Saturday, November 30, 2019

PSYC101 WorksheetTotal Points possible 100Place y Essays

PSYC101 WorksheetTotal Points possible: 100Place your first and last name, student ID and the date of your worksheet completion in the spaces below.Student Name:Student ID: Date: This worksheet is due by 11:55pm ET Sunday at the end of Week 6 of the course termYou may work on it ahead of its deadline but may not submit it prior to its assigned week. OVERVIEW:This worksheet requires unpacking the key elements of a published scholarly journal article and demonstrating APA source citation skills, activities you will engage in frequently in the completion of a variety of assignments including essays, research papers and literature reviews in future courses. To complete the worksheet, download and save a copy of it with your first and last name in the document title, answer the questions and attach your completed copy. Quoting is not permitted. All answers must be written as paraphrases, meaning that you must restate what you read in your own words, with the exception of technical terms s uch as the names of diagnostic tests. You are not required to source credit the article in your answers to the Section I "Key Article Components" questions. Section II, "Source citing and reference listing in APA format" is where you will demonstrate knowledge of how to correctly format source crediting in APA style. Answers will be graded for accuracy, thoroughness, clarity and correct spelling and grammar.No content of this document may be removed or reordered. Answers must be inserted in the spaces provided. ================================================================================== SECTION I:KEY ARTICLE COMPONENTS 1. Previous research and authors' rationales for conducting their study100 word minimumAfter reading the article's first five paragraphs, in the space below answer these two questions: What previous research has been conducted on the article authors' same or similar topics? What were their explanations for why their study was needed?2. Research method used50 word minimumIn the space below, describe the type of research method that the article authors used in conducting their study and explain why it was well suited for an investigation of their topic (Ex: individual or group interview, case study, laboratory controlled or naturalistic observation; administration of psychological tests). Refer back to the course textbook chapter on research methods for a review of method types and their purposes. 3. Participants involved in the study 100 word length minimumIn the space below, describe in narrative form (lists and sentence fragments cannot be used) the characteristics of the participants involved in the research study conducted by the article authors. What was the number of persons who participated; where were they recruited from; what were the participant demographics; were any participant screening procedures conducted; what criteria were used to determine who participated in the study and who didn't; were participants paid or did they receive any other type of compensation for being involved in the study; etc. Note: Some of the above information is provided in the article's "Measures" section, so you will want to use both it and the "Participants and Procedures" sections to answer these questions. 4. Measures usedIn the space below, list the measures used in the article authors' study. 5. Data analysesIn the space below, list the data analyses used to analyze the data gathered during the article authors' study. Note: You don't have to know how the analyses are conducted; only naming them is required here. 6. Study resultsIn the space below summarize the results of the study conducted by the article authors. 7. DiscussionIn the space below, summarize the conclusions reached by the authors in the final seven paragraphs of their article. What were their interpretations of the study results? What limitations of their study and needed future research did they note?SECTION IISOURCE CITING AND REFERENCE LISTING IN APA FORMATTip: If needed, examples of how to source credit in APA formatting style can be found in the Online Writing Lab, located at https://owl.english.purdue.edu/owl/resource/560/01/ The authors of the article are: Weili Lu, Philip T. Yanos, Steven M. Silverstein, Kim T. Mueser, Stanley D. Rosenberg, Jennifer D. Gottlieb, Stephanie Marcello Duva, Thanuja Kularatne, Stephanie Dove-Williams, Danielle Paterno, Danielle Hawthorne, and Giovanna Giacobbe.The article's title is: Public Mental Health Clients with Severe Mental Illness and Probable Posttraumatic Stress Disorder: Trauma E xposure and Correlates of Symptom SeverityThe article was published in Volume 26, on

Monday, November 25, 2019

Government Intervention and Antitrust Law essays

Government Intervention and Antitrust Law essays Government Intervention in Individual Markets: A Look at Government Intervention and Antitrust Law via the Microsoft Case Growth and Development in the US Economy In light of recent developments, I took a different approach to this paper. The Microsoft Antitrust case has been somewhat of a phenomenon that has become one of the most prominent cases in recent years. Because of this, I decided to look at government intervention into individual markets, along with antitrust law, via that particular case. I am of the opinion that we can learn a great deal by using that particular ongoing litigation. Antitrust law protects the public from companies that attain an undue domination of the marketplace via mergers, tying 1 product to another, vertical integration, and other practices tending to eliminate competition or bar entry into the market to newcomers. In the early 1980s, Microsoft was a much smaller company than it is today. However, it had already established a reputation of being a predator, a greedy predator. They were known to terminate licenses mercilessly once they figured out a way to clone a given technology, regardless of whether it was legal or not. Back then, Microsoft had some enthusiastic competition. The biggest of which were Borland (programming), Ashton-Tate (databases), Visicalc and Lotus (spreadsheets), as well as Wordstar and WordPerfect (word processors). All of these companies have now either merged out of existence or are completely defunct, with the exceptions of Borland and Lotus (which are barely afloat). Microsoft now has the leading product in each sector of the market once occupied by these firms. The company was responsible for ridding itself of these early competitors by either buying them out or simply driving them into the ground. This early disregard set the tone for how Microsoft does bu siness even today. Microsofts advantage comes from their domination of operating systems (...

Friday, November 22, 2019

Authenticity in Trumpet

Authenticity in Trumpet Jackie Kay’s novel Trumpet depicts characters who naturally challenge the conventional perceptions of race, gender, identity, and other socially constructed aspects of humanity. The text is set in the United Kingdom in the early to mid twentieth century, a time when being unconventional in these respects was particularly taboo. Kays novel establishes that many facets of identity cannot be viewed through an essentialist lens, and Kay uses the believable authenticity of her characters to exemplify this idea by pitting authenticity against societal norms. The main characters of the novel exhibit a variety of unconventional characteristics. Joss Moody, for example, is the biracial offspring of a Black man and a White woman, and the text frequently alludes to the inevitability of his parents’ marriage creating tensions and obstacles during his youth, even without directly depicting much of his childhood. Joss also marries Millie, a White woman, despite everyone perceiving him as incontrovertibly Black; Millie’s own family is reluctant to accept the aberrant relationship that she cements with Joss. Above all, though, the most pertinent challenge to societal norms is the fact that Joss is biologically female and living as a heterosexual man. This challenge is compounded by Joss and Millie adopting a son, Colman, to satisfy Millie’s yearn for a child. Even adopted children are faced with the life of being inherently unconventional, simply because they are raised by guardians other than their biological parents. With regard to the very unconventional characteristics depicted in the text, though, Kay makes a point to balance them against a conventional perception in such a way as to prove that these conventions are not fixed. Rather, conventional observers erroneously fail to consider perspectives that society has marginalized. For example, Kay bothers to mention several times that Colman actually favors his father, especially in his youth; consequently, many people make the mistake of claiming to see a resemblance that biologically is not present. On a more significant level, everyone in the text believes unquestioningly that Joss is a man until it is found out that he is biologically female. Joss lives as a man in every aspect of his life, even in ways that would not be necessary if he were only doing so to be a Jazz musician (i.e. courting, dating, marrying, and having frequent sex with Millie); this lifestyle points to the authenticity of Joss’s masculinity given that the very idea of authenticity is left undefined and undisputed. Even after learning that Joss is biologically female and still consenting to marry him, Millie only questions her relationship with Joss relative to having a baby; even then, she does not question the validity of the relationship. She genuinely asks herself, â€Å"Why can’t he give me a child? He can do everything else. Walk like a man, talk like a man, dress like a man, blow his horn like a man. Why can’t he get me pregnant† (Kay 61). Millie refers to Joss with masculine pronouns and describes the several ways in which Joss is every bit the man she wants. The only aspect of manhood she cannot find in him is the biological one, a factor that speaks to the authenticity of Joss’s gender challenging his sex. Late in the novel, Millie describes part of her and Joss’s morning routine after they had been married for a while, and what she describes further establishes masculinity as Joss’s authentic persona. It also alludes to her love for the man that Joss was as opposed to any attempt to delude herself into believing he was a man in order to facilitate some counterfeit love. She says, I wrapped two cream bandages around his breasts every morning, early. I wrapped them round and round, tight. I didn’t think about anything except doing it well. [†¦] I don’t remember thinking much. I had to help him get dressed so that he could enjoy his day and be comfortable. [†¦] He was always more comfortable when he was dressed. More secure somehow. My handsome tall man. He’d smile at me shyly. He’d say, ‘How do I look?’ And I’d say, ‘Perfect. You look perfect’ (Kay 317-8). In this passage, Millie says multiple times tha t she didn’t think about anything other than ensuring that her husband was comfortable. His security was her primary concern, and after Joss was dressed and secure in his manhood, they were both at ease. She is even able to admire the man she helps to build, an admiration which makes nothing but sense in light of the clichà © school of thought that every good man is a man that a good woman helped to build. Through instances such as the morning routine, Trumpet uses Joss’s authenticity to challenge the conventional views of gender in the early twentieth century. In doing so, Kays text parallels this major challenge with several other ancillary challenges to societal norms. The purpose of this pervasive trope is to show the variability of identity that the most rigid traditional conventions refuse to acknowledge.

Wednesday, November 20, 2019

The Personal Food Essay Example | Topics and Well Written Essays - 500 words

The Personal Food - Essay Example My favourite pizza should be hot and soft with a combination of different flavours. I am very impulsive when it comes to buying pizza and I am unable to control to restrain myself even if I have eaten at home (Turim). This is because the moments that I ate pizza during my childhood days defined special relationships that have persisted until the modern day. This paper will discuss my special relationship with pizza, highlighting its symbolic meaning in my life. As highlighted above, pizza is not just any other food to me. The first time I ate pizza was during a family outing when my mother ordered a large pizza for the entire family. During a time when pizza was only a delicacy to the upper class, it was a special moment for me to share a piece of pizza with my family. Notably, we were still a struggling middle class family then, and the financial turmoil did not make pizza an everyday meal. Therefore, as a child, I had the ecstasy of eating my first pizza. It was an exciting feeling to share that large pizza with my entire family as a symbol of unity (Aronovich 48). In the years that followed, during my elementary school days, I was invited to many birthday parties where pizza was served. This led to a symbolic relationship of pizza with long lasting friendships that I formed during my childhood days. During the celebration mood of birthdays, I bonded with my childhood friends. Until today, we still share a pizza when we meet in memory of the good old days. This is one reason why I have developed a unique attachment to the pizza (Aronovich 49). During my high school days, teachers adopted a rewarding system in an effort to motivate students who performed well. The top three students in every class had a rare opportunity of sharing a pizza during the lunch hours. I remember working hard each term so that I could emerge in the top three categories in anticipation for the

Tuesday, November 19, 2019

SAVING PRIVATE RYAN Assignment Example | Topics and Well Written Essays - 250 words

SAVING PRIVATE RYAN - Assignment Example The mise-en-scà ©ne sets camera angles to focus on emotions of the characters and the challenges that lie ahead of them. Lighting takes advantage of natural light with low key elements. Character and camera proxemics reveal the intimate level and relationship between soldiers. The costumes and makeup also create an element of realism (Dancyger, 2010, p.217). The use of sound in ‘Saving Private Ryan’ expresses the emotion and orientation of a soldier’s experience. It sets the full stage of battle, while taking us squarely in the midst of it. Sound in this film becomes a crucial storyteller. The sound design of the film guides the visceral experience felt (Dancyger, 2010, p.42). This film incorporates music in scenes where it strikes an emotional chord. The use of an orchestra achieves this effect. Battle scenes do not have music tracks, keeping the film realistic. In the movie, there is selective utilization of music to generate dramatic moments of retrospection and reverence. The editing of the film makes it seem entirely real from start to the end. The editing creates an exceptionally remarkable battle sequence without relying on quick-cut editing techniques, but using the MTV style. The editing techniques used in ‘Saving Private Ryan’ make battle scenes have an uneven and raw look (Dancyger, 2010,

Saturday, November 16, 2019

The ideal teacher Essay Example for Free

The ideal teacher Essay What characteristics should a teacher possess? What Makes a Good Teacher? Video – Effective Teacher †¢ An effective teacher can be seen in the following video: Introduction What does being a teacher mean? †¢ Having a vocation for the teaching profession. †¢ Being dedicated. †¢ Being surrounded by a large number of diverse students, each with their own baggage and unique character. Knowledge 1st Characteristic of an effective teacher †¢ Should be transmitted in a unique and fun manner. †¢ One should move from the known to the unknown. †¢ It is not how much one knows, but how much one can deliver. Knowledge Observation 1 †¢ At a particular Boys’ Area Secondary School, it was noticed that the boys had a low IQ. †¢ A highly motivated Maltese teacher used a practical example to help them learn. †¢ He compared the Maltese language to a cocktail. – The different drinks symbolized Italian, Arabic and English. †¢ As a result the children remembered the example more. Adaptation 2nd Characteristic of an effective teacher †¢ One should get to know one’s students to cater for them accordingly. †¢ Scaffolding activities accordingly, ensures maximum learning. â€Å"The wise adapt themselves to circumstances, as water  moulds itself to the pitcher† – Chinese Proverb Environment 3rd Characteristic of an effective teacher †¢ Creates a non-threatening and welcoming environment. Environment – Observation 1 †¢ A Maths lesson in a Boys’ Area Secondary School – The teacher greeted the students by the words ‘hurry up because you are wasting precious time’. – The students were not very friendly towards her and imitated her. – Whilst going out for recreation these students were heard echoing the teacher’s words to their peers who dawdled on their way out. Theory of Observational Learning †¢ The students’ picked up the  teacher’s habit and used it to their advantage. †¢ This can be applied to Albert Bandura’s theory of observational learning. Theory of Observational Learning †¢ Bandura established 4 steps – Attention – characteristics instilled within a person that will affect the way in which he is influenced. – Retention – the ability to remember what one sees and transforms it into visualizations or verbal expressions. – Reproduction – the ability to transform what one has retained into definite behaviour. – Motivation – one has to be given a reason or incentive to reproduce what he has observed and retained. Organisation Good Organisation 4th Characteristic of being an effective teacher †¢ Having good organisational skills. †¢ In order to keep the students focused, the explanation should be sequential to avoid confusion. †¢ The teacher should always follow a lesson plan. Bloom’s Taxonomy for Learning Domain †¢ The last two domains – Synthesis – Evaluation focus on the importance of having a lesson plan as a guidance for the lesson. Importance of a Lesson Plan †¢ A lesson plan is important – to make the lesson sequential. – to ensure the objectives devised were reached. – to assess whether students understood  or not. Conducting a Lesson †¢ The teacher starts off the lesson by correcting the home work, – the students participate and say their answers. †¢ Introduces the topic that will be tackled. †¢ The teacher may write down some notes on the whiteboard. †¢ Class work is given so as to make sure that the students understood the topic. Organisation – Observation 1 †¢ A particular maths teacher at a girl’s school, applied very good organisational skills in her lesson. †¢ She stated the aims of the lesson at the beginning of the lesson in a very clear way. †¢ She managed to do all the things she had  planned. †¢ On repeated observations, it was noted that she always had a well-planned lesson. †¢ Students were always motivated to learn. Organisation – Observation 2 †¢ Another class that was observed in the same school was a Maltese literacy class. – It aids students who find it difficult when it comes to reading and writing. †¢ She involved the students by asking them to continue reading from where she stopped and corrected them wherever they made a mistake. †¢ At the end, she gave them some pages to read at home. Classroom Layout 1 †¢ In the previous incidents mentioned, the desks were  neatly placed and organised in twos. – Students can help each other with any difficulties they might have. †¢ The teacher’s desk was facing the student’s desks. †¢ On some occasions, the teacher may still need to separate desks to avoid misbehaviour and interruptions before starting the lesson. Classroom Environment †¢ When students are already inside the classroom, the teacher should make his / her presence felt. †¢ On the contrary, when students change class, the teacher can alter the classroom layout to suit his/her approach to teaching. Disorganisation †¢ When the teacher is disorganized he/she will  not be able to deliver a well-balanced lesson. – This was noticed in an observation where the class only managed to read a small paragraph from a textbook throughout two whole double lessons. – The rest was random, out of point discussions. †¢ There was poor classroom management together with a lack of discipline. Observation Disorganisation †¢ During a Home-Economics practical session a disorganised teacher was observed. †¢ The teacher did not guide and assess the students. †¢ They ended up asking each other what to do next and did not learn any skills. Discipline Behaviourism †¢ Constant motivation is  compared to behaviourism – researched by B. F. Skinner. †¢ He called his research ‘The Operant Conditioning Theory’. †¢ Theory states that a particular behaviour can be increased by positive / negative reinforcements (praise / punishments). Bad Discipline Observation Ineffective Teacher †¢ Observation A particular teacher, instead of correcting the students in a gentle manner and explaining what was wrong, the teacher sent the students out of class together with their desk and chair. †¢ It was observed that most of the teachers reprimanded the students whenever they got something wrong. †¢ Students are demoralized and in consequence show no interest in learning. Albert Bandura †¢ Throughout our observations, one thing was particularly noticed. †¢ When a teacher scolds students, their actions turn out to be counterproductive as that same action is repeated by the students. †¢ This is backed up by the Social Cognitive Theory researched by Albert Bandura. †¢ The Bobo-Doll experiment – Children imitated what was seen both verbally and physically. Influential Teachers †¢ A teacher’s behaviour contributes to classroom management . Henry Adams once stated: â€Å"A teacher affects eternity; one can never tell  were the influence stops. † Good Discipline Observation – Effective Teacher 5th characteristic of being an effective teacher †¢ Keeps the same discipline methods with all students regardless of their gender, race, ability or religion. †¢ Positive reinforcement: praises students and corrects their mistakes. †¢ Greets the students. †¢ Prepares the things needed for the lesson beforehand and waits for the students to settle down. †¢ Goes around the students to check whether everyone is paying attention. †¢ Removes distracting materials such as any irrelevant writing on the board will be rubbed off. Communication of Ideas 6th Characteristic of being an effective teacher †¢ Ability to communicate ideas effectively. †¢ This is done through the use of a variety of resources. †¢ This is explained in Benjamin Bloom’s book – Taxonomy of Learning Domains. Resources Motivation †¢ A teacher should always motivate students in a fun way – that is what keeps them going; Albert Einstein once said: â€Å"It is the supreme art of a teacher to awaken joy in creative expression and knowledge. † Observation †¢ During a science lesson, one of us observed one such characteristic, †¢ The science teacher used a variety of interesting  resources such as: – – – – PowerPoint presentations Worksheets Information handouts Textbooks †¢ These resources enabled students to be enthusiastic and motivated. Importance of Resources Something commonly observed: †¢ Very few teachers made use of resources, †¢ Most of them used the traditional resources; white board and textbooks, †¢ Students ended up bored and disinterested throughout the lesson. Edgar Dale †¢ In the 1960’s he put forward the theory: †¢ Students retain more information by what they â€Å"do† as opposed to what they â€Å"hear†, â€Å"see† or â€Å"observe†. †¢ He devised the ‘Cone of Experience. ’ †¢ â€Å"Learning by doing† is nowadays known as â€Å"experiential learning†. Cone of Experience Ineffective Resource 1 Textbooks †¢ By time, textbooks become outdated. This means that more money has to be forked out by the school and parents to update them. †¢ Textbooks should be used as a reference for studying, revising or even further notes. Ineffective Resource 2 Whiteboard †¢ Teachers still rely on such a sole type of pedagogy application, †¢ Disadvantage: The teacher may not write clear and big enough for the students to read, †¢ There can be cases of impairment; eyesight problems. Positive Environment  7th Characteristic of being an effective teacher †¢ The ability to create a positive classroom environment. †¢ A positive classroom environment is boosted further by using: – the appropriate type of humour – at the appropriate time. Humour †¢ Teachers should foster the praxis of using humour as it is an effective technique. – This removes any tension in the relationship between the teacher and the student. – This leads to a better performance in the students’ academic life. Negative Attitude †¢ Students will learn less if the teacher uses a negative attitude towards them. †¢ This includes factors such as  sarcasm. Sarcasm †¢ Sometimes teachers confuse good humor with sarcasm. – The use of sarcasm may harm the teacherstudent relationship since what some think as funny others may find to be offensive. – Sarcasm is humiliating for students. What makes a bad teacher? Video – Ineffective Teacher †¢ An ineffective teacher can be seen in the following video: Conclusion †¢ A teacher should be a life-long learner which is committed to the teaching profession striving to reach and teach’ students. Plato claimed that â€Å" The direction in which education starts a man will determine his future life†.

Thursday, November 14, 2019

A comparison of Ancient Rome and Pre WW1 United States Essay -- essays

A comparison of Ancient Rome and Pre WW1 United States Title: The Roman Empire and the Early United States A comparison The purpose of this paper is to show the comparison between remarkable empires that were created in many years apart. I chose to compare Pre-World War I United States and the Roman Empire. The Roman Empire information is said to be recorded between 753BC – 1184 BC (ThinkQuest) and the Pre World War I information is between late 19th century and early 20th century (Encarta). Included in this paper will be in information comparing: Government, Economy, Military, and Religion. GOVERNMENT The Roman Empire had 3 different types of government during this period. During the 1st period Rome was controlled by a King, who acted as commander-in-chief during war times as well as the chief priest and judge (ThinkQuest). Decisions had to be approved by the Comitia Centuria and the Senate before the King could exercise his authority. The United States was set-up similar to the Roman Empire in regards to how decisions where executed. The United States government consists of a President, Congress and Senate. Taking these aspects into consideration, both the King and the President have to receive permission from other bodies of government before making decisions. ECONOMY Both the Pre World War I United States and the Roman Empire had vast amounts of agricultural products. The Romans had created a system equivalent to the United States, which seems amazin...

Monday, November 11, 2019

Frederick Douglass Essay Essay

Frederick Douglass has finally managed to run away from one of his masters to become a free slave, but yet he feels fear and paranoia. As he runs away, he contemplates all the possibilities of him getting caught by slaveholders or even turned in by his own kind. And it upsets him having to pass all the houses and food, but he has no shelter and starves with no food. This in fact heightens the intensity of his fear and paranoia because he is more likely to be caught with no where to hide and having no energy to run because he is starving. In The Narrative Life of Frederick Douglass, he utilizes things such as parallel syntactic structure, paradoxes, figurative language, and caesuras to help portray his feeling of built up unease and terror. Frederick Douglass really takes advantage of parallel syntactic structure to compare his situation of being run away to slaves. Frederick tries to get us to feel empathy in his current condition, while also speaking of the slaves. He says â€Å"-wanting shelter and no one to give it-wanting bread, and no money to buy it [†¦]† (Douglass 137). This seems more difficult to live with than having somewhat of shelter and having a bit of food, rather than Douglass having neither. He gets readers to question such things as, would one turn in a man in such need as? Would one understand more if one knew how it was to be in my condition? And this gets people to understand his despair and distress. Douglass uses his paradoxes in a creative way. Where he uses parallel syntactic structure, he also utilizes paradoxes. On page 137, where he says â€Å"-wanting shelter and no one to give it-wanting bread, and no money to buy it [†¦]† (Douglass). His use of contradiction is quite effective because it is hard to have all the things you want and need in one’s face, but one can not have it. For example, if a person wanted a new bike and one was just sitting there in their house waiting for them to take it, but their father was standing next to it and if he saw them touch it they would be grounded. And the bike was just sitting there taunting them. The paradoxes get people to understand how irritating it is to be passing by all these necessities stay you need to live and survive, taunting you as you pass by. While Douglass is running away, he relates slaves and hunting slaveholders, using figurative language, to wild beast and himself to the helpless prey. On page 136, Douglass says â€Å"†¦as hideous crocodiles seize upon his prey!† He says this because he feels so defenseless that he feels like a little animal going to be eaten. With all the slaveholders and there guns and all slaves that might turn him in, he doesn’t really stand a chance with no where to hide and running out of energy. In addition, on page 137 he says â€Å"†¦famished fugitive is only equaled by that with which monsters of the deep swallow up the helpless fish upon which they subsist,† In this he basically saying it is only a matter of time before they find him and take him in. He can’t really run from them with how hungry he is, he has no energy and no hope that he could out run them if he tried. On pages 136 and 137, caesuras are applied multiple times throughout these pages to conduct a sense of his worry and anguish. He says like â€Å"†¦in total darkness as to what to do, where to go, or where to stay -perfectly helpless both as to the means of defense and means of escape-â€Å" (Douglass 137) The breaks leave you kind of hanging because you don’t know if at the end of the next break he could be caught or even shot. And that is where the worry builds because while he was running away he didn’t either if at any second a slave would show up and turn him in. Or a slaveholder would shoot him from behind a tree. So a person really get into his shoes as a run away slave and sort of feel what it is like. Frederick Douglass really utilized these devices well. They all help build the reader to become like a fugitive slave just as he was. Relating slave and slaveholders to animals, and putting all the caesuras help the reader feel all the unease he felt because it was exactly how he was feeling. You would think at first that he was free now, and all his problems were gone yet they are still there. All the devices he used really help you come to that conclusion.

Saturday, November 9, 2019

Critical Review of the Literature of the role that Dietary Factors Play in Preventing Type 2 Diabetes Essay

Critical Review of the Literature of the role that Dietary Factors Play in Preventing Type 2 Diabetes’ Introduction Type 2 Diabetes (T2D) is a rapidly growing international public health issue. It has been reported that 285 million 20–79 year olds had the disease in 2010 worldwide and this is estimated to grow to 439 million by 2030. (19) T2D has been associated with a variety of other health problems such as cardiovascular disease, blindness and shortened life expectancy. (4,40) The prevalence of the disease is associated with obesity and overweight as well as a ‘Western’ dietary pattern and lack of exercise. (17) It has been reported that approximately 80% of people who develop T2D are obese or overweight prior to diagnosis.(8) Diabetes is a preventable disease, (19) with weight loss being identified as one of the most powerful interventions. (4) Diet and physical activity (PA) are effective interventions in attaining this (25) and have also been linked with reduction in risk independently. (40) The primary focus of this paper will look at diet and review the evidence on whether diet alone can help to prevent T2D. As a secondary theme it will also look at the evidence that diet can help to prevent the development of and help to control symptoms after T2D has been diagnosed. 8 papers will reviewed, (26-33) with a purpose of identifying some practical, evidence based dietary guidelines. Dietary guidelines are easier to follow when they indicate specific foods and patterns rather than nutrients and properties of foods and greater compliance can be achieved . (29,31) For this reason the studies reviewed focus on specific foods and diet styles rather than macronutrients and or micronutrients which do not translate into dietary guidelines as easily. Literature Search A literature review using the following databases was carried out; Pubmed, Web of Science, Embase, CINAHL, British Nursing Index and Medline. The following keywords were used in various combinations; Diet, prevention, food, T2D, interventions, dietary, fruit, vegetables, nutrition. Other resources such as ‘Google scholar’ and NHS Choices ‘behind the headlines’ were also utilised. Because T2D is an international issue, papers from around the world were considered. The criteria for inclusion was less than 10 years old, the intervention had to be a specific food group or diet style, measuring new incidents of T2D, or changes is symptoms associated with T2D and adults as the sample group. Diet as a tool to prevent T2D 6 Studies looked at whether diet can prevent T2D. Please refer to Table 1 for details of all the studies. Villegas et al (26) and Bazzano et al (27) looked at fruit, vegetable and fruit juices consumption and fruit and vegetable consumption respectively. Both of the studies used women only in their sample groups, limiting the generalizability of the findings to the wider population. (5) Dietary assessment was achieved through Food Frequency Questionnaires (FFQ) in both studies. Villegas et al (26) provided evidence of their FFQ having been validated, (21) however reported using it only 3 times within a 4.6 year timeframe, questioning the accuracy of their collected data. Bazzano et al (27) data collection was retrospective in that the FFQ was designed in 1984 and followed up at 4 year intervals. The concern with such a dated questionnaire is that it has not accounted for different trends that have occurred over time, affecting the accuracy of the results. Villegas et al (26) confirmed incidence of T2D through subjects meeting the criteria set out by the American Diabetic Association.(2) Bazzano et al (27) used criteria set out by National Diabetes Data Group for all participants up to and including 1997.(16) The Criteria for participants after 1998 was set out by the American Diabetic Association. The reason for this was due to new criteria being published at this time. (2) The main difference being the plasma glucose reading changing from 7.8mmol/l or more to 7.0mmol/l or more. (9) The Criteria Set out by the World Health Organisation in 1985, (24) could have been used to confirm incidence of T2D in the Bazzano et al (27) study . It was published 1 year after baseline data was taken and would have resulted in a higher percentage of participants being diagnosed with the same criteria, increasing consistency and reliability in the results. Villegas et al (26) reported that a higher consumption of vegetables was associated with a reduced risk of T2D. Participants who had a higher vegetable intake were also less likely to smoke and have higher levels of PA, both factors that can reduce the risk of T2D questioning the causality of the reduction in risk. (4) Participants with a higher fruit intake were also less likely to smoke and have higher levels of PA. There was no association made between fruit intake and risk of T2D therefore it is possible to consider that confounders like PA and smoking may not have effected the level of risk to T2D in this study. Bazzano et al (27) reported an inverse association between whole fruit and green leafy vegetable intake. Women who had a higher intake of fruit and vegetables were older, less likely to smoke and more likely to have higher levels of PA. Fruit Juice was positively associated with incidence of T2D which could be due to high sugar content.. (22) Also participants who had the highest fruit juice intake had the lowest levels of PA which is associated with increased risk of T2D. (20)Salas-Salvado et al (28) and Martinez-Gonzalez et al (29) both studied the risk of T2D and adherence to the Mediterranean diet (MedDiet). A MedDiet is characterised by high consumption of fruit, vegetables, whole grains, olive oil, nuts, pulses, fish and reduced consumption of red and processed meats, high fat dairy refined gains and foods high in sugar and starch. (11) Salas-Salvado et al (28) compared adherence to a MedDiet supplemented with either olive oil or nuts with a low fat diet (control group). The supplemented items in the MedDiets were given to participants. Participants in the control group were given non dietary gifts to encourage adherence. There are concerns about the ethics of using incentives and gifts in research. (6)Within this study the use of gifts appears innocuous, the concern lies with how adherence to the diet is reliably measured. When participants are given vital ingredients, this will influence their dietary intake, making it difficult generalize the results. (13) The sample population in this study were older and had at least 3 risk factors relating to cardiovascular disease again making it more difficult to generalise results. Participants were given 7 goals, including;  increasing vegetable and fruit consumption, reducing red and processed meat and increasing the consumption of either olive oils or nuts. The control group were asked to reduce all types of fat. Results showed that participants in the MedDiet groups had a greater reduced risk of T2D. Risk was reduced by 51% in the olive oil group and 52% in the nut group. These findings are backed up by other studies. (38-39) Diabetes incidence was lower in those who attained ≠¥ 4 of the 7 goals. PA levels and changes in weight did not differ through all 3 groups, although the participants in the both the MedDiet groups were associated with higher levels of PA. This study was carried out on Spanish participants, who traditionally follow a MedDiet. The control group may have had a strong adherence to a MedDiet naturally, which could impact on the reliability of the results. Martinez-Gonzalez et al (29) used participants who were nurses and university graduates. Prevalence in T2D is associated with lower socioeconomic status, (1) so by using the participants from a higher socioeconomic group may bias the findings. (13) Participants were not excluded if they had Diabetes at baseline. Data was collected via FFQ which consisted of 136 items with 9 responses ranging from never to more than 6 times a day. Points were allocated to determine a score indicating level of adherence. Questions covered areas such as cooking methods, supplements and fats and oils. This FFQ goes into a lot of detail to obtain the most information it can about participants diets, increasing the validity of the data. However reliability is compromised as participants are asked to recall food intake from the previous year decreasing the accuracy of data collected. (5) The results indicated a significant reduction in risk of developing T2D in those who with strong adherence to the MedDiet after adjustment for age and sex. Participants with a score of ≠¥ 6 had an 83% reduction. Although participants in this group had the highest levels of physical activity, which is a known factor in decreasing the risk of T2D, they also had a higher baseline prevalence for increased risk factors for Diabetes such as age higher BMI and higher blood pressure. This adds weight to the findings the MedDiet can reduce the risk of developing T2D. Fung et al (30) and VanDam et al (31) looked at more generalised dietary  patterns. VanDam et al (31) used a 131 item FFQ specifying specific foods, portion sizes and frequency of intake. Over a space of 12 years data on food intake was collected 3 times. In order to make these results more reliable data collection should have occurred more frequently. The participants were all male health professionals making the sample group quite specific reducing the ability to generalise the findings to the wider population. (13) Foods were classified into groups based on nutritional profiles. Factor analysis was then applied in order to identify food patterns. Two dietary patterns were identified ‘Prudent’ and ‘Western’. Prudent was characterised by high consumption of vegetables, fish and whole grains and Western by high consumption of red and processed meat, high-fat dairy and eggs. Men with higher Western patterns were younger, more likely to smoke and did less PA. Men with higher Prudent diet patterns were older less likely to smoke and engaged in more PA. The Prudent diet was associated with a modest reduction in risk in developing T2D with wholegrain foods having the highest inverse association. Fruit and vegetables were not considerably associated with reduced risk. The Western diet was associated with considerably higher risk of developing T2D. Processed meat, other processed foods and refined grains indicating the most significant association. This could indicate that cutting out specific foods could me more beneficial in reducing the risk of T2D than increasing intake of other foods. Fung et al (30) used participants from the Nurses Health Study which was established in 1976. This is the same study from which Bazzano et al (27) took their participants. The same FFQ was used in this study with baseline also being the 1984 FFQ as this was the expanded 116 item version. The information obtained was then used and classified in the same way as the VanDam et al (31) study producing the same Prudent and Western dietary patterns. The results from this study focus mainly on the Western diet pattern. Similarly to the men in the VanDam et al (31) study, women who scored high in the Western diet pattern were more likely to smoke. The results also mirrored that of the VanDam et al (31) study in that it reported an increased risk of developing T2D and a Western diet pattern. This study investigated the characteristics of the Western dietary pattern further and found positive associations between red and processed meats and  the development of T2D. This could also add weight to the previous comment that cutting out specific foods, such as red and processed meats could be more beneficial than adding other food groups in preventing T2D. A replica study using the same FFQ and Prudent and Western diet pattern and using a sample group that consisted of both men and women could add strength to the finds of both of these studies.(5) Diet as a tool in preventing the development of and giving greater control over the symptoms of T2D Elhayany et al (32) compared a low carbohydrate Mediterranean diet (LCM) a traditional Mediterranean diet (TM) and the 2003 American Diabetic Association diet (ADA) on health parameters. Glycemic control for people with T2D diagnosis was one of the outcome measures. Participants were randomly assigned to 1 of the 3 groups, given recommendations for daily intake on nutritional elements such as calories and protein and advised to engage in 30-45 minutes of PA a week. The LCM and TM diets included only low glycemic index carbohydrates, with LCM having a lower %. The TM and ADA diets had the same % of carbohydrates but the ADA also included mixed glycemic index carbohydrates. FFQ were used asking the participants to recall the last 24hour food intake. It is felt this data will be more accurate than those studies asking participants to recall food intake from the previous year, making results more reliable. Data was collected 3 times over a 12 month period. Results showed all groups had reduced weight and BMI with no significant difference. All 3 dietary interventions reduced factors that increase glycemic control such as HbA1c and triglyceride levels. The LCM diet was the most effective in increasing glycemic control. Esposito et al (33) compared a LCM and a low fat calorie restricted diet (LFD) on glycemic control and the delay on needing to commence antihyperglycemic medication in people newly diagnosed with T2D. The LCM diet was rich in fruit vegetables and whole grains and low in red meat. There was also a requirement that no more than 50% of calories was from  carbohydrates. Complex carbohydrates rather than low GI carbohydrates were stipulated. Some complex carbohydrates can have high GI levels, which are associated with increased risk of Diabetes. (10) The LFD was based on American Heart Association guidelines. (12) Participants were randomized into 1 of 2 groups asked to keep food diaries and given guidelines on increasing physical activity. Data was collected through reviews of the diary. Food diaries could provide more reliable information than FFQ if they are filled out daily. There is still a risk that they could be filled out inaccurately, and that participants may modifies their intake as a result of keeping a diary. The study reported that both groups lost weight, but reduction was greater in the LCM. Overall there was a significant difference in the need to commence antihyperglycemic medication between the LCM and the LFD; 44% and 70% respectively. Potentially this result could have shown more significance if low GI carbohydrates were stipulated instead of complex carbohydrates. Discussion The findings coming out of this review indicate that certain dietary interventions maybe helpful in reducing the risk of developing T2D and may also help with glycemic control after diagnosis.(26-33) Some food groups and dietary patterns provide more consistent evidence than others. The results regarding fruit intake and risk of T2D are inconsistent within this review with Villegas et al (26) reporting no association between fruit and risk reduction, where as Bazzano et al (27) did. High consumption of fruit and vegetables are a major component in the Mediterranean diet and the Prudent dietary pattern, both of which were associated with an inverse association. Vegetables are more consistently associated with a reduced risk, in this review and a recent meta-analysis, (3) particularly green leafy vegetables. (27) More research studying the effects of fruit and vegetables separately is needed. This inconsistency is reflected in other studies and systematic reviews. (7) High intake of fr uit and vegetables has often been associated with higher PA levels within this review, (26-29,31) which is a risk reducing factor in itself. Part of the problem could be that many studies that look at dietary interventions are prospective cohort studies and  although they can provide an association they can not prove whether the cause is due to the dietary item or another factor such as PA or weight loss. More experimental designed research is needed so that a direct cause between diet and the reduction of T2D can be established. (13) While it is unclear the exact role that fruit and vegetables play in reducing the risk of T2D there is an abundance of evidence that a diet rich in fruit and vegetables is beneficial in overall health (34-35) and weight reduction, (23) so including them as part of a healthy diet may indirectly help to reduce the risk of T2D. Red and processed meat has been more consistent in its positive association to developing T2D. Fung et al (28) and VanDam et al (29) found strong associations between consumption and increased risk of T2D. One of the characteristics of The Mediterranean diet is the absence or reduction of red and processed meats, and this diet has been associated with reduced risk. These findings were backed up in a recent meta-analysis paper (18) studying 3 cohorts who’s conclusion suggests that red meat consumption, particularly processed red meat is linked to higher risk of developing T2D. Meta-analysis produces level 1 evidence, providing increased confidence in the conclusions and good grounding for providing evidence based information such as dietary guidelines.(13) Diets high in red and processed meats are linked to high cholesterol (14) which is one of the leading causes of death in people with T2D (15) and other serious health conditions such as cancer and cardiovascular disease. (36) So while increasing fruit and vegetable intake may have a more beneficial and holistic effect on health, the same could be said for reducing the intake of red and processed. Salas-Salvado et al (28) produced higher level evidence being a randomised control trial giving more weight to their findings;(5) following a MedDiet can reduce the risk of T2D. One of the studies that looked at the effect of diet after diagnosis, (32) was also a randomised control trial providing the same level of evidence and weight to their findings that LCM can delay the need for hyperglycaemic medication therefore having a positive beneficial effect on T2D. Although these two studies looked at the effect of diet after diagnosis it could be reasonable to suggest that following the dietary  patterns associated with these findings, prior to diagnosis could help prevent T2D as they are similar dietary patterns to two of the other studies.(28-29) While the findings from this review indicate that making changes to ones diet may help to reduce the risk of Diabetes occurring, it also suggests that implementing the same kind of dietary changes may help with glucose control after Diabetes has been diagnosed, preventing the further development of the disease and the need for antihyperglycemic medication. (32-33) One study has implied that dietary changes in the form of energy restriction can actually reverse beta cell failure and insulin resistance, symptoms found in T2D. (37) It is a very small study and the dietary intervention is severe energy restriction making it difficult to generalise to the wider population, but it is a controlled study and could provide interesting findings that further research could be built upon, that dietary interventions may be able to reverse the symptoms of T2D. Collating this information together it seems reasonable to suggest that making positive changes to dietary habits could have benefits pre and post T2D diagnosis. Dietary Guidelines The findings from the 8 studies in this review can not all be discussed in detail due to word limitation. However recurring themes seem to be occurring, providing information on which to base a set of guidelines. Going by these findings the following guidelines are recommended: Reduce intake of red meat and processed meat (all colours) Substitute these with white meats and fish Reduce intake of other processed foods Reduce intake of refined grains Reduce intake of high sugar foods and drinks including fruit juices Carbohydrate intake should be based on items with a low GI score Increase intake of olive oil Increase nut intake Increase intake of pulses Increase wholegrain intake Increase vegetable intake especially green leafy vegetables Increase fruit intake A Mediterranean style diet is characterised by much of this advise and is therefore a recommended diet style to follow. Conclusion The prevalence of T2D is growing around the world. It has been associated with many other health problems and reduces quality of life and life expectancy. It is a preventable disease and diet is one of the ways in which this disease can be combated. Dietary guidelines have been recommended from the findings of this review, based on following a Mediterranean diet, reducing intake of red and processed meats and other processed foods and increasing intake of foods such as fruit and vegetables, wholegrains and olive oils and nuts. While it has been acknowledged that more research needs to be carried out to further examine the cause and effect between diet and T2D, it is reasonable to suggest that one may find these dietary changes beneficial in helping to reduce the risk of T2D and other areas of health, possibly helping to indirectly reduce risk of T2D. It is also reasonable to suggest that a change in diet may bring beneficial changes once diagnosis has been given. Table 1 Reference list 1. Agardh E, Allenbeck P, Hallqvist J, Moadi T and Sidorchuk A. Type 2 Diabetes and Socioeconomic Position: A Systematic Review and Meta-analysis. International Journal of Epidemiology. 2011: 40(3) 804-818 2. American Diabetic Association Report of the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Diabetes Care. 2000: 23(1s) 3. Carter P, Gray LJ, Troughton J, Khunti K, and Davies M. Fruit and vegetable intake and incidence of Type 2 Diabetes mellitus: A Systematic Review and Meta-analysis. British Medical Journal. 2010: 341:c4229 4. Davis MJ, Tringham JR, Troughton J, Kunit KK. Prevention of T2D mellitus. A review of the Evidence and its Application in a UK Setting. Diabetic Medicine. 2004: 21: 403-414 5. Gerrish K and Lacey A. The Research Process in Nursing. 2006 5th Edition. Oxford: Blackwell Publishing. 6. Grant RW and Sugarman J. Ethics in Human Subjects Research: Do Incentives Matter? Journal of Medicine and Philosophy. 2004: 29(6) 717-738 7. Hamer M, Chida Y. Intake of Fruit and Vegetables and Antioxidants and Risk of Type 2 Diabetes. A Systematic Review and Meta-analysis. Journal of Hypertension. 2007: 25:2361-2369 8. Hensrud DD. Dietary Treatment and Long-term Weight Loss and Maintenance in T2D. Obesity Research. 2001:9(4 supplement):348S-353S 9. Hickner RC, Brunson MA, McCammon M, Mahar MT, Garry JP, Houmard JA. Diabetic Groups as Defined by ADA and NDDG Criteria have a Similar Aerobic Capacity, Blood Pressure and Body Composition. American Diabetes Association and National Diabetes Data Group. Diabetologica. 2001: Jan 44(1) 26-32 10. Hodge AM, O’Dea K, English DR, and Giles GG. Glycemic Index and Dietary Fibre and the Risk of Type 2 Diabetes. Diabetes Care. 2004: 27(11) 2701-2706 11. Kastorini MC, Milionis HJ, Esposito K, Giugliano D, Goudevenos JA,Panagiotakos. The Effect of Mediterranean Diet on Metabolic Syndrome and its Components. Journal of the American College of Cardiology 2011: 57(11) 1299-1313 12. Krauss RM, Eckle RH, Howard B, Appel LJ, Daniels SR, and Deckelbaum RJ. AHA Dietary Guidelines: Revision 2000: A Statement for Healthcare Professionals from the Nutrition Committee of the American Heart Association. Circulation. 2002: 102:2284-99 13. LoBiondo-Wood G. and Haber J. Nursing Research. Methods and Critical Appraisal for Evidence Based Practice. 2006: 6th Edition. Mosby: Missouri 14. Micha R, Wallace SK, and Mozaffarian MD. Epidemiology and Prevention. Red and Processed Meat Consumption and Risk of Incident Coronary Heart Disease, Stroke and Diabetes Mellitus. A systematic Review and Meta-Analysis. American Heart Association. 2010: 121 2271-2283 15. Heart Disease and Stroke: The Nations leading Killers. At a Glance National Centre for Chronic Disease Prevention and Health Promotion. Division for Heart Disease and Stroke prevention. 2011: CS217229-AI 16. National Diabetes Data Group Classifications and Diagnosis of Diabetes Mellitus and Other Categories of Glucose Intolerance. Diabetes. 1979: 28 1039-1057 17. Neild L, Summerbell CD, Hooper L, Whittaker V, Moore H. Dietary Advice for the Prevention of T2D Mellitus in Adults (Review) The Cochrane Collaboration. 2008: Wiley 18. Pan A, Sun Q, Bernstein AM, Schulze MB, Manson JE, Willett WC and Hu FB. Red Meat Consumption and Risk of Type 2 Diabetes: 3 Cohorts of US Adults and an Updated Meta-analysis. American Journal of Clinical Nutrition. 2011: 94(4) 1088-1096 19. Shaw JE, Sicree RA, Zimmet PZ. Global Estimates of the Prevalence of Diabetes for 2010 and 2030. Diabetes Research in Clinical Practice. 2010:87:4-14 20. Sigal RJ, Kenny GP, Wasserman DH, Castaneda-Sceppa C and White RD. Physical Activity/Exercise and Type 2 Diabetes. A Consensus Statement from the American Diabetes Association. Diabetes Care. 2006: 29(6) 1433-1438 21. Shu XO, Yang G, Jin F, Liu D, Kushi L, Wen W, Gao YT, Zheng W. Validity and Reproducibility of the Food Frequency Questionnaire Used in the Shanghai Women’s Health Study. European Journal of Clinical Nutrition. 2004:58:17–23 22. Shulze MB, Manson JE, Ludwig DS, Colditz GA, Stampfer MD, Willet WC, and Hu FB. Sugar-Sweetened Beverages, Weight Gain, and Incidence of Type 2 Diabetes in Young and Middle-Aged Women. The Journal of the American Medical Association. 2004: 292(8):927-934 23. Tohill B, Seymour J, Serdula M, Kettle-Khan L, and Rolls BJ. What Epidemiological Studies Tell Us about the Relationship between Fruit and Vegetable Consumption and Body Weight. Nutrition Reviews. 2004: 365 -374 24. WHO Study Group on Diabetes Mellitus. Diabetes Mellitus: Report of a WHO Study Group. Geneva: World Health Organisation: 1985 25. NICE Public Health Guidance. Preventing Type 2 Diabetes: Population and Community Interventions. National Institute for Health and Clinical Excellence. 2011: Issue 35 26. Villagers R, Shu OX, Gao YT, Yang G, Elasy T, Li H and Zheng W. Vegetable but Not Fruit Consumption Reduces the Risk of Type 2 Diabetes in Chinese Women. The Journal of Nutrition. 2008: 138 574-580 27. Bazzano LA, Kamudi JJ, Hu FB, and Li TY. Intake of Fruit, Vegetables and Fruit Juices and Risk of Diabetes in Women. Diabetes Care. 2008: 31(7) 1311-1317 28. Salas-Salvado J, Bullo M, Babio N, Martinez-Gonzalez MA, Jurado NI, Basora J, Estruch R, Covas MI, Corella D, Aros F, Gutierrez VR, and Ros E. Reduction in the Incidence of Type 2 Diabetes With the Mediterranean Diet. Diabetes Care. 2011. 34:14-19 29. Martinez-Gonzalez MA, Fuente-Arrillaga CDL, Nunez-Cordoba JM, Basterra-Gotari FJ, Beunza JJ, Vazquez Z, Benito S, Tortosa A and Bes-Rasrollo M. Adherence to Mediterranean Diet and Risk of Developing Diabetes: Prospective Cohort Study. British Medical Journal. 2008: 336:1351 30. Fung TT, Schulze M, Manson JE, Willet WC, and Hu FB. Dietary Patterns, Meat Intake and the Risk of Type 2 Diabetes in Women. Archives of International Medicine. 2004:164:2235-2240 31. VanDam RM, Rimm EB, Willet WC, Stampfer MJ and Hu FB. Dietary Patterns and Risk for Type 2 Diabetes Mellitus in US Men. Annals of Internal Medicine. 2002:136: 201-209 32. Elhayany A, Lustman A, Abel R, Attal-Singer J and Vinker S. A Low Carborhydrate Mediterranean Diet Improves Cardiovascular Risk Factors and Diabetes Control Among Overweight Patients with Type 2 Diabetes Mellitus: A 1-year Prospective randomized intervention Study. Diabetes, Obesity and Metabolism. 2010: 12:204-209 33. Esposito K, Maiorino IM, Ciotola M, Palo CD, Scognamiglio P, Gicchino M, Petrizzo M, Saccomanno F, Beneduce F, Ceriello A and Guigliano D. Effects of a Mediterranean-Style Diet on the Need for Antihyperglycemic Drug Therapy in Patients with Newly Diagnosed Type 2 Diabetes. Annals of Internal Medicine. 2009: 151: 306-314 34. Van Duyn MAS and Pivonka E. Over view of the health benefits of fruit and vegetable consumption for the Dietetics Professional. Journal of the American Dietetic Association. 2000: 100(12) 1511-1521 35. 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Tuomilehto J, Lindstrom J, Eriksson JG, Valle TT, Hamalainen H, Ilanne-parikka P, Keinanen-Kiukaanniemi S, Laakso M, Louheranta A, Rastas M, Salminen V and Uusitupa M. Prevention of Type 2 Diabetes Mellitus by Changes in Lifestyle among Subjects with Impaired Glucose Intolerance. The New England Journal of Medicine. 2001: 344(18) 1343-1350

Thursday, November 7, 2019

OUR BLOOD essays

OUR BLOOD essays Bovine Spongiform Encephalopathy in our Blood Supply The well-being of the blood supply has always been a vital component of human existence. It is common knowledge that the existing blood supply is deficient to the increasing usage of blood and blood products. Ironically, as the topic of blood donation arises in society, fears and doubts as to how sanitary and healthful the blood of blood donors often surface. For instance, there is much criticism over allowing foreign travelers to Great Britain the opportunity to donate their blood. This criticism stems from the belief that the Great Britain endemic of Bovine Spongiform Encephalopathy (BSE or "Mad Cow Disease") can be physiologically related to the lethal Creutzfeldt-Jakob disease in humans. Although there is hardly any scientific evidence that supports this allegation, the United States Department of Agriculture and the FDA have introduced strict restrictions concerning the importation of British cattle products and the blood donation of British travelers. Critics, politicians, and the general public often utilize the conjecture of illegitimate facts and myths to shape their opinions concerning BSE. This is fine and great, but I believe a valid opinion on the subject must be backed by significant facts entailing the clinical epidemiology and history of Bovine Spongiform Encephalopathy, its relation to other transmissible spongiform encephalopathies (TSE), possible transmission to the human species, the causes of Creutzfeldt-Jakob disease, and any relationships between BSE and Creutzfeldt-Jakob disease. My opinion, based on the facts, is what I offer to you. Bovine Spongiform Encephalopathy (BSE) Bovine spongiform encephalopathy is a fatal brain disease of cattle. BSE is most common in dairy cattle, but not rare in beef cattle either. Cattle affected by BSE experience a progressive degeneration of the nervous system. Infected animals may show changes in behavior such as nervous...

Monday, November 4, 2019

Observing a four-month-old baby Assignment Example | Topics and Well Written Essays - 1000 words

Observing a four-month-old baby - Assignment Example At four months, babies are able to express themselves, making themselves an active part of their social environment. Observation The focus of the observation was a male baby named Sean Darren from Pennsylvania. This baby boy is developing fast under the care of his mother. He was born with glucose-6-phosphate dehydrogenase deficiency (G6PD), thus he was recommended to avoid certain foods like beans and soya. Some drugs or medications may also be harmful for him, thus he should not be given any medicine without the doctor’s advice. At his age, Sean is beginning to show funny tricks that make him look lovelier. He can recognize familiar faces of people around him; hence he calls the attention of his mother if he sees her around when he awakes. Similarly, he does not want to go with strangers and seems to choose people he goes with. He recognizes his own platter and jolts when he sees his mother holding it. He also takes his milk to his mouth and holds the bottle with the support of a cushion or pillow. Sean cries when he is hungry and wet. He feels uncomfortable to wear wet diapers so his mother makes it a point to change his diapers every 3-4 hours or earlier when needed. At the time of the observation, he was playing with his mother who was holding a rattle. Sean focuses his attention on the little toy, and grabs the toy from his mother and drops it on the sofa. His grip at this stage is not yet strong. He does this repeatedly, while his mother keeps on picking the toy and giving it to Sean. At times, Sean would hold the toy to his mouth and attempt to bite it but fails to do so because he could not place the handle of the toy exactly into his mouth. When he got tired, he turned to his mother’s ring and tried to take it but failed because the ring is in her mother’s finger. After a while, his attention was led to his feet, and he held his feet for more than three minutes while he laughed at his mother whom he thought was talking to him. Sea n smiles a lot when he is playing with colorful things. He has some colorful toys hanging above his crib. He tries to get hold of them by raising his hand while lying on his sleeping cushion. When carried by his mother, the little boy would grab anything, especially colorful things he sees around him. If he is successful in taking what he wants, he would usually take it to his mouth and chew. He drools while he plays with the object in his mouth. Age Based on his behavior and actions, Sean looks like a four-month old baby. Four-month-old babies are nice to hold because they can already react to stimuli in their environment. From looking at things and staring at them, four-year-olds are able to grab them and explore using their hands and mouth. Just like other four-year-old kids, Sean would take something and bring it to his mouth. At his age, he can roll on his side and sleep on his chest and crawl at short distances. With support from his mother, Sean can put his weight on his feet but is unable to stand on his own or even with support. Moreover, four-month-old babies can interact with people around them. They smile and giggle at people who are smiling at them. According to the Cooperative Extension Website, when tickled, these babies could laugh loud and babble. Additionally, four-month olds prefer sitting with support than lying on their backs. They can roll from side to side, lift their head forward, grab things around them, and put things inside

Saturday, November 2, 2019

Quantitative Methods database assignment Example | Topics and Well Written Essays - 2250 words

Quantitative Methods database - Assignment Example Data regarding the hotels were collected from 144 hotels found in these 3 cities and namely 45 hotels from Edinburgh, 54 hotels from London and 45 hotels from Manchester. The information collected were star rating status, review scores, existing price of property, provision of swimming pool, Wi-Fi and whether it is charged. The analysis was based on: The statistical analysis done were the t tests and the ANOVAs to find out whether the p value is les than 0.05 which will mean there is a significant difference between the observations(price) based on locality or other variables and if p value is greater than 0.05 such observed difference will not be considered significant(Warne,2012). Further regression analysis was done to find out how the variables are related to pricing and how they influence price (Wessa, 2014). The sign convention of the coefficients in the equation will indicate whether the particular variable positively or negatively correlates with pricing strategy. Fig 1: The above table and figure reflects the number of hotels in different localities. London has more 4 star and 5 star hotels compared to Edinburgh and Manchester. While 0 star, 1 star and 2 star and 3 star hotels are more in Edinburgh and Manchester compared to London. Fig 8: The above figure reflects the comparison of average price of different star rated hotels in all 3 cities. It reflects London hotels has highest value for the rooms in 2 star, 3 star, 4 star or 5 tar properties compared to similar properties in Manchester or Edinburgh. Two star hotels are significantly priced more in Manchester than Edinburgh (p0.05). In the equation Pri means room price, Sta means star ratings, Rsc means review scores, WiC means wifi charged, FiC means fitness centre, Loc means locality, Dummy variables was assigned to WiC ( if