By V. Boss. University of Sarasota. 2019.
The goal of the discipline is to expand knowledge The profession of nursing consists of people edu- about human experiences through creative concep- cated according to nationally regulated buy 100mcg misoprostol otc, deﬁned buy 200 mcg misoprostol with amex, and tualization and research purchase 200 mcg misoprostol. The standards and regulations are to preserve the safety of health care for members of society. The nursing regulations and standards are Knowledge of the discipline is the scientiﬁc speciﬁed predominantly in medical/scientiﬁc terms. This is according to tradition and is largely related to nursing’s early subservience to medicine. The the nurse leaders in health-care systems and in regu- discipline-speciﬁc knowledge is given birth and lating organizations have been developing standards fostered in academic settings where research and ed- (Mitchell, 1998) and regulations (Damgaard & ucation move the knowledge to new realms of un- Bunkers, 1998) consistent with discipline-speciﬁc derstanding. The goal of the profession is to provide knowledge as articulated in the theories and frame- service to humankind through living the art of the works of nursing. Members of the nursing profession are re- ment that will fortify the identity of nursing as a sponsible for regulating the standards of practice discipline with its own body of knowledge—one and education based on disciplinary knowledge that that speciﬁes the service that society can expect from reﬂects safe health service to society in all settings. The totality paradigm frameworks and Human Becoming language is unique to nursing. Nurses living the beliefs of this nine concepts written in verbal form with “ing” paradigm are concerned with participation of per- endings to make clear the importance of the ongo- sons in health-care decisions but have speciﬁc ing process of change as basic to human-universe regimes and goals to bring about change for the emergence. Nurses living the simultaneity unitary beings, as speciﬁed in the ontology, pre- paradigm beliefs hold people’s perspectives of their cludes any use of terms such as physiological, bio- health situations and their desires to be primary. Human Becoming, a school of thought named such The assumptions of the human becoming school of because it encompasses on ontology, epistemology, thought are written at the philosophical level of and methodologies, emanates from the simultane- discourse (Parse, 1998a). When the term (Rogers, 1992) and from existential phenomeno- “mankind” was replaced with “male gender” in the logical thought (Parse, 1981, 1992, 1994a, 1995, dictionary deﬁnition of “man,” the name of the 1997a, 1998a). In the assumptions, the author sets theory was changed to “human becoming” (Parse, forth the view that unitary humans, in mutual 1992). With process with the universe, are cocreating a unique the 1998 publication of The Human Becoming becoming. The mutual process is the all-at- School of Thought, Parse expanded the original onceness of living freely chosen meanings that arise work to include descriptions of three research with multidimensional experiences. The chosen methodologies and a unique practice methodology, meanings are the value priorities cocreated in tran- thus classifying the science of Human Becoming as scending with the possibles in unitary emergence a school of thought (Parse, 1997c). The principles and the assumptions of the human Human Becoming is a basic human science that becoming school of thought make up the ontology. The principles of human becoming, which describe the central phenomenon of nursing (the human- Human Becoming is a basic human science universe-health process), arise from the three that has cocreated human experiences as major themes of the assumptions: meaning, rhyth- its central focus. The ontology—that is, the assumptions and explicates fundamental paradoxes of human be- principles—sets forth beliefs that are clearly differ- coming (Parse, 1998a, p. Discipline-specific knowledge is articulated in Paradoxes are not opposites or problems to be unique language specifying a position on the phe- solved but, rather, are ways humans live their cho- nomenon of concern for each discipline. The principles are the author explicates the idea that humans con- referred to as the Human Becoming Theory. The struct personal realities with unique choosings concepts, with the paradoxes, describe the human- from multidimensional realms of the universe. This ontological base gives Reality, the meaning given to the situation, is the rise to the epistemology and methodologies of individual human’s ever-changing seamless sym- Human Becoming. Consistent with the Human Becoming symphony is the unique story of the human as mys- School of Thought, the focus of inquiry is on tery emerging with the explicit–tacit knowings of humanly lived experiences. The second principle (Parse, 1981, 1998a) de- Sciencing Human Becoming is the process of com- scribes the rhythmical patterns of relating human ing to know; it is an ongoing inquiry to discover with universe. Not all is explicitly methods; two are basic research methods and the known or can be told in the unfolding mystery of other is an applied research method (Parse, 1998a, human becoming. The methods ﬂow from the on- opportunities-restrictions present in all choosings tology of the school of thought. There are oppor- methods are the Parse Method (Parse, 1987, 1990, tunities and restrictions no matter what the choice. It is coming together two methods is to advance the science of Human and moving apart, and there is closeness in the sep- Becoming by studying lived experiences from par- aration and distance in the closeness. The phenomena for study changing; that is, moving beyond with the possibil- with the Parse Method are universal lived experi- ities, which are their intended hopes and dreams. Written texts from any lit- resist with powering in creating new ways of living erary source or any art form may be the subject of the conformity-nonconformity and certainty- research with the Human Becoming Hermeneutic uncertainty of originating, while shedding light on Method. The researcher in afﬁrming being in light of nonbeing” (Parse, 1998a, the Parse Method is truly present as the participant p. The being-nonbeing rhythm is all-at-once moves through an unstructured discussion about living the ever-changing now moment as it melts the lived experience under study. Humans, in originating, seek to the Human Becoming Hermeneutic Method is conform–not conform; that is, to be like others and truly present to the emerging possibilities in the unique all-at-once, while living the ambiguity of horizon of meaning arising in dialogue with texts the certainty-uncertainty embedded in all change. True presence is an intense attentive- The changing diversity arises with transforming the ness to unfolding essences and emergent meanings. The contributions of the ﬁndings from edge base underpinning true presence is speciﬁed studies using these two methods is “new knowledge in the assumptions and principles of human be- and understanding of humanly lived experiences” coming (Parse, 1981, 1992, 1995, 1997a, 1998a). Many studies have been con- True presence is a free-ﬂowing attentiveness that ducted and some have been published in which arises from the belief that the human in mutual nurse scholars used the Parse Method. Two studies process with the universe is unitary, freely chooses have been published in which the author used the in situations, structures personal meaning, lives Human Becoming Hermeneutic Method (Cody, paradoxical rhythms, and moves beyond with 1995c; Ortiz, 2003). Parse states: “To The applied research method is the descriptive know, understand, and live the beliefs of human be- qualitative preproject-process-postproject method. The different way that arises from the human number of studies have been published in which becoming beliefs is true presence” (Parse, 1987, the authors used this method (Jonas, 1995a; 1998b). Many papers are published explicating Mitchell, 1995; Northrup & Cody, 1998; Santopinto human becoming practice (Arndt, 1995; Banonis, & Smith, 1995), and a synthesis of the ﬁndings of 1995; Bournes, 2000, 2003; Bournes & Flint, 2003; these and other such studies was written and pub- Butler, 1988; Butler & Snodgrass, 1991; Chapman, lished (Bournes, 2002b). The goal of the nurse 2002; Quiquero, Knights, & Meo, 1991; Rasmusson, 1995; Rasmusson, Jonas, & Mitchell, 1991; Smith, 2002; Stanley & Meghani, 2001; among others). The goal of the nurse living the human be- True presence is a powerful human-universe coming beliefs is true presence in bearing connection experienced in all realms of the uni- witness and being with others in their verse. Nurses may be with persons in living the human becoming beliefs is true presence discussions, imaginings, or remembrances through in bearing witness and being with others in their stories, films, drawings, photographs, movies, changing health patterns. True presence is lived metaphors, poetry, rhythmical movements, and through the human becoming dimensions and other expressions (Parse, 1998a, p. The nurse with individuals or groups is truly present with the The Human Becoming School of Thought is a unfolding meanings as persons explicate, dwell with, guide for research, practice, education, and admin- and move on with changing patterns of diversity. Scholars Living true presence is unique to the art of from ﬁve continents have embraced the belief human becoming. It is sometimes misinterpreted system and live Human Becoming in a variety of as simply asking persons what they want and re- venues, including health-care centers and univer- specting their desires. 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More serious infec- tions cheap 200mcg misoprostol visa, particularly in infants and toddlers order misoprostol american express, may require medical treatment buy misoprostol 100mcg line. A healthy diet and lifestyle can help support proper immune function and reduce the risk of developing ear infections. Statistics show that three out of four children younger than three have had at least one ear infection. When this happens, the skin inside the ear becomes watery, reducing the natural acidity that ﬁghts incoming pathogens and infection may result. Swimmer’s ear usually clears up on its own, but requires a trip to the doctor if there is pain. For infants older than six months who are otherwise healthy and have mild symptoms, it is recommended to just keep an eye on your child for 72 hours. Once symptoms are detected, the ear infection is treated with a course of antibiotics to avoid complica- tions. For severe cases where a child has recurrent ear infections, surgery may be rec- ommended to place small tubes inside the ears to drain ﬂuid and relieve pressure. The concern is that hearing loss from chronic ear infections may delay language and speech development. Children are under general anaesthesia during surgery, and usually recover quickly with little pain. There are maintenance issues and minor complications that may result from ear tubes, so it is important to discuss all factors with your doctor before proceeding with surgery. Children involved in this long-term study were followed from approximately age three to age 11. Over the years, the researchers tested the children for reading, writing, spelling, behavioural issues, social skills, and intelligence, and found that there 214 was no signiﬁcant difference between the two groups. As a result of this groundbreaking study, guidelines regarding the treatment of chronic ear infections with tubes were re- evaluated and changed to encourage a watchful, waiting approach to treatment. E • Chewing gum that contains xylitol (a natural sugar found in some fruits) can help reduce the risk of ear infections. Studies have shown that xylitol interferes with the growth of some bacteria that may cause ear infections. Foods to avoid: • Dairy products may increase the risk of infection in those with sensitivities or allergies to cow’s milk. Top Recommended Supplements Echinacea: Can help to reduce the severity and duration of cold symptoms, which may help to prevent ear infections from developing, although this has not been speciﬁcally studied. Dosage: 1–2 mL (depending on age) of echinacea tincture taken three times per day or more. Echinacea should be started as soon as symptoms appear and continued until a few days after they are gone. Studies have shown that aged garlic extract can destroy the major bacteria that cause ear infections. Dosage: Adults should take two to six capsules daily; children should take one or two capsules daily. Complementary Supplements Oil of oregano: Has antibacterial and antifungal properties. Vitamin C: Helps support immune function and reduces the severity of cold symptoms. Dosage: Adults should take 1,000 mg; children should take 250–500 mg three times daily. Encourage a healthy diet, including lots of vegetables, fruits, whole grains, ﬁsh, ﬂaxseed, yogurt, and chewing gum with xylitol. Aged garlic ex- tract can help support immune function and protect against infections. Eczema affects about six million Cana- dians and is the most common skin problem in children under the age of 12. There are several forms of eczema, including: Atopic dermatitis: Atopic dermatitis is the most common form of eczema, affecting about 10 percent of all Canadians. It usually begins in infancy and varies in severity during childhood and adolescence. It is thought to be due to a combination of dry, irritable skin and a malfunction in the body’s immune system. Contact dermatitis: This is caused by exposure to an irritant or allergen, such as laundry soap, dyes, cosmetics and skin products, cleaning products, or plants (poison ivy). E Neurodermatitis: This form develops in areas where something, such as tight cloth- ing, rubs or scratches your skin and causes an irritation. Seborrheic dermatitis: Seborrheic dermatitis is a red rash with yellowish and oily scales, which is known as cradle cap when it affects infants. It may also affect adults and can be triggered by stress or other health conditions such as Parkinson’s disease. Stasis dermatitis: This may be caused by varicose veins and chronic venous insufﬁ- ciency, which cause a buildup of ﬂuid beneath the skin of the legs. This ﬂuid buildup interferes with your blood’s ability to nourish your skin and places extra pressure against the skin. While eczema can be uncomfortable to deal with, it is not contagious and can be managed well with a variety of conventional and natural methods. Symptoms vary in severity and include: • Dryness • Itching • Redness • Skin lesions (crusty, scaly patches) • Swelling In severe cases, ﬂuid-ﬁlled vesicles, ulcers, or cracks may occur. If the skin becomes red and warm to the touch, it may be infected and require immediate medical attention. Eczema ﬂare-ups can also be triggered by food additives (preservatives and E dyes) and spices. These products should not be used over the long term, as they may cause side effects such as burning, itching, blis- tering, easy bruising, and thinning of skin. Elidel (pimecrolimus) is a drug that affects the immune system and helps reduce ﬂare-ups. Pumpkin and sunﬂower seeds also con- tain zinc, which is important for skin health. Foods to avoid: • Spices, dairy, caffeine, alcohol, and chemicals present in processed and fast foods may trig- ger ﬂare-ups. Note: Since food allergies can cause eczema, consider an elimination diet (see Appendix D) to determine if dairy, wheat, or other common allergens are the source of your skin problems. Lifestyle Suggestions If you have contact dermatitis, avoid exposure to known irritants. For all forms of eczema, the following tips can help reduce ﬂare-ups: • Use only hypoallergenic skin products, soaps, and detergents and rinse well with water. Look for creams that are thick and emollient and contain one or more of the following: chamomile; vitamins A, E, and C; calendula; licorice; and lavender. Complementary Supplements Celadrin: A mixture of fatty acids that reduce inﬂammation. Probiotics: Beneﬁcial bacteria with immune-regulating properties; help improve digestion and reduce allergic reactions. Witch hazel: An astringent that helps dry up weeping eczema and reduces itching and inﬂammation.
The nurse acts to provide con- respond to contextual changes by either a homeo- ditions or resources essential to help the accommo- static or homeorhetic process order misoprostol 100mcg without a prescription. Systems have a set dation process order misoprostol 100mcg on line, may impose regulatory or control point (like a thermostat) that they try to maintain mechanisms to stimulate or reinforce certain be- by altering internal conditions to compensate for haviors 200mcg misoprostol amex, or may attempt to repair structural com- changes in external conditions. A behavioral system is embedded in an tion of ability or effort are behavioral homeostatic environment, but it is capable of operating inde- processes we use to interpret activities so they are pendently of environmental constraints through the consistent with our mental organization. Hierarchic Interaction The combination of systems theory and develop- Each behavioral system exists in a context of hier- ment identiﬁes “nursing’s unique social mission archical relationships and environmental relation- and our special realm of original responsibility in ships. Hierarchies, or a pattern of Next, we review the model as a behavioral system relying on particular subsystems, lead to a degree of within an environment. A disruption or failure will not destroy the Person whole system but leads instead to a decomposition to the next level of stability. Johnson conceptualized a nursing client as a behav- The judgment that a discontinuity has occurred ioral system. The behavioral system is orderly, is typically based on a lack of correlation between repetitive, and organized with interrelated and in- assessments at two points of time. For example, terdependent biological and behavioral subsys- one’s lifestyle prior to surgery is not a good ﬁt post- tems. These discontinuities can provide op- subsystems that interrelate to form the behavioral portunities for reorganization and development. Dialectical Contradiction The client is seen as a collection of behav- ioral subsystems that interrelate to form The last core principle is the motivational force for the behavioral system. Johnson (1980) described these as drives and noted that these responses are devel- oped and modiﬁed over time through maturation, system. A person’s activities in the plex, overt actions or responses to a variety of stim- environment lead to knowledge and development. Behavioral system balance is restored and a new level of development The parts of the behavioral system are called sub- is attained. They carry out specialized tasks or func- Johnson’s model is unique, in part, because it tions needed to maintain the integrity of the whole takes from both general systems and developmental behavioral system and manage its relationship to theories. She did not consider the seven subsys- in this author’s operationalization of the model, as tems as complete, because “the ultimate group of in Grubbs (1980), I have included eight subsystems. Johnson noted new subsystems or indicated changes in the struc- that these subsystems are found cross-culturally ture, functions, or behavioral groupings in the orig- and across a broad range of the phylogenetic scale. Each subsystem has functions that serve to meet structural components that interact in a speciﬁc the conceptual goal. These parts are goal, set, choice, and ac- activities carried out to meet these goals. The goal of a subsystem is deﬁned as the de- haviors may vary with each individual, depending sired result or consequence of the behavior. The on the person’s age, sex, motives, cultural values, basis for the goal is a universal drive whose exist- social norms, and self-concepts. In subsystem goals to be accomplished, behavioral general, the drive of each subsystem is the same for system structural components must meet func- all people, but there are variations among individ- tional requirements of the behavioral system. With drives as the impetus for the behav- tained, it must be protected, nurtured, and stimu- ior, goals can be identiﬁed and are considered uni- lated: It requires protection from noxious stimuli versal. The behavioral set tain behavior; and stimulation, which contributes represents a relatively stable and habitual behav- to continued growth of the behavior and counter- ioral pattern of responses to particular drives or acts stagnation. It is learned behavior and is inﬂuenced by functional requirements threatens the behavioral knowledge, attitudes, and beliefs. Set contains two system as a whole, or the effective functioning of components: perseveration and preparation. The preparatory Johnson referred to the internal and external envi- set functions to establish priorities for attending or ronment of the system. She also noted that there are forces in dering that serves as the mediating link between the environment that impinge on the person and to stimuli from the preparatory and perseveratory which the person adjusts. Here attitudes, beliefs, information, and consists of all elements that are not a part of the knowledge are examined before a choice is made. Choice refers to the vided no other speciﬁc deﬁnition of the environ- individual’s repertoire of alternative behaviors in a ment, nor did she identify what she considered situation that will best meet the goal and attain the internal versus external environment. The larger the behavioral reper- can be inferred from her writings, and system the- toire of alternative behaviors in a situation, the ory also provides additional insights into the envi- more adaptable is the individual. The concern is with objects, and phenomena that can potentially per- the efﬁciency and effectiveness of the behavior in meate the boundary of the behavioral system. Actions are any observable re- external stimulus forms an organized or mean- sponses to stimuli. The behavioral system attempts to main- tain stability, each must have a constant supply of tain equilibrium in response to environmental functional requirements (sustenal imperatives). Areas of external conﬁned to conditions of the system’s survival, and environment of interest to nurses include the it includes biological as well as psychosocial needs. It also suggests noted that “[i]llness or other sudden internal or ex- a classiﬁcation of the various states or processes on ternal environmental change is most frequently re- the basis of some principle and perhaps the estab- sponsible for system malfunction” (Johnson, 1980, lishment of a hierarchy among them. Johnson also referred to physical and social variables that inﬂuence set, choice, and action. For ex- as the inference about illness may be made, it may ample, a nurse attempting to respond to the needs be inferred that wellness is behavioral system bal- of an acutely ill hospitalized six-year-old would ance and stability, as well as efﬁcient and effective need to know something about the developmental behavioral functioning. Nursing is viewed as “a service that is complemen- tary to that of medicine and other health profes- Health sions, but which makes its own distinctive Johnson viewed health as efﬁcient and effective contribution to the health and well-being of functioning of the system and as behavioral system balance and stability. Behavioral system balance Nursing is viewed as “a service that is and stability are demonstrated by observed behav- complementary to that of medicine and ior that is purposeful, orderly, and predictable. Behavior changes when efﬁciency and effective- ness are no longer evident or when a more optimal people. Individuals are ing from medicine by noting that nursing views the said to achieve efﬁcient and effective behavioral patient as a behavioral system, and medicine views functioning when their behavior is commensurate the patient as a biological system. In her view, the with social demands, when they are able to modify speciﬁc goal of nursing action is “to restore, main- their behavior in ways that support biologic imper- tain, or attain behavioral system balance and stabil- atives, when they are able to beneﬁt to the fullest ity at the highest possible level for the individual” extent during illness from the physician’s knowl- (Johnson, 1980, p. This goal may be expanded edge and skill, and when their behavior does not re- to include helping the person achieve an optimal veal unnecessary trauma as a consequence of illness level of balance and functioning when this is possi- (Johnson 1980, p. Behavior system imbalance and instability are The goal of the system’s action is behavioral sys- not described explicitly but can be inferred from tem balance. For the nurse, the area of concern is a the following statement to be a malfunction of the behavioral system threatened by the loss of order behavioral system: and predictability through illness or the threat of illness. The goal of nurses’ action is to maintain or The subsystems and the system as a whole tend to be restore the individual’s behavioral system balance self-maintaining and self-perpetuating so long as con- ditions in the internal and external environment of and stability or to help the individual achieve a the system remain orderly and predictable, the condi- more optimal level of balance and functioning. She also identiﬁed are not met, malfunction becomes apparent in behav- questions to be asked when analyzing system func- ior that is in part disorganized, erratic, and dysfunc- tioning, and she provided diagnostic classiﬁcations tional. Illness or other sudden internal or external to delineate disturbances and guidelines for inter- environmental change is most frequently responsible ventions.
Most obsessions are focused on a single idea order misoprostol 100mcg free shipping, so you may not have a Staircase of Fear to climb buy misoprostol amex. However discount generic misoprostol uk, you can still utilize exposure to help you deal with many different obses- sions. Rank how upsetting the thought or image is to you on a scale of 0 (no upset) to 100. Repeat the thought or image over and over and over and over and over and over and over and over and over and over and over (oops, we’re getting a tad compulsive here aren’t we? Continue repeating the thought or image for 20 to 30 minutes or as long as it takes to reduce your level of upset (in Step 2) by at least 10 to 20 points. Re-rate your thought or image on the same scale (0 [no upset] to 100 [totally disturbing]). They often try to immediately expunge obsessive thoughts and images from their minds when they occur. The problem with that approach is that attempting to suppress thoughts only makes them surface more frequently. Chapter 9: Facing Feelings: Avoiding Avoidance 147 Treating compulsions Treating compulsions, like the treatment of other anxieties and fears, involves exposure as the ﬁrst step. You gather materials for a Staircase of Fear, arrange your materials into an actual staircase, and start your climb. The only difference in the treatment of compulsions is that you have to do one extra thing: Not only do you expose yourself to the problematic activities or items, but you also must stop yourself from engaging in the compulsive behav- ior. The following example shows you how this treatment procedure works for a particular compulsion. However, the compulsion is ruining her life by unnec- essarily taking up huge amounts of time. In Worksheet 9-16, you see the partial results of her Climb to the Top Exercise, her repeated exposures to problematic events and activities while not washing her hands. In fact, Gina makes a con- certed effort not to wash for at least an hour after the exposure. Worksheet 9-16 Gina’s Climb to the Top Exercise Activity (Exposure without the Anxiety Ratings: 0 (no fear) to 100 (terriﬁed) compulsion) Handling garments at a 30, 20, 15, 10: This was sort of gross at ﬁrst clothing store because I kept thinking about all the other people who touched them before me. Handling money with my bare 35, 30, 40, 25, 25, 30, 20, 15: This was tough hands because I usually wear gloves to handle money. Touching doorknobs with my 55, 55, 60, 60, 50, 40, 30, 30, 35, 25, 25: bare hands I hated doing this. I know I have to keep practicing this one, but I’m ready for the next step, I think. Touching the handrails on the 75, 75, 80, 60, 60, 55, 55, 45, 35, 35, 35: escalator and keeping them Whew, that was hard! Gardening without gloves 80, 80, 75, 70, 60, 55, 45, 55, 45, 35, 35, 35: Wow, it wasn’t easy to not wash those disgusting hands. You may use different soap, arrange things a little differently, or make a slight change in your routine. Worksheet 9-17 My Reﬂections Chapter 10 Lif ting Mood T hrough Exercise In This Chapter Figuring out how much physical activity you need Giving yourself reasons to exercise Coming up with an exercise strategy Finding motivation to stick with the program hy devote a whole chapter to exercise in a book that deals with anxiety and depres- Wsion? Well, because getting up and moving increases the naturally occurring feel-good endorphins in the human body. When endorphins, substances occurring naturally in the brain that are chemically similar to morphine, spread through your brain, you get a sense of well-being and pleasure. In this chapter, we tell you how much exercise you need to get those endorphins going, and we tell you about all the known beneﬁts of exercise. You pick your top ten reasons for begin- ning or sticking with an exercise program and then ﬁgure out an exercise plan that ﬁts your lifestyle. We also offer some tips for ﬁnding the motivation to keep exercise going in your life. The best time to get into an exercise habit is when you’re young because exercise helps to keep you healthy throughout your life. However, it’s never too late to start — even 90-year- olds beneﬁt from regular exercise! However, for men over 40, women over 50, and anyone with a chronic disease or other health concerns, it’s best to check with a physician before beginning a vigorous exercise regimen. Every ﬁve years, the United States government updates its guidelines for nutrition and exer- cise. The 2005 recommendations signiﬁcantly increased the recommended amount of time for healthy people to engage in vigorous physical activity. Here they are: Children should be physically active about an hour a day on most days. Adolescents should engage in at least 60 minutes of exercise every day, most days of the week. If you want to lose weight, you should exercise between 60 and 90 minutes on most days. Fitness consists of the following: Cardiorespiratory endurance: Your body’s ability to pump blood and circulate oxygen, which is improved by elevating your heart rate safely for increasing periods of time. Body composition: Your body’s ratio of fat and lean mass, which is improved by all types of exercise. Flexibility: Your body’s ability to move ﬂuidly and with good range, which is improved by stretching or activities such as swimming. Muscular strength: Your body’s ability to lift and push, which is improved largely through weight training. Muscular endurance: Your body’s ability to sustain effort without getting tired, which is also improved by all kinds of exercise. However, we believe that exercise has so many beneﬁts that everyone physically capable of moving around would feel better if they just did it. So this section covers the many good things that can happen — as well as the bad things that can be prevented — when you exer- cise. You may ﬁnd a few of these items surprising, but they’re all 100 percent true and well documented. You didn’t think you’d get away with just reading a list of reasons for exercise, did you? Follow the instructions here in order to identify the ten reasons you should be exercising. Some items may be relevant to just about everyone; others may be particularly important to you. For example, if you have a family history of dia- betes or colon cancer, those items may be especially important and make it on your top ten list. When you ﬁnish checking off the items that pertain to you, spend a few moments deciding which ones are the most important and relevant to you. Fitting Exercise into Your Life You may have some pretty good reasons for exercising now, but wow, 30 to 90 minutes — where will you ﬁnd the time? The government guide- lines state that it’s just as useful to do your exercise in 10- or 15-minute segments. And it may help you to know that exercise con- sists of just about any type of activity that occurs at a moderate level of intensity.