Tuesday, January 28, 2020

Benefits of a Healthy Body Weight in the Elderly

Benefits of a Healthy Body Weight in the Elderly A Review Of The Benefits Of Nutritional Intervention In Improving Body Weight, BMI, Activities Of Daily Living (ADL), Decrease Functional Limitation and Healthcare Cost Among Elderly. Introduction Malnutrition is a condition in which consumption of insufficient of nutrients that are required by the body to maintain optimal function of the organs and tissues. Secondary to chronic or progressive disease, older people are vulnerable to malnutrition (Klipstein-Grobusch, Reilly, Potter, Edwards, Roberts, 1995; Watson, 1999). So it was believed that as the population of the elderly increases, cases of malnutrition among the elderly will also increase. 5-10% of non- institutionalized elderly are malnourished is shown in epidemiological studies (Posner et al., 1994). Furthermore, studies have shown that 51-61% of nursing home residents are at risk of malnutrition and 12-29% residents are malnourished (Guigoz, 2006; Suominen et al., 2005; Wojszel, 2006). Therefore, it can be concluded that malnutrition affect all the elderly no matter where they stay. The purpose of the review is to determine the effectiveness of nutritional intervention in improving nutritional status among the elder ly and reduce healthcare cost at the same time in order to prevent further increasing of malnutrition among elderly. It is relevant to nursing with the use of nutritional intervention such as oral supplementation because nurses can help the patients to monitor nutritional status and give feedback to the dietician when the patients are not compliance or the supplementations are not suitable for them to consume. Benefits of nutritional intervention Continuous intervention The first study used observational, prospective, longitudinal, cohort study which involved 378 elderly malnourished patients aged over 70 who lived in community, at home or in institutions which selected by general practitioners in France from two groups, group 1 with rare and group 2 with frequent prescription of oral nutritional supplements with contain high energy and protein. The aim of the study is to determine the impact of nutritional support on the cost and related comorbidities among elderly. Each patient was required to complete 12 months follow-up to measure the nutritional status, medical care consumption and identify malnutrition-related comorbidities. Nutritional status was adjusted using a generalized linear modeling approach and medical care costs were adjusted using a propensity score framework. Mini Nutritional Assessment (MNA) was significantly better in group 2 than 1from the first evaluation until the end of the study (P Another study was done in Amsterdam to determine the effectiveness of oral supplementation in decreasing functional limitation among malnourished elderly patients in hospital which involved 210 Dutch patients who aged 60 years and above using randomized control trial. Patients in intervention group received standardized nutritional support in hospital and continuing until three months after discharge. Telephone counseling by dietician is done to give advice and stimulate compliance to the proposed nutritional intake every other week after discharge. Patients in control group received the usual care and did not receive post-discharge nutritional support. Cost data were collected from societal perspective and measures using two cost diaries. The degree of difficulties patient experience with 6 activities such as climbing stairs, dress themselves, getting up and sitting down in a chair (score 0-6) measured by Functional Limitation Questionnaire (Kriegsman, Deej, van Eijk, Penninx Boeke , 1997). After three months follow-up, patients in control group had longer mean length of hospital stay and often admitted to other inpatient institutions compared to patients in intervention group. Patients in intervention groups were able to do more physical activities and costs spent were lower than in control group. The probability of the cost-effective for the intervention lies around 0.5 compared with the usual care which was 0.6 at maximum. After oral nutritional support was given, significant improvements in functional limitations was confirmed by the study done by Woo, Ho, Mak, Law, Cheung (1994). Need-based intervention A group of 92 elderly who aged 65 years and above in nursing home at Taiwan participated in a randomized, double blind, controlled trial which included one year follow-up to observe mortality. This study done to examine the effectiveness of need-based strategy in improving the nutritional status among elderly in nursing home. Elderly in intervention group were given routine monitoring and a warm soup which contained nutrient supplement while elderly in control group were given routine care and normal warm soup. The content in the soup and detail about the study was not told to the resident involved. The participants’ nutritional status was evaluated using MNA and the height, weight, mid-arm circumference, calf circumference, BMI was measured and calculated. The elderly in intervention group who give supplement would be suspended once either one of the â€Å"at risk† condition was corrected. Over-nutrition can be prevented and saved cost by giving supplements when it is needed. There was significantly improved body weight, BMI, mid-arm circumference, calf circumference and others in intervention group (all p Conclusion From this review, it concluded that nutritional intervention such as oral supplementation is effective in preventing malnutrition among elderly. Oral supplementation can be taken with warm soup that is easily prepared, saved costs and with no associated digestive problems. Even though overall studies used different methods implementing oral supplementations, the results clearly showed that there was improvement in patients’ body weight, BMI, ADL and nutrition status after nutritional intervention used. It is also effective using oral supplementation with routine screening such as MNA which enables early identification of those who are at risk so that an appropriate intervention can be taken. We as nurses are able to assess the patients’ nutritional status frequently using MNA by reporting any changes to the dietician and able to administer the oral supplementation ordered for the patients. Limitations for all the studies were small sample sizes used and health condition of the patients participated may change during the study which will cause the ineffective of the oral supplementation. Future research should be done in various hospitals, community hospitals and nursing homes so that results obtained will be more accurate. The study should be done with a longer follow-up to give more opportunities for the patients to improve and a more accurate cost spent can be obtained. A longer follow-up can determine the effectiveness of nutritional intervention on quality of life and physical activities accurately. 1 | Page

Monday, January 20, 2020

Commentary on Alphonso Lingis’s article, The World as a Whole Essay

Commentary on Alphonso Lingis’s article, â€Å"The World as a Whole† Martin Heidegger’s work in Being and Time elucidated a phenomenological ontology in which death and anxiety function as the imminent possibility of impossibility, circumscribing Dasein and inscribing weight to Dasein’s temporal existence. He constructs an individual whose ontological whole is made of three fundamental elements that function as a whole; understanding, feeling and action. This being, Dasein (translated as Being There), exists in the world, and Heidegger constructs Dasein’s ontology as being-in-the-world. This is the way Alphonso Lingis predicates his understanding of Heidegerrian phenomenology in an essay from Research in Phenomenology entitled â€Å"The World as a Whole†. In this paper, I will review this article, for it holds two extremely interesting facets to be understood by any student of phenomenology. First off, it is a very well written review of Heidegger’s phenomenology: it spans from the work in Being and Time to the work done in Poetry Language Thought, and all the way to a later essay entitled â€Å"Things†. Heidegger’s work changed radically over this time, and Lingis does a great job at showing a fluidity in his work, particularly through the notion of dwelling. Also in this article one can find some great similarities between the work of Martin Heidegger and Alphonso Lingis’s own work on death, anxiety, imperatives, the elemental and enjoyment. Lingis’s own writing rarely refers explicitly to his predecessors, his writing is full of imagery and refers constantly to experience, it can be difficult for a reader of Lingis to locate his influences by just reading his work. But, this work (along with Deathbound Subjectivities) shows Li... ...g experience as a burden, â€Å"when we are in the mood of exhilaration†¦the sense of lightness of being†¦is the sense of alleviation of the burden of being and thus presupposes and reveals it†¦Why not say that the oppressive, burdensome sense of the world presupposes the more basic sense of the lightness of the clearing around us. † This is a key point in Lingis’s transition from Heidegger, and shows his Levinasian influences. In conclusion, this article is a great artifact for any student of phenomenology. Lingis is a very articulate writer, who can point out the most perplexing complexities in Heidegger’s work and lay them out for anyone to read. He also makes huge steps in realizing Heidegger’s limitations in his notions of equipmentality and mood by recognizing the burden of the world not primary to existence, that existence is primarily lived through enjoyment.

Saturday, January 11, 2020

Katherine Mansfield Essay

She was born in 1888 in Wellington, a town labeled â€Å"the empire city† by its white inhabitants, who modeled themselves on British life and relished their city’s bourgeois respectability. [1] At an early age, Mansfield witnessed the disjuncture between the colonial and the native, or Maori, ways of life, prompting her to criticize the treatment of the Maoris in several diary entries and short stories. [2] Mansfield’s biographer, Angela Smith, writes: â€Å"It was her childhood experience of living in a society where one way of life was imposed on another, and did not quite fit in† that sharpened her modernist impulse to focus on moments of â€Å"disruption† or encounters with â€Å"strange or disturbing† aspects of life. [3] Her feelings of disjuncture were accentuated when she arrived in Britain in 1903 to attend Queen’s College. In many respects, Mansfield remained a lifelong outsider, a traveler between two seemingly similar yet profoundly different worlds. After briefly returning to New Zealand in 1906, she moved back to Europe in 1908, living and writing in England and parts of continental Europe. Until her premature death from tuberculosis at the age of 34, Mansfield remained in Europe, leading a Bohemian, unconventional way of life. The Domestic Picturesque Mansfield’s short story â€Å"Prelude† is set in New Zealand and dramatizes the disjunctures of colonial life through an account of the Burnell family’s move from Wellington to a country village. The story takes its title from Wordsworth’s seminal poem, â€Å"The Prelude,† the first version of which was completed in 1805, which casts the poet as a traveler and chronicles the â€Å"growth of a poet’s mind. †[4] Although the Burnell family moves a mere â€Å"six miles† from town, the move is not inconsequential; it enacts a break with their previous way of life and alerts the family members to the various discontinuities in their lives. Beneath the veneer of the Burnells’ harmonious domestic life are faint undercurrents of aggression and unhappiness. The haunting specter of a mysterious aloe plant and a slaughtered duck in their well-manicured yard suggests that the family’s â€Å"awfully nice† new home conceals moments of brutality and ignorance toward another way of life that was suppressed and denied. [5] As I will propose, these two incidents echo the aesthetic concept of the sublime, as they encapsulate a mysterious power that awes its beholders and cannot be fully contained within their picturesque home. Through her subtle, dream-like prose, Mansfield deploys traditional aesthetic conventions like the picturesque while simultaneously transfiguring, subverting, and reinventing them in a modernist context. The concept of the picturesque was first defined by its originator, William Gilpin, an 18th century artist and clergyman, as â€Å"that kind of beauty which is agreeable in a picture. †[6] Thus, a scene or representation is beautiful when it echoes an already-established, artistic conception of beauty, revealing the self-reinforcing way in which art creates the standard of beauty for both art and life. Mansfield presents these picturesque moments in order to demystify them and reveal the suppression and violence they contain. In addition to â€Å"Prelude,† her stories â€Å"Garden Party† and â€Å"Bliss† dramatize the transformation and inversion of picturesque moments of bourgeois life and domestic harmony. While she seems to exhibit a certain attachment to these standard aesthetic forms, Mansfield subtly interrogates many of these conventions in a strikingly modernist way. Through her childhood in a colony, Mansfield also became attuned to the violence and inequalities of colonialism. As Angela Smith suggests, her early writings demonstrate a keen sensitivity towards a repressed history of brutality and duplicity. [7] In her 1912 short story â€Å"How Pearl Button Was Kidnapped,† she questions and overturns the perspective of the colonialist, whose vantage point historically trumps that of the native. The deliberate ambivalence of the word â€Å"kidnapping† dramatizes the conflict between the colonist’s perspective and Pearl’s joyful, eye-opening experiences during her abduction. In a similar way, empire dramatized for Mansfield the way that a picturesque, bourgeois household could suppress alternative perspectives. The Sublime In â€Å"Prelude,† the mysterious, sublime aloe plant disrupts the pleasant domesticity of the Burnell household. Their well-manicured yard with its tennis lawn, garden, and orchard also contains a wild, unseemly side—â€Å"this was the frightening side, and no garden at all. †[8] This â€Å"side† contains the aloe plant, which exerts a mysterious, enthralling power over its awed beholders. In its resemblance to the ocean, the aloe assumes the characteristics of the sublime: â€Å"the high grassy bank on which the aloe rested rose up like a wave, and the aloe seemed to ride upon it like a shop with the oars lifted. Bright moonlight hung upon the lifted oars like water, and on the green wave glittered the dew. †[9] For many writers and poets, the ocean was a manifestation of the sublime because of its unfathomable power and scale that awed and humbled its observers. The aloe’s strikingly physiological effect on its viewers recalls Edmund Burke’s sublime, which overpowers its observer and reinforces the limitations of human reason and control. In his famous treatise on the sublime, Burke writes: â€Å"greatness of dimension, vastness of extent or quantity† is a powerful cause of the sublime, as it embodies the violent and overpowering forces of nature. [10] In a similar vein, the child, Kezia Burnell’s first impression upon seeing the â€Å"fat swelling plant with its cruel leaves and fleshy stem† is one of awe and wonder. [11] In this case, the sublimity of the aloe plant disrupts and challenges the domestic picturesque as it defies mastery, categorization, and traditional notions of beauty. In its resistance to categorization and control, the sublime embodies the part of the ungovernable landscape that the Burnell family cannot domesticate and the picturesque cannot frame. As a result, in â€Å"Prelude,† the magnitude of the sublime interrupts and fractures the tranquil surface of the picturesque by exposing the unfathomable depths beneath it. The colonial backdrop of the Burnells’ yard also contributes to the mysterious, occult power of the aloe. This unruly part of their property hints toward a landscape that eludes domestication and serves as a constant reminder that the Burnell family is living in a land that is not quite theirs and cannot be fully tamed. [12] At the age of 19, Mansfield wrote that the New Zealand bush outside of the cities is â€Å"all so gigantic and tragic—and even in the bright sunlight it is so passionately secret. †[13] For Mansfield, the bush embodies the history of a people whose lives have been interrupted and displaced by European settlers. [14] After wars, brutal colonial practices, and European diseases had devastated the local Maori population, the bush became a haunting monument to their presence. As the Burnell family settles down to sleep on the first night in their new home, â€Å"far away in the bush there sounded a harsh rapid chatter: â€Å"Ha-ha-ha†¦ Ha-ha-ha. †[15] In her subtle way, Mansfield unveils the voices of those whose perspectives are excluded from this portrait of nocturnal domestic harmony. In a similar way, the aloe plant exudes an unfathomable history that is beyond the time and place of the Burnells. Even its age—implied by the fact that it flowers â€Å"once every hundred years†Ã¢â‚¬â€suggests that the aloe exists on a different scale than its human beholders. [16] In its ancient, superhuman scale, the aloe gestures towards the â€Å"gigantic,† indicating a subtle, but implicitly threatening power within, or in proximity of the home. The aloe is a kind of lacuna in the imperial landscape of New Zealand, whose power threatens the colonial household and its control over the landscape. [17] By disrupting and encroaching upon the ostensibly safe domestic sphere, the aloe also echoes the â€Å"unheimlich,† or uncanny, an aesthetic concept explored by Sigmund Freud in his 1919 essay, â€Å"The Uncanny. † The uncanny becomes, in part, an invasive force violating the sacred, domestic sphere and hearkens back to a previously repressed or hidden impulse: â€Å"The uncanny is something which ought to have remained hidden but has come to light. †[18] In â€Å"Prelude,† the aloe is initially depicted as a threatening force that â€Å"might have had claws instead of roots. The curving leaves seemed to be hiding something. †[19] Positioned within the safe space of their property, the aloe is a menacing, ungovernable force that seems to encroach upon it. The plant becomes part of the repressed history of the landscape—a history that is only apparent to Kezia, her mother Linda Burnell, and her grandmother Mrs. Fairfield, who are attuned to the forces below the surface of the picturesque exterior. Violent Underpinnings Beneath many of Mansfield’s picturesque domestic scenes are moments of violence and rupture. In â€Å"Garden Party,† for instance, a poor man falls to his death during the preparations for a much-anticipated social gathering of the wealthy Sheridan family, undermining the convivial spirit of the occasion. In â€Å"Prelude,† Pat, the handyman, slaughters a duck while the children watch with grotesque enthrallment as it waddles for a few steps after being decapitated. â€Å"The crowning wonder† of the dead duck walking hearkens back to Burke’s sublime, which is experienced in â€Å"Prelude† within the confines of the private residence. [20] The sublimity of this apparent defiance of the properties of death acts as a dramatic external force imposing on the observers’ intellect and reason in a profoundly Burkian way. But later that night, when the duck is placed in front of the patriarch, Stanley Burnell, â€Å"it did not look as if it had ever had a head. †[21] The duck’s picturesque dressing—â€Å"its legs tied together with a piece of string and a wreath of little balls of stuffing round it†Ã¢â‚¬â€conceals its violent death. [22] In a similar way, the â€Å"awfully nice† picturesque house is imposed upon the landscape, as if it had never been any other way. [23] Through reconfiguration and transformation, a new imperial order conceals the fact that an older order once lay beneath it. In both cases, the picturesque functions as a way of naturalizing the violent order of domination. As Pat’s golden earrings distract Kezia from her grief over the duck’s death, the duck’s pretty garnish conceals its â€Å"basted resignation. †[24] There is no such thing as a pure aesthetics, Mansfield seems to suggest, as each serene moment is implicated in some act of violence, brutality, or suppression. In â€Å"Prelude,† the good-natured Pat disrupts a pre-existing picturesque scene in which ducks â€Å"preen their dazzling breasts† amidst the pools and â€Å"bushes of yellow flowers and blackberries. †[25] Tellingly, the duck pond contains a bridge, a typical feature of the picturesque that reconciles or bridges the gap between different aspects of the scenery. In this way, the Burnell family’s cultivation of the land by planting and slaughtering ducks disrupts another underlying order. Their unquestioning appropriation of this pre-existing order mirrors the way colonial life disrupted and undermined the indigenous Maori life. Juxtaposing two picturesque scenes that interrupt and conflict with one another, Mansfield questions and unravels the conventional image of the picturesque. This interplay of various conflicting aesthetic orders constitutes part of Mansfield’s modernist style, in which aesthetic forms are ruptured, fragmented, and overturned. As the yard’s landscape bears traces of the Maori past, so the quiet harmony of the Burnells’ domesticity is underscored by deep, unspoken tensions and an animosity that hints at the uncanny. In fact, the only character who expresses any contentment is Stanley, who reflects, â€Å"By God, he was a perfect fool to feel as happy as this! †[26] Yet even he shudders upon entering his new driveway, as â€Å"a sort of panic overtook Burnell whenever he approached near home. †[27] Beneath this veneer of marital bliss and familial harmony, his wife Linda occasionally ignores her children and expresses hatred towards her husband and his aggressive sexuality: â€Å"there were times when he was frightening—really frightening. When she screamed at the top of her voice, ‘You are killing me. ’†[28] Meanwhile Stanley and Beryl, Linda’s sister, seem to have a flirtatious, indecent relationship: â€Å"Only last night when he was reading the paper her false self had stood beside him and leaned against his shoulder on purpose. Hadn’t she put her hand over his†¦ so that he should see how white her hand was beside his brown one. †[29] Dramatizing these dynamics, Mansfield suggests that a â€Å"happy† household outside of town is not as â€Å"dirt cheap† as Stanley boasts; it comes at the cost of servitude, sexual aggression, and a ravaged Maori landscape. [30] Through these layers, which Mansfield subtly strips off one at a time, she artfully exposes the way that an existing political and aesthetic order is not what it seems to be or how it has always been. Her short stories are fraught with their own tensions; while exposing the picturesque as false and absurd, she nevertheless draws on its conventional associations. Similarly, her subtle attempts to question colonial power are embedded in a seemingly idealized portrait of colonial life. Mansfield creates a seemingly beautiful or normal image, such as the happy family in â€Å"Prelude,† â€Å"Bliss,† or â€Å"Garden Party,† and then slowly challenges it through a subtle counter-narrative. In this way, her deployment of modernist techniques is less pronounced than that of James Joyce and her other modernist contemporaries. Just as she challenges aesthetic conventions, Mansfield unravels the reader’s ideas about her own stories by presenting a seemingly beautiful, transparent narrative that is haunted by tensions, lacunae, and opacity. Like the headless walking duck, these fictions of transparency and harmony quickly collapse upon closer inspection.

Friday, January 3, 2020

Victoria Anderson - The Angel of Death - 901 Words

The Angel of Death We have all heard about the tragedy of the Holocaust. Horrendous, atrocious, brutal. These are all words that are used to describe the endless suffering of the Jewish people. But what not many people know of are the dark and sinister scientists that were behind a lot of this genocide. Thousands of people, murdered. Not the citizens that were plastered on the headlines of every Newspaper, but the victims who suffered in silence. The innocent people that were tortured, degraded, and experimented on by one man: Dr. Josef Mengele. This man, or monster, rather, was no striking character in the beginning. Living his early life as the average-Joe, and the rest of it a criminal, he is raw proof that science, the beauty it is, can be used in the ugliest manner. Josef Mengele, born on March 16, 1911, was an ordinary man. Josef was the oldest brother of 3, and the son of Karl Mengele, who, as stated in Posner Ware’s novel Mengele: The Complete Story, founded a company , Karl Mengele and Sons that produced farming utensils. Just like many of today’s high school students, he studied hard and fell in love with the arts. Graduating in 1930, he was accepted to the University of Munich to study medicine (4-7). At the young age of 24, Mengele had achieved a Ph.D. in Physical Anthropology. According to the United States Holocaust Memorial Museum, two short years later, at the Institute for Hereditary Biology and Racial Hygiene in Frankfurt, he was employed as theShow MoreRelatedAnalysis Of Sir Arthur Conan Doyle Essay1684 Words   |  7 Pagesup in stories such as â€Å"The Adventure of the Norwood Builder†, â€Å"The Dancing Men†, and â€Å"The Solitary Cyclist† (Cawthorne 33). His own mother even inspired â€Å"The Adventure of the Copper Beeches† and begged him not to kill off Sherlock Holmes. After the death of Sherlock Holmes, she even received a message from her son saying, â€Å"So now a long farewell to Sherl ock. He still lives, however, thanks to your entreaties† (Cawthorne 20). When he brought back Holmes in â€Å"The Hound of the Baskervilles†, he was inspiredRead MoreA Critical Review of â€Å"the Ambiguities of Football, Politics, Culture, and Social Transformation in Latin America† by Tamir Bar-on.14147 Words   |  57 Pagesattention, sponsors, fans, and salaries that the NBA (National Basketball Association) players get. Literature Review: Article 1: †¢ Title: â€Å"Toy for Boys? Women’s marginalization and Participation as Digital Gamers† by Garry Crawford and Victoria Gosling †¢ Connection to research problem: In this article, the authors suggest that women do not play video games (digital games) as much as men do and that this is mainly because the gaming industry views the concept of video games as belongingRead MoreOne Significant Change That Has Occurred in the World Between 1900 and 2005. Explain the Impact This Change Has Made on Our Lives and Why It Is an Important Change.163893 Words   |  656 PagesRobert H. G. Lee, The Manchurian Frontier in Ch’ing History (Cambridge, MA: Harvard University Press, 1970); Alan Moriyama, Imingaisha: Japanese Emigration Companies and Hawaii 1894–1908 (Honolulu: University of Hawaii Press, 1985); James Reardon-Anderson, Reluctant Pioneers: China’s Expansion Northward, 1644–1937 (Stanford: Stanford University Press, 2005); Michael Weiner, Race and Migration in Imperial Japan (London: Routledge, 1994). 25. Kingsley Davis, The Population of India and Pakistan (NewRead MoreStephen P. Robbins Timothy A. Judge (2011) Organizational Behaviour 15th Edition New Jersey: Prentice Hall393164 Words   |  1573 PagesLichtenstein, University of Massachusetts at Boston Robert Liden, University of Illinois at Chicago Don Lifton, Ithaca College Ginamarie Ligon, Villanova University Beth Livingston, University of Florida Barbara Low, Dominican University Doyle Lucas, Anderson University Alexandra Luong, University of Minnesota Rick Maclin, Missouri Baptist University Peter Madsen, Brigham Young University Lou Marino, University of Alabama Catherine Marsh, Northpark University J. David Martin, Midwestern State University