Health Belief Model Essay

The health belief model is a useful tool in health education as it assesses the patient’s perception of the disease process on their lives and their readiness to make changes in their lives based on those perceptions. A patient who is s/p MI must make dietary and activity level adjustments to their lives and can make the patient feel overwhelmed at the mountain of lifestyle changes heading their way (Eldeman & Mandle, 2010). Using the health belief model, the nurse can assess the current dietary and activity habits of the patient, their perception of the severity of the condition requiring lifestyle changes, and together with the patient, formulate a plan consisting of multiple small changes that yield healthy results, while encouraging the patient to see the benefits of altering their lifestyle. Patients are more likely to make necessary changes when they perceive the outcomes as personally beneficial, and making several, small changes, such as using fresh green beans instead of canned to decrease the sodium intake, helps the patient to feel more in control and gives them confidence by decreasing the overwhelming feelings that large changes can invoke. An appropriate nursing diagnosis for this patient would be: Anxiety related to changes in environment and routines and as evidenced by expressions of inadequacy in make necessary changes (Gulanick, 2007). Appropriate interventions would be : Assess the patient’s readiness to learn, current lifestyle habits, knowledge of health condition, and desired learning mode (i.e. visual, auditory, kinesthetic). Allow the patient to express fears and concerns regarding the lifestyle changes. Develop, with the patient, a strategy for making lifestyle changes building on small short term goals, such as cooking techniques, dietary substitutions to currently enjoyed foods, simple exercise techniques easily incorporated into lifestyle. Provide resource material and/or support groups for patient to utilize once at home. Outcomes for assessing behavior changes: Patient accurately describes health condition and necessary lifestyle changes. Patient accurately describes techniques for implementing lifestyle changes. Patient expresses confidence in making required lifestyle changes. References Edelman, Mandle, C. (2010). Health Promotion Throughout the Life Span (7th ed). Mosby. Retrieved from http://pageburstls.elsevier.com/books/9780323056625/id/B9780323056625000103_p0935 Gulanick, M. (2007). Nursing Care Plans: Nursing Diagnosis and Intervention (6th ed). C.V. Mosby. Retrieved from http://pageburstls.elsevier.com/books/0-323-03954-5/2/10

Human Nature in Shakespear’s Plays Essay

Topic- in Shakespeare’s plays how is his unusual detailed knowledge of nature as well as of human beings shown? Shakespeare was a man who deeply loved nature and the beauty of it. He was not just an author who experienced and enjoyed nature but also as someone who studied, understood and knew nature intimately. In this essay there will be discussions about how Shakespeare would often use examples from nature to describe the nature of human beings in his plays and how did he show a deep understanding and knowledge of human nature which he would put that deep knowledge in his plays and poems. Shakespeare’s greatest influences were the works of other great writers as well as from variety of books, and plays which he used as subject materials for his own plays. He got most of his ideas from existing written literature. All of his plays were based on British history, adjusted to suit the occasion. He also drew ideas from many things that he grew up with, like his love for nature gave him several ideas how to write some of his plays and poetry. Besides this, he got many ideas from his childhood as his father is known to have often told him ‘bedtime stories’. Shakespeare may have got inspirations from nature and some ideas of characterizations from real life experiences but his plots where never made from events that happened in his life. Two of his favorite writers were Geoffery Chaucer (1340- 1400) and Plutarch (46-120). Chaucer, who was the first poet ever to be buried at the â€Å"poet’s corner† in Westminster Abby was from a wealthy family where his father was as a deputy to King Edward the third’s butler. Chaucer’s poetry was in Middle English and he was known to be one of the finest poets in England. Shakespeare admired him and many of the sources of his plays came from Chaucer’s poems. Plutarch studied philosophy and he taught it as a teacher in Rome where he earned the admiration of the emperors Trajan and Hadrian. Plutarch’s work was translated by Sir Thomas North which had become very popular in Renaissance England. His translations were then used by Shakespeare himself as sources for many of his plays like Cleopatra, Julius Caesar, Coriolanus, Timon of Athens, etc. The way Shakespeare examined and admired nature was quite different from regular viewers. His way of seeing nature was deep and he would use it in many other forms as well. He would usually find ideas for his poems by what he saw and nature was the biggest part that inspired him how to write his poems and plays. For example in one of his plays named King Lear, the concept of nature is considered to be the groundwork of the whole play. From Kingship through to personal human relations, to the views of the empire, from the representation of human nature to the animal imagery, there was nature filling every line of King Lear. Nature is a socially constructed concept which is made in order to legitimize the existing social order. By drawing a brief sketch of the political and social beliefs of the Elizabethan and Jacobean ages, it will be at the same time outlining the arguments for believing that nature truly is the socially constructed concept. The Elizabethan and Jacobean age was a time of change and disorder. They were not known for their unity. Elizabeth had her subjects worry about who would succeed her as she was not married, therefore there was no heir to carry on with the throne. ‘Kings are justly called Gods for that they exercise a manner or resemblance of divine power on the earth. ’ This quote was taken from the speech of James I where he describes the divine rights of Kings. James I had succeeded Elizabeth I to be the first Stuart King. Although he had the Kingship, he still was not able to overcome the political and financial problems of the state. In order for the continuation of his reign, the unity and harmony of the state and nature was of great importance. He legitimized his power by naturalization. Therefore by ‘nature’ everyone has its place, and knows the duties and obligations to that place, and those who have power cannot be questioned which are the divine rights of Kings. The belief in the social order restricting from the natural order is an important concept to hold when probing the idea of nature being utilized to maintain the status quo. The interdependence of man and nature as a theme is explored in King Lear. Men are always represented in the relation to the divine hierarchy which is the physical world and the world of animals but they are never represented in isolation. It becomes easier to understand the actions of Lear with the almost constant references to nature, once the concept of correspondence between man’s nature and the natural world is understood in terms of legitimizing the social order. In King Lear, the tragedy shown in the play is when Lear tries attempting to overthrow the ‘natural’ social order by handing over his crown to his daughters. Once disorder is initiated by Lear’s revocation of his powers and rights as King, disaster in corresponding hierarchies follow. Lear’s abandonment of his power is in direct opposition to the concept of the Divine Right of Kings. According to the laws of nature, it was impossible for Lear to stop being a king, because that was his rightful position by divine ordination and in fact throughout the play he is still referred to as the King, even though he has divided his crown. Also Lear is unable to stop seeing himself as the King, which can be seen from his banishment of Kent, soon after he has relinquished his powers: Hear me, recreant, on thine allegiance, hear me: That thou hast sought to make us break our vows, Which we durst never yet, and with strained pride To come betwixt our sentence and our power, Which nor our nature, nor our place can bear, Our potency made good take thy reward. King Lear (1. 1. 169-173) In this speech Lear not only uses the power of the King which he no longer holds to banish Kent, but he also, unknown to himself, explains why he cannot or should not divide his kingdom, for it goes against both his ‘nature’ and his ‘place’ to divide his ‘power’ from his ‘sentence,’ which is exactly what he does, thereby attempting to deny his nature and position. Aside from the natural position of Kings the natural social order can also be seen in terms of power relations between characters: King over subjects, fathers over daughters, husbands over wives. This naturalization can be seen as being represented by the character of Lear. He possesses his daughters, because he controls over them, therefore it is only ‘natural’ that they should proclaim their love for him. Cordelia’s refuses this which is therefore shocking to Lear and he calls her ‘a wretch whom nature is ashamed’. (1. 1. 213-214) The animal imagery that is shown in King Lear indicates the unnaturalness of a character‘s behavior in comparison to how they should behave if they observed the natural social order. This contradiction again underlines the distinction between nature and the ‘natural social order’. Shakespeare was good in phycology and describing the human character. He did not state many new ideas of human nature in his place as much as he did on the personalities and behaviors that all human beings have. There still are experts that claim that Shakespeare was the ‘inventor of human nature. However, these were Shakespearean experts and not the experts in psychology or human personality. It was not that Shakespeare new more things around him than other people but it was how he saw and examined things and people around him. In many of his plays and poems he showed deep knowledge of human nature. The way in which we experience fear, love, hatred, jealousy, despair, or anything else one can name. The way he wrote it and staged it would leave many artists in the dust and that the meaning of his work would stay with readers and viewers while everything around them changed. Shakespeare managed to grasp what it took to shape the essence of human nature in many of its aspects and drop it into text and drama in a way that would draw our ears, our eyes and our hearts. Unlike psychology, Shakespeare tries attempting to understand why people do what they do. He simply outshone most others, in many times and many places, at drawing portraits of the mystery of human behavior. Shakespeare used to combine nature and human nature together in many of his plays and poems. He used to describe human behavior by relating them with nature. In one of his plays known as Troilus and Cressida, he quotes the following: Let not virtue seek Remuneration for the thing it was; For beauty, wit, High birth, vigor of bone, desert in service, Love, friendship, charity are subjects all To envious and calumniating time One touch of nature makes the whole world kin, That all with one consent praise new-born gawds, Though they are made and moulded of things past, And give to dust that is a little gilt More laud than gilt o’erdusted. (3. 3. 169–179) This quote was spoken by the character known as Ulysses where he says this to the great Greek warrior Achilles who did not participate in the Trojan War because he contained a broken pride and was in love with a Trojan. He did not understand why he was not liked by the other Greeks and Ulysses tried to get Achilles mind back into action by giving him an uncomplimentary lecture on human nature. In the seventh line of Ulysses’ quote, he speaks about the ‘touch of nature’ which means ‘natural traits’. These are vital characteristics that make us all in this world kin. The phrases nowadays used for our ‘touch of nature’ as warmth or generosity or any other romantic ideal is different from how Ulysses describes it. He sees unanimity in our gaudy originalities as our ‘touch of nature’ is a short memory. The past deeds of Achilles, like beauty, wit, love, and so on, are subject to the ravages of time. In other words, it is our nature to forget these types of faded glories because they do not seem important anymore as there are bigger things that should be remembered instead of wasting it on these small glories that will be slowly forgotten in the future. Shakespeare’s unusual yet deep ways of describing human nature through his characters in his plays were unique. From the way he wrote his plays and poems, it would almost feel like to the reader and viewer that he lived in another type of world and that he saw everything around him very differently from normal people. He was very good in describing what he felt through what he saw as well. In one of his well-known plays called Hamlet, one of Hamlet’s quotes he says as following: What a piece of work is a man, how noble in reason, how infinite in faculties, in form and moving how express and admirable, in action how like an angel, in apprehension how like a god! The beauty of the world, the paragon of animals—and yet, to me, what is this quintessence of dust? Man delights not me— nor woman neither, though by your smiling you seem to say so. (2. 2. 303–312). This passage exemplifies how Hamlet says that man is like an angel or god in apprehension. The ‘quintessence of dust’ states that from all God’s work, Man is one of the noblest. Despite all this nobility, Hamlet is not delighted by all this grace or beauty of man. This is one of the moments where his sincerity is genuinely in question as he explains this to two of the king’s followers or ‘parasites’ as he seems them as, Rosencrantz and Guildenstern. He feels like there is nothing in Denmark for him and that it feels like a prison to him where he is stuck in following his uncle’s orders and wished that there was another choice for him to follow instead. Even though Man is described as the beauty of God’s works, from what he sees man as in his life gives him another image of human nature.

Preparation and Reactivity of Sn1 2-Bromobutane

Preparation and SN1 Reactivity of 2-Bromobutane Paul DeJong Department of Chemistry, Illinois State University, Normal, IL 61790-4160 Submitted: April 4, 2013 Introduction The purpose of part 1 of the lab is to prepare 2-Bromobutane using SN1 reactions. The purpose of part 2 of the lab is to determine the relative reactivity of alkyl halides under SN1 conditions. Results and Discussion The Overall Reaction The Proposed Mechanism Experimental Procedure To prepare 2-bromobutane in part one of the lab, you have to set up a flask apparatus with a thermowell and a Claisen adapter.Attached to the Claisen adapter is a thermometer measuring the temperature in the flask and a vertical condenser for reflux. Add in the reactants to the flask, sulfuric acid, 2-butanol, and ammonium bromide. Heat to 95OC and then maintain temperature for 30 minutes. Then, water was added and simple distillation began. The aqueous layer of the distillate was removed leaving the product, 2-bromobutane. For part 2, two drops of each of the following were placed in 3 different test tubes: 2-bromobutane, 1-bromoutane and 2-bromo-2-methylpropane.In each of the tubes an even amount of silver nitrate is added. Observations of the reactions precipitate are recorded. Same process is done with 2-chlorobutane, 2-iodobutane, and 2-bromobutane. Experimental Stoichiometry Compound| Molecularweight| Quantity| Moles| 2-butanol| 74. 12 g| 7. 4 mL (6. 0 g)| 0. 081| Sulfuric acid| 98. 08 g| 20 mL (12M)| 0. 24| Ammonium bromide| 97. 94 g| 8. 0 g| 0. 082| The limiting reactant is 2-butanol. Yield Data 2-bromobutane| | Molecular Weight| 137. 02 g|Theoretical Yield (moles)| 0. 081 mol| Theoretical Yield (grams)| 11. 10 g| Actual Yield| 10. 11 g| NMR Table Signal| Chemical Shift| Multiplicity| Integration| A| 4. 11| Multiplet| 1H| B| 1. 85| Pentet| 2H| C| 1. 60| Doublet| 3H| D| 1. 08| Triplet| 3H| Reactivity of Alkyl Halides Compound| Observations at Room Temp| Observations upon Heating| 1-bromobutane| Clear| Very little change but some white ppt| 2-bromobutane| Clear| Moderately cloudy white ppt| 2-bromo-2-methylpropane| Brown tint| Very milky white ppt|Compound| Observations at Room temp| Observations upon heating| 2-chlorobutane| Clear| No ppt at all| 2-bromobutane| Clear| Moderately white and some yellow ppt| 2-iodobutane| Dark brown| Thick, milky white and yellow ppt| Conclusion Overall, the first part of the lab produced 2-bromobutane using SN1 reactions. This product was then used in the second part of the experiment to determine the relative reactivities of alkyl halides. Reactivity increases as follows 1O < 2O < 3O and Cl- < Br- < I –

Classical Criminology vs. Biological Determinism Essay

Classical Criminology vs. Biological Determinism - Essay Example Human beings in his theory are believed to be hedonistic, acting in terms of their own self-interest, they are rational and are capable to consider the course of action that is really in their self-interest. In 'On Crimes and Punishments', Beccaria stays that in just society punishments ought to be proportional to the degree of crime, they ought to bring to mind the crime in the mind of observes, to strengthen the connection in the people's mind between the crime and the punishment. [Beccaria, p. 13-15] Beccaria's Classical Criminology claims that people by their nature are 'selfish and pursue their self-interest; they want to avoid pain and increase their happiness' [Ellis, L. & Walsh, A., p. 17-18] Also they are 'rational, capable of calculating what is really in their self-interest, and therefore can be considered to be free' [Beccaria, p.7-8] Biological determinism, appeared in the 1920s, stays that 'biological factors such as an organism's individual genes completely determine how a system behaves or changes over time'. [Gibson, M., p.34] Considering certain human behavior, for example, committing murder, biological determinism look only at 'innate factors, such as genetic makeup', ignoring non-innate factors, such as social customs and expectations, education, and physical environment. As for the human nature, Lombroso thinks that 'all human behavior is innate and cannot be changed or altered'. The theory of biological determinism claims that 'humans - their appearance, behavior, and even long-term fate - are entirely determined by genes' [Ellis, L. & Walsh, A., p.36]. Biological determinists deny that effects of environmental variables on a gene, and a single mutation can have far-reaching effects on the phenotype. Lombroso also states that everything in a person innate. According to his theory, the criminals cannot be reformed - they were 'born that way', that suggest a kind of defense for the criminal. [Lombroso, C., p.17] Moreover, biological determinism divorces human action from human responsibility, where the blame for actions is placed on the genes exclusively; it also negates the idea of free will entirely, because all behavior is said to be controlled by the genes. Based on the theory of the social contact, Beccaria suggests that 'if people lived without government, their interests would conflict and their lives be that of perpetual war. There would be no secure and hence little happiness'. [Beccaria, C., p.117-119] So that, he continues to think that 'therefore, people agree to give up some of their freedom for the sake of their overall security and happiness' - they make promises not to do some activities, but do others. These promises he calls 'laws', and stays that 'laws are the terms under which independent and isolated men come together in society, in order to enjoy what remains in security and calm' [Beccaria, C., p.39]. Beccaria says that people's behavior need to be controlled by the government with the help of laws, while biological determinism assume that human behavior is governed by the genes, and 'the environment here is not at all important in the determination of appearance, behavior, and functionality'. [Ellis, L. & Walsh, A., p. 76] As for the government, Classical Criminology (Caesar Beccaria, in particular) perceives it as the 'sum' of the individual promises - so that, people have created the government in order to defend their mutual promises by laws and

Everyday Use by Alice Walker Essay Example | Topics and Well Written Essays - 1000 words

Everyday Use by Alice Walker - Essay Example However, her hopes are dashed when Dee returns with different world views and opinions about her heritage. Walker develops the theme of the meaning of heritage through the plot when Dee constructs a new heritage for herself after being angered by the oppression she feels exists in her family. Dee’s character is seen to have rejected her family legacy by giving herself a new name which she believes truthfully represents her African heritage. Dee’s renaming is the author’s way of trying to connect the past and indicates the flexible nature of identity. Walker does not mention Mama’s real name nor does he explain the foundation of Maggie’s name and this is meant to depict their unchanging and strong ties to their heritage and family legacy. The lack of name changing by the two characters shows that their identities are stable. Dee’s name changing reflects on her lack of belief in her true heritage as she believes that her name represents the fam ily oppressors, and views it as racist. Walker uses Dee’s character to portray the many confusing ideas that many African Americans have about their true heritage. Dee is seen not to truly understand the meaning of being African and all her actions to look African are viewed as meaningless. She differs greatly from her sister Maggie when she arrives from college and wants to possess some family quilt heirlooms. Dee does not seem to see the quilts as useful and would prefer to use them as artifacts to be used as decorations to represent a time that is long lost and from the past. Mama and Dee, however, view the quilts as very important in the family and believe that the quilts represent the presence of those that made and used the quilts. They see the quilts to be true tokens of their family origin and heritage as opposed to foreign and impersonal objects. The conflict between the three women intensifies when Mama chooses Maggie to be the one to own the quilts, as she believes that she will treat them with respect by using them in the way they were intended to be used. The theme of the diverse power of education is developed by the author through the depiction of how Dee’s achievement of higher education proves to be more divisive to the family’s relationship. Dee’s character is used by the author to show how education can change one’s view of heritage and culture. The education that Dee has received has alienated her from her family and she views her family home to be strange. Family values have been replaced by arrogant ideals and a loss of identity and heritage that only family can provide. Walker uses Dee’s character to show how education can influence an individual’s view of the life that they live. Dee’s education has caused her to have a different view on heritage and family legacy therefore causing her to disrespect anything but her own view. Walker uses the characters to depict how education, or t he lack of, is harmful. Due to her ignorance and lack of education, Maggie is seen to have hampered her achievement of self fulfillment. She is portrayed as one who has accepted the circumstances of her protected life and one who does what they are told. Walker uses the yard as a symbol to represent an area devoid of the short comings and regrets that fill Mama’s life. The yard appears in the beginning of the narrative as it is being thoroughly prepared for Dee’s arrival form college. The yard is used as a symbol that represents freedom and the lack of

Technology for patient safety Essay Example | Topics and Well Written Essays - 750 words

Technology for patient safety - Essay Example fication of the patient, wrong drug prescription, infectious contact with staff, or a prescription that has a reactive quality with another drug already being administered, etc. Over the past few years the need to establish and regulate an effective safeguarding system for both; the patients and the staff, from the day to day errors was felt as a result of which newer technologies for patient safety were formed. This literature aims to address patient safety technologies. All the patient safety technologies and systems developed are first tested and verified to be compatible with certain standards of the Joint Commission or other respective certification organizations. For the effective functioning of the technologies and ensuring their working state; a health care facility must fulfill the standards provided by the certification authority which address issues like medication use, infection control, surgery and anesthesia, transfusions, restraint and seclusion, staffing and staff competence, fire safety, medical equipment, emergency management, and security. The process mentioned isn’t that simple so as to directly implement a certain technology. It is first tested in a health care facility and is first proven to be compatible not only with the health care environment but also with the patients and the other general community. These technologies also focus on detailed data provision to the doctors which is quite important since the doctor must be informed about the patient and his/her condition along with the patient being informed about the health care environment. Polls are taken amongst the patients to take into consideration their views and comfort to implement a certain Patient Safety Technology. For instance; results from a study at a quality of care unit in Geneva University Hospitals, Switzerland, found that more than â€Å"90% of patients said they would agree to wear an ID bracelet†. With the accreditation of a health care institute comes the

Managerial Economics Essay Example | Topics and Well Written Essays - 1750 words

Managerial Economics - Essay Example ple in 1977 approximate 48 computers were exported by computer manufacturing firms into various destination, while in 2001, one hundred and twenty five million computers were shipped. In the year 2002, the computer usage increased by a figure of five hindered million (Cetnews, 2002). According to data report on Bloomberg by Ricadela, 2013, the shipment of computers decline globally by 14 percent. However, this trend has changed over the recent times. Research data indicates that approximate one billion personal computers were shipped globally between 2001 and 2002. Whereby, out of those computer70 percent were meant to be utilized in business while twenty five percent were to be used in homes for personal use. Additionally, out of all those computers shipped between these periods, approximate 82 percent were desk top while sixteen percent were laptops (Cetnews, 2002). The table below indicates the year and the computer the numbers of computer shipment. Year Numbers of Personal comput er shipments 1977 48000 2000 125,000,000 2002 500,000,000 Source: (Cetnews, 2002) It can be scrutinized that computers shipment has been increasing as types elapse. This is because computer manufactures have came up with creative and innovative techniques of manufacturing different brands of computer that not only meat market demand but also meat the needs of different users ranging from personal use, business use, corporate uses among other applications (Displaysearch,2008). The table below displays various percentages of computer brands shipped into various destinations. Source: Jeremy Reimer, 2009 Computer Brands % of Computer shipment Dell 2.8% HP 5.8% Kohjinsha 1% Acer 38.3% Medion 3% Asus 30.3% Intel 1% MSI 5.7% Lenovo 0.7% Toshiba 0.5% Source: (Displaysearch, 2008) Therefore,...Managerial economics provides managers with efficient tool understand and techniques for making managerial decisions. The interaction of consumers and producers can be easily understood via managerial economics berceuse it integrate the aspects of micro and macro economics when making analysis of factors that causes changes in demand and supply of commodities. Therefore, it can be scrutinized that numerous factors contributed to an increase in demand for computer in a free market. Whereby, a free market involves a market that is free from government intervention. Commodity prices in this market are determined by market forces (demand and supply). A decrease in computer prices led to a decrease in demand because more suppliers are willing to supply computers at higher prices in order to make higher returns. Additionally, computer prices were falling despite higher returns because of some factors affecting demand such as availability of substitutes, increase in number of computer suppliers to mention just but a few. However, this may not always be the case because some shift factors may have an impacted on demand and supply of computers. Additionally, graphs and data have been utilized to analyze the reason why computers prices remained low despite having a higher demand. Some shift factors were found to cause computer prices to fall despite having a higher demand. Among the factors include; technological changes, availability of substitutes, decline in cost of manufacturing computers.

Not everyone needs a College Education to be Financially Successful in Essay

Not everyone needs a College Education to be Financially Successful in Life - Essay Example Through an analysis of people who have attained success without a degree, careers where a college education is not necessary, and alternative methods of achieving financial success, this essay demonstrates that it a college education is not necessary for financial success. Although there are many people that have found success through their college education, there are also a number of individuals that have found success without a college degree. One of the most prominent examples is that of Bill Gates. Throughout his childhood Gates had cultivated an interest in computer technology. While he attended Harvard for a semester he quickly recognized that he would find more success if he concentrated on his personal business. Gates would become to richest man in the world. While Gates’ example is extreme, such instances readily occur in smaller situations on a frequent basis. While a college education is necessary for success in careers such as medicine, there are a number of careers where a college education is not necessary. In large part college contains courses within specific academic disciplines, such as science, sociology, or mathematics. Although a number of career implement this higher-level thinking, for other careers such knowledge is extraneous. For example, the career of a construction worker, a plumber, or many times grocery and restaurant managers are learned not through formal education, but real world experience. With dedication and hard work it is possible for an individual without a college degree to gradually gain promotions or increased clients and in time find more financial success than individuals with a college education. Although a high paying job is very helpful for achieving financial success, there are many things that contribute to financial success that don’t involve a college education. Benjamin Franklin famously noted that a penny saved is penny earned. Indeed, one of the primary things that contribute to financial success

ASPECT OF COMPLIANCE TO TREATMENT IN RELATION TO THE DIAGNOSIS OF TYPE Essay

ASPECT OF COMPLIANCE TO TREATMENT IN RELATION TO THE DIAGNOSIS OF TYPE 2 DIABETES - Essay Example The present era witnesses a great deal of stress in every aspect of life. This results in increased incidence of hypertension, or cardiovascular diseases (CVD). Stress also induces dyslipidaemia and diabetes. Research and various clinical findings formulate that appropriate treatment is essential to decrease the incidence of morbidity and mortality happening due to all these ailments. It is essential to understand that all these conditions require lifelong treatment. Compliance with medicine is most essential to procure health benefits and to curtail the forthcoming consequences in terms of economic burden, wastage of time and money and other associated diseases with these ailments (Putzer, 2004). The present era witness a remarkable mount in occurrence and pervasiveness of type 2 diabetes in both pediatric and adult groups due to outbreak of overweight resulting in obesity, sedentary life style, resistance towards insulin and other metabolic conditions. It is therefore imperative to screen patients who show high-risk for diabetes and pre-diabetes. This step not only ensures on time diagnosis and exact classification but also ensures rapid onset of treatment and hence decreased risk for complications (Putzer, 2004). In order to avoid these complications it is essential that lifestyle modifications encompassing, modifications in diet, loss of weight and an appropriate schedule of physical exercise to sustain glycemic control. When these interventions fail then oral anti-diabetic agents are added as a part of regimen. It is established that type 2 diabetes cases require insulin therapy. When insulin or its analog is administered, there is a decrease in hypoglycemia. In severe cases when oral agents are also not able to procure enough control over the glycemic index, insulin therapy is given (Putzer, 2004). The situation

Globalization of business operations and industries Essay Example for Free

Globalization of business operations and industries Essay Globalization of business operations and industries has created a new challenge for organization penetrating in international markets. Several factors require management when firms focus on diversifying its product/service offering in international markets. Especially limiting the viewpoint to human resource requires managing the workplace diversity, employee selection mechanism, cultural differences, and managing the intercultural communication requires assessing the capabilities of organization to address these issues. International market business operations present the companies with acquiring new set of skills and transformation in human resource policy in order to perform the services with flexibility that doest not hinder in goals achievement. Workplace diversity management is the essential and important issue that needs to be address by an organization entering in international markets. Since diverse workforce consist of people belonging to different culture, races, having different ethnic background, a different way of learning; thus providing different ideas merging in organization. This enables organization to utilize and focus on enlarge business challenges in different business markets. Strategic HRM policy structure gives flexibility to organization for changing its focused principle in consideration of market needs; such as cultural dimensional factors identified by Hofstede on various dimensions helps identify the factors to be addressed by organization based on the market needs. Cultural differences have strong implications for organization expanding in international markets. Therefore, organization needs to give autonomy and flexibility to employees that will serve organizational purposes in international markets by leveraging the HRM policies. This can be done by regulating the rewards and compensation package structure for employees who will need to be relocating in different workplace locations due to their skills required to penetrate and serve in international markets. In relation to managing cultural differences, organization must define a comprehensive and decentralized decision making structure through defining the hierarchy management channel in its policy for international markets. Since few activities of firm remain limited in centralized location, so in order to comprehend the objective proper decision making style will enable accuracy and timeliness of activities. Decentralization of decision making structure will reduce the possible delay in decision making due to multi-level hierarchy structure of an organization and will also result in better assessment of any situation due to diverse workforce. Communication between departments and stakeholders is highly significant when concerning the international operations of an organization. Effectiveness of organizational culture for performing international operations is based on the communication style related to information processing, decision convey ability, surpassing the imperative information related to business decision making, and matters related to managing intercultural communication barrier. Ambiguous and unstructured problems require managing the barriers to improve the interdepartmental sharing of information for goals accomplishment. This issue can be addressed by initiating equal employment opportunity program for international business which would limit the selective culture growth of organization and encourage workplace diverse. Frame of reference affects the cross-cultural communication due to selective visionary capabilities of employees to foresee the potential growth possibilities. Therefore organization must initiate a formalized recruitment program focusing on viewing various individual dimensions in its SHRM policy structure to normalize the responses towards reducing frame of reference. Stereotypical response by employees increases the biasness that affects the communication at international level increasing the chances of intergroup conflict affecting the effective goals accomplishment of organization. In association to this, chances of misunderstanding increases when firm do not address discrimination issue in its HRM policy to manage international operations functionality. Impartiality of decisions thus contributes towards progressive growth pertaining to employee contribution. At international level, cognitive dissonance is also a big challenge for firms to manage as ambiguity in information sharing leads towards strong misunderstanding among departments which may be depicted in actions leading towards wrong objectives setting. Company must address the corporate culture issue and coordination mechanism in its HRM policy to reduce the impact of cognitive dissonance on organizational goals accomplishment. Sony Corporation has developed a communication structure identified in its HRM policy to increase the effectiveness of communication among its employees in regional offices and production sites located in China. Employees are given combined training sessions, and encouraged to participate in workshops which increases the communication among employees belonging to different cultures and understand their potential issues that may arise due to operations in international markets. Human resource ethical issue also has implication for firms either they operate locally or in international markets. Employee privacy, job safety, health standard, workplace environment and condition, legislation for employees’ rights protection are essential duties for senior management to address in strategic HR policy. This although may create certain challenges to address by management but provide job satisfaction to employees; policies amendment concerning addressing the ethical issues differ of country basis due to differing working demand and obligations by country law. However, an organization can standardize the procedure and policies giving protection to employees as its ethical responsibility. SHRM policy can emphasize on employee welfare concept that aimed at addressing the factors leading to increased employee living standard; consequently, employee involvement in work increases and firm’s penetration power in international markets also strengthen due to direct participation of employees in organizational objectives achievement.

Treaments for Post Traumatic Stress Disorder

Treaments for Post Traumatic Stress Disorder Posttraumatic stress disorder occurs when individuals experience intrusive effects of a disturbing event that they have experienced for more than one month. PTSD is also marked by an individual’s determined avoidance of any stimuli that might remind them of the aforementioned event, along with a marked shift in mood and behavior which is distressing to the people around them. Over the years, a number of therapeutic techniques have been used to treat PTSD. Due to their effectiveness, exposure therapies and eye movement desensitization and reprocessing (EMDR) are two of the most widely used of these techniques. These have been utilized to treat soldiers as well as civilians who have experienced trauma. However, the nuances of their application, in terms of their effectiveness against specific demographics have yet to be determined. This paper will critically evaluate a number of different studies conducted using exposure techniques, EMDR, or both and determine their effectivenes s in treating individuals with PTSD. Even though EMDR has its roots in exposure therapy, for the purposes of this study, EMDR and exposure therapies will be regarded as two distinctive therapeutic techniques (CITE). One of the biggest issues faced by PTSD treatment research is a large number of studies with subpar methodologies. Due to this, Foa and Meadows (1997) published seven standards that should be present in any research that deals with treatment outcomes of PTSD. They are known as the â€Å"Gold Standards† for treatment outcome studies. According to Foa and Meadows, every suitable PTSD research should have clearly defined symptoms; reliable and valid measures; use of independent evaluators; trained assessors; manualized, replicable, specific treatment programs; treatment adherence; and an unbiased assignment to treatment. Ready et al. (2012) provides an effective utilization of group-based exposure therapy which sets the precedent in favor of exposure techniques among veteran soldiers. Their decision to divide the participants into three groups of ten ensures that every individual can form personal connections with other members of the group given the limited time of the treatment program. The small group size also allows the participants, who would typically avoid social situations, to not feel overwhelmed when asked to share their experiences. On the other hand, the lack of any gender diversity within the sample group reduces external validity and adds to the stereotype that only men who have been in combat suffer from PTSD. Given the comorbidity of PTSD and substance abuse (CITE), using drug abuse as exclusion criteria further decreases its external validity. Allocating the first part of the program to forming support groups among participants is an effective use of the small sample size. It also helps in prolonging the social and emotional support that participants get during the program so that they will continue to support each other after its conclusion. Using each individual’s presentations as a form of exposure allows for a highly personalized exposure treatment while allowing them to understand that others have faced the same situations that they have. However, since they are required to listen to it as homework, it can only be effective with highly motivated participants. Seeing the long-term effectiveness of this type of exposure technique, Ready et al. (2012) proposed that the number of times that participants are required to listen to the presentations be increased from 10 to 20, which would theoretically increase the rate at which symptoms of PTSD would disappear. Overall, group based exposure therapy (GBET) is shown to be an effective short-term and long-term treatment for PTSD. Through research conducted in a Ugandan refugee camp, Neuner et al. (2008) demonstrated that, even with laypersons with minimal training in psychotherapy, exposure techniques such as narrative exposure therapy (NET) can be used to treat PTSD. Just nine research assistants, all laypersons, were employed to conduct this study among a sample size of 277 individuals. While they were given a 6 week crash course on therapeutic techniques and communication skills, the use of unqualified personal to treat psychological disorders is unethical and could have negatively affected the participants being treated. Furthermore, it would have been better to use research assistants who weren’t from the camps that the study was being conducted on; this would have decreased threats to the validity of the study such as demand characteristics and participant expectations. However, the subject of PTSD wasn’t alien to the laypersons since all of them had been diagnosed with it at one point or another, meaning that they could empathize with the participants via personal experience. Since follow-up assessments showed that 70% of the participants who underwent NET can no longer be diagnosed with PTSD, this type of psychotherapy can be used in war-torn regions where professional help isn’t readily available. But the validity of the final results can be questioned due to the large number of participants who could not be located for the post-test and follow-up sessions, even though the study had adjusted for attrition during participant selection. Another exposure technique, known as imagery rescripting and exposure therapy (IRET), was used by Long et al. (2011) to treat nightmares associated with PTSD. Like in the aforementioned case of Ready et al. (2012), this program also suffered from the issue of being all male. Furthermore, the temporal relevance of the study can be questioned since the participants were primarily veterans of the Vietnam War and none of the participants had participated in active combat since the early 1990s. While IRET had great success in decreasing the frequency of nightmares and increasing the quality of sleep, it wasn’t shown to have any effect on other symptoms associated with PTSD. The validity of these findings can be further questioned by the fact that the mean age for the participants were 62.1 years; meaning that their sleep disturbances may be the result of factors other than PTSD. Despite all of this, the self-employed and individualized exposure techniques used in this study, along with the extensive psychoeducation that preceded it, makes it a highly effective tool to treat nightmares associated with PTSD, even in individuals who have been suffering from it for decades. Rothbaum, Astin, and Marstellar (2005) attempted to compare the efficacy of prolonged exposure therapy (PE) to EMDR with respect to the treatment of rape victims. One of the things that stood out from this study was the fact that every assessment and evaluation that is required during the course of the study was conducted by independent, blind evaluators. In addition to that the integrity of the specific therapies was measured by assessors who rated them highly. The sample size used was appropriate but a high dropout rate, combined with a few peculiar additions to the sample groups negatively affects the validity and reliability of the study; three participants who would not have otherwise been able to pass the exclusion criteria were allowed to participate in the study. It also used the participant’s subjective opinion on the most significant events in their lives, on which the treatments were focused on, which stands out due to the lengths they went to make the results of th is study independent and objective. Furthermore, the remarkable success at which both PE and EMDR was able to treat the participants, raises questions on the reliability of the treatment process; 95% of the PE group and 75% of the EMDR group of patients who have been suffering from PTSD for over a decade, were no longer diagnosable as PTSD patients after a treatment process that lasted a few weeks. Despite all that, the efficacy of both exposure techniques and EMDR in treatment compared to no treatment cannot be questioned. Ahmad, Larsson, and Sundlein-Wahlsten’s (2006) study, which was conducted using participants between the ages of 6 to 16, demonstrated that PTSD is prevalent even among children. The randomized controlled nature of the study along with the independent assessments makes it high in internal validity. Participants on the control group of this also showed improvements; they however, improved in non PTSD related symptoms. Moreover, the inventory that was administered had been modified in such a way that it can be understood and used easily with children. Furthermore, a more extensive evaluation can be carried out in the form of longitudinal studies or case studies regarding the relationship between PTSD in children and the history of mental illness in their family. Like many other programs which tested different treatments of PTSD, this study lacked a larger sample size, and utilized extensive exclusion criteria; this could affect its generalizability. In addition to this, they fai led to make independent assessments of their follow-up evaluations, affecting its claim of having blind assessments. Similar to Rothbaum, Astin, and Marstellar’s (2005) study which used the victim’s subjective opinion of their worst experience in order to conduct their PTSD assessment, this study also decided to focus on one single incident that the young participants or their guardians deemed significant. This is an effective method of administering EMDR, since it is more efficient in treating specific memories that are distressing to the participants. However, in a broader perspective, while a case can be made to the point that subjective opinions of individuals’ most distressing events are relevant to treating PTSD since it’s the individuals themselves who are experiencing them, it should also be pointed out that what an individual considers to be the most significant event in his/her life need not be the most significant event in terms of psychological and emotional trauma. Therefore, it should be best to conduct extensive background checks before any kind of decisio n is made regarding the significance of any life events. In a study published by Taylor et al. (2003), a side by side comparison of prolonged exposure therapy and EMDR with respect to specific symptoms of PTSD was conducted to determine which technique was more effective against each of them. Compared to most other studies conducted regarding PTSD, this study had a fairly large sample size (n=60) with the majority of them being Caucasian and women. While the study employed an impressive sample size, since the participants were primarily diagnosed with chronic and severe forms of PTSD, the external validity of the results can be brought into question. However, since most of the participants of the study had chronic PTSD, it reduces the possibility that the changes that were observed in the pretests and posttests are purely due to temporal changes. The validity can be further questioned due to the difference in educational qualifications of the two therapists who administered these therapeutics techniques. However, independent expert assessm ent of their interrater reliability produced high scores, disproving these doubts. Moreover, the treatments were administered using standardized manuals which increased the validity of the study by ensuring that all participants received near as similar treatments as possible. This study is the first study to have achieved the aforementioned â€Å"gold Standard† for PTSD outcome treatment research (CITE). This study’s observed reductions in PTSD symptoms for all three subject groups were determined by the authors as a result of the effect of unintended exposure during relaxation training and EMDR techniques. This contradicts with the belief that in EMDR, eye movement â€Å"enhances the retrieval of episodic memory and increases cognitive flexibility† (CITE). While exposure techniques and eye movement desensitizing and reprocessing (EMDR) are similar to each other in many ways and are efficacious in their treatment of PTSD, their approaches, implementations, and goals are quite different from one another. EMDR treats PTSD by asking the patients to subjectively choose the memory or experience that they think is causing them the most distress and treating them so that they are desensitized to this particular experience. The root of their PTSD is determined to be their most distressing memory and by desensitizing them to that experience and the re-experiencing that follows it, they are shown to have significant decrease in symptoms of PTSD. While some specialized exposure therapies employ similar approaches, others such as the NET and GBET explores an individual’s whole life or a particular period in which they were susceptible to distressing experiences respectively. This method allows the therapist to play a part in determining the most significant event in an individual’s life and adjusting the treatment process accordingly. In addition to that, since Taylor et al. (2003) showed that prolonged exposure therapy was more effective than EMDR in reducing the levels of re-experiencing and avoidance, the authors of the study concluded that it is the superior therapeutic technique. All in all, both exposure techniques and EMDR are very good at what they are supposed to do; but exposure techniques are better at it. Therefore, a hypothesis can be derived from the above discussed studies which states that specialized exposure techniques are more efficacious in the treatment of PTSD than EMDR across social and temporal demographics.