By W. Grompel. South Pacific University.

The doctor may ask the person his or her address discount solian 50 mg overnight delivery, what year it is or who is serving as president cheap 50mg solian fast delivery. The individual may also be asked to spell a word backward generic 100mg solian fast delivery, draw a clock or copy a design. The doctor will also assess mood and sense of well-being to detect depression or other illnesses that can cause memory loss and confusion. Physical exam and diagnostic tests A physician will: » Evaluate diet and nutrition. Information from these tests can help identify disorders such as anemia, infection, diabetes, kidney or liver disease, certain vitamin deficiencies, thyroid abnormalities, and problems with the heart, blood vessels or lungs. All of these conditions may cause confused thinking, trouble focusing attention, memory problems or other symptoms similar to dementia. Neurological exam A doctor will closely evaluate the person for problems that may signal brain disorders other than Alzheimer’s. The physician will also test: » Reflexes » Coordination » Muscle tone and strength » Eye movement » Speech » Sensation The doctor is looking for signs of small or large strokes, Parkinson’s disease, brain tumors, fluid accumulation on the brain, and other illnesses that may impair memory or thinking. Researchers are studying other imaging techniques so they can better diagnose and track the progress of Alzheimer’s. A diagnosis of Alzheimer’s reflects a doctor’s best judgment about the cause of a person’s symptoms, based on the testing performed. Find out if the doctor will manage care going forward and, if not, who will be the primary doctor. Alzheimer’s disease is life-changing for both the diagnosed individual and those close to him or her. While there is currently no cure, treatments are available that may help relieve some symptoms. Research has shown that taking full advantage of available treatment, care and support options can improve quality of life. A timely diagnosis often allows the person with dementia to participate in this planning. The person can also decide who will make medical and financial decisions on his or her behalf in later stages of the disease. This interactive tool evaluates needs, outlines action steps and links the user to local services and Association programs. Since Alzheimer’s affects people in different ways, each person may experience symptoms — or progress through the stages — differently. On average, a person with Alzheimer’s lives four to eight years after diagnosis, but can live as long as 20 years, depending on other factors. Changes in the brain related to Alzheimer’s begin years before any signs of the disease. The following stages provide an overall idea of how abilities change once symptoms appear and should be used as a general guide. Stages may overlap, making it difficult to place a person with Alzheimer’s in a specific stage. Early-stage Alzheimer’s In the early stage of Alzheimer’s, a person may function independently. Despite this, the person may feel as if he or she is having memory lapses, such as forgetting familiar words or the location of everyday objects. During a detailed medical interview, doctors may be able to detect problems in memory or concentration. As the disease progresses, the person with Alzheimer’s will require a greater level of care. You may notice the person with Alzheimer’s confusing words, getting frustrated or angry, or acting in unexpected ways, such as refusing to bathe. Damage to nerve cells in the brain can make it difficult to express thoughts and perform routine tasks. At this point, symptoms will be noticeable to others and may include: » Forgetfulness of events or about one’s own personal history. People can wander or become confused about their location at any stage of the disease. If not found within 24 hours, up to half of those who get lost risk serious injury or death. Late-stage Alzheimer’s In the final stage of the disease, individuals lose the ability to respond to their environment, carry on a conversation and, eventually, control movement. As memory and cognitive skills worsen, significant personality changes may occur and extensive help with daily activities may be required. At this stage, individuals may: » Need round-the-clock assistance with daily activities and personal care.

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Dietary Fiber Intake and Colonic Adenomas People with colonic adenomas are at elevated risk of developing colon cancer (Lev discount solian 50mg mastercard, 1990) solian 50 mg cheap. Several epidemiological studies have reported that high Dietary Fiber and low fat intakes are associated with a lower incidence of colonic adenomas (Giovannucci et al generic 50 mg solian visa. For example, Giovannucci and coworkers (1992) studied a population of 7,284 men from the Health Professionals Follow-up Study and found a significant negative relationship between Dietary Fiber intake and colonic adenomas. The inverse relationship with Dietary Fiber persisted when they adjusted for other nutrients commonly found in fruits and vegetables. The overall median dietary intake of Dietary Fiber in this population was 21 g/d, with a median intake of 13 g/d for the lowest quintile and 34 g/d for the highest quintile. Possible Reasons for the Lack of a Protective Effect of Dietary Fiber in Some Trials There is considerable debate and speculation as to why clinical inter- vention trials on the relationship between fiber intake and colon cancer have not shown the expected beneficial effect of fiber. Some of the recent prospective studies, such as the Nurses’ Health Study (Fuchs et al. As noted above, the Health Professionals Follow-up Study showed a protective effect of Dietary Fiber from the diet against colonic adenomas (Giovannucci et al. However, when the same cohort was later investigated for the relationship between intake of Dietary Fiber and colon carcinoma, no relationship was found (Giovannucci et al. A partial explanation for the difference is due to differences in ways that the data were analyzed based on informa- tion that was known at the time of analysis. A similar situation was found in the Nurses’ Health Study cohort, which initially found that the combination of high Dietary Fiber and low saturated or animal fat intake was associated with a reduced risk of adenomas (Willett et al. Again, at follow-up in the same cohort, no relation- ship was found between Dietary Fiber intake and colon cancer incidence (Fuchs et al. This may also account for the lack of a protective effect of Dietary Fiber in the three recently reported clinical intervention trials (Alberts et al. Perhaps, as Giovannucci and colleagues (1992) suggest, intake of Dietary Fiber may influence the early stages of carcinogenesis, whereas dietary fat may have a greater influence on the progression of initiated cells into cancer. Another possible expla- nation for the lack of a positive effect of fiber on colon cancer involves the potential confounding role of starch. Resistant starch intake has been associated with increased concentrations of fecal ammonia (Birkett et al. Ammonia is toxic to normal colonic cells and stimulates the growth of malignant cells (Visek, 1978). Thus, diets that are high in resistant starch, but low in fiber, may have adverse effects (Birkett et al. Individuals May Not Consume Sufficient Amounts of Fiber or the Right Type of Fiber. Neither the prospective studies nor the three large intervention trials reported aspects of colonic function (Alberts et al. It is possible that bulkier stools or faster transit through the colon reduce the risk of bowel cancer (Cummings et al. In addition, posi- tive benefits of fiber with respect to colon cancer may not occur until Dietary Fiber intake is sufficiently high; for example, greater than the median 32 g/d for the highest quintile in The Health Professionals Follow-Up Study of men (Giovannucci et al. Infor- mation is lacking on the role of Functional Fibers in the incidence of colon cancer because of the lack of intake data on specific Functional Fibers col- lected in epidemiological studies. Most animal studies on fiber and colon cancer, however, have used what could be termed Functional Fibers (Jacobs, 1986). Because evidence available is either too conflicting or inadequately understood, a recommended intake level based on the prevention of colon cancer cannot be set. Dietary Fiber and Protection Against Breast Cancer A growing number of studies have reported on the relationship of Dietary Fiber intake and breast cancer incidence, and the strongest case can be made for cereal consumption rather than consumption of Dietary Fiber per se (for an excellent review see Gerber [1998]). Between-country studies, such as England versus Wales (Ingram, 1981), southern Italy versus northern Italy versus the United States (Taioli et al. However, starchy root, vegetable, and fruit intakes were not related to breast cancer risk for either diet. Prospective Studies There have been at least two prospective studies relating Dietary Fiber intake to breast cancer incidence in the United States and both found no significant association (Graham et al. A Canadian study showed a significant protective trend for the intake of cereals, with borderline significance for Dietary Fiber (Rohan et al. Verhoeven and coworkers (1997) investigated the relationship between Dietary Fiber intake and breast cancer risk in The Netherlands Cohort Study. This prospective cohort study showed no evidence that a high intake of Dietary Fiber decreased the risk of breast cancer. Case-Control Studies Eight of eleven reported case-control studies showed a protective effect of Dietary Fiber against breast cancer (Baghurst and Rohan, 1994; De Stefani et al. For studies that showed this protection, the range of the odds ratio or relative risk was 0. Intervention Studies Most intervention studies on fiber and breast cancer have examined fiber intake and plasma or urinary indicators of estrogen (e. Since certain breast cancers are hormone dependent, the con- cept is that fiber may be protective by decreasing estrogen concentrations.

Binge drinking and its consequences are not a necessary rite of passage which adolescents m ust go through to m ark their status as em erging adults cheap 50mg solian fast delivery, rather it is a feature of our social landscape solian 50 mg cheap. Changing this aspect of our drinking behaviour m eans challenging the attitudes in adults and young people as to its desirability generic solian 100 mg fast delivery. From a preventative perspective, the other issue to consider is both the ready availability of alcohol and the linked issue of the lack of social events and venues for adolescents where alcohol does not feature. W hilst it m ay be outside of the scope of schools to address these areas directly, they are issues the wider school com m unity (particularly parents) can engage in. The other issue to be considered from a context perspective is awareness of how adult alcohol use im pacts on children and young people. Am ong the approxim ate 600,000 people living in the South W estern Area Health Board region it is estim ated that: 20 The Epidemiological Triangle of Drug Use y 18,000 adults would identify themselves as having a problem with their alcohol use. Research shows that there is a com plex grid of m ultiple influences which relate to drug use and other problem behaviours, rather than sim plistic single ‘cause and effect’ m odels. Those influences which m ay increase the likelihood of drug use are referred to as risk factors and those which may reduce the likelihood of drug use are referred to as protective factors. It is important to note that models like this are not predictors of individual drug use. Just because a young person is surrounded by risk factors, it does not automatically follow that he or she will engage in any of the problem behaviours identified – rather it postulates that there is a higher risk of such behaviours. Web of Influence Domains Individual Risk and Protective Factors y Biological and Psychological Dispositions y Attitudes and Values y Knowledge and Skills y Problem Behaviours † Refers to the total complex of external social, cultural and economic conditions affecting a community or an individual. School/Work Risk and Protective Factors y Bonding y Climate y Policy y Performance 4. Community Risk and Protective Factors y Bonding y Norms y Resources y Awareness/Mobilisation 5. Society/Environment Related Risk and Protective Factors y External social, economic and cultural conditions y Norms y Policy/Sanctions For a more detailed discussion of risk and protective factors recommended reading would be Dr. Mark Morgan’s ‘Drug Use Prevention – An Overview of Research’ published by the National Advisory Committee on Drugs in 2001. As with the previous section, it is important to note that the following information is aimed at an adult audience in order to build their capacity to engage with young people in drugs education and prevention work in the school setting and, as such, is not a resource to be given out to students in an unmediated fashion. Engaging young people in discussion around drug facts should always be done in a way which is (i) developmentally appropriate (ii) in accordance with the curriculum being used (iii) in accordance with the school’s substance policy The information is organised around the following headings: y Name y Physical Description(s) y Administration y Desired Effects y Duration of Effects y Signs and Symptoms of Use y Short Term Risks y Long Terms Risks y Legal Status 25 Drug Facts All drugs are viewed in terms of both their desired effects and their associated short and long-term risks. This emphasis on risk, as opposed to distinctions between so called ‘soft’ and ‘hard’ drugs is because the risks involved in drug use are not located purely within the drug itself but rather, how the drug is used, how much is used, who uses it and where – as discussed earlier in the section on the epidemiological triangle. Equally, the soft/hard distinction can also be used to build an argument as to which drugs (i. Drugs and the Law Drug laws in Ireland are complex and subject to change and schools are advised to be proactive in developing a good working relationship with local Gardaí as they will be able to clarify issues relating to drug laws. The laws that are the most relevant to the school setting include the Misuse of Drugs Acts 1977 and 1984. Offences under the Misuse of Drugs Act include: y Possession of any small amount for personal use y Possession with intent to supply to another person y Production y Supplying or intent to supply to another person y Importation or Exportation y Allowing premises you occupy to be used for the supply or production of drugs or permitting the use of drugs on premises y Growing of opium poppies, cannabis and coca plants y The printing or sale of books or magazines that encourage the use of controlled drugs or which contain advertisements for drug equipment There are other laws controlling tobacco, alcohol, solvents and medicines. Equally, drugs, their various uses and our understanding of them change over tim e. W ith this in m ind, there is a list of organisations and websites at the end of this handbook which you can consult if you encounter substances or related behaviours not included in the following section. Tobacco use also figures in cannabis smoking, where cannabis users may use tobacco along with the crumbled cannabis resin in the production of a joint or spliff (hand-rolled cannabis cigarette). Tobacco can also be administered via smokeless products such as snuff, which is sniffed, or ‘dipped’ that is, held between the lip and the gum of the mouth. Under Section 6 of the Tobacco (Health Promotion and Protection) Act 1988 the importation and distribution of these smokeless products are banned due to concerns around their adverse effects on health. However, the acute effects of nicotine dissipate within a few minutes and nicotine disappears from the body in a few hours, as it is metabolised fairly rapidly. It is the combination of the mode of administration (smoking) and nicotine’s highly addictive properties (the W orld Health Organisation ranks nicotine as being more addictive than heroin, cocaine, alcohol, cannabis and caffeine18) which impact on the number of dependent users. By inhaling, the smoker can get nicotine to the brain very rapidly with every puff. A typical smoker will take 10 puffs on a cigarette over a period of five minutes that the cigarette is lit. Thus, a person who smokes about one and a half packs (30 cigarettes) daily gets 300 ‘hits’ of nicotine to the brain each day. W ithin eight hours of stopping, oxygen in the blood increases to norm al levels and carbon m onoxide levels in the blood drop to norm al.