The Determinants Of Diabetes Health And Social Care Essay

The Determinants Of Diabetes Health And Social Care Essay Diabetes affects over 3 million adults in Australia alone-of which 90% is type 2 (Baricevic, 2007) non-insulin dependent diabetes mellitus (NIDDM-for the sake of this essay diabetes is referring to type 2 NIDDM). There are numerous biological and socioeconomic determinants of the disease which has developed into Australias fastest growing chronic disease. Whilst it is often considered a lifestyle disease (Scobie Samaras, 2009) this is a common misunderstanding with many other contributing factors such as genetics, the environment and economic circumstances. Whilst much research has gone into the management/treatment of diabetes, work on addressing the upstream determinants has begun. Physiotherapists play a vital role in the prevention and treatment of the condition with them often prescribing exercise programs for diabetic patients. Diabetes results from a total or partial insulin deficiency, resulting in hypoglycaemia. This deficiency prevents glucose movement between the blood and cells, creating a build-up of glucose in the bloodstream. As a result of the hypoglycaemia, several key symptoms are present including blurred vision; increased healing times; unexplained weight gain; increased passing of urine; thirstiness; tiredness and dizziness. In 2010 diabetes accounted for 6.6% of Australias total burdens of disease and has been identified as one of the eight national health priorities (AIHW, 2010). Section 1 Hamdy, Goodyear, Horton (2004) contend that there are three key contributing factors to the onset of diabetes. These include genetic predisposition, decreased insulin action and a defect in the pancreatic ÃŽÂ ² cell. However the most well-known biological and behavioural determinants of the condition relate to obesity with the relative risk being 1.8 for an overweight person and a staggering 3.2 for obese people (Marks, Coyne, Pang, 2001). Weight related determinants include obesity (morbid and moderate), sedentary lifestyle, poor diet and low levels of physical activity (Ramlo-Halsted Edelman, 1999). Hamdy, Goodyear Horton (2004) suggest the primary reason for such societal changes leading to the dramatic rises in the rates of both obesity and more so diabetes is urbanisation. They suggest that the recent world-wide urbanisation and increase in technology has created a society where traditional incidental forms of exercise have been alleviated in favour of technology and the advances that it has facilitated. Ethnic groups have particularly been affected by these changes with their traditional forms of life transformed as they too are impacted by globalisation. An example of such a group in Australia is the Indigenous Australians. As with nearly all areas of health, they are severely over represented in the percent suffering from diabetes. __________ Other factors contributing to the onset of the disease include older age, Section 2 Despite these factors being well documented as some of the primary causes of diabetes, Scobie Samaras (2009) argue that these factors accelerate the onset rather than being the primary cause. -biological/behavioural determinants of health Age Genetic background-parental history -groups at particular risk: Elderly People with a family history Certain ethnic groups (eg Aboriginal Australians) Low SES Section 2 (link back in with individual determinants) -Factors such as poverty, poor education, social exclusion, unemployment and lack of or poor quality housing all contribute to health inequalities. -socioeconomic determinants of health PolicyÆ’Â  PA levels in schools, NPAG, education CommunityÆ’Â  access to parks/paths EnvironmentalÆ’Â  safety, access to fresh food SocietalÆ’Â   urbanisation and increase in technology = down incidental exercise EconomicÆ’Â  employment/occupation, income, wealth Section 3 Traditionally treatment of diabetes has focused on the downstream factors, with the focus being at an individual level. Exercise and weight loss are key aspects of the treatment, given that ________. Exercise alone leads to a significant improvement in insulin sensitivity (Misra, et al., 2008). In line with the National Physical Activity Guidelines (Department of Health and Ageing, 2010), it is recommended that individuals participate in at least 30 min of walking 5 days per week. The guidelines highlight four key points for all adults regarding physical activity, with these being particularly important for people with diabetes. They are: Think of movement as an opportunity, not an inconvenience Be active every day in as many ways as you can Put together at least 30 minutes of moderate-intensity physical activity on most, preferably all, days If you can, also enjoy some regular, vigorous activity for extra health and fitness (Department of Health and Ageing, 2010) In conjunction with exercise, a healthy diet is essential for the effective treatment of diabetes (DA Victoria, 2002). This has been proven to have the single greatest natural impact on blood glucose levels; as well as aiding weight loss and decreasing insulin resistance. Foods should not be limited to low GI, with a diet focussed on high protein (such as fish and low fat dairy); high carbohydrates (such as pasta, bread and fruit) and low saturated fat/sugar (Baricevic, 2007). The AIHW (2010) suggests that the most appropriate method of treatment is initially through diet and exercise, progressing only later to medication. Diabetes medication primarily acts to help regulate the blood glucose levels. Given that with this condition insulin is unable to effectively function, it becomes important to have a way to regulate blood sugar. The normal range is 3.5-6 mmol/L prior to meals and 3.5-8mmol/L directly afterwards (DA Victoria, 2002). Glucose management is very important to keep the risk of cardiovascular disease down, and without regulation the person may suffer from hypo/hyperglycemia. That said, Ramlo-Halsted Edelman (1999) point out that the optimal regimen particularly for medication will change for each individual as the condition progresses. There are two different options for medication-tablets or insulin injections. The tablets are taken orally and decrease the release of stored glucose in the liver, keeping blood sugar levels down. In contrast, i nsulin injections come in the form of a needle (syringe) or a pen and are used when the pancreas is unable to produce the required amounts of insulin (Baricevic, 2007). Diabetes, as with many health conditions, requires a multi-disciplinary team for successful treatment and management. Diabetes Management in General Practise (2009) describes the roles of at least eight different team members in the treatment of diabetes. These include: General practitioner Exercise specialist (commonly a physiotherapist) Podiatrist Optometrist Oral health professional Diabetes educator (nurses etc) Dietician Endocrinologist/diabetologist Whilst not all of these health professionals will necessarily be involved in every individuals treatment, the teams cooperation is vital for long-term treatment. To help with individual treatment of diabetes, the Australian Government has established the National Diabetes Services Scheme (NDSS). The program has in excess of 900 000 registered people with diabetes and is continuing to grow. There are several key elements of the scheme with subsidised products and information as well as education. Through this program, there are 2200 outlets which supply discounted products for treatment to the registrants. Whilst treatment is very common, alongside it is an extensive management plan. DA Victoria (2002) describes several aspects to proper management. Aside from being physically active and eating well as previously mentioned, it is preferable for a diabetic to link up with a local support team for help, support and to maintain a positive attitude. Additionally testing blood glucose regularly and medicating appropriately as prescribed is also important. Diabetes Management in General Practise (2009) also emphasises the need to quit smoking (if applicable), have less than two standard drinks per day and ensure BMI (body mass index) in less than 25 to achieve general wellbeing. Hawley Zierath (2008) also outline the importance of minimising the risks and effects of complications. They state that this can be achieved through controlling glycaemia, blood pressure and lipid levels; in conjunction with regular health checks (focussing on eye, kidney and foot problems). Section 4 Prevention of diabetes is an absolute priority especially when over 60% of type 2 cases are preventable. With diabetes being the 7th leading cause of death in Australia (AIHW, 2010), there is no question why the Australian Government has made the condition a national health priority. According to Weeson (2000), upstream treatment by primary health professionals should be the focus of all approaches. These upstream factors include______________. Simple steps can easily help prevent or delay the onset of diabetes (Type 2 Diabetes, 2011) through implementing a healthy lifestyle. Diabetes Australia encourages individuals to maintain a healthy weight, participate in regular physical activity, eat healthy food, manage blood pressure/cholesterol and not smoke, to decrease the onset of the condition (Type 2 Diabetes, 2011). There is a very strong link between physical activity and diabetes as previously mentioned, however it should benoted that participation in a moderate or preferably brisk walking regimen can decrease the incidence of diabetes by 30% (Jeon, Lokken, van Dam, 2007). Furthermore Jeon, Lokken van Dam (2007) describe this strong relationship saying that there is also a link between the amount of physical activity and the reduction of risk-an amazing 58% decrease in the incidence of prediabetes can be achieved through exercise previously stated. Zimmet (2000) emphasises that diabetes cannot be stooped by traditional medical approaches. Given the scale and enormity of the issue, he contends that drastic socioeconomic and cultural status changes are required to make progress. Zimmet (2000) says that international diabetes and public health organisation need to lobby and mobilise politicians and non-government agencies. Through this, the issues causing the pandemic (socioeconomic, behavioural, nutritional and public health) can be addressed. A multi-disciplinary task force is suggested to aid in the reversal of the socioeconomic issues, as Zimmet feels that individuals alone acting to change will not make a big enough difference (Zimmet, 2000). The National Evidence Based Guidelines for the Primary Prevention of Type 2 Diabetes (Colagiuri, Girgis, Gomez, Walker, Colagiuri, ODea, 2009) describe four key areas to creating effective preventative action for diabetes. These include: Having a strong theoretic base for the program Designing the program with clear messages, incorporating a multifaceted approach to deliver these messages Encouraging family involvement Intensive and sustained campaign over a long duration The guidelines also discuss the facets within the broader community that should be targeted for prevention of the condition. One of the central elements to effectively targeting the population is education (Colagiuri, Girgis, Gomez, Walker, Colagiuri, ODea, 2009). Through media, the guidelines propose that the education can change attitudes as well as levels of knowledge. This can have a particularly profound impact on the short term increase in physical activity. This was seen in the Life be in it___________ In terms of prevention for individuals, the guidelines also provided several points specifically targeting those in the risk groups. The guidelines (Colagiuri, Girgis, Gomez, Walker, Colagiuri, ODea, 2009) specify individuals at particular risk as having a score greater than or equal to 15 on the AUSDRISK risk assessment tool. There are three levels of action to prevent the onset of diabetes. Initially lifestyle modifications such as weight management, progressing to pharmacological interventions where necessary and in cases with severe risk bariatric surgery may be considered. Furthering the treatment dietary considerations previously mentioned, in order to prevent diabetes sugar-sweetened drinks have been identified with fast food as items that pose the largest threat of inducing diabetes (Hu, van Dam, Liu , 2001). Fish oil and polyunsaturated fats have also been proven to help with the prevention of the condition. Other -conversion from high risk to low risk lifestyle = moderate style Physiotherapists play a large role particularly in the treatment, but also the prevention of diabetes. Ozdirenc, Kocak Gutekin (2004) highlighted the importance of physiotherapy in the accurate prescription of exercise. They suggested that any exercise prescribed in the interest of decreasing complication with diabetes or preventing it should be undertaken at 65-75% of a persons VOà ¢Ã¢â‚¬Å¡Ã¢â‚¬Å¡ max and emphasised the necessity of a professional in such prescription. According to their study, physical exercise can lead to a significant decrease in physical impairment and provide improvements to functional limitations that the person had suffered. In contrast, they determined that low levels of activity caused a decreased cardio respiratory capacity and hence lessened ability to walk longer distances. These effects of inactivity too have the potential to be improved through the implementation of a physical activity regime (Ozdirenc, Kocak, Gutekin, 2004). Physiotherapists also p lay an important role in the prevention of diabetes through education and public health promotion. At an individual level such professionals can help their clients who are identified as being at risk (of diabetes) to make behavioural modifications to lessen their personal risks. In addition to this, physiotherapists can help their patients with diabetes develop an exercise program to aid in weight loss and improving their future prognosis. At a broader level physiotherapists can be involved in policy development and other awareness campaigns. For example the National Physical Activity Guidelines require experts and other professionals inputs to develop programs with the key elements previously mentioned such as strong theoretical bases. Conclusion -prevention must be a key focus given that -a condition that is highly amenable to primary intervention

hitchcock :: essays research papers

Suspense   Ã‚  Ã‚  Ã‚  Ã‚  I think the best example of suspense in Alfred Hitchcock’s films is Psycho. The suspense is built well through the music and the camera angles. I will choose the shower-stabbing scene to demonstrate all these elements, because the scene displays all these elements the best. The music fits the situations and events that take place. The playing of the screeching music when Norman Bates is in the process of stabbing Lila Crane in the shower, just the effect of the music makes this one of the most suspenseful scenes in movies history, at least in my opinion. Also, the camera angle builds the suspense. The angle of her screaming when the man opens the shower, then the cutting off to the knife and then the blood, displays the effects of the camera angles, and without even show the murder. The angle on the knife makes us perceive that she is being stabbed without even seeing it. And the blood makes us assume that she is dead, without even showing the body. He buil ds suspense without showing the specific details of a scene. Plot Twists   Ã‚  Ã‚  Ã‚  Ã‚  Hitchcock uses plot twists in his films to give the viewers the idea that something going on is happening, but in reality, it’s not. For example, in Psycho, Norman Bates’ mother really turners out to be Bates himself. And for Dial M for Murder, the key that was left on the stairs was used to help the detective catch Tony. The Trouble with Harry is that the whole time Harry has died of a heart attack, but we didn’t know that and all the other characters didn’t either. In Rope there really isn’t one. You could say that the two brothers killing David and putting him in that box could be a plot twist. An finally in Vertigo the lady really turning out to be someone else is a plot twist in the movie. Auditory Cues   Ã‚  Ã‚  Ã‚  Ã‚  The two films that rely on auditory cues are Dial M for Murder and Rope.

Analysis of the Article: “The New Psychology of Leadership” Essay

Analysis of the Article: â€Å"The New Psychology of Leadership† Scientific American Mind Journal, August 2007   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   The article by Stephen D. Reicher tells us about how the definition of â€Å"Leaders† has been changed over time, and how it transformed to suit today’s society (Reicher, Platow and Haslam). It tells about how this effective leadership contradicted the conventional notion of what a leader should be, how a leader should act. It gave the September 11 bombing, where President George W. Bush has stepped up to give us a clear definition of what today’s leaders are like. Bush was merely an example, and that there are other aspects that would give a meaning to the â€Å"leaders† of today, redefining the belief that it only takes willingness and character to become a successful leader.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   The first point that was stressed, and that was manifested by President Bush during the 9/11 bombing was that leaders have been remodeled by the society today. It is not only willingness and character that the people need. Today’s leaders should also be able to act or be like them, be one with the people. Through that, there will be unity; and with a unified following, the leader can then mobilize these people to achieve the changes, as for the time of the bombing, was the call for America to act as one against terrorism.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   In the article, there are several changes that have been shown when it comes to a characteristic that a leader should possess. The first of these changes was about charisma, evolving to a consensus. The notion about how leaders should possess charisma in order to attain success have been slowly shadowed by the fact that charismatic leaders are not effective leaders if they wont be able to get something going. It was then replaced by how well a leader adapts to his situation, and how he is able to lead people, which defines him as a leader. He should not be defined as how many people he can convince, instead he should be defined by how many people he was able to mobilize and bring out changes with his leadership.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Another defining character that an effective leader should possess is to be able to blend in with the crowd, the very people he is leading and supervising. He should be one of the gang, and not to be seen as the high-and-mighty sovereign ruler of the land. This is to gain the confidence and the respect of the people. If he is able to be seen as someone like them or someone who understands them, then the leader would definitely have their trusts and be able to mobilize these people toward the goals and objectives of the leaders which are also for the people’s interests.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   The leader should also be fair with his constituents or to those who are in lower positions from them. This is to maintain the trust and the positive outlook from these people, for them to think that these leaders are not taking advantage of their position, or that these leaders do not deserve their position at all. It is through their followers that the leader will be able to determine what to do, which is usually dependent on how the group thinks. Fairness can be observed by effective leaders in resolving problems between members, wherein there should be no favoritism shown. The leader should also be able to verbalize their leadership, being able to wield words and deliver them correctly to the people. This is one way of strengthening his command and building the respect of his followers, so that they can be effectively mobilized by the leaders.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   This article is a useful source of information on how a person can be an effective leader. This also updates us of how the society today defines an effective leader. This is because an effective leader doesn’t have a constant or concrete definition, of what should possess to become an effective leader. It still lies on his constituents, in his followers, that would define him on how a leader should be. This is because a leader is also a servant, and that is why a leader also has to be of service to others, which are the general public. Reicher, Stephen D., Michael J. Platow, and S. Alexander Haslam. â€Å"The New Psychology of Leadership†.   2007.   Scientific American Mind. August 9 2007. .

Medea And Oedipus Rex - 1447 Words

Rough Draft #2 The answer to the question of whether personal desires affect people’s actions more than the influence of others may seem like a one sided answer. However, upon closer inspection, it is acceptable to say that although some would argue that people’s own desires dictate their actions, the influences of others play a more prominent role in how an individual acts. The Greek tragedies â€Å"Medea† and â€Å"Oedipus Rex† are both stories that explore this controversial topic. â€Å"Oedipus Rex† follows the story of a king named Oedipus. His land is plagued, and the only way to get rid of this plague is to exile the one who killed the previous ruler of Thebes. Oedipus begins his search, along the way communicating with people that help him learn†¦show more content†¦10). These characteristics she develops and the actions she takes are an outcome solely due to the outside influence of Jason. Robert B. Palmer even describes Medea as a â€Å"demon witch who thirsts for blood and vengeance.† ( Palmer para. 3). The destruction of the relationship Jason and Medea shared is an obvious reason for Medea’s actions and is shown very early in the story, however Oedipus’s outside influences develop as the story progresses. Oedipus is effected by outside influences as much as Medea is, however it is not as exemplified. The outside influences slowly creep into Oedipus’s mindset as the story moves on. Despite how swayed Oedipus might have been by others, he showcases actions influenced only by personal desires in the beginning of the story. Oedipus is one who has a position of power, which may have shaped him to trust his own mind and decisions over others. His mental toughness is broken through however with characters such as Tiresias and the Herdsman. Little details about his past break down the barrier that shields his mind from being influenced by outside sources. As Effie Coughanowr suggests, Oedipus willingly listening to this toxic information serves as, â€Å"a single false step and tragedy becomes reality.† (Coughanowr para. 17). This process is a long one where at the end he is seen as broken man that blames himself for the events unfolded. The manner in which he blames himself , â€Å"O Kithairon, why did you bring me in? Or once you hadShow MoreRelatedThe Hubris In Oedipus Rex And Medea1027 Words   |  5 Pageshubris to showcase a characters downfall. Hubris has a huge part in plays like â€Å"Oedipus Rex† and â€Å"Medea†. The Hubris in Oedipus Rex and Medea, which leads to the eventual downfall of the characters and teaches the readers a valuable lesson by showcasing Jason’s ego and pride, Medea’s anger and pride, and Oedipus Rex’s arrogance and stubbornness. 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It is common that the person’s character becomes their undoing. Hubris teaches the readers a valuable lesson by showcasing Jason’s ego and pride, Medea’s anger and pride, and Oedipus Rex’s arrogance and stubbornness. Jason’s ego and pride are illustrated when he betrays his wife, Medea, then proceedsRead More Tragedy In Drama Essay1713 Words   |  7 Pagesfatal error in judgement that would lead to his fall. Oedipus Rex is considered by most as the source for Aristotle’s ideas about tragedy, as it is a classic example of a hero with a tragic flaw that brings about his downfall. Again, we have a person of high standing in Oedipus, who is neither entirely good nor entirely bad. However, it is Oedipus’ pride that pervades as his tragic flaw throughout the play. 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After several murders, Medea and Jason move to Corinth, which is where the play takes place. Here, Medea gives birth to two children by Jason establishing a family. Jason later moves out, divorcing Medea and moving in with Glauce, the daughter of CreonRead More Comparing Female Characters in Euripides Medea and Sophocles Oedipus the King and Antigone1555 Words   |  7 PagesComparing Female Characters in Euripides Medea and Sophocles Oedipus the King and Antigone      Ã‚  Ã‚   In the times of the ancient Greeks, women had an unpretentious role. They were expected to do take on the accepted role of a woman.   In most cases, a womans role is restricted to bearing young, raising children, and housework. In Sophocles Oedipus   the King, Antigone, and Medea, the dominant female characters impacted upon men with authority and political power.   It is Read More Willy Loman as Tragic Hero of Death of a Salesman Essay1519 Words   |  7 PagesHero of Death of a Salesman       Willy Loman, the title character of the play, Death of Salesman, exhibits all the characteristics of a modern tragic hero. This essay will support this thesis by drawing on examples from Medea by Euripedes, Poetics by Aristotle, Oedipus Rex by Sophocles, and Shakespeares Julius Caesar, while comments by Moss, Gordon, and Nourse reinforce the thesis.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Death of Salesman, by Arthur Miller, fits the characteristics of classic tragedy. ?.... this isRead MoreParent Child Relationship in Greek Mythology Essay1625 Words   |  7 Pagesschemed the overthrow of their husbands, with the help of their offspring. 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