Medical study of type 2 diabetes in sub-saharan africa The WritePass Journal

Medical study of type 2 diabetes in sub-saharan africa Introduction Medical study of type 2 diabetes in sub-saharan africa IntroductionEpidemiologyRisk FactorsComplicationsTreatmentMajor Challenges and SolutionsConclusionsRelated Introduction In recent times there has been a surge in non-communicable diseases, especially Type 2 diabetes mellitus (T2DM), in sub-Saharan Africa (SSA). This is an extra burden upon the healthcare systems, which already have to cope with the high prevalence of communicable diseases such as HIV/AIDS, tuberculosis and malaria. I chose to read up on this issue as it is a topic that is not really addressed in the field of diabetes. Epidemiology There were approximately around 200 million people with diabetes worldwide. This figure is on the rise and has the potential to reach around 380 million in the year 2025. This huge increase also is expected to be seen in Africa and Asia. T2DM is the most common form of diabetes with around 90% of diabetic patients. The current prevalence of T2DM in SSA is only a third of the HIV prevalence, however it is estimated to reach the same as current HIV prevalence by 2025. The prevalence is around 1.4% or lower in most SSA countries, however it is raised to around 3% in South Africa. There is also a greater prevalence of the disease in urbanised areas, as apposed to the more rural locations. It has been. The prevalence of diabetes in Africa was around 3 million in 1994, rising to 7.1 million by the year 2000. In 2010 the figure was around 12 million and is set to rise up to around 24 million by the year 2030. This phenomenon may be due to the rapid urbanisation these countries are facing. Risk Factors These factors can be split into modifiable (i.e. can be changed) and non-modifiable. Modifiable risk factors include the rise in obesity seen in SSA. This rise can be attributed to the rapid urbanisation of SSA countries. A study in 2002 showed the extent of clinically overweight/obese people in South Africa to be 56% for females and around 29% for males. Other studies have shown diabetic patients in SSA have a higher BMI than non-diabetic patients. However, one may argue that it is truncal obesity, which is more closely linked to T2DM than BMI. One study has shown the level of truncal obesity in Cameroon to be 18% in males and 67% in females. This may be due to the consensus that women who are larger are deemed healthier and richer, especially in countries where HIV is prevalent. The diet of the people of SSA is becoming more westernised including the rise of saturated fats, sugars and lower levels of fibre. This paired with rapid urbanisation leading to a more inactive lifestyle is likely to contribute to the rise in T2DM seen. Countries of SSA are also increasing their GDP and so are becoming more prosperous. This is linked with the urbanisation, which has been mentioned. This has lead to the rise in processed foods consumed, inactive lifestyle and inevitable increase in obesity. Non-modifiable risk factors include age and ethnicity. The most common age group for T2DM was 45-65 year. Some studies showed that more women had T2DM than women in certain SSA countries. There is also an effect from ethnic origin, for example some countries have a higher population of Indian people, where the prevalence of T2DM is higher. Other risk factors include TB or the use of antivirals, which may increase the likelihood of contracting T2DM. Complications Complications arising from T2DM can either be classified as macrovascular or microvascular. Macrovascular complications include cardiovascular disease and stroke. Microvascular complications include nephropathy, neuropathy and retinopathy. Patients from developed countries have greater macrovascular morbidity, whereas in SSA the opposite is true. In developed countries T2DM mortality is due to CVD and renal complications, however in SSA the mortality is greatly due to infections and metabolic problems. Infections include sepsis and TB. Metabolic problems are usually keto-acidosis and hyperosmolar non-ketotic coma. However there is still a lot of un-obtained data, which is due to the poor documentation of the cause of death. It is one of the challenges to increase the number of deaths reported, and also to report it accurately. Treatment The key to decreasing the morbidity and mortality associated with T2DM is to maintain good control over the blood glucose levels. This can be achieved using a diet management plan, exercise and, if needed, the use of appropriate medication. Drugs, which can be administered, include sulphonylureas, which promote insulin secretion after a rise in glucose levels. Meglitinides, which are insulin secretagogues. Biguanides such as Metformin, decrease the rate of gluconeogenesis and thus lower blood glucose. Insulin can also be used as a last resort in T2DM to maintain good glucose control. A study has highlighted the poor blood-glucose control for patients with T2DM in SSA. These were patients who were on various different treatment regimens ranging from sulphonylureas to insulin. This maybe due to lack of availability of drugs, high cost of drugs/lack of funds, lack of adherence, lack of patient education and late presentation. One paper showed that a few health care settings in Tanzania only had a couple of sulphonylureas and insulin in their drug stores. Major Challenges and Solutions To understand why there is poor care of patients with T2DM in SSA, one has to identify the problems that are faced in order to create a solution. The economy of these countries is already stretched and so have low healthcare budgets. This means that there is not enough money to purchase drugs and provide optimal healthcare to T2DM patients who require chronic care. This problem is exacerbated due to the fact that communicable diseases such as HIV take up more of the budget, leaving a decreasing amount of money to be spent on non-communicable chronic conditions. There is also a lack of qualified healthcare providers and so insufficient manpower. This maybe due to the lack of training and courses in order to create these qualified healthcare providers. There are also poor healthcare referral systems. This inevitably shows the lack of organisation within the healthcare systems in SSA. This needs to be tackled by reorganising the healthcare infrastructure and create/improve training programmes for the staff. Greater drug supply is also essential. One study showed that there was a lack of insulin in some SSA countries such as Mali. There also needs to be improved access to care, as many patients can’t reach the required level of care in order to manage their T2DM well. There is also poor patient education in SSA, and so this leads to poor adherence of treatments as well as poor glycaemic control. T2DM is a chronic disease and so patient education is key in good management of the disease in order to decrease complications arising. Greater primary and secondary prevention strategies need to be established, as this will be economically beneficial. Interventions need to be cost effective as there are limited resources and funds. A lot of the data collected regarding T2DM care is inaccurate or just simply not collected. In order to assess the characteristics of the disease in SSA, better data collection methods need to be initiated. Poor record keeping is detrimental to the care of the T2DM patient, where glucose monitoring ensures stable control. An example to follow is the National Diabetes and Hypertension Program in Cameroon. This initiative saw the coming together of health-care providers, policy-makers and people from the community in order to tackle the growing epidemic of T2DM in SSA. Strategies are shown in figure 2. This program ensured greater monitoring, documentation as well as better interventions which all lead to better care for T2DM patients. Conclusions With the rapid urbanisation and greater prosperity seen in sub-Saharan Africa, T2DM is becoming an underestimated epidemic. With the focus on communicable diseases, the care of T2DM is not improving, as seen by the multitude of problems faced in SSA. Strained healthcare budgets mean that it is necessary, more than ever, to produce cost-effective initiatives. Governments need to understand the dangers of communicable diseases as well as non-communicable diseases. Better primary and secondary prevention strategies need to be created to target issues such as the rising levels of obesity. Governments need to issue better guidelines, training and promote policymaking. Initiatives such as National Diabetes and Hypertension Program in Cameroon have had very positive feedback and have set the standard for other governments within SSA. If this problem is not addressed, there will be a negative impact on T2DM morbidity and mortality. This will inevitably reduce the socioeconomic growth in SSA countries, which is vital for the prosperity of the country.

Writing Comparison and Contrast Essays

Writing Comparison and Contrast Essays Writing Comparison and Contrast Essays Writing Comparison and Contrast Essays Among different kinds of essays you have to write at school, comparison and contrast essays are perhaps the most interesting ones. Writing comparison and contrast essays develops your analytical skills, you can improve your ability to compare and make conclusions. Well, if you are not sure how to write a comparison and contrast essay, you are reading the right article. Starting your comparison and contrast essayTo make a good start of your comparison and contrast essay, make sure you know the basis for comparison. Start with providing some common features, after that find the characteristics which are different, and then make a conclusion. For instance, you do not know how to write a comparison and contrast essay on the Bible. Well, pick out one story which you like. For example, let it be a story about Cain and Abel. As a matter of common features, write that both of them worked very hard. Then, to contrast them, start with giving the infor mation that Cain worked in the field, and Abel was a shepherd. Then, write that Abel was humble and kind, and Cain was envious and mean. Once, both of them decided to make a sacrifice to God. While God accepted Abels gift, Cains sacrifice was neglected. That is why we can make a conclusion that God sees in a persons heart, it is impossible to hide anything from Him.Comparison contrast essay writing secretsWriting comparison and contrast essays, remember that it is important to sound emphatic. Sometimes it is not easy to find points to compare. For example, you may not know how to write a comparison and contrast essay on some modern book. Modern authors often avoid describing their characters as opposites; they want them to look like real people which have both positive and negative traits. This can complicate writing comparison and contrast essays. For instance, how to write a comparison and contrast essay on History? If you have to compare two poques, choose the main points to characterize. They can be the economical situation in the country, the demographical situation, the level of science development. Write some information about education and culture of these periods. Writing comparison and contrast essays on History, it is also important to mention the level of material welfare of people. In conclusion write in which poque peoples life was better. Now we think that you know how to write a comparison and contrast essay and you will easily complete your assignment.

Intermodal Transportation in the US Case Study Example | Topics and Well Written Essays - 500 words

Intermodal Transportation in the US - Case Study Example Intermodal Transportation in the US Government involvement in the country’s intermodal transportation system, particularly in the cargo sector, would allow for continuous movement of products by a number of modes of transport. Congress approved the Transportation Equity Act for the 21st Century (TEA-21) as a successor of ISTEA. This policy was not as far-reaching as ISTEA even though it continued the campaign for intermodalism and center on the ISTEA chassis (Konings et al., 2008). This regulation guaranteed the consideration of cargo mobility in the course of the planning procedure and offered more profound flexibility to fund intermodal stations that entail key and minor freeways, railway stations, sea terminals, and airports. Until this law was passed, the challenge of connectivity between and amongst intermodal stations was not a primary concern. If the federal government had prioritized efforts to solve this challenge, connectors to the country’s freeway system would have improved intermodal services and lowered freeway congestion. I also agree with the author that in a free market economy, the industry had been limited in their ability to deliver innovations in intermodal transportation. In the past 2 Â ½ decades, the movement of goods has been seamless only because of intermodalism in the cargo industry (Holguin-Veras et al., 2008).The most visible manifestation of intermodalism in a free market such as the United States is the increase in container traffic.

The Rococo Style of Art Essay Example | Topics and Well Written Essays - 500 words

The Rococo Style of Art - Essay Example Pope uses satire in his literature to express a certain perspective. He reveals the ludicrousness and unsuitable behavior that the 18th century people of England had towards fashion. The woman Belinda symbolizes the kind of women busy indulging and competing for fashion, which can be slightly term as an act of stupidity. The satire is edifying and aloof. He does not directly attack a particular person but points out the moral infidelity in the society. The society in context is the 18th century aristocratic era of the rise in the fashion industry. Although he also tackles other relevant topics whereby he continues the use of his satirical prose (Levey 45-70). An illustration is the case of the judge where he criticizes him for making rushed rulings in a ridiculous manner. The Rape of the Lock incorporates the masterful traits of a laudable blockbuster, nevertheless is used sarcastically to an apparently trivial narcissistic exclusive squabble. It eventually achieves a fanciful ridicu le epic by combining the petty and unchanging. This piece of literature presents a humorous and light tone. This consequentially elucidates the eccentric kind of the poem’s vital quarrel. The atrocities done by Baron like â€Å"raping† or stealing and the memorable hair style of Belinda are some of the issues of conflict. â€Å"The meeting points the sacred hair dissever from the fair head, forever and forever! Then flashed the living lightning from her eyes, and screams of horror rend the affrighted skies†.

Teacher & school Essay Example for Free

Teacher school Essay The positive and negative behaviors exhibited by teachers determine, to a great extent, their effectiveness in the classroom and, ultimately, the impact they have on student achievement. Several specific characteristics of teacher responsibilities and behaviors that contribute directly to effective teaching are listed for each of the following categories: ï‚ · The teacher as a person ï‚ · Classroom management and organization ï‚ · Organizing and orienting for instruction ï‚ · Implementing instruction ï‚ · Monitoring student progress and potential ï‚ · Professionalism Red flags signaling ineffective teaching are presented at the end of each section. Both positive and negative characteristics are based on a plethora of research-based studies that address the concept of improving the educational system for both students and teachers. These qualities are general for any content area or grade level. Subject-specific qualities presented for the four content areas typically found in all schools includ THE TEACHER AS A PERSON. The teacher is the representative of the content and the school. How a teacher presents himself makes an impression on administrators, colleagues, parents, and students. Often a student links the preference to a particular subject to a teacher and the way the subject was taught. A teacher who exudes enthusiasm and competence for a content area may transfer those feelings to the students. In addition, how the teacher relates to the pupils has an impact on the students’ experience in the class. The teacher’s personality is one of the first sets of characteristics to look for in an effective teacher. Many aspects of effective teaching can be cultivated, but it is difficult to effect change in an individual’s personality. A. Positive Qualities  Ã¯â€š · Assumes ownership for the classroom and the students’ success ï‚ · Uses personal experiences as examples in teaching,

Child Labor - Economic Exploitation of Children Essays -- Foreign Dome

Child Labor - Economic Exploitation of Children   Ã‚  Ã‚  Ã‚  Ã‚  Child labor is a serious problem in many parts of the world, especially in developing countries. It has been linked to many nations and cultures for hundreds of years. Child labor is defined by Article 32 of the Convention on the Rights of the Child: as any economic exploitation or work that is likely to be hazardous or interferes with the child’s education, or is harmful to the child’s health or physical, mental, spiritual, moral, or social development. Labor is defined as a difficult, or fatiguing mental and/or physical work. It wasn’t until the Industrial Revolution that it became the problem it is today. With the arrival of the factory system in the 18th century, during the 1700s, children as young as five were being used as workers in England. During this period, a law called the English Poor Act gave the government the responsibility to care for children that had no parents or whose parents were too poor to care for them. Under this law, the government would take these â€Å"pauper children† and place them in jobs where they could become apprentices and learn a trade. The law was not usually affective because when children were handed over to the factory owners and usually became slaves. This is a violation of the â€Å"Human Rights Document: Universal Declaration of Human Rights† in article 4, which states: no one shall be held in slavery or servitude; slavery and the slave trade shall be prohibited in all their forms. Children were used to tend to machines in factories and many worked in the dark, damp coalmines, carrying coal on their backs up ladders. Many children would work 10 to 15 hour days. This is a violation of the â€Å"Human Rights Document† in article 24, which states: everyone has the right to rest and leisure, including reasonable limitation of working hours and periodic holidays with pay. They were forced to work in dangerous and unhealthy conditions, and their wages were incredibly small. There are many reasons why these children work; poverty, lack of education, lack of knowledge of one’s rights, and cultura l tradition are all contributing factors. These children are often deprived and mistreated. They may get beaten or severely punished for making even the slightest mistake. This is another violation of the â€Å"Human Rights Document† in article 1, which states: all human beings are bor... ...the child labor; they don’t have any legal power. The trade unions are weak and don’t have the funds to do the job. Over several years the proposed law, now known as the Child Labor Deterrence Act, has been reintroduced along with a companion bill in the House. However, no vote has been taken on the House bill and the proposal was still pending at the beginning of 1998.   Ã‚  Ã‚  Ã‚  Ã‚  Some U.S. cities are passing laws to ensure that the goods they purchase are not made in foreign or domestic sweatshops. In 1992, the organization established the International Program on the Elimination of Child Labor (IPEC), which has implemented more than 600 action programs in 27 countries. The goal of these programs is to prevent and fight child labor by helping children withdraw from work in selected villages, provide support services for the children and their families, and change community attitudes towards child labor.   Ã‚  Ã‚  Ã‚  Ã‚  Putting an end to child labor requires changes on many fronts, especially on attitudes about child labor and the world’s poor. To help bring about changes in attitudes, activists in many countries are raising awareness that child labor violates fundamental human rights.   Ã‚  Ã‚  Ã‚  Ã‚  

Hiring the Educated

Hiring the Educated — A New Approach to Staffing the Automobile Factory Dawn Kennedy January 25, 2012 Managing Human Resources Dr. Pat Smallwood Hiring the Educated — A New Approach to Staffing the Automobile Factory Overview: This case shows us how Ford and Chrysler’s workforce and staffing processes have changed over the years. We see how the industry has moved from being dominated by the less educated worker to the highly educated worker and why this phenomenon has taken place. We are also taken through how the new selection process that Ford uses to hire it’s employees, as well as the statistical information surrounding their hiring process. Question 1: What do you think Ford’s overall strategic perspective is? How well does its new selection system support this strategy? Ford’s overall strategic perspective is to hire the highly educated worker in an effort to lower training costs and to be able to succeed in the global market. According to the article, I would that Ford is right on target as far as cutting training costs. As far as succeeding in the global market, the article makes it clear that this remains to be seen, however, my personal opinion is that Ford is a very strong competitor and will continue to be for many years to come. Question 2: What steps are included in Ford’s selection procedure? According to the chapter, what other techniques could it incorporate? Ford’s selection process includes rigorous math and cognitive testing, as well as teamwork skills testing and finally drug testing, followed by a physical exam. Other techniques that could have been incorporated include trainability testing, personality testing, and honesty testing. Question 3: Are there any other factors that are causing the auto companies to alter their selection procedures and look for more educated employees? They are looking for ways to lower training costs and they also need more employees who can supervise themselves due to a lack of adequately trained supervisors. Question 4: How do you think this scenario will play out? Will the educated workers leave? Will they stay? I think the educated workers will stay because they are now the ones that are being sought after for their ability to multitask and be more fluid within the different departments. Question 5: What type of work will the high school dropouts and immigrants who used to be selected to work in these car plants now be doing? The high school dropouts and immigrants may be given an opportunity to prove themselves through the use of the rigorous testing Ford has implemented for their hiring processes, but chances are that these individuals will be demoted or let go for more menial labor positions. Question 6: What benefits will Chrysler get from educating high school students? The recruits will be highly educated in the areas in which Chrysler consider important and will be work-ready upon their graduation from high school. This means that the people that they are educating while still in school will be valuable assets to their company as soon as they graduate. Once they are available to the general workforce, there will be no delay in these individuals ability to begin being of service to Chrysler. CERTIFICATION OF AUTHORSHIP: Upon submission of this paper I certify that I am the author of this paper and that any assistance I received in its preparation is fully acknowledged and disclosed in the paper. I have also cited any sources from which I used data, ideas or words, either quoted directly or paraphrased. I also certify that this paper was prepared specifically for this course. ************************************************************************ Instructor’s grade on assignment: ______________ Instructor’s comments: