Constipation is not a glamorous topic, but it's certainly important, especially in older adults. As anyone who has experienced occasional or even chronic constipation can tell you, it can really put a damper on quality of life and well-being. Constipation can also cause more substantial problems, such as: * Severe abdominal pain, which can lead to emergency room visits * Hemorrhoids, which can bleed or be painful * Increased irritability, agitation, or even aggression, in people with Alzheimer's disease or other forms of dementia * Stress and/or pain that can contribute to delirium (a state of new or worse confusion that often happens when older adults are hospitalized) * Fecal incontinence, which can be caused or worsened by having a hard lump of stool lodged in the lower bowel * Avoidance of needed pain medication, due to fear of constipation Fortunately, it's usually possible to help older adults effectively manage and prevent constipation. This helps maintain well-being and quality of life, and can also improve difficult behaviors related to dementia. The trouble is that constipation is often either overlooked or sub-optimally managed by busy healthcare providers who aren't trained in geriatrics. They are often focused on more "serious" health issues. Also, since many laxatives are available over-the-counter, some providers may assume that people will treat themselves if necessary. Personally, I don't like this hands-off approach to constipation. Although several useful laxatives are indeed available over-the-counter (OTC), I've found that the average person doesn't know enough to correctly choose among them. Also, although in geriatrics we often do end up recommending or prescribing laxatives, it's vital to start by figuring out what is likely to be causing or worsening an older person's constipation. For instance, many medications can make constipation worse, so we usually make an attempt to identify and perhaps deprescribe those. In short, if you're an older adult, or if you're helping an older... Who can benefit from laxatives? A. those with constipation B. those overweight C. not enough information D. those with heart problems
A

(Question)
Dietary supplements are big business, with around half of the Australian population using at least one type per year; most commonly a multivitamin and mineral pill. Many people take supplements as a form of dietary insurance in case they are not meeting their nutrient needs from foods alone. Others take them as a form of health insurance to protect against certain diseases. Some just take them out of habit. Supplements do have a role to play in some situations. People with a diagnosed deficiency, those with malabsorption conditions, women planning pregnancy, and people with very poor diets all can benefit from specific nutrient supplementation. But what about the benefit of supplements across the broad population? The mantra of most health professionals, which is even etched on the label of many supplements, is that supplements may only be of assistance if dietary sources are lacking. To see if this is supported by solid evidence, a systematic review of 63 clinical trials involving some form of supplementation in non-pregnant adults was carried out by a team of medical researchers. The clinical trials were broad in their nature with many nutrients studied including vitamins A, B6, B12, C, D and E; folic acid; calcium; selenium, omega-3 fatty acids; ginkgo biloba; glucosamine; saw palmetto; and milk thistle. All of the studies were randomised controlled trials and evaluated a range of health outcomes including risk of heart disease, cancer, diabetes, bone fractures, cognitive function and all-cause mortality. From the 63 studies, no benefit was seen in 45 studies with 10 of these showing a trend towards harm and just two showing a trend towards a benefit. Of the remaining studies, four showed harm with a greater risk of cancer with beta-carotene and a higher risk of fractures with a once-yearly dose of vitamin D. One study showed a lower risk of cancer with selenium supplementation, but this was not validated in much larger trials. Twelve studies showed a benefit and these mostly involved vitamin D... Medical professionals probably believe that A. not enough information B. Supplements are dangerous C. Supplements do not help D. Supplements should only be taken if needed
(Answer)
D

Ques: It was not entirely true that Patch knew there was food in the mountains. He had never been to the mountains. No squirrel in all the Center Kingdom, as far as he knew, had ever been to the mountains. For between the kingdom and the mountains, surrounding it on all sides like a moat around a castle, there lay a blasted concrete wasteland, as wide as fifty squirrels laid nose to tail, and horrific death machines roared up and down this wasteland at terrifying speeds, all day and night. What's more, humans and dogs often crossed between the mountains and the kingdoms. And sometimes the dogs were not leashed. A squirrel would have to be very desperate indeed to dare the wastelands. It was Toro who had told Patch about the food in the mountains. Toro was Patch's friend. And that itself was extraordinary. Patch had always talked to birds. The drey he had grown up in -- Silver's old drey, before she became leader of the Seeker clan -- had been only a few branches away from a nest of robins. Once, in early spring when he was still a baby, Patch had crawled out of Silver's drey and into the robin's nest, and had spent a whole day among the chicks before Silver returned home and retrieved him. The robin mother had been unamused by Silver's profound apologies, and even less amused when Patch had returned to her nest the very next day. Eventually Silver taught Patch to leave the robins alone, but not before he had learned how to speak Bird. Most squirrels of the Center Kingdom could say and understand a few simple things in Bird, but Patch could actually hold conversations. And so, one autumn day when a bluejay swooped past and stole an acorn out of Patch's paws, Patch shouted angrily at the thief in Bird to bring it back; and the thief, intrigued, wheeled around in midair, perched on a branch above Patch, and looked curiously down at the irate squirrel. "Thieving feather-brained no-nose hawkbait!" Patch shouted up. "Stupid blind furry groundworm!" the bluejay retorted, and began to peck at the acorn. Who taught Patch to leave the robins alone? A. Silver B. not enough information C. Toro D. a bluejay.
Ans:
A