The Science and Practice of Micronutrient Supplementations in Nutritional Anemia

Nutritional anemia is the most common type of anemia, affecting millions of people in all age groups worldwide. While inadequate access to food and nutrients can lead to anemia, patients with certain health status or medical conditions are also at increased risk of developing nutritional anemia. Iron, cobalamin, and folate are the most recognized micronutrients that are vital for the generation of erythrocytes. Iron deficiency is associated with insufficient production of hemoglobin. Deficiency of cobalamin or folate leads to impaired synthesis of deoxyribonucleic acid, proteins, and cell division. Recent research has demonstrated that the status of copper and zinc in the body can significantly affect iron absorption and utilization. With an increasing number of patients undergoing bariatric surgical procedures, more cases of anemia associated with copper and zinc deficiencies have also emerged. The intestinal absorption of these 5 critical micronutrients are highly regulated and mediated by specific apical transport mechanisms in the enterocytes. Health conditions that persistently alter the histology of the upper intestinal architecture, expression, or function of these substrate‐specific transporters, or the normal digestion and flow of these key micronutrients, can lead to nutritional anemia. The focus of this article is to review the science of intestinal micronutrient absorption, discuss the clinical assessment of micronutrient deficiencies in relation to anemia, and suggest an effective treatment plan and monitoring strategies using an evidence‐based approach.     

Beyond calcium and vitamin D

The role of calcium and vitamin D in the prevention and management of osteoporosis is widely accepted by clinicians. However, the importance of other vitamins and minerals for bone health has not been clearly defined. This article reviews available information for several vitamins (vitamins A, C, E, and K) and miscellaneous minerals (fluoride, iron, magnesium, phosphorus, and potassium), and their potential effects on bone health.     

Concentric Interactive Group Model: A Unique Experience for Patients and Staff

PURPOSE. The purpose of this article is to describe the Concentric Interactive Group Model, a unique psychotherapeutic group therapy model, for the treatment of patients with difficulties related to aggression. In the first of three phases of the group, the patient discusses his/her aggression while staff observe; in the second phase, the staff discuss what occurred in the first phase while patients observe; and in the third and last phase, patients and staff discuss, clarify, and reinforce what was learned in the previous phases. CONCLUSIONS. The uniqueness of the model is in the opportunity it offers the patient to learn to manage aggression through both dialogue and observation. PRACTICE IMPLICATIONS. Nurses can use this observation and modeling as a potentially powerful intervention for addressing maladaptive aggressive behaviors in their patients.     

From Fragmentation to Wholeness: An Integrative Approach With Clients Who Dissociate

topic . Three domains of treatment with the client who dissociates.
source . Author's clinical work, review of literature.
goal . To describe the use of building ego strength, modulating affect, and supporting abreaction to decrease fragmentation.
conclusion . The nurse psychotherapist can use these interventions to decrease fragmentation with clients who dissociate.