It’s October, which means it’s that time of the year again: flu vaccination time! Back when I worked in a primary care clinic, this is when we made a big push to offer the seasonal flu shot to all of our patients. (And we got ourselves immunized, as well.) Not all of our patients agreed. Many older adults are skeptical of the need to get a yearly vaccination against influenza. They aren’t sure it will help. Or they think that the vaccination will actually give them a mild case of the flu. Or they just don’t like needles. Or maybe they aren’t sure which type of seasonal flu shot to get: the regular one or one of the newer “stronger” versions, designed for older adults? I’m never surprised when people bring up these questions. Vaccination for seasonal influenza can indeed be a confusing topic. But it’s certainly important to consider. Depending on the year, the Centers for Disease Control (CDC) estimates that every year, influenza affects 9-60 million Americans, causes 140,000-710,100 hospitalizations, and results in 12,000-56,000 deaths. (Influenza is more severe in some years than others.) Most people get better without needing hospitalization, but some people get very sick. Older adults are especially likely to get dangerously ill from catching the flu. So I agree with the CDC’s recommendation: everyone over the age of 6 months should get their seasonal flu shot. In fact, I’m about to go get mine. As a healthy woman in her 40s, I’m not that concerned about getting dangerously ill from influenza. Instead, I get my annual flu shot because I want to minimize my chance of getting sick and perhaps exposing my older patients to influenza. This month, you’ll probably be encouraged to get vaccinated too. So in this article, I’ll address some key things to know about influenza and the flu shot, along with some common questions and concerns. Here’s what I’ll cover: * The basics of influenza and vaccination against the flu * What to know about flu shots for older adults * What’s new and resources for the 2017-2018 flu... According to the above context, choose the correct option to answer the following question. Question: How long did it probably take the author to get her flu shot? Options: - a month - all of October - not enough information - a few minutes
a few minutes


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Zoos are not my favorite places. I always wish the animals could be free. I can’t think of anything “funny” I have seen at the zoo exactly although there has to be something…. we used to go to Catskill Game Farm and Bronx Zoo in NY so I am sure there has to have been something notable, if not funny…. At Catskill Game Farm there were Peacocks that walked around free and made startling noises. There were also punk flamingoes there that were amazing to see. Maybe the funniest (not so funny though) thing was in the area where you could feed deer and baby pigs so sometimes they’d all come around at once and mob you? My daughter wanted to feed who she wanted to feed but the deer and the pigs had their own ideas. The deer liked these crackers kind of like rye crisps and the baby pigs went for the bottles of milk or formula. When my daughter tried to pick and choose and just feed one suddenly she would be surrounded by many. I think my husband must have videos of what transpired. One of these days it might be entertaining to view them again. At the Bronx Zoo I remember going one or more years during the winter to see the animal light sculptures and huge block ice carving and the penguins and polar bears maybe? I can’t remember anything funny happening. When we went out to San Diego around years ago during a business trip my husband got to go on then my daughter and I went with him. I took my daughter to the Zoo and Sea World but she was so young then and it was so long ago I can’t recall much except standing on line to see the pandas and just collapsing on a open type tour after trying to carry her and a collapsible stroller and diaper bag all around. She was so young but seemed to enjoy jumping on some bouncy trampoline type thing at the Sea World. My husband might remember the funny things better than I do. According to the above context, choose the correct option to answer the following question. Question: What does the author do for a living? Options: - not enough information - She works at a bank - She is a computer programmer - She is unemployed
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not enough information


Question: 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... According to the above context, choose the correct option to answer the following question. Question: What are some side effects of constipation in the elderly? Options: - nausea, increased heart rate - decreased irritability and bleeding - pain, irritability, bleeding - not enough information
Answer:
pain, irritability, bleeding