Effective Care are the common sense solutions that can save lives & money.
Health insurance can't insure effectiveness of the care, or access to care if staff are limited. Efficient, effective, economical - 3 goals.
We are all Leaders and Followers in different ways.
Patients follow advice but also need to lead in their own healthcare.
Learning things the hard way may work however following advice may also work, though we may not like it - the thing to remember is that advice that helped others doesn't always work for everyone. Expecting the need for fine tuning advice to fit individual needs might help prevent frustration or quitting the attempt to improve health or some other change.
Patients can learn from other's hard lessons by following advice gained from clinical research or recommended best practices - tried and true methods to do something in business or other industries.
Patients and healthcare teams need to also keep in mind that the evidence based recommendations - healthcare best practices based on lab or clinical research - are an average, a starting point from which the patient may have to do some trial and error adjusting of the dose or treatment until improvement is consistent.
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- "To be yourself in a world that is constantly trying to make you something else is the greatest accomplishment." - Ralph Waldo Emerson
This website is for patients, professionals, policy writers or researchers - leaders and followers.
It is said that those who adapt the best are most likely to survive -
- "It is not the strongest of the species that survives, nor the most intelligent that survives. It is the one that is most adaptable to change."
That quote is attributed to Charles Darwin and Origin of the Species, however with modern internet quote investigation resources and teams available, the quote was traced to a management studies text according to the Darwin Correspondence Project. (Darwin Correspondence Project)
The problem with learning things the hard way isn't just being wrong sometimes is unpleasant, but that sometimes irreversible damage is caused. However the problem with following evidence based recommendations or other best practices -- is that sometimes irreversible damage is caused. If something hurts ask questions, get second opinions, change a daily habit that deep down you know is not helping you but you didn't want to admit it to yourself.
The benefit of learning things the hard way is that one may also have learned to try minor changes and check effectiveness until a working solutions was found - basically doing one's own research without the ethics approval or funding grant applications but also without the benefit of a professional input and a published result. The problem with both learning things the hard way and following advice from whatever source is that there might be a better solution, a more effective or easier or less expensive solution.
Sharing information with each other can help everyone consider whether their methods might benefit from change or help show which seems more beneficial or superior in some way than average and worth continuing or copying. Quotes, proverbs, folk sayings are often best practices - wisdom to consider.
- "Invite people into your life that don't look or think like you." -Mellody Hobson
- "If you're the most intelligent person in the room . . . you're in the wrong room." - James D Watson.
Reading puts you in the room with the authors or editors of the text – at least at the time that they wrote it. The date of the work is worth noting for a reminder to consider any culture changes or scientific advancements that may have occurred at or since that time..
The date may also reveal how long it can take for research discoveries to make to patient care. It can be an average of 17 years. See: Translational Research: Translating research into Patient Care Strategies. Other discoveries have taken more than 50 or 100 years to make it to the patient or consumer in the form of treatment or safety regulations. See: Translational Medicine: Getting research to the patient.
The time it takes for research to reach the patient or consumer might also be thought of as the time it takes to adapt to new information, the time it takes to adapt to the need for change. Adapting to change is leading, following the status quo, the usual way of doing things is following - old habits or tradition.
Treating underlying causes can be more effective than treating symptoms, and more cost effective.
Effective care solutions may be a combination of evidence based recommendations from clinical research and best practices - advice parents or others tend to find helpful but a preponderance of studies may not have confirmed it or insufficient research may have been performed. Reduced profit potential may be why some seemingly effective treatments do not get funding for the clinical trials desired for making evidence based recommendations.
- “A leader takes people where they want to go. A great leader takes people where they don’t necessarily want to go, but ought to be.” – Rosalynn Carter
Healthcare professionals and other industries follow regulations and lead in their own area of expertise.
We may think of patients and doctors when thinking about healthcare, or we may think of nurses, however there are many levels of leaders and followers within healthcare and other industries.
Patients may follow medical advice and lead in self-care and monitoring symptom changes, and patients may lead as patient advocates or in support of clinical studies.
Healthcare professionals may lead in a business setting or professional organization or as a patient care provider. They also have to follow professional credentialing and ethics guidelines and federal, state, and local regulations. Insurance requirements may be following federal requirements and care providers may need to consider affordability and insurance coverage for different treatment choices.
Research teams have to have experimental designs approved for ethical use for humans or animal studies and generally also need to seek funding sources and apply for grants.
- “Leaders are visionaries with a poorly developed sense of fear and no concept of the odds against them.” - Robert Jarvik
Interdependent - win/win solutions are best because we are on the same team.
We are all leaders and followers in different ways. We are also interdependent - we need each other in different ways. Children are our future taxpayers, caregivers, and leaders and yet they are followers of their caregivers and society as they learn to lead in their own self-care and other daily routines.
Win/win solutions are good for both sides of an agreement - both sides are benefiting in some way and giving up a reasonable concession in exchange.
- "When one side benefits more than the other, that's a win-lose situation. To the winner it might look like success for a while, but in the long run, it breeds resentment and distrust." -Dr. Stephen R. Covey, "Habit 4: Think win/win." TM, (franklincovey.com)
Caregivers provide care: housing, food, love, and children provide love, help, and fun - a reminder that the world is an exciting place to taste, and thunk, (listen to), and explore. It is difficult to keep everything out of a toddler's mouth, they have an innate curiosity to know what their environment tastes like, feels like, smells and sounds like. Mothers need eyes in the back of their head - but instead of panicking, think of it as strengthening their immune system and try to avoid using harsh cleansers in toddler areas.
Why should people without children care about the education or healthcare of children? People should care about children’s education and care because they are our future healthcare providers, taxpayers, teachers, pilots, or our patients, or future prisoners. How we care for children can affect their health and behavior as children and as adults.
Allowing students some areas where they lead in their education may help sweeten the process. Adults may be more motivated to learn a skill or topic when they think it will help them improve in their personal or work life.
Why should people in one industry care about those in another? Or why should people who live in cities care about people living in rural areas? Because we lead and follow in different ways - lead as suppliers or producers, as transporters, or sales and marketing. We also share the air and water and may lead as polluters or as forest and wetland managers..
This site can also be read in a tabbed document.
The information on this site is provided for educational purposes, for anyone interested in finding learning within him, her, or themselves. The text is also available in book format called Instinct & Policy: Effective Care and Best Practices for Promoting Health and Preventing Harassment and Discrimination. (book doc)
- The first twelve chapters are an overview of how and why to write policies, and why accurate research is important for helping to write effective policies.
- The second half of the site includes a Glossary and Resources section and additional chapters on topics that go into more specific detail on health topics including oxidative stress, vitamin D and autoimmune disease, TRP channels and pre-eclampsia and other conditions that may be affected by overactive TRP channels, and recipes and menu ideas with foods that may help health by increasing Nrf2 which helps our immune system and increases our own production of antioxidants - some of this material is original work and some is summarized from other researchers discoveries.
- This website has image collections in slideshow format which the book document does not have. However the document has a title sidebar which can make it easy to navigate between sections. Some of the sections are also available as shorter articles on the blog style website effectiveselfcare.info..
Two other sites are available which work best on a computer rather than a mobile device:
- Image collages, and information focused on the environment, climate change and how technology may be able to help is on the website earth-ocean.info. Some of the blog is a series that is also available in a tabbed document - ideas for improving the health of the ocean: (Oxygenating the Ocean.doc)
- More image collages and information focused on the interconnection between health, the environment, society and peace is on the website: peace-is-happy.org. Some of the information on prenatal and early childhood health from the site is included in a book draft based on a series about preventative health care from the effectiveselfcare.info site. Preventive Care for Multifactorial Disorders (doc).
What do I want to do when I grow up? -- Type a little faster:
- “If my doctor told me I had only six minutes to live, I wouldn't brood. I'd type a little faster. ― Isaac Asimov
My leadership roles may be as a health advocate with patient, healthcare professional, and food industry experience. My health limits my abilities at times. This site combines general reader level information with academic research. Writing separate articles for peer reviewed academic journals and books or other media for general readers is a goal. Podcast or video possibly in educational course format has also been a goal.
We all have a part to play. Policies, regulations, best practices and procedural checklists help save lives. The more who are aware of our interdependence on each other and on the rest of the planet, the better it may be for us all.
Evidence Based Guidance is a starting point.
Health care takes a team - educate with professional guidance.
As a dietitian or as anyone in our modern world, life gets busy and complicated. Jargon within your own field of interest can become difficult to keep up with let alone trying to understand and remember the lingo used in other industries or in the healthcare field in general.
Having a reference with all the diagnoses and recommendations for that diagnosis in one place is a convenience that dietitians are used to having in their toolbox. The standard in the nutrition world is by Sylvia Escott-Stump and it is a reference that every health professional would benefit from having on their desk. I referred to my copy frequently for the occasional odd diagnosis and for common diagnoses when writing or updating handouts.
- Something for every health professional's toolbox: Nutrition and Diagnosis-Related Care, 8th Ed. 2015, (Escott-Stump). The updated edition includes a section on oxidative stress/inflammation and a section on autism, both of which are topics I cover on this site, effectivecare.info, or the associated blog site, effectiveselfcare.info. The book Nutrition and Diagnosis-Related Care, 8th Ed. would be the reference to use for reliable evidence-based nutrition recommendations approved for use in hospitals and other healthcare facilities.
The information on my websites includes information from peer reviewed articles but it also includes original recipes and ideas of mine that have not been peer reviewed at this time.
In the internet age we get used to the search engine but prior to that a well organized encyclopedia like reference and condensed pocket versions to carry with when doing hospital or nursing home rounds were the norm. The comprehensive collection of information about lab tests and ethnic or other trends common to a diagnosis is still valuable for dietitians or others and having a condensed checklist of all the factors to consider asking about in one place can be life-saving for patients.
The body is complex, add the variety of different types of bodies of all the ethnic groups and genders and a comprehensive checklist of all the questions to think about for a diagnosis is really simply necessary. Who can remember everything all the time? Not many health professionals that I've met as a patient have asked many questions of me beyond standard ones. How are you feeling is vague. How is the surface of your tongue feeling when you eat is very specific and would be helpful to check B vitamin status. A visual inspection of the tongue's surface is also necessary for a thorough nutrition analysis.
Time is limited however it is helpful for patients and clinicians to have time for questions about symptoms for a thorough understanding of the problem and accurate diagnosis. It has been written or said that up to 80% of a medical diagnosis in our current system is based simply on the lab tests. Ask yourself, do you want to be seen as a test tube or as a whole person?
I prefer to be seen as a whole person. My name is Jennifer Depew, R.D., a Registered Dietitian. My work experience was primarily helping prenatal clients and caregivers of young children but I have also worked with home care and residential facility clients of all ages and varied diagnoses. Thanks for visiting.
- More about my work experience is included on the Introduction page which also has links and introduction to each of the first 12 chapters of this site (and available ias a documetnt : Instinct & Policy: Effective Care and Best Practices for Promoting Health and Preventing Harassment and Discrimination. (book document link) More about what nutritionists might do for an individual or a business is available on the earth-ocean.info site in a series of pages (Nutrition) and more details about my professional experience and education is on the About Jen page.
To be effective, care may need to be individualized.
Pumpkin seeds & The DASH Diet
Effective health care involves daily choices - healthy habits.
Something as simple as our food choices, such as eating a handful of raw, unsalted shelled pumpkin seeds regularly, may help prevent or manage life threatening conditions such as the prenatal complication called pre-eclampsia.
I learned about the exceptional nutritional value of pumpkin seeds for providing zinc in a college nutrition class. It was an upper level class for dietitians and the assignment was either simple or complex depending on your lifestyle or your approach to homework. The challenge - record your diet for a week and calculate the nutrient content to see how well you were meeting your own nutritional needs.
It is particularly useful information for people following a vegetarian or vegan diet because meats are a good source of zinc but very few vegetarian foods are rich in zinc. For several years during college I did eat a vegetarian diet and had read what I could find about making myself well-balanced meals so I remembered the information and shared it with others as a nutrition counselor. Pumpkin seeds and education about the DASH diet helpped prenatal clients with risk of hypetension or preeclampsia avoid having problems recur. It made me curious what was the benefit? The DASH diet is rich in magnesium from the additional focus on nuts, beans and seeds which are all good sources of magnesium. How else might pumpkin seeds be benefiting prenatal clients?
- Pumpkin seed kernels are the inner green part that have been shelled. Their texture is similar to sunflower seed kernels but their oil content has a more health promoting nutrient balance than the oil content of sunflower seed kernels.
- Ideally shop for raw pumpkin seed kernels that are not salted. Salted, roasted pumpkin seeds may also be labeled Pepitos and the salt content may be excessive if eaten in much quantity.
- An 1/8th to 1/4 cup of raw pumpkin seed kernels, 2 to 4 Tablespoons might be a reasonable serving size of the unsalted type or lightly salted and roasted types.
- Roasting the seeds increases the phospholipid content but also increases some more negative oxidation chemicals which would decrease some of the benefits of the oil. (P.12) For freshness of the roasted snack, the raw pumpkin seed kernels can be lightly pan roasted for a few minutes with a dash of oil until they puff a little. Toss with a sprinkle of salt and let cool on a paper towel to absorb extra oil. Store any extra in an airtight container to retain crispiness and prevent further oxidation.
- Oxidation of seeds or nuts: spoilage of the oils due to contact with oxygen from the air. Storing all nuts and seeds in airtight containers in a cool or even freezing temperature extends their safe eating shelf life. Rancid oil has a recognizable odor and bad taste and nuts and seeds should be discarded rather than eaten if they have gotten too old and turned rancid as the oxidized oils can be unhealthy, especially if eaten in a larger quantity. One or two wouldn't be a problem but once the off-taste is noticed throw away the remainder of the package or possibly you might be able to return it to the store if it was a recent purchase. (P.13)
Magnesium is a mineral found in many foods but it can also be easily become deficient due to increased urinary losses due to alcohol or other dietary choices. It is important in protecting against damage caused by oxidative stress. More information is available in section G3. Relaxation & Stress.. Relaxation methods like meditaiton or simply ten deep breaths can help reduce stress levels and restore needed oxygen. When stresssed we tend to hold our breath, to stop breathing for a moment, when under extreme stress. Tips for Reducing Stress (forbes.com)
Pre-eclampsia can be life threatening for mom and expected baby.
Preeclampsia is a severe form of hypertension that may have included severe nausea and vomiting and dehydration during early pregnancy or throughout the pregnancy. Excess fluid retention and difficulty clearing toxins can be symptoms. Seizures can be a life threatening risk for the mother and reason for an increased risk for premature delivery for the infant which can increase health complications or risk of death for the infant. Magnesium sulfate is given intravenoussly to help control the seizures risk toward the end of pregnancy.
Delivery of the placenta typically leads to an improvement for the woman however occasionally seizures can be a risk in the first few weeks afterr delivery. Genetic differences or development problems of the placental cells in the first weeks after conception may lead to increased risk for preeclampsia as there is increased risk for family members and genetic differences in a type of TRP channel has been identified.
TRP channels control transport of minerals and other chemicals across cell membranes, including the membranes of the mother's placenta and the baby's umbilical cord. Toxins, nutrients, and fludi all cross membranes in different ways and amounts. TRP channels can be like a toll gate that uses magnesium as the payment of energy instead of a credit card or cash.
More information and some possible strategies that might help reduce risk to mom and baby are included in section G5. Preeclampsia and TRP channels.
Why did pumpkin seeds help preeclampsia? I started reading.
Current medical research didn't have answers for me regarding what I had observed regarding the DASH diet and prenatal hypertension, but an imbalance or deficiency in magnesium and other nutrients may be involved.
Magnesium deficiency can cause a variety of problems and I found there were quite a few alternative practitioners recommending more use of it but it is not a part of standard treatment for prevention of preeclampsia. It is used for the acute care of patients near delivery who are given intravenous magnesium which I was told feels like fire running through your veins. Many or several patients were very eager to never experience that again and were happy with the pumpkin seeds and DASH diet recommendation.
An underlying problem with vitamin D may be involved in a tendency towards low magnesium levels as vitamin D is involved in calcium and magnesium metabolism. Someone with a darker skin complexion living in a northern climate or who works nights and doesn't get much sun exposure might be more at risk for low vitamin D levels. However it is included in many foods and in the prenatal or one-a-day supplements that are commonly used - so why would people be at risk when we don't have a large problem anymore with childhood rickets (children with dark skin complexions who are fully breastfed may be more at risk for the condition.)
My reading lead me to more reading and public health issues involving low vitamin D became apparent at the population level. The average vitamin D level for US citizens was lower than that of Canadian citizens - who would be getting less sunlight on average. That information was a new puzzle which eventually led me to the disturbing information that glyphosate may be inhibiting the body's ability to form vitamin D with the help of sunlight. Are US citizens getting more glyphosate residue than the average Canadian? I don't know. What I did find out however is that vitamin D is essential for helping a mother or an allergy or autoimmune patient to be less overly allergic or sensitive to the baby's DNA - which is foreign to the mother's white blood cells.
More detail is included in section G4. Autoimmune Disease & Vitamin D.
Policy guides our lives in many ways we don't realize.
"Try to learn something about everything & everything about something". ~T.H.Huxley
Policy is a rule that a business or nation, or a family or an individual has decided to follow. Procedures are the steps that have been planned or tested and found to be effective for achieving the goal of the policy or for enforcing it. Evaluation of daily behavior is generally involved in measuring and showing that a plan is being carried out on a regular basis.
Writing policy and procedures that will be effective is a skill that can be learned but it also involves an understanding of people and a respect for physics. None of us can perform tasks when there isn't enough time or resources or if the plan is based on incorrect information, or was based on information that simply changed - but the plan wasn't changed - yet. The best policies are clear and discussed on a regular basis as guidance rather than used as an after-the-fact punishment that goes into the employee record or is used to fire workers. A good overview of how to use policies effectively is included in an article about what to wear to work, and what to save for after hours by Liz Ryan, see forbes.com: Ten Things Never, Ever to Wear to Work. It is a Q/A article about wardrobe for setting customers and coworkers at ease which also discusses the value in having more flexible policies that are based on regular conversations during office hours rather than used as punitive, gotcha-breaking-the-policy reprimands that go into an employee record. (P.1)
The question of "normal" and how it differs for all of us somewhat is considered from the perspective of my own childhood - which was not typical and I'm sharing in part for that very reason - to show that people can be different and that is okay - or that people can be different and can benefit from individualized diet choices and health care. My ideas are presented as a ideas, not necessarily correct or incorrect, but simply ideas that might be worth adapting for your own use in some way that I couldn't possibly know because I don't have your set of unique experiences.
Sharing is caring, pass it forward.
Templates are available for writing policy but based on one I started, note the logo is underway, it would be difficult to complete without more knowledge of the requirements. The template has guidance about what types of things to include and where to put them in the document but it doesn't really have guidance about what details you would be writing. More familiarity with the federal policy and what it requires would be needed before this template could be completed: (HIPAA policy template). It's a nice start - for someone who is familiar with the goals of the HIPAA legislation, (HIPAA) but for someone who is new to the job and told to write something it wouldn't be enough information. Once I had something more complete I might modify the logo but for now, it can stay. Discussion of differences itself isn't necessarily racist or discriminatory but can be necessary to help reveal strengths and how teamwork can help improve on weaknesses. No one can do everything and templates give you a team from the word processing company or other company you're working with. But even they need you to consider your individual company or personal values when you are developing a plan of action. A policy and the procedural steps are like a sports play or recipe card for a cook. Think about what efficient time management plus realistic ability can handle - and - write that - with the legal requirements in mind so when the inspectors happen to visit everyone isn't breaking the law - that would be bad.
To save you the click through, "Needs work" is the joke - the logo is a drawing of a paper airplane.
Who and what does your company care about, what is the story of the era?
A template is helpful but it can not tell you what your own place of business or your own group of workers' values might require for a policy to be easy to implement and effective without needing as much oversight or reprimands.
The value in considering the underlying story or narrative of an economically significant point in history is discussed in the article Economics and the Human Instinct for Storytelling, (review.chicagobooth.edu). Past events are discussed. Climate change and the need for rapid changes in the way we as a species collectively and individually do things is an underlying narrative of our current time. But the changes in our environment are being denied or suppressed, or attacked, or desperately pleaded for, and planned and worked towards, by a variety of different groups. What are we to think? When two opposite beliefs are clashing in our minds it can add to stress. Cognitive dissonance is a term for when we are forced to cope with sets of different beliefs about a topic.
Cognitive dissonance is an underlying narrative of our current time.
The most effective health care is self care - the ultimate Do-It-Yourself Project.
Waiting for others to tell you to take a break or to go see the doctor may leave your body in worse shape than necessary.
Start early with healthy habits and the long term may take care of itself without needing long term chronic illness management. A variety of therapy ideas and resources to experiment with on your own are available online and in self-help type books but seeking out a group or individual therapist or nutritionist or exercise coach or health care specialist is a better now than never plan - Take charge of your health early and it may stick by you for the long run!
Disclaimer
Health can be a do-it-yourself project. Take charge everyday.
- Disclaimer: Opinions are my own and the information is provided for educational purposes within the guidelines of fair use. While I am a Registered Dietitian this information is not intended to provide individual health guidance. Please see a health professional for individual health care purposes.
- The Academy of Nutrition and Dietetics has a service for locating a nutrition counselor near you at the website eatright.org: (eatright.org/find-an-expert).
- This site is for informational purposes only and has no products for sale or subscription services. Any links that include products or books for sale are not affiliated with this site.*I've more recently added some links to photo books that can be viewed in full online- if I have them available for sale.
- Any quoted material is provided for educational purposes within the guidelines of Fair Use and is provided without written or verbal permission or endorsement by the source.
Some research regarding how long it takes medical research results to reach the individual patient suggests that it may take on average 17 years. Accuracy of findings is important but some patients may not be able to wait that long and all findings may not be helpful to all patients. Seek individualized health care guidance from a health professional and also be proactive about paying attention to your own health. Our bodies tell us what hurts and what feels better in order to help guide us towards daily habits that promote health. Pain is a symptom saying something is wrong - it may be saying stop what you're doing and rest, re-hydrate, seek healthy food or fulfill some other need instead of continuing the painful activity. For the reference about 17 years for medical research to be translated into indicidual patient guidance on average, and more on the topic of translational research and individualized genetic screening see Translational Research – translating research into patient guidance on effectiveselfcare.info. I'm currently laying down to type this update because sitting up is exhausting and makes my heart rate race too fast. I've been healthier and I've been sicker - I prefer healthier.