformation in the work world. Ethical content—as principles of doing good, Nurses can reintroduce the spiritual and eth- doing no harm, allowing choice, being fair, and ical dimensions of caring. The deep values promise-keeping—functions as the compass in our that underlie choice to do good for the many decisions to sustain humanity in the context of po- will be felt both inside and outside organiza- litical, economic, and technological situations tions. Roach (2002) pointed out act on this awareness and no longer surren- that ethical caring is operative at the level of dis- der to injustices and oppressiveness of sys- cernment of principles, in the commitment needed tems that focus primarily on the good of a to carry them out, and in the decisions or choices to few. The holographic Theory of health is a community responsibility, an idea that is Bureaucratic Caring—idealistic, yet practical; rooted in ancient Hebrew ethics. The expression of visionary, yet real—can give direction and human caring as an ethical act is inspired by spir- impetus to lead the way. Spiritual/ ethical caring for nursing does not question whether or not to care in complex systems but inti- mates how sincere deliberations and ultimately the facilitation of choices for the good of others can or This transformation toward relational should be accomplished. Nurses can reintroduce the spiri- The recognition that we need to change the way we tual and ethical dimensions of caring. However, nurse researchers, nurse admin- istrators, and nurses in practice can use the politi- cal and/or economic dimensions of the Theory of Applications of Bureaucratic Caring as a framework to guide prac- tice and decision making. Use of these dimensions of the theory integrates the constructs of politics, Marilyn Ray’s economics, and caring within the health-care organization. The purpose of this chapter is to illuminate the Theory of notion of political/economic caring in the current health-care environment. Ray’s (1989) original Theory of Bureaucratic Caring included political Bureaucratic and economic entities as separate and distinct structural caring categories. The revised Theory of Bureaucratic Caring, however, is represented Caring as a complex holographic theory. Turkel dimensions of bureaucratic caring as portrayed in this chapter are illuminated as interrelated constructs. The political and economic dimensions of bu- Current Context of Health-Care reaucratic caring encompass not only health-care Organizations reform at the national level, but also refer to the po- litical and economic impact of these changes at the Review of the Literature: Political organizational level. Through sections on the cur- and Economic Constraints of rent context of health-care organizations, review of Nursing Practice the literature related to the political and economic constraints of nursing practice, economic caring Economic Implications of Bureau- research, political and economic implications of cratic Caring Theory: Research in bureaucratic caring, and visions for the future, we Current Atmosphere of Health-Care learn how the Theory of Bureaucratic Caring Reform applies. Economic/Political Implications Current Context of of Bureaucratic Caring Health-Care Organizations Summary In the wake of the controversial health-care reform References process that is currently being debated in the United States, the central thesis in today’s economic health-care milieu in both the for-profit and not- for-profit sectors is managed care (Williams & Ray (1989, p. Managed care is an economic con- tion of America and other health care systems to cept based on the premise that purchasers of care, corporate enterprises emphasizing competitive both public and private, are unwilling to tolerate management and economic gain seriously chal- the substantial growth of the last several years in lenges nursing’s humanistic philosophies and theo- health-care costs. Managed care involves managed ries, and nursing’s administrative and clinical competition and is based on the assumption that policies. Within traditional complex health-care or- nursing services to the bed rate for patients ganizations, community or public health agencies, (Shaffer, 1985). This new form of health-care fi- trators who must determine how these resource nancing, based on the ratio of benefits over costs or dollars will be allocated within their respective the “highest quality services at the lowest available institutions.

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