This study evaluated the effects of applying Roy's Adaptation Model in nursing care on quality of life dimensions in 60 patients with type 2 diabetes. Patients were randomly assigned to experimental and control groups. Educational programs based on the model were provided to the experimental group for one month. Quality of life was assessed before and after using the D-39 scale. Results showed significant improvements in the experimental group for diabetes control, energy/mobility, and social support dimensions of quality of life. No significant differences were found for stress/anxiety or sexual activity. The study concluded the model has positive impacts on some quality of life aspects for diabetic patients.
A SYSTEMATIC REVIEW ON SELF-REPORTED QUESTIONNAIRES TO ASSESS MEDICATION ADH...Aji Wibowo
Adherence to pharmacological therapies are keys to effective treatments in diabetic patients. Previous reviews found that most adherence measurement studies on chronic diseases used a self-reported scale. However, there is no consensus on the best scale to measure adherence in diabetic patients. The purpose of this systematic review was to identify the potential self-reported scale that could be considered for measuring medication adherence in diabetic patients and to provide recommendations for researchers or clinicians to determine appropriate adherence selfreported scales in diabetic patients. This review follows general guidelines in the implementation of systematic reviews. After further review, it was found that 33 studies met all inclusion criteria from 4 databases (Wiley, Science Direct, Scopus, and PubMed). The articles were done by the PRISMA, while the keywords were determined by the PICO method. Most research was conducted in Asia (69.7%) and America (18.2%) on patients with type 2 diabetes (81.3%), patients in hospitals (54.5%), suffering for 1-6 months (54.5%), and using a cross-sectional study design (78.8%). HbA1c clinic data (57.6%) were used in most studies as biological markers of adherence. The measurement scales of medication adherence in diabetic patients are MMAS-8 (57,.5%), MMAS-4 (12.1%), BMQ (9%), MCQ (6%), ARMS (3%), ARMS-D (3%), GMAS (3%), LMAS-14 (3%), and MARS-5 (3%). This review provides information on the different self-reported scales most widely used in diabetic medication adherence research. Various aspects need to be considered before choosing the scale of adherence.
Abstract—Diabetes is a disease which is on continuous increase specialy in country like India. It involve is a multisystem so intend to affect quality of life of patients. So this study was conducted on 250 Diabetes Mellitus patients to observe their quality of life on various domains viz Physical, Mental, Social and environmental through WHOQOL-Bref questionnaire. It was found that 54.4% were unable to level their quality of life, they say neither good nor bad. But 23.2% were feeling bad and 22.4 % were feeling good about their quality of life. Whereas regarding patient's satisfaction about their health 39.2% were unable to level their quality of life and 35.6% were dissatisfied and 25.2 % were satisfied with their health. Significantly more cases were unable to understand about their quality of life than their satisfaction to their health. It was also found that Physical quality of life was affected most followed by environmental, psychological and social dimension of quality of life.
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
All manuscripts are subject to rapid peer review. Those of high quality (not previously published and not under consideration for publication in another journal) will be published without delay.
Effectiveness of health coaching on diabetic patients:A systematic review and...LucyPi1
Abstract
Background: Using health coaching to improve the quality of life and health outcomes of the patients with
diabetes mellitus, has emerged as a possible intervention. However, the few published randomized controlled trials
using health coaching for patients with diabetes mellitus have reported mixed results. The present meta-analysis
aimed to determine the effectiveness of health coaching on modifying health status and quality of life among
diabetic patients and to clarify the characteristics of coaching delivery that make it most effective. Methods: This
study searched for articles on randomized controlled trials of health coaching interventions targeting type 2 diabetic
patients that were published in the English language from January 2005 through December 2018 in the Cochrane,
Medline, PubMed, Trip, and Embase databases. Patients in the control group received usual diabetes mellitus care,
and those in the experimental group received health coaching based on usual diabetes mellitus care. The primary
outcomes included Hemoglobin A1c (HbA1c) and cardiovascular disease risk factors, including systolic blood
pressure, diastolic blood pressure, triglyceride, high-density lipoprotein cholesterol (HDL-C), low-density
lipoprotein cholesterol, total cholesterol, and body weight. The secondary outcomes included quality of life,
self-efficacy, self-care skills, and psychological outcomes. Results: Health coaching intervention has a significant
effect on HbA1c [mean difference (MD) = -0.35, confidence interval (CI) = -0.47, -0.22, I2 = 83%, P < 0.001] and
HDL-C (MD = -0.50, CI = -0.93, -0.07, I2 = 10%, P = 0.02). The most effective strategy for health coaching
delivery associated with improvement of HbA1c was decreasing the number of sessions and increasing the duration
of each session. However, no significant difference was found for weight, SBP, diastolic blood pressure,
triglyceride, low-density lipoprotein cholesterol, or total cholesterol. Mixed results were reported for the effect of
health coaching on quality of life, self-efficacy, self-care skills, and depressive symptoms outcome. Conclusion:
Health coaching intervention has a significant effect on HbA1c and HDL-C, and the most effective strategy is
decreasing the number of sessions while increasing session duration. However, these results should be interpreted
with caution as the evidence comes from studies at some risk of bias with considerable heterogeneity and
imprecision.
AbstractBackground Hypertension is the most common non-.docxbartholomeocoombs
Abstract
Background:
Hypertension is the most common non-communicable disease and the leading cause of cardiovascular disease in the world. Current management of hypertension stressed the importance of salt and diet modifications. Unfortunately, many hypertensive patients do not have proper knowledge of this, which results to inadequate practice. Therefore, there is need to develop strategies that will help to improve knowledge and practice of salt and diet modifications among hypertensive.
Objective
: To determine the effect of nursing intervention on knowledge and practice of salt and diet modifications among hypertensive patients.
Materials and Methods
: A quasi experimental design was conducted using purposive sampling to select the sample size of 38 participants. A researcher-developed questionnaire derived from the literature review and Hypertension Self-Care Activity Level Effects (H-SCALE) adapted from Warren-Find low and Seymour (2011) was used to measure knowledge and practice of salt and diet modification among the participants. Data gathered from participants were expressed using tables and percentages while research questions were answered with descriptive statistics of mean and standard deviation through statistical package for the social science software version 21.
Results
: the study revealed that higher percentage of the participants (81.6%) had poor of knowledge of salt and diet modification pre-intervention, also 92.1% of the participants reported poor practice before intervention. Intervention was given to the participants and results showed a positive change in knowledge and practice of salt and diet practice post-intervention.
Conclusion
: regular training should be given to hypertensive patients by nurses to improve their knowledge and practice of salt and diet modification for effective blood pressure control.
Keywords
:
Hypertension, Knowledge, Practice, Salt and Diet modification, Nigeria
Introduction
The burden of hypertension and other noncommunicable diseases is rapidly increasing and this poses a serious threat to the economic development of many nations. Hypertension is a global public health challenge due to its high prevalence and the associated risk of stroke and cardiovascular diseases in adults.
Globally, hypertension is implicated to be responsible for 7.1 million deaths and about 12.8% of the total annual deaths (World Health
Organization (WHO), 2018). Africa, among other WHO regions was rated highest with increased prevalence of high blood pressure, estimated at 46% from age 25 years and above in which Nigeria contributes significantly to this increase (Okwuonu, Emmanuel, & Ojimadu 2014; Ekwunife, Udeogaranya, & Nwatu, 2018; WHO, 2018). This is so in spite of the availability to safe and potent drugs for hypertension and existence of clear treatment guidelines, hypertension is still grossly not controlled in a large proportion of.
A SYSTEMATIC REVIEW ON SELF-REPORTED QUESTIONNAIRES TO ASSESS MEDICATION ADH...Aji Wibowo
Adherence to pharmacological therapies are keys to effective treatments in diabetic patients. Previous reviews found that most adherence measurement studies on chronic diseases used a self-reported scale. However, there is no consensus on the best scale to measure adherence in diabetic patients. The purpose of this systematic review was to identify the potential self-reported scale that could be considered for measuring medication adherence in diabetic patients and to provide recommendations for researchers or clinicians to determine appropriate adherence selfreported scales in diabetic patients. This review follows general guidelines in the implementation of systematic reviews. After further review, it was found that 33 studies met all inclusion criteria from 4 databases (Wiley, Science Direct, Scopus, and PubMed). The articles were done by the PRISMA, while the keywords were determined by the PICO method. Most research was conducted in Asia (69.7%) and America (18.2%) on patients with type 2 diabetes (81.3%), patients in hospitals (54.5%), suffering for 1-6 months (54.5%), and using a cross-sectional study design (78.8%). HbA1c clinic data (57.6%) were used in most studies as biological markers of adherence. The measurement scales of medication adherence in diabetic patients are MMAS-8 (57,.5%), MMAS-4 (12.1%), BMQ (9%), MCQ (6%), ARMS (3%), ARMS-D (3%), GMAS (3%), LMAS-14 (3%), and MARS-5 (3%). This review provides information on the different self-reported scales most widely used in diabetic medication adherence research. Various aspects need to be considered before choosing the scale of adherence.
Abstract—Diabetes is a disease which is on continuous increase specialy in country like India. It involve is a multisystem so intend to affect quality of life of patients. So this study was conducted on 250 Diabetes Mellitus patients to observe their quality of life on various domains viz Physical, Mental, Social and environmental through WHOQOL-Bref questionnaire. It was found that 54.4% were unable to level their quality of life, they say neither good nor bad. But 23.2% were feeling bad and 22.4 % were feeling good about their quality of life. Whereas regarding patient's satisfaction about their health 39.2% were unable to level their quality of life and 35.6% were dissatisfied and 25.2 % were satisfied with their health. Significantly more cases were unable to understand about their quality of life than their satisfaction to their health. It was also found that Physical quality of life was affected most followed by environmental, psychological and social dimension of quality of life.
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
All manuscripts are subject to rapid peer review. Those of high quality (not previously published and not under consideration for publication in another journal) will be published without delay.
Effectiveness of health coaching on diabetic patients:A systematic review and...LucyPi1
Abstract
Background: Using health coaching to improve the quality of life and health outcomes of the patients with
diabetes mellitus, has emerged as a possible intervention. However, the few published randomized controlled trials
using health coaching for patients with diabetes mellitus have reported mixed results. The present meta-analysis
aimed to determine the effectiveness of health coaching on modifying health status and quality of life among
diabetic patients and to clarify the characteristics of coaching delivery that make it most effective. Methods: This
study searched for articles on randomized controlled trials of health coaching interventions targeting type 2 diabetic
patients that were published in the English language from January 2005 through December 2018 in the Cochrane,
Medline, PubMed, Trip, and Embase databases. Patients in the control group received usual diabetes mellitus care,
and those in the experimental group received health coaching based on usual diabetes mellitus care. The primary
outcomes included Hemoglobin A1c (HbA1c) and cardiovascular disease risk factors, including systolic blood
pressure, diastolic blood pressure, triglyceride, high-density lipoprotein cholesterol (HDL-C), low-density
lipoprotein cholesterol, total cholesterol, and body weight. The secondary outcomes included quality of life,
self-efficacy, self-care skills, and psychological outcomes. Results: Health coaching intervention has a significant
effect on HbA1c [mean difference (MD) = -0.35, confidence interval (CI) = -0.47, -0.22, I2 = 83%, P < 0.001] and
HDL-C (MD = -0.50, CI = -0.93, -0.07, I2 = 10%, P = 0.02). The most effective strategy for health coaching
delivery associated with improvement of HbA1c was decreasing the number of sessions and increasing the duration
of each session. However, no significant difference was found for weight, SBP, diastolic blood pressure,
triglyceride, low-density lipoprotein cholesterol, or total cholesterol. Mixed results were reported for the effect of
health coaching on quality of life, self-efficacy, self-care skills, and depressive symptoms outcome. Conclusion:
Health coaching intervention has a significant effect on HbA1c and HDL-C, and the most effective strategy is
decreasing the number of sessions while increasing session duration. However, these results should be interpreted
with caution as the evidence comes from studies at some risk of bias with considerable heterogeneity and
imprecision.
AbstractBackground Hypertension is the most common non-.docxbartholomeocoombs
Abstract
Background:
Hypertension is the most common non-communicable disease and the leading cause of cardiovascular disease in the world. Current management of hypertension stressed the importance of salt and diet modifications. Unfortunately, many hypertensive patients do not have proper knowledge of this, which results to inadequate practice. Therefore, there is need to develop strategies that will help to improve knowledge and practice of salt and diet modifications among hypertensive.
Objective
: To determine the effect of nursing intervention on knowledge and practice of salt and diet modifications among hypertensive patients.
Materials and Methods
: A quasi experimental design was conducted using purposive sampling to select the sample size of 38 participants. A researcher-developed questionnaire derived from the literature review and Hypertension Self-Care Activity Level Effects (H-SCALE) adapted from Warren-Find low and Seymour (2011) was used to measure knowledge and practice of salt and diet modification among the participants. Data gathered from participants were expressed using tables and percentages while research questions were answered with descriptive statistics of mean and standard deviation through statistical package for the social science software version 21.
Results
: the study revealed that higher percentage of the participants (81.6%) had poor of knowledge of salt and diet modification pre-intervention, also 92.1% of the participants reported poor practice before intervention. Intervention was given to the participants and results showed a positive change in knowledge and practice of salt and diet practice post-intervention.
Conclusion
: regular training should be given to hypertensive patients by nurses to improve their knowledge and practice of salt and diet modification for effective blood pressure control.
Keywords
:
Hypertension, Knowledge, Practice, Salt and Diet modification, Nigeria
Introduction
The burden of hypertension and other noncommunicable diseases is rapidly increasing and this poses a serious threat to the economic development of many nations. Hypertension is a global public health challenge due to its high prevalence and the associated risk of stroke and cardiovascular diseases in adults.
Globally, hypertension is implicated to be responsible for 7.1 million deaths and about 12.8% of the total annual deaths (World Health
Organization (WHO), 2018). Africa, among other WHO regions was rated highest with increased prevalence of high blood pressure, estimated at 46% from age 25 years and above in which Nigeria contributes significantly to this increase (Okwuonu, Emmanuel, & Ojimadu 2014; Ekwunife, Udeogaranya, & Nwatu, 2018; WHO, 2018). This is so in spite of the availability to safe and potent drugs for hypertension and existence of clear treatment guidelines, hypertension is still grossly not controlled in a large proportion of.
Evaluating the Quality of Life and Social Support in Patients with Cervical C...CrimsonpublishersTTEH
Aims: Purposes of this descriptive correlational research were to 1) describe quality of life and social support and 2) look at the correlation of certain factors and quality of life in women with cervical cancer after treatment. Methods: Fifty-three women diagnosed with cervical cancer who were followed up after finished the treatments at the Gynecological outpatient department of a university hospital in 2016.They were asked to fill 3 questionnaires; 1) the general information; 2) Social support; and 3) Functional Assessment of Chronic Illness Therapy (FACT-Cervix). Alpha Cronbach’s coefficients for the social support was .73 and for the FACT-Cervix was .91. Data were analyzed by descriptive statistic and Spearman Rank Test.Result: Results showed that participants’ age was ranged from 30 to 86, mean=55.15 (SD=10.05). Social support was about 29 to 59, mean=48.23 (SD=6.76). Symptom distress was from 0 to 9, mean=3.36 (SD=2.83). For quality of life was diverted from 75 to159, mean=126.02 (SD=21.09). The results discovered that there was no correlation between age and social support with the quality of life, however, there was negative correlation between symptom distress and quality of life with r=-.40 at p=0.003.Conclusion: This study disclosed that social support for this women’s group could not help to improve their quality of life. Their symptom distress seems to have a direct effect on their QOL. Thus, the healthcare team needs to alleviate patients’ distress in order to improve the quality of life in cervical cancer survivors.
Running head SEARCHING AND CRITIQUING THE EVIDENCE1SEARCHING .docxtoltonkendal
Running head: SEARCHING AND CRITIQUING THE EVIDENCE 1
SEARCHING AND CRITIQUING THE EVIDENCE 4
Searching and Critiquing the Evidence
Student’s Name
Institution
Date
Searching and Critiquing the Evidence
There are various research studies that have been done on the outcome of self-care on Type 2 Diabetes Mellitus patients. In most of the studies, the most prevalent results are that self-care is an effective method of improving the health and lifestyle outcomes of Type 2 Diabetes patients. Krishna and Boren (2008) conducted a systematic review of evidence-based studies done between 1996 and 2007. The study analyzed 18 researches done within the selected time period and found that using phone calls and text messages to assist diabetes patients could improve the self-management outcomes. Shrivastava et al. (2013) analyzed the effectiveness of self-management for the diabetes mellitus patients. The study found that self-care helps to reduce the rate of morbidity and mortality among diabetes patients.
In addition, Steinsbekk et al. (2013) conducted a meta-analysis comparing the differences between the outcomes of group based self-management education and routine treatment for Type 2 diabetes patients. The study analyzed 21 studies that included studied on 2833 participants. The results of the meta-analysis showed that group-based self-management education helped to improve the psychosocial, clinical, and lifestyle outcomes among the diabetes patients. Lastly, Tang et al. (2008) examined the impact of social support and quality of life on the self-care behaviors of African American Type 2 diabetes patients. The study followed an observational design with 89 African-American adults, who were aged 40 and above. The study found that social support is vital for self-management to be effective in diabetes treatment.
The selected studies have helped to strengthen the merit of my selected theoretical framework. The theory selected for the study was Dorothea Orem’s Self Care Theory. These studies have helped to demonstrate some important evidence-based facts about the effectiveness of self-care for diabetes patients hence helping to prove the credibility of the theory. The scrutiny of these studies has helped to discover the degree of effectiveness of this theory and the best application methods that can make it an effective approach to improving the outcomes of patients with Type 2 Diabetes Mellitus.
Levels of Evidence in the Articles
The classification of the level of evidence of a given research is important in evidence-based studies because they help to show how accurate, credible, or reliable a research is (Gray, Grove & Sutherland, 2017). The most prevalent evidence in the research articles analyzed is Level II evidence. Level II evidence is one that is obtained from at least one randomized control trial (Moran, Burson & Conrad, 2017). The articles by Krishna and Boren (2008) and Steinsbekk et al. (2013) conducted meta-analyses of various rese ...
Psychometric assessment of the Life Satisfaction Questionnaire.docxamrit47
Psychometric assessment of the Life Satisfaction Questionnaire (LSQ) and a
comparison of a randomised sample of Swedish women and those su�ering from
breast cancer
Marianne Carlsson
1
, Elisabeth Hamrin
2
& Ragny Lindqvist
1
1Department of Public Health and Caring Sciences, Caring Sciences Unit, Uppsala University, Sweden; 2Department of
Medicine and Care, Division of Nursing Science, University of LinkoÈping, Sweden
Accepted in revised form 29 August 1998
Abstract. In a previous study, the Life Satisfaction
Questionnaire (LSQ) was developed especially for
women with breast cancer. The aim of the present
study was to assess the psychometric properties of the
LSQ in a randomized sample of Swedish women and
to compare the perceived quality of life with that of
women su�ering from breast cancer. Another aim was
to relate the result to educational background. A total
of 257 women aged 20±80, randomly selected from the
Swedish population register, answered the LSQ. The
result was compared with that from 362 women aged
27±78 su�ering from breast cancer. The construct
validity was calculated by a principal component
analysis, and the reliability by Cronbach a-coe�-
cients. It was concluded that the LSQ has acceptable
validity and reliability. The result also showed that the
women with breast cancer rated their perceived qual-
ity of life higher than women in general with respect to
the quality of personal relations and the quality of
daily activities, but lower for physical symptoms. In
the comparison with respect to educational back-
ground, women with university education rated their
quality of life higher than women with other types of
education. The testing of the LSQ will continue.
Key words: Breast cancer, Psychometric assessment, Quality of life
Introduction
The term `quality of life' refers to a person's perceived
quality of her/his physical, psychological, social and
existential functioning [1]. Several instruments have
been developed to measure quality of life in di�erent
groups of people. Some measure quality of life in
general, e.g. the NHP (Nottingham Health Pro®le)
[2], the SIP (Sickness Impact Pro®le) [3], the Swed-
Qual [4], the MOS SF-36 (Medical Outcome Studies
Short Form) [5, 6], and the QLI (Quality of Life In-
dex) by Ferrans and Powers [7]. Others are more
speci®c, for instance, for cancer patients, the QLI
(Quality of Life Index) by Spitzer et al. [8], the FLIC
(Functional Living Index Cancer) [9], the CIPS
(Cancer Inventory of Problem Scale) [10], the
CARES (Cancer Rehabilitation Evaluation System)
[11], the FACT (Functional Assessment of Cancer
Therapy) [12], and the EORTC QLQ-C30 (European
Organisation for Research and Treatment in Cancer,
Quality of Life Questionnaire) [13].
A literature review by Carlsson and Hamrin [14]
showed that the diagnosis of breast cancer evokes
grief, anger and intense fear in women. But the ma-
jority do not experience long-term emotional distress.
Risk factors for psychological dist ...
Study of medication appropriateness during hospital stay and revisits in medi...iosrjce
IOSR Journal of Pharmacy and Biological Sciences(IOSR-JPBS) is a double blind peer reviewed International Journal that provides rapid publication (within a month) of articles in all areas of Pharmacy and Biological Science. The journal welcomes publications of high quality papers on theoretical developments and practical applications in Pharmacy and Biological Science. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
Body mass-index-quality-of-life-and-migraine-in-studentsAnnex Publishers
Migraine is reported globally with a higher prevalence in students. The present study aims to evaluate the association between nutritional status, quality of life (QL) and characteristics of migraine.
A cross-sectional study. Headache characteristics, level of disability caused by migraine crises (Pediatric Migraine Disability Assessment - PedMIDAS) and QL (Pediatric Quality of Life Inventory- PedsQL) were assessed. Anthropometric variables were also measured.
Data were collected from 98 students with a mean age of 11.2 ± 1.7 years. Migraine had the highest prevalence (54.8%). The average Body Mass Index (BMI) of the total sample was 20.0 ± 3.8 kg/m2, and among students with migraine and students with tension headache, the average BMIs were 20.4 ± 4.0 and 19.5 ± 3.4 kg/m2, respectively (p = 0.264, Student's t-test). Around 47.5% from migraineurs were overweight or obese. Regarding QL, the average total score in students with migraine was 74.4 ± 12.4, with no differences observed among normal weight, overweight or obese students, and no correlation between the scores of the PedsQL and BMI (r = -0.182, p = 0.165, Pearson correlation coefficient) was observed. There was a high percentage of overweight students with migraine. Analyses show no associations between the nutritional status, frequency, severity, disability caused by crises, or QL.
Article Type: Editorial
Title: Challenges Met by Healthcare Professionals (Nurses) at the time of Covid-19 Pandemic
Year: 2021; Volume: 1; Issue: 2; Page No: 3 – 4
Author: Sumathi Senthilvel
DOI: 10.55349/ijmsnr.20211234
Affiliation: Associate Editor, IJMSNR, Formerly Assistant Professor in Nursing, Department of Fundamental Nursing, Amrita College of Nursing. Ponekkara, Kochi, Kerala. Email ID: AssociateEditor@ijmsnr.com
Article Summary: Submitted : 26-October-2021
Revised : 10-November-2021
Accepted : 02-December-2021
Published : 31-December-2021
Background: Diabetic Retinopathy is a non-communicable disease and metabolic disorder. It is a public health problem in Worldwide. In this paper, finding influencing factors and how much probability to development of DR among known T2DM patients.
Materials and Methods: This was a hospital-based cross-sectional and observational study among T2DM patients, with and without DR in the diabetes clinic with sample of 150 patients. Statistical analysis used chi-square and binary logistic regression analysis was used to identify correlates of DR after controlling of confounders.
Results: In this present study, among 150 patients, 39 (26%) patients had DR. Smoking habit was strongly associated with development of DR (AOR=15.39, p=0.002), patients had history of hypertension was associated with DR (AOR=1.10, p=0.016), medication, in that insulin users were strongly associated with DR (AOR=5.72, p=0.002), duration of diabetes mellitus with >10 years was associated with DR (AOR=1.18, p=0.001), total cholesterol with abnormal was 5-fold more increase in risk with the development of DR (AOR=5.86, p=0.065) but not significant, high hba1c with >6.5% was associated with the progression of DR (AOR=1.34, p=0.035), and fasting blood sugar with abnormal was associated with the progression of DR (AOR=1.01, p=0.027) except age but, showed positive association with DR. Probability of developing DR in a T2DM patient was 98%.
Conclusion: From this study, we revealed that influencing variables were hba1c, smoking habit, intake of tablet/insulin, duration of DM, history of hypertension and fasting blood sugar. The chance/probability of developing retinopathy was very high among known diabetes patients those who had longer duration of DM. Hence, we have recommended a periodic eye screening is mandatory in T2DM patients.
Keywords: diabetes mellitus, diabetic retinopathy, influencing factors, probability, multivariate analysis
Understanding the nutrition care needs of patients newly diagn.docxgibbonshay
Understanding the nutrition care needs of patients newly diagnosed
with type 2 diabetes: a need for open communication
and patient-focussed consultations
Lauren BallA,C, Ruth DavmorA, Michael LeverittB, Ben DesbrowA, Carolyn EhrlichA
and Wendy ChaboyerA
AMenzies Health Institute Queensland, Griffith University, Gold Coast 4222, Qld, Australia.
BSchool of Human Movement and Nutrition Sciences, The University of Queensland,
Brisbane 4072, Qld, Australia.
CCorresponding author. Email: [email protected]
Abstract. Patients who are newly diagnosed with type 2 diabetes mellitus (T2DM) commonly attempt to modify their
dietary intake after receiving nutrition care from primary health professionals. Yet, adherence to dietary recommendations
is rarely sustained and factors influencing adherence are poorly understood. This study exploredT2DMpatients’ experiences
of dietary change and their views on how primary health professionals can best support long-term maintenance of dietary
change.Apurposive sample of 10 individuals recently diagnosedwithT2DMparticipated in three individual semi-structured
qualitative telephone interviews: at baseline, then at 3 and 6 months after recruitment. Interview questions were modified
from the initial interview inorder to investigate emergingfindings.A two-step data analysis process occurred throughcontent
analysis of individual interviews andmeta-synthesis of findings over time. Participants initiallymadewide-ranging attempts
to improve dietary behaviours, butmost experienced negative emotions from the restraint required tomaintain a healthy diet.
Participants felt confused by the conflicting advice received from health professionals and other sources such as friends,
family, internet and diabetes organisations. Participants frequently reported feeling rushed and not heard in consultations,
resulting in limited ongoing engagement with primary healthcare services. These findings suggest that there is opportunity
for primary health professionals to enhance the dietary support provided to patients by: acknowledging the challenges of
sustained improvements in dietary intake; open communication; and investing in patient relationships through more
patient-focussed consultations.
Additional keywords: chronic disease, general practice, primary care, nutrition therapy, nutritional management.
Received 28 April 2015, accepted 18 August 2015, published online 5 October 2015
Introduction
Type 2 diabetes mellitus (T2DM) is a lifestyle-related chronic
disease and leading cause of morbidity andmortality in Australia
(Australian Institute of Health andWelfare 2007). Over 5%of the
Australian population has been diagnosed with T2DM, and an
additional 0.9% is predicted to be diagnosed annually (Australian
Bureau of Statistics (ABS) 2012). T2DM is typically diagnosed
and managed in the primary healthcare setting, and patients with
T2DM receive health care from a variety of primary health
professionals (Diabetes Australia 2012). Impor ...
Quantitative/Mixed-Methods
American InterContinental University
March 27, 2018
Running head: QUANTITATIVE/MIXED-METHODS
1
QUANTITATIVE/MIXED-METHODS
2
Quantitative/Mixed-Methods
Abstract
Case studies which are done in the field of medicine work towards improving the health of the population. There are some of the parts contained in case studies which are abstract, results, limitations of results, conclusions, and applications. The common statistical methods used in research are descriptive numerical and qualitative thematic analyses. The results of the studies show that equal participation of individuals in the health sector will help boost public health. Limitations of results are that although some strategies may work towards improving health sector, not all of them are effective.
Public health is an important sector in any country for it directly affects the economy of the nation. There need to be certain ways which should be employed with the aim of supporting and improving public health. In this paper, I am going to examine 4 contemporary peer-reviewed articles which employ quantitative or mixed-methods concerning ways on how to improve the health of the public. The interest of the paper is to aid in achieving the best impact in public health sector via using programs which will improve health outcomes drastically. Enhancement of public health will in return help to improve the well-being of populations across the world. Public health awareness on how to avoid unhealthy lifestyles should be created.
In the articles, samples and populations used were appropriate for it showed the real representative of the population at hand. All the samples used in the 4-contemporary peer-reviewed articles fulfilled the rule of thumb hence making them appropriate. The samples used were suitable for they were used to estimate the population parameters for it stood for the entire inhabitants. The samples used were larger but not too large to consume more resources of money and time. The larger sample has helped to produce accurate results making the samples valid and appropriate. The appropriateness of the samples used in these articles, it has been proved via usage of target variance. In using target variance an estimate to be derived from the model eventually attained.
Each article which has been used includes having results, limitations of results, conclusions, and applications. The first contemporary peer-reviewed article is entitled, Refugee women’s involvements of maternity-care facilities in Canada: a methodical review using a description synthesis written by Gina MA Higginbottom, Myfanwy Morgan, Miranda Alexandre, Yvonne Chiu, Joan Forgeron, Deb Kocay and Rubina Barolia. The article was published 11 February 2015. The results show that there needs to have a healthier understanding of the aspects that produce discrepancies in availability, adequacy, and outcomes during parenthood care (Higginbottom, Morgan, Alexandre, Chiu, Forg ...
357Piyawan Kanan et al.Vol. 23 No. 4Piyawan Kanan.docxlorainedeserre
357
Piyawan Kanan et al.
Vol. 23 No. 4
Piyawan Kanan, RN, PhD Candidate, Faculty of Medicine Ramathibodi
Hospital and Faculty of Nursing, Mahidol University, Thailand.
E-mail: [email protected]
Correspondence to: Noppawan Piaseu*, RN, PhD, Associate Professor,
Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital,
Mahidol University, Thailand. E-mail: [email protected]
Porntip Malathum, RN, PhD, Assistant Professor, Ramathibodi School
of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University,
Thailand. E-mail: [email protected]
Basia Belza, RN, PhD, Professor, Biobehavioral Nursing and Health Systems
Department, School of Nursing, University of Washington, Seattle, USA.
E-mail: [email protected]
Predictors of Diabetes Self-Management in Older Adults with
Poorly Controlled Type 2 Diabetes Mellitus
Piyawan Kanan, Noppawan Piaseu*, Porntip Malathum, Basia Belza
Abstract: Poorly controlled type 2 diabetes, a complex phenomenon, is rapidly increasing
particularly in older adults worldwide and in Thailand, the setting of this study. Effectiveness
of diabetes self-management demands various factors supporting optimal outcomes. This
descriptive correlational study examined the influences of ecological factors including
gender, time since diagnosis, family history of type 2 diabetes mellitus, abdominal obesity,
diabetes complications, health literacy, social networks, and social support on diabetes
self-management. Through purposive sampling, the participants consisted of 166 older
adults with poorly controlled type 2 diabetes mellitus at two hospitals in central Thailand
province. Data were collected using questionnaires on the Functional, Communicative
and Critical Health Literacy Scale, the revised Summary of Diabetes Self-Care Activities
Scales, the Social Network in Adults Life, and the Diabetes Severity Complication Index;
and nutrition assessment including waist circumference and HbA1c. Descriptive statistics
and Stepwise Multiple Regression Analysis were used for data analysis.
Results revealed that health literacy, abdominal obesity, time since diagnosis, and
gender could together predict diabetes self-management, accounting for 14.7% of the
variance. Prior to developing an effective intervention, an additional variable more specific to
older adults needs to be examined such as self-efficacy that affects older adults’ confidence
regarding health behavior modification. Nevertheless, these findings suggest approaches
for nurses to promote diabetes self-management education that includes enhancing health
literacy, and modifying health behaviors for control of abdominal obesity based on other
health conditions, particularly in male older adults with type 2 diabetes mellitus.
Pacific Rim Int J Nurs Res 2019; 23(4) 357-367
Keywords: Diabetes Mellitus, Health literacy, Older adults, Poor control, Self-management,
Thailand, Type 2 Diabetes
Introduction
The aging population i ...
Determine the Patients' Satisfaction Concerning In-hospital Information Progr...iosrjce
IOSR Journal of Nursing and health Science is ambitious to disseminate information and experience in education, practice and investigation between medicine, nursing and all the sciences involved in health care.
Nursing & Health Sciences focuses on the international exchange of knowledge in nursing and health sciences. The journal publishes peer-reviewed papers on original research, education and clinical practice.
By encouraging scholars from around the world to share their knowledge and expertise, the journal aims to provide the reader with a deeper understanding of the lived experience of nursing and health sciences and the opportunity to enrich their own area of practice
Evaluations of and Interventions for Non Adherence to Oral Medications as a P...NiyotiKhilare
The focus of this presentation will be medical non-adherence as a psychosocial issue in diabetes. The presentation will also focus elaborately on empowerment as an intervention amongst other interventions.
Angela’s Ashes - Murasaki Shikibu said that the novel happens be.docxdurantheseldine
Angela’s Ashes
- Murasaki Shikibu said that the novel "happens because of the storyteller's own experience . . . not only what he has passed through himself, but even events which he has only witnessed or been told of—has moved him to an emotion so passionate that he can no longer keep it shut up in his heart." What is the passionate emotion that is communicated in your novel? Why was the author of your novel moved to write? What is the thing that the novelist had to communicate? In your paper, explain the author's motivating emotion and how it is explored in the novel.
.
ANG1922, Winter 2016Essay 02 InstructionsYour second e.docxdurantheseldine
ANG1922, Winter 2016
Essay 02 Instructions
Your second essay is due by noon on Thursday, April 5th – by email only!
This essay must be an expository or informative essay. You have to explain something, give the pertinent information about it,
maybe describe the situation, maybe describe some process involved – the specifics depend on your topic. It might help to
know what an expository essay is not: it is not opinion nor argument. It might include any of the strategies, such as
description, comparison, contrast, and even narration, but the main purpose is to expound upon your topic. The possibilities are
endless.
Consider some possibilities if you were writing about guitars: You could explain what to look for in a guitar, how to record
guitar, part of the history of guitars (you couldn't do the whole history), categorize the types of guitars, explain the different
types of pick-ups available, and on and on. As another example, you could write something about current issues – explaining
the issue, the sides, the actions taken, the proposed solutions . . . whatever you decide to focus on. Those are just two
examples. The main criteria is that your essay is expository or informative, not an opinion or an argument.
You still have to write an introduction and a conclusion, of course. You do not have a required number of points or paragraphs.
Instead, you have a word limit: 750 word minimum, 1000 word maximum.
Rules for formatting your assignments
1) No cover page.
2) No headers. No footers.
3) At the top of the first page only, put your name and identify the assignment.
4) Set your page format to “letter” (8.5 x 11 in.). Beware: you may have A4 as your default page format.
5) Set the document language to “English” and use the spell checker.
6) Single spaced text, with a blank line between paragraphs.
7) Font: Times New Roman, 11 point.
Name your file properly <NAME – essay 2 – TITLE.doc>, put your name in your document also, and send it to
[email protected]
SPECIAL REQUIREMENTS (actually, third and fourth are not so special; they are an essential quality of effective writing)
➢ Use these comparative structures: as ____ as _____ ; less & than; more & than;
➢ Use comparatives in various parts of the sentence: the subject, the verb, and the object – all three
➢ Use at least all these at least twice each: colon, parentheses, and dash
➢ all of these conjunctions: even so, although, furthermore, moreover, if, unless (highlight them somehow)
A checklist for you:
1) _______ All of the above requirements are met
2) _______ Sentences have a variety of beginnings
3) _______ Concise, and precise, wording
4) _______ Specific, concrete images and details – avoid vague, obvious statements and abstractions
5) _______ Audience (well-chosen, well-defined, appropriately addressed), Purpose (focused, feasible, refined, clearly
expressed), and Persona (credible, evident from the text)
6).
More Related Content
Similar to 1 JNMS 2015; 2(4)The effect of roys adaptation model and q.docx
Evaluating the Quality of Life and Social Support in Patients with Cervical C...CrimsonpublishersTTEH
Aims: Purposes of this descriptive correlational research were to 1) describe quality of life and social support and 2) look at the correlation of certain factors and quality of life in women with cervical cancer after treatment. Methods: Fifty-three women diagnosed with cervical cancer who were followed up after finished the treatments at the Gynecological outpatient department of a university hospital in 2016.They were asked to fill 3 questionnaires; 1) the general information; 2) Social support; and 3) Functional Assessment of Chronic Illness Therapy (FACT-Cervix). Alpha Cronbach’s coefficients for the social support was .73 and for the FACT-Cervix was .91. Data were analyzed by descriptive statistic and Spearman Rank Test.Result: Results showed that participants’ age was ranged from 30 to 86, mean=55.15 (SD=10.05). Social support was about 29 to 59, mean=48.23 (SD=6.76). Symptom distress was from 0 to 9, mean=3.36 (SD=2.83). For quality of life was diverted from 75 to159, mean=126.02 (SD=21.09). The results discovered that there was no correlation between age and social support with the quality of life, however, there was negative correlation between symptom distress and quality of life with r=-.40 at p=0.003.Conclusion: This study disclosed that social support for this women’s group could not help to improve their quality of life. Their symptom distress seems to have a direct effect on their QOL. Thus, the healthcare team needs to alleviate patients’ distress in order to improve the quality of life in cervical cancer survivors.
Running head SEARCHING AND CRITIQUING THE EVIDENCE1SEARCHING .docxtoltonkendal
Running head: SEARCHING AND CRITIQUING THE EVIDENCE 1
SEARCHING AND CRITIQUING THE EVIDENCE 4
Searching and Critiquing the Evidence
Student’s Name
Institution
Date
Searching and Critiquing the Evidence
There are various research studies that have been done on the outcome of self-care on Type 2 Diabetes Mellitus patients. In most of the studies, the most prevalent results are that self-care is an effective method of improving the health and lifestyle outcomes of Type 2 Diabetes patients. Krishna and Boren (2008) conducted a systematic review of evidence-based studies done between 1996 and 2007. The study analyzed 18 researches done within the selected time period and found that using phone calls and text messages to assist diabetes patients could improve the self-management outcomes. Shrivastava et al. (2013) analyzed the effectiveness of self-management for the diabetes mellitus patients. The study found that self-care helps to reduce the rate of morbidity and mortality among diabetes patients.
In addition, Steinsbekk et al. (2013) conducted a meta-analysis comparing the differences between the outcomes of group based self-management education and routine treatment for Type 2 diabetes patients. The study analyzed 21 studies that included studied on 2833 participants. The results of the meta-analysis showed that group-based self-management education helped to improve the psychosocial, clinical, and lifestyle outcomes among the diabetes patients. Lastly, Tang et al. (2008) examined the impact of social support and quality of life on the self-care behaviors of African American Type 2 diabetes patients. The study followed an observational design with 89 African-American adults, who were aged 40 and above. The study found that social support is vital for self-management to be effective in diabetes treatment.
The selected studies have helped to strengthen the merit of my selected theoretical framework. The theory selected for the study was Dorothea Orem’s Self Care Theory. These studies have helped to demonstrate some important evidence-based facts about the effectiveness of self-care for diabetes patients hence helping to prove the credibility of the theory. The scrutiny of these studies has helped to discover the degree of effectiveness of this theory and the best application methods that can make it an effective approach to improving the outcomes of patients with Type 2 Diabetes Mellitus.
Levels of Evidence in the Articles
The classification of the level of evidence of a given research is important in evidence-based studies because they help to show how accurate, credible, or reliable a research is (Gray, Grove & Sutherland, 2017). The most prevalent evidence in the research articles analyzed is Level II evidence. Level II evidence is one that is obtained from at least one randomized control trial (Moran, Burson & Conrad, 2017). The articles by Krishna and Boren (2008) and Steinsbekk et al. (2013) conducted meta-analyses of various rese ...
Psychometric assessment of the Life Satisfaction Questionnaire.docxamrit47
Psychometric assessment of the Life Satisfaction Questionnaire (LSQ) and a
comparison of a randomised sample of Swedish women and those su�ering from
breast cancer
Marianne Carlsson
1
, Elisabeth Hamrin
2
& Ragny Lindqvist
1
1Department of Public Health and Caring Sciences, Caring Sciences Unit, Uppsala University, Sweden; 2Department of
Medicine and Care, Division of Nursing Science, University of LinkoÈping, Sweden
Accepted in revised form 29 August 1998
Abstract. In a previous study, the Life Satisfaction
Questionnaire (LSQ) was developed especially for
women with breast cancer. The aim of the present
study was to assess the psychometric properties of the
LSQ in a randomized sample of Swedish women and
to compare the perceived quality of life with that of
women su�ering from breast cancer. Another aim was
to relate the result to educational background. A total
of 257 women aged 20±80, randomly selected from the
Swedish population register, answered the LSQ. The
result was compared with that from 362 women aged
27±78 su�ering from breast cancer. The construct
validity was calculated by a principal component
analysis, and the reliability by Cronbach a-coe�-
cients. It was concluded that the LSQ has acceptable
validity and reliability. The result also showed that the
women with breast cancer rated their perceived qual-
ity of life higher than women in general with respect to
the quality of personal relations and the quality of
daily activities, but lower for physical symptoms. In
the comparison with respect to educational back-
ground, women with university education rated their
quality of life higher than women with other types of
education. The testing of the LSQ will continue.
Key words: Breast cancer, Psychometric assessment, Quality of life
Introduction
The term `quality of life' refers to a person's perceived
quality of her/his physical, psychological, social and
existential functioning [1]. Several instruments have
been developed to measure quality of life in di�erent
groups of people. Some measure quality of life in
general, e.g. the NHP (Nottingham Health Pro®le)
[2], the SIP (Sickness Impact Pro®le) [3], the Swed-
Qual [4], the MOS SF-36 (Medical Outcome Studies
Short Form) [5, 6], and the QLI (Quality of Life In-
dex) by Ferrans and Powers [7]. Others are more
speci®c, for instance, for cancer patients, the QLI
(Quality of Life Index) by Spitzer et al. [8], the FLIC
(Functional Living Index Cancer) [9], the CIPS
(Cancer Inventory of Problem Scale) [10], the
CARES (Cancer Rehabilitation Evaluation System)
[11], the FACT (Functional Assessment of Cancer
Therapy) [12], and the EORTC QLQ-C30 (European
Organisation for Research and Treatment in Cancer,
Quality of Life Questionnaire) [13].
A literature review by Carlsson and Hamrin [14]
showed that the diagnosis of breast cancer evokes
grief, anger and intense fear in women. But the ma-
jority do not experience long-term emotional distress.
Risk factors for psychological dist ...
Study of medication appropriateness during hospital stay and revisits in medi...iosrjce
IOSR Journal of Pharmacy and Biological Sciences(IOSR-JPBS) is a double blind peer reviewed International Journal that provides rapid publication (within a month) of articles in all areas of Pharmacy and Biological Science. The journal welcomes publications of high quality papers on theoretical developments and practical applications in Pharmacy and Biological Science. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
Body mass-index-quality-of-life-and-migraine-in-studentsAnnex Publishers
Migraine is reported globally with a higher prevalence in students. The present study aims to evaluate the association between nutritional status, quality of life (QL) and characteristics of migraine.
A cross-sectional study. Headache characteristics, level of disability caused by migraine crises (Pediatric Migraine Disability Assessment - PedMIDAS) and QL (Pediatric Quality of Life Inventory- PedsQL) were assessed. Anthropometric variables were also measured.
Data were collected from 98 students with a mean age of 11.2 ± 1.7 years. Migraine had the highest prevalence (54.8%). The average Body Mass Index (BMI) of the total sample was 20.0 ± 3.8 kg/m2, and among students with migraine and students with tension headache, the average BMIs were 20.4 ± 4.0 and 19.5 ± 3.4 kg/m2, respectively (p = 0.264, Student's t-test). Around 47.5% from migraineurs were overweight or obese. Regarding QL, the average total score in students with migraine was 74.4 ± 12.4, with no differences observed among normal weight, overweight or obese students, and no correlation between the scores of the PedsQL and BMI (r = -0.182, p = 0.165, Pearson correlation coefficient) was observed. There was a high percentage of overweight students with migraine. Analyses show no associations between the nutritional status, frequency, severity, disability caused by crises, or QL.
Article Type: Editorial
Title: Challenges Met by Healthcare Professionals (Nurses) at the time of Covid-19 Pandemic
Year: 2021; Volume: 1; Issue: 2; Page No: 3 – 4
Author: Sumathi Senthilvel
DOI: 10.55349/ijmsnr.20211234
Affiliation: Associate Editor, IJMSNR, Formerly Assistant Professor in Nursing, Department of Fundamental Nursing, Amrita College of Nursing. Ponekkara, Kochi, Kerala. Email ID: AssociateEditor@ijmsnr.com
Article Summary: Submitted : 26-October-2021
Revised : 10-November-2021
Accepted : 02-December-2021
Published : 31-December-2021
Background: Diabetic Retinopathy is a non-communicable disease and metabolic disorder. It is a public health problem in Worldwide. In this paper, finding influencing factors and how much probability to development of DR among known T2DM patients.
Materials and Methods: This was a hospital-based cross-sectional and observational study among T2DM patients, with and without DR in the diabetes clinic with sample of 150 patients. Statistical analysis used chi-square and binary logistic regression analysis was used to identify correlates of DR after controlling of confounders.
Results: In this present study, among 150 patients, 39 (26%) patients had DR. Smoking habit was strongly associated with development of DR (AOR=15.39, p=0.002), patients had history of hypertension was associated with DR (AOR=1.10, p=0.016), medication, in that insulin users were strongly associated with DR (AOR=5.72, p=0.002), duration of diabetes mellitus with >10 years was associated with DR (AOR=1.18, p=0.001), total cholesterol with abnormal was 5-fold more increase in risk with the development of DR (AOR=5.86, p=0.065) but not significant, high hba1c with >6.5% was associated with the progression of DR (AOR=1.34, p=0.035), and fasting blood sugar with abnormal was associated with the progression of DR (AOR=1.01, p=0.027) except age but, showed positive association with DR. Probability of developing DR in a T2DM patient was 98%.
Conclusion: From this study, we revealed that influencing variables were hba1c, smoking habit, intake of tablet/insulin, duration of DM, history of hypertension and fasting blood sugar. The chance/probability of developing retinopathy was very high among known diabetes patients those who had longer duration of DM. Hence, we have recommended a periodic eye screening is mandatory in T2DM patients.
Keywords: diabetes mellitus, diabetic retinopathy, influencing factors, probability, multivariate analysis
Understanding the nutrition care needs of patients newly diagn.docxgibbonshay
Understanding the nutrition care needs of patients newly diagnosed
with type 2 diabetes: a need for open communication
and patient-focussed consultations
Lauren BallA,C, Ruth DavmorA, Michael LeverittB, Ben DesbrowA, Carolyn EhrlichA
and Wendy ChaboyerA
AMenzies Health Institute Queensland, Griffith University, Gold Coast 4222, Qld, Australia.
BSchool of Human Movement and Nutrition Sciences, The University of Queensland,
Brisbane 4072, Qld, Australia.
CCorresponding author. Email: [email protected]
Abstract. Patients who are newly diagnosed with type 2 diabetes mellitus (T2DM) commonly attempt to modify their
dietary intake after receiving nutrition care from primary health professionals. Yet, adherence to dietary recommendations
is rarely sustained and factors influencing adherence are poorly understood. This study exploredT2DMpatients’ experiences
of dietary change and their views on how primary health professionals can best support long-term maintenance of dietary
change.Apurposive sample of 10 individuals recently diagnosedwithT2DMparticipated in three individual semi-structured
qualitative telephone interviews: at baseline, then at 3 and 6 months after recruitment. Interview questions were modified
from the initial interview inorder to investigate emergingfindings.A two-step data analysis process occurred throughcontent
analysis of individual interviews andmeta-synthesis of findings over time. Participants initiallymadewide-ranging attempts
to improve dietary behaviours, butmost experienced negative emotions from the restraint required tomaintain a healthy diet.
Participants felt confused by the conflicting advice received from health professionals and other sources such as friends,
family, internet and diabetes organisations. Participants frequently reported feeling rushed and not heard in consultations,
resulting in limited ongoing engagement with primary healthcare services. These findings suggest that there is opportunity
for primary health professionals to enhance the dietary support provided to patients by: acknowledging the challenges of
sustained improvements in dietary intake; open communication; and investing in patient relationships through more
patient-focussed consultations.
Additional keywords: chronic disease, general practice, primary care, nutrition therapy, nutritional management.
Received 28 April 2015, accepted 18 August 2015, published online 5 October 2015
Introduction
Type 2 diabetes mellitus (T2DM) is a lifestyle-related chronic
disease and leading cause of morbidity andmortality in Australia
(Australian Institute of Health andWelfare 2007). Over 5%of the
Australian population has been diagnosed with T2DM, and an
additional 0.9% is predicted to be diagnosed annually (Australian
Bureau of Statistics (ABS) 2012). T2DM is typically diagnosed
and managed in the primary healthcare setting, and patients with
T2DM receive health care from a variety of primary health
professionals (Diabetes Australia 2012). Impor ...
Quantitative/Mixed-Methods
American InterContinental University
March 27, 2018
Running head: QUANTITATIVE/MIXED-METHODS
1
QUANTITATIVE/MIXED-METHODS
2
Quantitative/Mixed-Methods
Abstract
Case studies which are done in the field of medicine work towards improving the health of the population. There are some of the parts contained in case studies which are abstract, results, limitations of results, conclusions, and applications. The common statistical methods used in research are descriptive numerical and qualitative thematic analyses. The results of the studies show that equal participation of individuals in the health sector will help boost public health. Limitations of results are that although some strategies may work towards improving health sector, not all of them are effective.
Public health is an important sector in any country for it directly affects the economy of the nation. There need to be certain ways which should be employed with the aim of supporting and improving public health. In this paper, I am going to examine 4 contemporary peer-reviewed articles which employ quantitative or mixed-methods concerning ways on how to improve the health of the public. The interest of the paper is to aid in achieving the best impact in public health sector via using programs which will improve health outcomes drastically. Enhancement of public health will in return help to improve the well-being of populations across the world. Public health awareness on how to avoid unhealthy lifestyles should be created.
In the articles, samples and populations used were appropriate for it showed the real representative of the population at hand. All the samples used in the 4-contemporary peer-reviewed articles fulfilled the rule of thumb hence making them appropriate. The samples used were suitable for they were used to estimate the population parameters for it stood for the entire inhabitants. The samples used were larger but not too large to consume more resources of money and time. The larger sample has helped to produce accurate results making the samples valid and appropriate. The appropriateness of the samples used in these articles, it has been proved via usage of target variance. In using target variance an estimate to be derived from the model eventually attained.
Each article which has been used includes having results, limitations of results, conclusions, and applications. The first contemporary peer-reviewed article is entitled, Refugee women’s involvements of maternity-care facilities in Canada: a methodical review using a description synthesis written by Gina MA Higginbottom, Myfanwy Morgan, Miranda Alexandre, Yvonne Chiu, Joan Forgeron, Deb Kocay and Rubina Barolia. The article was published 11 February 2015. The results show that there needs to have a healthier understanding of the aspects that produce discrepancies in availability, adequacy, and outcomes during parenthood care (Higginbottom, Morgan, Alexandre, Chiu, Forg ...
357Piyawan Kanan et al.Vol. 23 No. 4Piyawan Kanan.docxlorainedeserre
357
Piyawan Kanan et al.
Vol. 23 No. 4
Piyawan Kanan, RN, PhD Candidate, Faculty of Medicine Ramathibodi
Hospital and Faculty of Nursing, Mahidol University, Thailand.
E-mail: [email protected]
Correspondence to: Noppawan Piaseu*, RN, PhD, Associate Professor,
Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital,
Mahidol University, Thailand. E-mail: [email protected]
Porntip Malathum, RN, PhD, Assistant Professor, Ramathibodi School
of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University,
Thailand. E-mail: [email protected]
Basia Belza, RN, PhD, Professor, Biobehavioral Nursing and Health Systems
Department, School of Nursing, University of Washington, Seattle, USA.
E-mail: [email protected]
Predictors of Diabetes Self-Management in Older Adults with
Poorly Controlled Type 2 Diabetes Mellitus
Piyawan Kanan, Noppawan Piaseu*, Porntip Malathum, Basia Belza
Abstract: Poorly controlled type 2 diabetes, a complex phenomenon, is rapidly increasing
particularly in older adults worldwide and in Thailand, the setting of this study. Effectiveness
of diabetes self-management demands various factors supporting optimal outcomes. This
descriptive correlational study examined the influences of ecological factors including
gender, time since diagnosis, family history of type 2 diabetes mellitus, abdominal obesity,
diabetes complications, health literacy, social networks, and social support on diabetes
self-management. Through purposive sampling, the participants consisted of 166 older
adults with poorly controlled type 2 diabetes mellitus at two hospitals in central Thailand
province. Data were collected using questionnaires on the Functional, Communicative
and Critical Health Literacy Scale, the revised Summary of Diabetes Self-Care Activities
Scales, the Social Network in Adults Life, and the Diabetes Severity Complication Index;
and nutrition assessment including waist circumference and HbA1c. Descriptive statistics
and Stepwise Multiple Regression Analysis were used for data analysis.
Results revealed that health literacy, abdominal obesity, time since diagnosis, and
gender could together predict diabetes self-management, accounting for 14.7% of the
variance. Prior to developing an effective intervention, an additional variable more specific to
older adults needs to be examined such as self-efficacy that affects older adults’ confidence
regarding health behavior modification. Nevertheless, these findings suggest approaches
for nurses to promote diabetes self-management education that includes enhancing health
literacy, and modifying health behaviors for control of abdominal obesity based on other
health conditions, particularly in male older adults with type 2 diabetes mellitus.
Pacific Rim Int J Nurs Res 2019; 23(4) 357-367
Keywords: Diabetes Mellitus, Health literacy, Older adults, Poor control, Self-management,
Thailand, Type 2 Diabetes
Introduction
The aging population i ...
Determine the Patients' Satisfaction Concerning In-hospital Information Progr...iosrjce
IOSR Journal of Nursing and health Science is ambitious to disseminate information and experience in education, practice and investigation between medicine, nursing and all the sciences involved in health care.
Nursing & Health Sciences focuses on the international exchange of knowledge in nursing and health sciences. The journal publishes peer-reviewed papers on original research, education and clinical practice.
By encouraging scholars from around the world to share their knowledge and expertise, the journal aims to provide the reader with a deeper understanding of the lived experience of nursing and health sciences and the opportunity to enrich their own area of practice
Evaluations of and Interventions for Non Adherence to Oral Medications as a P...NiyotiKhilare
The focus of this presentation will be medical non-adherence as a psychosocial issue in diabetes. The presentation will also focus elaborately on empowerment as an intervention amongst other interventions.
Angela’s Ashes - Murasaki Shikibu said that the novel happens be.docxdurantheseldine
Angela’s Ashes
- Murasaki Shikibu said that the novel "happens because of the storyteller's own experience . . . not only what he has passed through himself, but even events which he has only witnessed or been told of—has moved him to an emotion so passionate that he can no longer keep it shut up in his heart." What is the passionate emotion that is communicated in your novel? Why was the author of your novel moved to write? What is the thing that the novelist had to communicate? In your paper, explain the author's motivating emotion and how it is explored in the novel.
.
ANG1922, Winter 2016Essay 02 InstructionsYour second e.docxdurantheseldine
ANG1922, Winter 2016
Essay 02 Instructions
Your second essay is due by noon on Thursday, April 5th – by email only!
This essay must be an expository or informative essay. You have to explain something, give the pertinent information about it,
maybe describe the situation, maybe describe some process involved – the specifics depend on your topic. It might help to
know what an expository essay is not: it is not opinion nor argument. It might include any of the strategies, such as
description, comparison, contrast, and even narration, but the main purpose is to expound upon your topic. The possibilities are
endless.
Consider some possibilities if you were writing about guitars: You could explain what to look for in a guitar, how to record
guitar, part of the history of guitars (you couldn't do the whole history), categorize the types of guitars, explain the different
types of pick-ups available, and on and on. As another example, you could write something about current issues – explaining
the issue, the sides, the actions taken, the proposed solutions . . . whatever you decide to focus on. Those are just two
examples. The main criteria is that your essay is expository or informative, not an opinion or an argument.
You still have to write an introduction and a conclusion, of course. You do not have a required number of points or paragraphs.
Instead, you have a word limit: 750 word minimum, 1000 word maximum.
Rules for formatting your assignments
1) No cover page.
2) No headers. No footers.
3) At the top of the first page only, put your name and identify the assignment.
4) Set your page format to “letter” (8.5 x 11 in.). Beware: you may have A4 as your default page format.
5) Set the document language to “English” and use the spell checker.
6) Single spaced text, with a blank line between paragraphs.
7) Font: Times New Roman, 11 point.
Name your file properly <NAME – essay 2 – TITLE.doc>, put your name in your document also, and send it to
[email protected]
SPECIAL REQUIREMENTS (actually, third and fourth are not so special; they are an essential quality of effective writing)
➢ Use these comparative structures: as ____ as _____ ; less & than; more & than;
➢ Use comparatives in various parts of the sentence: the subject, the verb, and the object – all three
➢ Use at least all these at least twice each: colon, parentheses, and dash
➢ all of these conjunctions: even so, although, furthermore, moreover, if, unless (highlight them somehow)
A checklist for you:
1) _______ All of the above requirements are met
2) _______ Sentences have a variety of beginnings
3) _______ Concise, and precise, wording
4) _______ Specific, concrete images and details – avoid vague, obvious statements and abstractions
5) _______ Audience (well-chosen, well-defined, appropriately addressed), Purpose (focused, feasible, refined, clearly
expressed), and Persona (credible, evident from the text)
6).
Anecdotal Records Anecdotal Record Developmental Domain__ _.docxdurantheseldine
Anecdotal Records
Anecdotal Record Developmental Domain__ __________________________ ________
Child’s Name: ______________________________ Date: ___________________________
Child’s Age: _____________________________ Time: ____________________________
Date of Birth: _______________________________ Observer:____ ____________________
Setting: _________________
Anecdotal:
Interpretation:
Implication for Planning:
Anecdotal Records
Anecdotal Records are detailed, narrative descriptions of an incident involving
one or several children. They are focused narrative accounts of a specific event.
They are used to document unique behaviors and skills of a child or a small
group of children. Anecdotal Records may be written as behavior occurs or at a
later time.
!
Anecdotal!Record!Developmental!Domain2________________________________________________!
!
!
Child’s(Name:(______________________________! ((((((((((Date:(______________________________!(
(
Child’s(Age:(_________________________________!
(((((((((((
((((((((((Time:(_____________________________!
(
Date(of(Birth:(_______________________________!
(((((((((((
((((((((((Observer:(________________________!
(
Setting:(_______________________________________________________________________________________(
!
!
Anecdotal:(
!
(Describe exactly what you see and hear; do not summarize behavior. Use
words conveying exactly what a child said and did. Record what the child did
when playing or solving a problem. Use specific language to describing what the
child said and did including facial expression and tone of voice; avoid
interpretations of the child’s behavior; For example “He put on a firefighter’s hat
and said, “Let’s save someone!” or “He looked towards the puzzle piece and then
looked toward the puzzle. He put the puzzle piece on the puzzle and turned the
piece until it fit. He took the puzzle piece out.” Avoid using judgmental language)!
(
Interpretation:(
!
(What specific inferences can you make from this anecdotal record? What does
it tell you about this child’s growth and development? The inferences must be
directly related to the domain designated in the anecdote and refer to a specific
aspect of the domain.)
(
Implication(for(Planning:(
!
(Give a specific activity that you would incorporate into curriculum planning as a
result of what you learned about this child. Be sure the plan is directly related to
the area of development described in the anecdote. Be sure the activity is a
different activity than the one in the anecdote. Include a brief explanation of why
you would create the specific activity.)!
Anecdotal Records
!
Anecdotal!Record!Developmental!Domain2!Social!
!
!
Child’s(Name:(Jai!Liam! ((((((((((Date:(January!11,!2010!(
(
Child’s(Age:(4!years!1!month!
(((((((((((
((((((((((Time:(9:15!AM!
(
Date(of(Birth:(February!9,!2006!
(((((((((((
((((((((((Observer:(Ms.!Natalie!
(
Setting:(Ray!of!Light!Montessor.
Andy and Beth are neighbors in a small duplex. In the evenings after.docxdurantheseldine
Andy and Beth are neighbors in a small duplex. In the evenings after work, Andy enjoys practicing the
tuba, while Beth likes to relax and read novels. Unfortunately, Andy is not very good at his instrument,
and noise from his playing penetrates the walls and annoys Beth.
The daily utility Andy derives from playing the tuba for m minutes and spending xA dollars on other
consumption is given by
UA = xA + 32 log(m):
Andy would be happy to play his horn all day, except that he gets tired from blowing and he needs
to drink Red Bull (which is costly) to keep up his energy. (For simplicity, assume Andy gets no direct
utility benet from drinking Red Bull.) In fact, because there are diminishing returns to the eectiveness
of energy drinks, Andy has to increase his rate of Red Bull consumption the longer he plays the tuba.
Thus, Andy incurs c(m) dollars of Red Bull expense from playing the tuba m minutes in a day, where
c(m) =m2/36
Beth's happiness in a day is simply a function of how many dollars xB she spends on consumption
and how many minutes m of Andy's tuba playing she must endure. She becomes increasingly irritated
by the tuba the longer the playing goes on. Her utility is given by
UB = xB -m2/12
:
Assume that Beth and Andy have $150 of income to spend each day, and that they cannot save or
borrow any extra (they either use it or lose it).
1. From the perspective of a social planner with a utilitarian social welfare function, what is the
socially optimal amount of tuba playing each day?
2. Suppose there is no law stipulating whether Andy has a right to play his horn, or whether Beth
has a right to peace and quiet (it is hard to measure noise levels and sources, and to give rights
to this).
(a) Describe intuitively whether a market failure exists in this context.
(b) Calculate how many minutes m Andy chooses to play each day, and the resulting utilities of
Andy and Beth.
(c) Is there any deadweight loss from Andy's choice (if so, calculate it)?
3. Beth complains to her Landlord about the tuba noise, and in response the Landlord installs
noise meters that precisely record the level and source of noise in the apartments. The Landlord is
considering a policy where residents would be charged a fee of per minute of noise above a certain
threshold (the tuba would exceed this threshold). The Landlord wants to set to maximize total
welfare, as in part 1.
(a) In one concise sentence, describe intuitively how the optimal should be set.
(b) Calculate the optimal .
2
(c) What is the most Beth would be willing to pay the Landlord to induce him to implement the
policy in (b) (vs. the status quo described in part 2)?
(d) The Landlord does not want to make Andy upset. How much must the Landlord pay Andy
before he would agree to the policy in (b)?
4. Suppose the Landlord considers two alternative policies of \noise rights:"
(a) The Landlord gives Beth the rights to peace and quiet.
(b) The Landlord gives Andy the right to make noise.
These rights would be wri.
Andrew John De Los SantosPUP 190SOS 111 Sustainable CitiesMar.docxdurantheseldine
Andrew John De Los Santos
PUP 190/SOS 111 Sustainable Cities
March 21, 2019
Assignment 4: Researching Urban Sustainability
Solution
s
1. RESEARCH QUESTION:
How can composting food waste help reduce climate change and enhance sustainability?
2. SEARCH TERMS/COMBINATIONS:
I used different combinations of search terms:
1. Compost AND Sustain*
2. Compost AND “food waste” AND environment
3. “Compost Biochar” AND “Carbon Sequestration”
4. “Food Waste” AND “Carbon Sequestration”
3. DATABASES SEARCHED:
I used the following databases:
1. Scopus
2. Web of Science
4. ANNOTATED BIBLIOGRAPHY
Bolan, N. S., Kunhikrishnan, A., Choppala, G. K., Thangarajan, R., & Chung, J. W. (2012). Stabilization of carbon in composts and biochars in relation to carbon sequestration and soil fertility. Science of The Total Environment, 424, 264–270. https://doi.org/https://doi.org/10.1016/j.scitotenv.2012.02.061
(Word Count: 194)
Dr. Nanthi Bolan previously worked for the Centre for Environmental Risk Assessment and the Cooperative Research Centre for Contaminants Assessment and Remediation of the Environment at the University of South Australia, and now at the University of Newcastle, and he has published many highly-cited studies on biochar, according to Google Scholar. Current intensive farming techniques removes carbon from the soil, so it's necessary to enhance its capacity to act as a carbon sink and thereby help to mitigate climate change. In Dr. Bolan’s paper, she looked at how to enhance carbon sequestration in soil using compost and biochar from organic materials to mitigate GHG emissions. The methodology used was to run different decomposition experiments on various organic amendments to measure the release of CO2. Results showed that compost combined with clay materials increased the stabilization of carbon the most. However, when organic material undergoes pyrolysis (heated at high temperatures with little oxygen) and becomes biochar, it further enhances its ability to stabilize and sequester carbon. Additionally, it was found that both compost and biochar enhance soil quality. Therefore, composting food waste or turning it into biochar can improve soil quality and reduce carbon emissions.
Oldfield, T. L., Sikirica, N., Mondini, C., López, G., Kuikman, P. J., & Holden, N. M. (2018). Biochar, compost and biochar-compost blend as options to recover nutrients and sequester carbon. Journal of Environmental Management, 218, 465–476. https://doi.org/https://doi.org/10.1016/j.jenvman.2018.04.061
(Word Count: 155)
Dr. Oldfield works at the School of Biosystems and Food Engineering at the University College Dublin, Ireland. In his paper, he looked at the potential environmental impact of end-of-life of organic materials in agriculture and how the applications compare to that of traditional mineral fertilizer. He looked at global warming, acidification, and eutrophication impacts among pyrolysis (biochar), composting (compost), and its combination (biochar-compost .
Android Permissions Demystified
Adrienne Porter Felt, Erika Chin, Steve Hanna, Dawn Song, David Wagner
University of California, Berkeley
{ apf, emc, sch, dawnsong, daw }@ cs.berkeley.edu
ABSTRACT
Android provides third-party applications with an extensive
API that includes access to phone hardware, settings, and
user data. Access to privacy- and security-relevant parts of
the API is controlled with an install-time application permis-
sion system. We study Android applications to determine
whether Android developers follow least privilege with their
permission requests. We built Stowaway, a tool that detects
overprivilege in compiled Android applications. Stowaway
determines the set of API calls that an application uses and
then maps those API calls to permissions. We used auto-
mated testing tools on the Android API in order to build
the permission map that is necessary for detecting overpriv-
ilege. We apply Stowaway to a set of 940 applications and
find that about one-third are overprivileged. We investigate
the causes of overprivilege and find evidence that developers
are trying to follow least privilege but sometimes fail due to
insufficient API documentation.
Categories and Subject Descriptors
D.2.5 [Software Engineering]: Testing and Debugging;
D.4.6 [Operating Systems]: Security and Protection
General Terms
Security
Keywords
Android, permissions, least privilege
1. INTRODUCTION
Android’s unrestricted application market and open source
have made it a popular platform for third-party applications.
As of 2011, the Android Market includes more applications
than the Apple App Store [10]. Android supports third-
party development with an extensive API that provides ap-
plications with access to phone hardware (e.g., the camera),
WiFi and cellular networks, user data, and phone settings.
Permission to make digital or hard copies of all or part of this work for
personal or classroom use is granted without fee provided that copies are
not made or distributed for profit or commercial advantage and that copies
bear this notice and the full citation on the first page. To copy otherwise, to
republish, to post on servers or to redistribute to lists, requires prior specific
permission and/or a fee.
CCS’11, October 17–21, 2011, Chicago, Illinois, USA.
Copyright 2011 ACM 978-1-4503-0948-6/11/10 ...$10.00.
Access to privacy- and security-relevant parts of Android’s
rich API is controlled by an install-time application permis-
sion system. Each application must declare upfront what
permissions it requires, and the user is notified during in-
stallation about what permissions it will receive. If a user
does not want to grant a permission to an application, he or
she can cancel the installation process.
Install-time permissions can provide users with control
over their privacy and reduce the impact of bugs and vul-
nerabilities in applications. However, an install-time per-
mission system is ineffective if developers routinely request
more perm.
ANDREW CARNEGIE PRINCE OF STEELNARRATOR On November 25th, 1835 i.docxdurantheseldine
ANDREW CARNEGIE PRINCE OF STEEL
NARRATOR On November 25th, 1835 in Dunfermline, Scotland , William Carnegie plied his trade on the handloom which filled the first floor of his humble stone bungalow. But his mind that day was not on making fine linen cloth. His wife, Margaret , was in labor in the other room of their home, a small attic. That night, she gave birth to their first child, a son they named Andrew . The child's father, William , was a fine craftsman who provided a comfortable home for his wife and son, but his business was devastated by the textilefactories. William Carnegie refused to seek work in the factories and the family suffered through the poverty caused by his pride. It was Andrew's mother, Margaret , who supplied the strength to keep the family together. From her example, Andrew learned the value of hard work at an early age. Even then while doing his chores, he showed contempt for things that stood in his way. One of his jobs was to fetch water from the town well. By custom, the townspeople put out their buckets to form a line the night before. But Andrewgot tired of watching late risers take their place in front of him. One morning, he simply kicked their buckets out of theway and took his place at the head of the line. No one stopped him. Going to school wasn't mandatory and Andrewdidn't start until he was eight. Most of his early education was learned at the feet of his father and uncles, George Lauder , who ran a grocery market, and Tom Morrison , a fiery public speaker whose working-class opinions about the wealthy antagonized powerful people. Young Andrew would learn there was a price to pay for his Uncle Tom Morrison'sconfrontations with political foes. From his bedroom window,Andrew could see the tree line of the beautiful PittencrieffEstate, which contained ruins from the historical legacy ofMary , Queen of Scots. Just once a year, the owner of the estate allowed the public to come in and stroll the grounds, with one exception. He barred anyone related to a Morrison . So Andrew was forced to stay outside while all of his playmates were allowed to go into the park. The pain of this annual event in his young life would forever color Carnegie'sattitudes about his personal right to freedom of expression and his belief in the equality of all men. By the winter of 1847, another kind of pain would threaten the Carnegie family, which now included his brother, Tom , born in 1843 . DespiteMargaret's valiant efforts, they faced a prospect of soup lines to survive. Against everyone's advice, she decided to uproot the family and immigrate to America , where she had relatives living in Pittsburgh . Twelve-year-old Andrew was afraid of leaving the only home he'd ever known. He would later write of his departure from Scotland , " I remember I stood with tearful eyes as my beloved Dunfermline vanished from view." Andrew had never seen the sea when they booked passage on the converted whaling ship, the Wiscasset, bound forAmerica.
Andrew CassidySaint Leo UniversityContemporary Issues in Crimina.docxdurantheseldine
Andrew Cassidy
Saint Leo University
Contemporary Issues in Criminal Justice Administration (CRJ 575)
July 25, 2014
Dr.
Donald G. Campbell
Abstract
Leaders fail to act accordingly based off theories that are examined in detail explaining the fall of a organization.
Background
Leadership failures can be attributed to theories based off emergence or nature of the particular type or style of leadership. Some theories that are examined are the traditional leadership theory, behavior and leadership styles theory, contingency and situational theory, transactional and transformational theory, comparison of charismatic and transformational leadership and finally the new leadership which represents the servant, spiritual, authentic and ethical style of leadership (
Swanson, C. R., Territo, L., and Taylor, R. W., 2012)
. Many reasons are listed why leaders fail but an effective leader should be developing and effective organization.
Reasons Why Leaders Fail
A leader fails to act because of five different reasons (Haller, C.L., 2010). The first is the interpersonal skills of a leader. If the leader has a poor skill in interpersonal then the leader has lost the ability to inspire their people. Poor communication fails underneath poor interpersonal skills. A well-rounded leader gives feedback to their employees, which correlates a element that produces a high functioning organization. Sometimes leaders fear the confrontation. A good example of side stepping this would be learning the art of verbal judo. The technique allows a employer to hear and understand the feelings but also takes into consideration the feelings of this a particular individual. Part of being a leader is making risk decisions on short notice that may be difficult but may involve address issues with others that closely work around you.
The second reason leaders fail is the inability to adapt and change. Part of the society we now live in requires us to adapt and overcome changes in the world. A good leader must be able to see the good in anything and promote change from within. New situations arise on daily basis and strategies must be formed accordingly in order to embrace the change. The one thing a good leader can count on is constant change in the workplace. I believe this to be especially true in law enforcement. The third reason leaders fail to act is because leaders focus more on self -promotion focusing on being important or powerful. The perception in the workplace is that this type of action is a betrayal of trust and a failure of integrity. The objective focus in this particular leader makes the performance not good enough to succeed but wants a celebrity status in return. Some leaders want what is not theirs and pride themselves as being top dog in a organization. The fourth reason why leaders fail is because of their indecisiveness. A direct result of this is because the leader has alack of confi.
Andrea Azpiazo – Review One. Little Havana Multifamily Developme.docxdurantheseldine
Andrea Azpiazo – Review One. Little Havana: Multifamily Development Project
This report states that Little Havana is considered a low to moderate income market. However, the report also informs that demand for the proposed apartments will come from the mid to upper-income population of the Little Havana area, but it does not provide demographic data to support that demand. Who are they? What age groups? Is it primarily family households, retirees, millennials, or a mix? These are essential questions that need to be answered for an investor to have some indication of where the potential growth in rental rates will come.
No Operating Expenses are listed other than Management Fee, which is on the low end of the industry scale and likely since this is a new building. What are the projections for electricity, building and grounds maintenance, water? Although this is new construction, there will be operating expenses required throughout the holding period. Will there be a washer and dryer in the units? What about laundry or vending machines as a source of Other Income.
Based on data provided in the report, the CAP Rate for this proposed Multifamily development is significantly higher than the averages for the area, at 5.3-5.7%. Considering this is new Class A development which is not expected to carry high CAPEX reserves for a typical investment holding period of 5-7 years, the Going-In and Going-Out CAP Rates should be lower. Additionally, 70% LTV at 9% is indicative of higher risk. Is there an issue with the developer which has not been disclosed and precludes them from obtaining better terms?
The asking rent for this proposed multifamily development is 21.42% over the average rents for comparable apartments in the area. An additional bathroom in the units and one parking space per unit does not support the $1,400 asking rent, particularly when considering that there are no amenities in this building to attract a demographic that is willing to pay $300, or 21.42%, more in rent for the subject area.
Being new construction, why weren’t hurricane impact windows or shutters included, which are more in line with current building codes and municipal planning, such as Miami21? This reduces property insurance costs. The new owner may have to invest in these as part of capital expenditures.
The proposed development does not appear to fit the current target market and relies on expectations for future growth and demand in the area. Further examination, with more due diligence from sites such as STDB, US Census data, NREI, CBRE is warranted to determine the viability of this project for the proposed holding period.
Andrea Azpiazo
–
Review One. Little Havana: Multifamily Development Project
This report states that Little Havana is considered a low to moderate income market. However,
the report also informs that demand for the proposed apartments will come from the mid to
upper
-
income population of the Little Ha.
And what we students of history always learn is that the human bein.docxdurantheseldine
"And what we students of history always learn is that the human being is a very complicated contraption and that they are not good or bad but are good and bad and the good comes out of the bad and the bad out of the good, and the devil take the hindmost." - All the King's Men, Robert Penn Warren
1. What can you analyze about the syntax of this text?
2. AP Style Question: How does this excerpt's syntax affect the arrangement of details and overall pacing of the text?(Structure 3.A)
3. AP Style Question: How do the diction, imagery, details, and syntax in a text support multiple tones? (Narration 4.C)
THE JOY LUCK CLUB
"That night I sat on Tyan-yu's bed and waited for him to touch me. But he didn't. I was relieved." - Amy Tan, The Joy Luck Club
QI: What effect does the syntactical arrangement have on the quote?
Q2: AP Style Question: Which details from the text indicate the identity of the narrator or speaker? (Narration 4.A)
"1984"
"For, after all, how do we know that two and two make four? Or that the force of gravity works? Or that the past is unchangeable? If both the past and the external world exist only in the mind, and if the mind itself is controllable - what then?" George Orwell, 1984
Q: What effect does the syntactical arrangement have on the quote?
.
and Contradiction in Architecture Robert Venturi .docxdurantheseldine
and
Contradiction
in Architecture
Robert Venturi
with an introduction by Vincent Scully
The Museum of Modern Art Papers on Architecture
The Museum of Modern Art, New York
in association with
the Graham Foundation for Advanced Studies in
the Fine Arts, Chicago
Distributed by Harry N. Abrams, Inc., New York
Trustees of The Museum of Modern Art as of October I992
David Rockefeller, Chairman ofthe Board; Mrs. FrankY. Larkin, Donald B.
Marron, Gifford Phillips, Vice Chairmen; Agnes Gund, Presiden; Ronald S.
Lauder, Richard E. Salomon, Vice Presidents; John Parkinson 111, Vice
President and Treasurer, Mrs. Henry Ives Cobb, Vire Chairman Emeritus
Mrs. John D. Rockefeller jrd, President Emerim, Frederick M. Alger 111,
Lily Auchincloss, Edward Larrabee Barnes, Celeste G. Bartos, Sid R. Bass,
H.R.H. Prinz Franzvon Bayern,** Hilary P. Califano, Thomas S. Carroll,*
Mrs. Gustavo Cisneros, Marshall S. Cogan, Robert R. Douglass, Gianluigi
Gabetti, Lillian Gish,** Paul Gottlieb, Mrs. Melville Wakeman Hall,
George Heard Hamilton,' Barbara Jakobson, Philip Johnson, John L.
Loeb,* Robert B. Menschel, Dorothy C. Miller,** J. Irwin Miller,*
S. I. Newhouse, Jr., Philip S. Niarchos, James G. Niven, Richard E.
Oldenburg, Michael S. Ovitz, Peter G. Peterson, John Rewald,** David
Rockefeller, Jr., Rodman C. Rockefeller, Mrs. Wolfgang Schoenborn,*
Mrs. Robert F. Shapiro, Mrs. Bertram Smith, Jerry I. Speyer, Mrs. Alfred R.
Stern, Mrs. Donald B. Straus, E. Thomas Willianis, Jt, Richard S. Zeisler.
* Tmstee Emeritus **Honorary Tmstee Ex-Oficio T~ruees: David N .
Dinkins, Mayor of the City ofNew firk, Elizabeth Holtzman, Comptrolhr
of the City of New firk, Jeanne C. Thayer, President of The International
Council
Copyright O The Museum of Modern Art, New York, 1966, 1977
All rights resewed
Second edition 1977, reprinted 1979, 1981, 1983, 1985, 1988, 1990, 1992
Library of Congress Catalogue Card Number 77-77289
The Museum of Modern Art ISBN 0-87070-282-3
Abrams ISBN 0-8109-6023-0
Second edition designed by Steven Schoenfelder
Printed by Princeton University Press, Lawrenceville, New Jersey
Bound by Mueller Trade Bindery, Middletown, Connecticut
The Museum of Modern Art
I I West 53 Street
New York, New York 10019
Printed in the United States of America
Distributed in the United States and Canada by Harry N. Abrams, Inc., New York
A Times Mirror Company
Contents
Acknowledgments 6
Foreword 8
Introduction 9
Preface 13
1. Nonstraightforward Architecture:
A Gentle Manifesto 16
2. Complexity and Contradiction vs.
Simplification or Picturesqueness 16
3. Ambiguity 20
4. Contradictory Levels:
The Phenomenon of "Both-And" in Architecture 23
5 . Contradictory Levels Continued:
The Double-Functioning Element 34
6. Accommodation and the Limitations of Order:
The Conventional Element 41
7. Contradiction Adapted 45
8. Contradiction Juxtaposed 56
9. The Inside and the Outside 70
10. Theobligation T.
Ancient Egypt1The Civilization of the Nile River V.docxdurantheseldine
Ancient Egypt
1
The Civilization of the Nile River Valley: Egypt
Geography – Isolated by deserts on both sides.
The Nile’s periodic flooding made civilized life possible in Egypt. During drought or famine, Egypt was the place to go because Egypt always has water (cf. the story of Joseph and his brothers in Genesis).
The kingdom was divided into two parts: Lower Egypt and Upper Egypt (Upper Egypt is in the south), with Lower Egypt being a bit more cosmopolitan than Upper Egypt.
Unlike Mesopotamia, stone was plentiful.
2
Pre-Dynastic Egypt: There is some evidence that very early on (3400-3200 BC), Egypt was influenced by Mesopotamia (corresponds to Jemnet Nasr period at Uruk). The evidence includes:
the use of rectangular sun-dried mud-brick in building,
the use of cylinder seals only during this time (Egypt usually used stamp-seals before and after this period),
pictographic writing (the “idea” comes from Mesopotamia),
the idea of kingship, social stratification and specialization,
certain kinds of painted pottery,
and pictures of twisted animals and battling with animals.
This contact may explain Egypt’s sudden explosion into a complex, advanced civilization with writing. The use of mud-brick is peculiar, noting the abundance of stone. There is evidence, however, that the development begins in Upper Egypt (i.e., the south). Two distinct cultures, the Upper, with social stratification and royal artistic expression, etc., and the Lower, with contacts in Palestine, etc.
Egypt seems to go from the Neolithic to a complex civilization overnight. Linear development is not apparent. Agriculture appears to be introduced from outside.
The Pharaoh (the king) is somehow responsible for the yearly success of the Nile. His throne was Isis, the wife of Osiris and the mother of Horus. The king is identified with Horus.
Egypt seeks to portray changeless continuity over thousands of years. This is somewhat true, but not entirely accurate. Ancient Egypt went through a few periods of relative chaos or lack of centralized power. Egypt, however, as is well known, chose not to usually record such periods for posterity.
4
Map of Egypt
5
Egyptian history begins with King Narmer
Narmer united Upper and Lower Egypt
He is likely the same person as Menes
Mizraim is often the Hebrew name for Egypt
The combination of the two crowns appears.
This is the beginning of the First Dynasty, and of Egyptian history
He established his capital at the new city of Memphis (= neutral ground)
It was a new city, said to have arisen out of the ground when Narmer diverted the Nile.
The royal burial grounds of Saqqara and Giza are located nearby.
The uniting of Egypt is commemorated on the Palette of King Narmer (fig. 2.3)
Egyptian artistic canon for relief figures is manifested:
head and feet in profile, with one foot forward, but eye and shoulders shown frontally (cf. fig. 2.2)
This is the beginning of Egypt’s Bronze Age
It is also the beginning of Egy.
Anayze a landmark case. The assesment should include a full discussi.docxdurantheseldine
Anayze a landmark case. The assesment should include a full discussion of the case, the courts decision and the impact it had on the US political/legal environment.
8-12 pages
12 point times new roman font
at least 5 crediible sources
Selected cases:
Roe v. Wade (1973)
Miranda v. Arizona (1966)
Dred Scott v. Sandford (1854)
Plessy v. Ferguson (1896)
Brown v. Board of Education (1954)
Mapp v. Ohio (1961)
United States v. Nixon (1974)
Regents of the Univ. of California v. bakke (1978)
Lawrence v. Texas(2003)
Bush v. Gore (2000)
.
Anatomy and Physiology of the Digestive SystemObjectives· Iden.docxdurantheseldine
Anatomy and Physiology of the Digestive System
Objectives
· Identify the anatomical structures of the digestive system and their functions
· Explain the physiology of digestion through the system
Assignment Overview
This exercise helps students understand the anatomical structures of the digestive system
Deliverables
Annotated diagram of the digestive system
Step 1 Draw a diagram. (It is OK to take a diagram from the internet and label it.)
Using the drawing tools provided by your word-processing program, draw a diagram that traces the pathway and physiological processes of a bite of food through the digestive system. Annotate each step in the digestive process with a brief paragraph describing what happens in the step.
Be sure to include ALL the following topics:
· The organs of the digestive system (This includes the alimentary canal AND the accessory organs of digestion)
· The actions of the digestive system
· Propulsion
· Absorption
· Chemical digestion
· Mechanical d
Running head: CREATING A LANGUAGE RICH ENVIRONMENT1
CREATING A LANGUAGE RICH ENVIRONMENT6
Creating a Language Rich Environment
Kawanda Murphy
Instructor Afiya Armstrong
Ece315 Language Development in young Children
12/17/18
Creating a Language Rich Environment
Introduction
Children learn best in environments that support optimum creativity as well as development opportunities. As such, teachers must strive to foster a learning environment that enhances language acquisition among students. Learners can grasp different languages with the right practice, instructions as well as encouragement. Every teacher has a responsibility to have a classroom set up with specific learning areas as well as plan for their use (Celic, 2009). The ways in which he or she creates the opportunities for productive language acquisition can enable learners to lower their mistakes, allow learners at different educational levels interact with one another, as well as create a natural learning environment that teaches and provides various opportunities for language learning (Piper, 2012). Therefore, I have designed a classroom floor plan with three centers- the computer corner, the collaborative work table and reading corner- that do not only promote literacy, but also language acquisition.
The Classroom Floor plan
This floor plan is specifically designed to provide children with the opportunities on how learn and use language in natural ways. The three primary areas designed for promoting language learning and use include the computer corner, the reading center as well as the collaborative worktable.
The Computer Corner
The computer corner has 2 computer desks than can be used by between 2 and 3 learners at a time. The computer area supports language development among learners by providing them with the opportunities on how to use a computer, play interactive reading game, print words for learning as well as use other educational programs that promote reading as well as language acq.
ANAThe Article Review by Jeanette Keith on Book by Stephanie McCu.docxdurantheseldine
ANAThe Article Review by Jeanette Keith on Book by Stephanie McCurry
Stephanie McCurry.Masters of Small Worlds: Yeoman Households, Gender Relations and the Political Culture of the Antebellum South Carolina Low Country. New York: Oxford University Press, 1995. 320 pp. $39.95 (cloth), ISBN 978-0-19-507236-5.
Reviewed byJeanette Keith (Bloomsburg University of Pennsylvania)
Published on H-CivWar (February, 1996)
FOR DISCUSSION - Analyze this article as a myth regarding TOPIC“The Enslave South”!
Stephanie McCurry's superb study of antebellum South Carolina deserves a place on the shelves and reading lists of all historians of the South and the Civil War. In lucid prose, backed up by careful and sophisticated research, she provides an answer to one of the most basic questions about the war and the region, a question best posed in the terms many professors have heard from freshmen students: "If most Southerners didn't own slaves, then why did they fight for the Confederacy?" For her answer, McCurry looks at the South Carolina Low Country.
The Low Country represents the Slave South carried to extremes, characterized as it was by huge plantations, a majority slave population, and a political system unique in the South for its elitism. South Carolina was not "the South" any more than Massachusetts was "the North," but its very nature as the extreme example of "Southern-ness" makes it an excellent place to ask some basic questions about the nature of antebellum society and its relationship to the political system. McCurry's answers demolish some deeply cherished myths about the Low Country and cast new light on some very old questions in the historiography of the South.
McCurry's book is about yeoman farmers, their families, their religion, and their relationships (political and otherwise) with the planters. McCurry notes that the very presence of yeoman farmers in the Low Country has been written out of history: they exist only as "the people" in the discourse of planter politicians. Ironically, two opposing groups are responsible for this -- the descendants of planters, who have found their self-created myth of the aristocratic Low Country both soothing and a lucrative tourist attraction, and antebellum travelers like Frederick Law Olmsted, who assumed the degredation of the non-planter white population and who usually saw in the South what he wished to see.
Through the use of quantified data, McCurry establishes the existence of yeoman farmers in the Low Country and demonstrates that they were the majority of the white male population in the region. According to McCurry, these farmers owned small amounts of land and possibly a few slaves. Their strategy for survival, as described by McCurry, will be familiar to any student of the new rural social history. They produced food first for family sustenance and then grew cotton for the market. Farmers were masters of small households and controlled the labor of their wives, their children and (if they .
Analyzing workers social networking behavior – an invasion of priva.docxdurantheseldine
Analyzing workers' social networking behavior – an invasion of privacy?
Salesforce.com
's ‘Chatter’ is analytics software that can be used by IT administrators to track workers' behavior on social networking sites during working hours. The data collected can be used to determine who is collaborating with whom, and to inform developers about how much their applications are being used – a concept often referred to as stickiness. While these reasons for tracking users appear to be bona fide, is this a threat to personal privacy?
.
Analyzing and Visualizing Data Chapter 6Data Represent.docxdurantheseldine
Analyzing and Visualizing Data
Chapter 6
Data Representation
Introducing Visual Encoding
Data representation is the act of giving visual form to your data.
Viewers: When perceiving a visual display of data, it is decoded using the shapes, sizes, positions and colors to form an understanding
Visualizers: Doing the reverse through visual encoding, assigning visual properties to data values
Comprised of a combination of two properties
Marks: Visible features like dots, lines and areas
Attributes: Variations applied to the appearance of marks, such as size, position, or color.
Introducing Visual Encoding cont.
TBA
Introducing Visual Encoding cont.
TBA
Introducing Visual Encoding cont.
TBA
Introducing Visual Encoding cont.
TBA
Introducing Visual Encoding cont.
Marks and Attributes are the ingredients, a chart type is the recipe offering a predefined template for displaying data.
Different chart types offer different ways of representing data.
Introducing Visual Encoding cont.
TBA
Introducing Visual Encoding cont.
TBA
Introducing Visual Encoding cont.
TBA
Introducing Visual Encoding cont.
Chart Types
TBA
Chart Types
Exclusions
Inclusions
Categorical comparisons
Dual families
Text visualization
Dashboard
Small multiples
A note about ‘storytelling’
Influencing Factors and Considerations
TBA
Influencing Factors and Considerations cont.
TBA
Influencing Factors and Considerations cont.
TBA
Influencing Factors and Considerations cont.
TBA
Influencing Factors and Considerations cont.
TBA
Influencing Factors and Considerations cont.
TBA
Influencing Factors and Considerations cont.
TBA
Influencing Factors and Considerations cont.
TBA
Influencing Factors and Considerations cont.
TBA
Influencing Factors and Considerations cont.
TBA
Influencing Factors and Considerations cont.
TBA
Influencing Factors and Considerations cont.
TBA
Analyzing and Visualizing Data
Selecting a Graph
Selecting a Graph
Pie Charts
Compare a certain sector to the total.
Useful when there are only two sectors, for example yes/no or queued/finished.
Instant understanding of proportions when few sectors are used as dimensions.
When you use 10 sectors, or less, the pie chart keeps its visual efficiency.
Selecting a Graph cont.
Bar Charts/Plots
Ordinal and nominal data sets
Compare things between different groups or to track changes over time
Measure change over time, bar graphs are best when the changes are larger
Display and compare the number, frequency or other measure (e.g. mean) for different discrete categories of data
Flexible chart type and there are several variations of the standard bar chart including horizontal bar charts, grouped or component charts, and stacked bar charts.
Frequency for each category of a categorical variable
Relative frequency (%) for each category
Select.
Analyzing and Visualizing Data Chapter 1The .docxdurantheseldine
Analyzing and Visualizing Data
Chapter 1
The Components of Understanding
A Definition for Data Visualization
Data
Representation
Presentation
Understanding
The Components of Understanding cont.
Process of Understanding
Perceiving
Interpreting
Comprehending
The Components of Understanding cont.
1.2 The Importance of Conviction
Principles of Good Visualization Design
Trustworthy
Accessible
Elegant
Principle 1
Principle 1: Good Data Visualization is Trustworthy
Trust vs Truth
Trust Applies Throughout the Process
Principle 1 cont.
Principle 2
Principle 2: Good Data Visualization is Accessible
Reward vs Effort
The Factors Your Audiences Influence
The Factors You Can Influence
Principle 3
Principle 3: Good Data Visualization is Elegant
What is Elegant Design?
How Do You Achieve Elegance in Design?
Principle 3
.
Analyzing a Primary Source RubricName ______________________.docxdurantheseldine
Analyzing a Primary Source Rubric
Name ________________________ Date _______
Class ____________________________________
Exemplary Adequate Minimal Attempted
Analysis of
Document
Offers in-depth analysis
and interpretation of the
document; distinguishes
between fact and opinion;
explores reliability of
author; compares and
contrasts author's point
of view with views of
others
Offers accurate analysis
of the document
Demonstrates only a
minimal understanding
of the document
Reiterates one or two
facts from the document
but does not offer any
analysis or interpretation
of the document
Knowledge of
Historical Context
Shows evidence of
thorough knowledge of
period in which source
was written; relates
primary source to specific
historical context in
which it was written
Uses previous general
historical knowledge to
examine issues included
in document
Limited use of previous
historical knowledge
without complete
accuracy
Barely indicates any
previous historical
knowledge
Identification of
Key Issues/Main
Points
Identifies the key issues
and main points included
in the primary source;
shows understanding of
author's goal(s)
Identifies most but not all
of the key issues and
main points in the
primary source
Describes in general
terms one issue or
concept included in the
primary source
Deals only briefly and
vaguely with the key
issues and main points in
the document
Resources Uses several outside
resources in addition to
primary source
Uses 1–2 outside
resources in addition to
primary source
Relies heavily on the
material/information
provided
Relies exclusively on the
material/information
provided; no evidence of
outside resources
Identification of
Literary Devices
Analyzes author's use of
literary devices such as
repetition, irony, analogy,
and sarcasm
Mentions author's use of
literary devices but does
not develop fully
Does not discuss author's
use of literary devices
Does not discuss author's
use of literary devices
Understanding of
Audience
Shows strong
understanding of
author's audience
Shows some
understanding of
author's audience
Shows little
understanding of
author's audience
Shows no understanding
of author's audience
Analyzing a Primary Source Evaluation Form
Name ________________________ Date _______
Class ____________________________________
Exemplary Adequate Minimal Attempted
Analysis of
Document
Knowledge of
Historical Context
Identification of
Key Issues/Main
Points
Resources
Identification of
Literary Devices
Understanding of
Audience
COMMENTS:
ALI 150
C. Stammler
Exploring “Definition” Essays
For each assigned reading do the following for your analytical response:
Note: Your analysis must be TYPED and it is Due the Date the reading is due. (no late
work accepted)
A. the Text
A.Analyze: In your response, include the following information for EACH TITLED
TEXT: Title and Author
1.
B.If it is a Direct Thesis, copy it down. (include para)
C.If you could not locate a “Direct Thesis” and.
We all have good and bad thoughts from time to time and situation to situation. We are bombarded daily with spiraling thoughts(both negative and positive) creating all-consuming feel , making us difficult to manage with associated suffering. Good thoughts are like our Mob Signal (Positive thought) amidst noise(negative thought) in the atmosphere. Negative thoughts like noise outweigh positive thoughts. These thoughts often create unwanted confusion, trouble, stress and frustration in our mind as well as chaos in our physical world. Negative thoughts are also known as “distorted thinking”.
The Indian economy is classified into different sectors to simplify the analysis and understanding of economic activities. For Class 10, it's essential to grasp the sectors of the Indian economy, understand their characteristics, and recognize their importance. This guide will provide detailed notes on the Sectors of the Indian Economy Class 10, using specific long-tail keywords to enhance comprehension.
For more information, visit-www.vavaclasses.com
Model Attribute Check Company Auto PropertyCeline George
In Odoo, the multi-company feature allows you to manage multiple companies within a single Odoo database instance. Each company can have its own configurations while still sharing common resources such as products, customers, and suppliers.
This is a presentation by Dada Robert in a Your Skill Boost masterclass organised by the Excellence Foundation for South Sudan (EFSS) on Saturday, the 25th and Sunday, the 26th of May 2024.
He discussed the concept of quality improvement, emphasizing its applicability to various aspects of life, including personal, project, and program improvements. He defined quality as doing the right thing at the right time in the right way to achieve the best possible results and discussed the concept of the "gap" between what we know and what we do, and how this gap represents the areas we need to improve. He explained the scientific approach to quality improvement, which involves systematic performance analysis, testing and learning, and implementing change ideas. He also highlighted the importance of client focus and a team approach to quality improvement.
Synthetic Fiber Construction in lab .pptxPavel ( NSTU)
Synthetic fiber production is a fascinating and complex field that blends chemistry, engineering, and environmental science. By understanding these aspects, students can gain a comprehensive view of synthetic fiber production, its impact on society and the environment, and the potential for future innovations. Synthetic fibers play a crucial role in modern society, impacting various aspects of daily life, industry, and the environment. ynthetic fibers are integral to modern life, offering a range of benefits from cost-effectiveness and versatility to innovative applications and performance characteristics. While they pose environmental challenges, ongoing research and development aim to create more sustainable and eco-friendly alternatives. Understanding the importance of synthetic fibers helps in appreciating their role in the economy, industry, and daily life, while also emphasizing the need for sustainable practices and innovation.
How to Split Bills in the Odoo 17 POS ModuleCeline George
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Operation “Blue Star” is the only event in the history of Independent India where the state went into war with its own people. Even after about 40 years it is not clear if it was culmination of states anger over people of the region, a political game of power or start of dictatorial chapter in the democratic setup.
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Palestine last event orientationfvgnh .pptxRaedMohamed3
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Instructions for Submissions thorugh G- Classroom.pptxJheel Barad
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Instructions for Submissions thorugh G- Classroom.pptx
1 JNMS 2015; 2(4)The effect of roys adaptation model and q.docx
1. 1 JNMS 2015; 2(4)
The effect of roys adaptation model and quality of life of
diabetic patient
Effects of roy’s adaptation model in nursing practice on the
quality of life in
patients with type II diabetes
Abstract
Background and Purpose: Diabetes has adverse effects on the
quality of life of patients. Roy’s adaptation model could be used
to
enhance quality of life among diabetic patients. This study
aimed to evaluate the effects of Roy’s adaptation model in
nursing practice
on the quality of life in patients with type II diabetes.
Methods: This quasi-experimental study was conducted on 60
diabetic patients randomly divided into two groups of
experiment and
control (N=30) at Hamadan Diabetes Research Center. Data
were collected using Diabetes-Specific Quality of Life Scale
(D-39) in
five dimensions, which was completed before and after
intervention in both groups. Educational care programs were
executed based
on Roy’s adaptation model only for experimental subjects in
five sessions during one month. Data analysis was performed
using
independent and paired t-test in SPSS.
Results: At the beginning of the study, both groups were
matched in terms of demographic characteristics and quality of
2. life dimensions
(P>0.05). Comparison of mean scores of quality of life areas
between the two groups before and after intervention was
indicative of
a significant difference in the aspects of diabetes control,
energy and mobility and social support (P<001). However, there
was no
significant difference in the dimensions of stress, anxiety and
sexual activity (P>0.05).
Conclusion: According to the results of this study, use of Roy’s
adaptation model has positive effects on some dimensions of
quality
of life in patients with type 2 diabetes; these domains were
diabetes control, energy and mobility, and social support.
However, further
studies with longer durations are required as to investigate the
efficacy of this model in the areas of anxiety and sexual
activity.
Keywords: Adaptation, Diabetes, Nursing theory, Quality of
Life
Sayed Reza Borzou1, Safura Khan Mohammadi2, Gholam
Hossein Falahinia3*, Saeed Mousavi4, Zahra Khalili5
(Received: 21 Jan 2014; Accepted: 20 Jul 2015)
Journal of Nursing and Midwifery Sciences 2015; 2(4):1-7
http://jnms.mazums.ac.ir
1 Department of Medical-Surgical Nursing, Chronic Disease
Home Care Research Center, Hamadan University of Medical
Sciences, Hamadan, Iran
2 Medical-Surgical Nursing, Nursing and Midwifery Faculty,
Hamadan University of Medical Sciences, Hamadan, Iran
3,* Corresponding author: Department of Medical-Surgical
3. Nursing, Chronic Disease Home Care Research Center,
Hamadan University of
Medical Sciences, Hamadan, Iran. Email: [email protected]
4 Department of Biostatistics & Epidemiology, Hamadan
University of Medical Sciences, Hamadan, Iran
5 Nursing and Midwifery Faculty, Chronic Disease Home Care
Research Center, Hamadan University of Medical Sciences,
Hamadan, Iran
Original article
Introduction
With the ever-increasing rate of urbanization around
the world and problems such as the need to control
communicable diseases and changes in population
structure, researchers have been concerned about the
high prevalence of chronic diseases, such as cancer,
cardiovascular diseases, brain stroke and diabetes (1).
According to the American Diabetes Association,
sweet diabetes is one of the major diseases causing
physical and mental problems in different populations
(2). Prevalence of sweet diabetes, also known as
silent epidemic, is on a rising trend across the world,
especially in developing countries (3).
In Iran, it has been estimated that approximately 6%
of the population (over 4,000,000 people) suffer from
sweet diabetes (4). Considering the high prevalence
of this disease in the world and Iran, its short-term
and long-term complications, and heavy treatment
costs, enhancement of quality of life seems to play
a key role in the treatment of patients with chronic
diseases (5).
4. 2JNMS 2015; 2(4)
Borzou R, et al.
Quality of life is defined as a feeling of well-being
arising from satisfaction with different aspects of life,
which are particularly important to an individual (6).
Previous studies on the evaluation of quality of life
indicate that diabetes complications have significant
adverse effects on all the domains of quality of life
among the patients. The majority of diabetic patients
are reported to have poor quality of life since diabetes
adversely influences physical and mental health
(7,8), physical function and individual and social
communications (9).
Given the importance of quality of life in diabetes,
various nursing models could be used to enhance
this parameter among diabetic patients. One of
the efficient nursing models in this regard is Roy’s
adaptation model (4), which is widely used owning
to its simplicity and accessibility (10). The innate
theory of this model has a great capability to describe
different individuals, embracing a broader scope
compared to other adaptation theories. Therefore,
clinical managers are increasingly turning to the
application of this model in clinical settings (11).
According to Roy’s adaptation model, individuals
should attain and improve their physical and
psychological adaptability (12). In general, three
main stimuli affect adaptability, and manipulation of
these stimuli during health care programs results in
5. the enhancement of adaptation (13).
Through accurate investigation of different
individual aspects (e.g., physiological aspects, self-
perception, role play and independence), this model
determines the causes of inadaptability (main and
background causes, other stimuli). This helps to
design a comprehensive program to develop healthy
behaviors in individuals (14). Furthermore, this
model could be used in the treatment of patients with
chronic diseases and plays a key role in the effective
execution of medical procedures (15).
Several studies have confirmed the efficacy of
Roy’s adaptation model in the treatment of fatigue in
patients undergoing hemodialysis (16), psychological
adaptation of diabetic patients (4), mental adaptation
of patients with heart failure (17), and improving self-
esteem in elderly patients (18). Literature search in
different databases revealed that no studies have been
conducted in our country evaluating the effects of this
model on the quality of life among diabetic patients.
This study aimed to investigate the efficacy of Roy’s
adaptation model in nursing practice on the quality
of life among patients with diabetes. If the positive
impacts of this model are demonstrated, it could be
used to develop efficient medical programs, reduce
physical and mental problems, decrease medical
costs, enhance adaptation level, and promote quality
of life among patients with type 2 diabetes.
Materials and methods
This quasi-experimental study was performed using
6. a pretest-posttest method. For data collection, we
used two forms and one scale, which were completed
by the patients, as follows:
A) Demographic Information Forms/Personal and
Social Information
This form contained such information as age,
gender, education level, place of residence, marital
status, disease duration, type of treatment, family
records and number of hospitalizations due to
diabetes.
B) Investigation of Type 2 Diabetic Patients based
on Roy’s Adaptation Model
This form was used for the primary investigation
of our medical program in the experimental group.
It consisted of four dimensions, including the
physiological aspect, self-perception, role play and
independence. In the physiological aspect, questions
were about physical activity, resting, nutrition
status, excretion, bloodstream, oxygenation, liquids,
electrolytes and endocrine glands. In the domain of
self-perception, there were questions regarding the
state of mind, personal feelings and imagination
of the subjects about their body. As for role play,
the questions concerned relationships with family
members, family roles (e.g., role of spouse and
mother) and family expectations. With regards to
independence, the questions focused on individual
and social communications and habitual behavior of
the subjects.
This form was extracted from reputable scientific
resources, and the content was approved by the
7. researchers (19). Reliability of questionnaires has
been confirmed using the retest method in a study
3 JNMS 2015; 2(4)
The effect of roys adaptation model and quality of life of
diabetic patient
conducted by Sadegh Nejad et al. (r=0.75) and Faze
Asgarpour (r=0.79) (16.4).
C) Diabetes-Specific Quality of Life Scale (D-39)
This scale has been designed for the evaluation
of quality of life among diabetic patients (20). It
consisted of 39 items in 5 dimensions of diabetes
control (12 items), energy and mobility (15 items),
social support (5 items), stress and anxiety (4 items),
and sexual activity (3 items), which were scored on a
Likert scale (1-7).
Accordingly, score one was interpreted as the
lowest effect, and score seven was indicative of the
most significant effect on the quality of life of diabetic
patients. Score range was 39-273, and higher scores
represented lower quality of life (21). Reliability
of this scale has been previously investigated in a
transformative psychological paper (22).
In our study, value of Cronbach’s alpha was
estimated at 0.95 in diabetes control, 0.66 in stress and
anxiety, 0.90 in social support, 0.96 in sexual activity,
and 0.87 in energy and mobility. Additionally, forms
prepared by researchers were used for 10 patients
8. within one-week intervals. Reliability of these forms
was confirmed by Cronbach’s alpha estimated at 0.94.
Inclusion criteria were as follows: 1) minimum age
of 25 and maximum age of 70; 2) history of diabetes
treatment for six months; 3) absence of mental
disorders and 4) patient consent for participation.
Exclusion criteria were as follows: 1) presence of
diseases affecting quality of life; 2) decease of the
patient and 3) refusal of patient to participate in the
research. It should be noted that four patients left the
study due to illness or traveling and were replaced
with other patients.
Objectives of the study were explained to the
participants, and they were granted terms of
confidentiality. In addition, patients were allowed
to leave the experiment at any time. Informed
consent was obtained from all the participants, and
demographic questionnaires and quality of life scale
(D-39) were completed by the subjects. Medical care
program based on the Roy’s adaptation model was
performed on the intervention group.
For each patient, different factors such as
incompatible behaviors, main stimuli, background
stimuli and remaining stimuli were determined
according to the completed questionnaires.
Afterwards, based on the demands and conditions of
patients, educational courses were held at the diabetes
center of Hamadan during one month in five 2-hour
sessions.
Educational team consisted of the physicians of
9. our diabetes center, nurses (researchers), nutrition
experts and clinical psychologists. Topics discussed
in the sessions were as follows: nature of diabetes,
causes and risk factors, symptoms, and treatment of
diabetes (first session); early and late complications
of diabetes and effects of exercise on diabetes (second
session); diabetes, stress and anxiety (third session);
diabetes and nutrition (fourth session); diabetes and
self-esteem (fifth session).
At the end of the sessions, D-39 quality of life
scale was completed again by both study groups, and
the obtained data before and after intervention were
analyzed using independent and paired t-test.
Results
According to the demographic data in this study,
women constituted the majority of participants
in the control (69.2%) and experimental groups
(65.5%). Most of the participants in the control group
(41.8%) were within the age range of 50-60 years,
and experimental subjects were mostly (37.4%) over
60 years of age. Results of Chi-square test indicated
that the study groups were matched in terms of
demographic characteristics (P>0.05) (Table 1).
In this research, we first verified the normality
of quality of life dimensions using Kolmogorov-
Smirnov test. Afterwards, we compared the mean
scores of quality of life dimensions in the control and
experimental groups before the intervention using
independent t-test; accordingly, both groups had the
same mean scores (P>0.05). Moreover, obtained
results were indicative of a significant difference
between the study groups after the intervention in
10. terms of diabetes control, energy and mobility, and
social support (P<0.001) (Table 2).
Paired t-test was performed to compare the mean
scores of quality of life dimensions before and
after intervention in both groups; these results are
presented in Table 3.
4JNMS 2015; 2(4)
Borzou R, et al.
With respect to diabetes control, mean score
of experimental group was 58.86±8.91 before
intervention and 35.37±10.13 after intervention,
which was indicative of a statistically significant
difference (P<0.001). However, the difference was
not significant in the control group (P>0.05).
In the dimension of social support, mean score
of experimental group was 22.17±2.73 before
intervention and 13.86±4.38 after intervention. As
for the control group, these values were 13.96±4.61
before intervention and 13.57±4.47 after intervention,
which were indicative of a statistically significant
difference between the study groups (P<0.001).
Regarding energy and mobility, mean score
Table 1. Demographic characteristics of patients in
experimental and control groups
Control GroupExperimental Group
11. Demographic Information Absolute
Abundance
Relative
Abundance
Absolute
AbundanceRelative Abundance
1661.51862.1Basic Education
Education Status
519.2724.1High School Diploma
27.726.9Undergraduate
311.526.9Postgraduate
13.800<1
Duration of Diabetes (Year)
1453.2723.81-5
415.2930.65-10
622.8723.810-20
415.213.420-30
1246.21862.1Tablets
Treatment
1142.31137.9Insulin
1661.51965.5Yes
12. Family History
1038.5931No
1661.51862.10
History of Hospitalization due to
Diabetes (Frequency)
519.2724.11
311.5310.32
27.7003≤
Table 2. Comparison of mean and standard deviation (SD) of
quality of life dimensions in study groups
Control GroupExperimental Group
Quality of Life Dimensions
SDMeanSDMean
T=0.71
P=0.4811.0437.888.9158.86Before Intervention
Diabetes Control
t=-7.78
P=0.00011.0737.4210.1335.37After Intervention
t=-1.20
P=0.244.8913.032.5913.55Before Intervention
Anxiety
t=-0.49
P=0.624.9612.884.6614.44After Intervention
13. t=0.24
P=0.814.6113.962.7322.17Before Intervention
Social Protection
t=-8.11
P=0.0004.4713.574.3813.86After Intervention
t=-0.80
P=0.435.326.612.957.96Before Intervention
Sexual Activity
t=-1.18
P=0.245.356.615.197.75After Intervention
t=-0.02
P=0.9812.5440.37.7451.2Before Intervention
Energy and Mobility
t=-3.89
P=0.00011.739.6911.8739.75After Intervention
5 JNMS 2015; 2(4)
The effect of roys adaptation model and quality of life of
diabetic patient
of experimental group was 51.20±7.74 before
intervention and 39.75±11.87 after intervention,
which was indicative of a significant difference
(P<0.001). In the control group, there was no
significant difference between the mean scores before
and after intervention (P>0.05).
In the dimensions of stress, anxiety and sexual
14. activity, there was no significant difference between
the mean scores between the groups before and after
intervention (P>0.05).
Discussion
In the present study, we investigated the impact of
Roy’s adaptation model in nursing practice on the
quality of life of patients with type 2 diabetes in the
city of Hamadan, Iran. According to the results, use
of Roy’s adaptation model in medical practice could
positively affect quality of life among diabetic patients
in the area of diabetes control. In this regard, Krapk
et al. (2004) reported that adherence to appropriate
drug regimen and medical recommendations plays
a key role in the control of diabetes (21). Moreover,
some researchers have reported that adaptation to
the disease is an important factor in the control of
diabetes (23).
Social support is another area of quality of life. In
the present study, the intervention had a significant
effect on this dimension in the experimental group.
In another study, Alipour et al. (2009) observed a
significant relationship between different types of
social support (e.g., emotional, structural, functional
and material) and quality of life (24). Furthermore,
Gao et al. suggested that social support could
positively affect blood sugar control in diabetic
patients (25).
Another area of quality of life is energy and
mobility. In our study, use of Roy’s adaptation
model significantly affected this dimension in the
experimental group. In another research, Saremi
15. (2011) stated that exercise and mobility play
a pivotal role in the prevention and control of
resistance to insulin among diabetic patients (26).
Similarly, Esteghamati et al. (1999) suggested that
exercise has a positive effect on the management of
diabetes treatment (27). In addition, Sadeghnejad
et al. (2011) reported that use of Roy’s adaptation
model in the health care program could significantly
enhance psychological and physical adaptation of
patients with type 2 diabetes (4).
With regard to the areas of stress, anxiety and
sexual activity, the results obtained by D-39
scale in the current study indicated no significant
difference between the mean scores of these
domains between the study groups before and after
the intervention. This could be due to the duration
of the intervention, as well as the unwillingness of
some participants to express their private issues.
In this regard, Adolfsson et al. (2006) evaluated
the effects of education on patients with type 2
diabetes and concluded that education enhances
the self-esteem of diabetic patients (28). On the
other hand, Bayazi et al. (2012) reported that 12
sessions of cognitive and behavioral intervention
could not reduce anxiety and depression in patients
with cardiac diseases (29).
Conclusion
In conclusion, our results indicated that use of
Table 3. Comparison of quality of life scores in different
dimensions before and after intervention in study groups
Control GroupExperimental GroupQualQuality of Life
Dimensions
16. After InterventionBefore InterventionAfter InterventionBefore
Intervention
t=-2.06
P=0.0511.07± 37.4211.04± 37.88t=-8.81
P=0.0010.13± 35.378.91± 58.86Diabetes Control
t=-0.75
P=0.464.96± 12.884.89± 13.03t=1.02
P=0.314.66± 14.442.59± 13.55Anxiety
t=-3.07
P=0.004.47± 13.574.61± 13.96t=-8.57
P=0.004.38± 13.862.73± 22.17Social Protection
t=0.00
P=1.005.35± 6.615.32± 6.61t=-0.21
P=0.8375.19± 7.752.95± 7.96Sexual activity
t=-1.07
P=0.2911.7± 39.6912.54± 40.3t=4.81
P=0.0011.87±39.757.74± 51.20Energy and Mobility
6JNMS 2015; 2(4)
Borzou R, et al.
Roy’s adaptation model in medical practice could
17. positively affect some dimensions of quality of
life, such as diabetes control, energy and mobility
and social support, among patients with type 2
diabetes. However, this medical plan had no effects
on the areas of stress, anxiety and sexual activity.
It is recommended that further research with more
educational sessions be conducted in this regard. The
main limitation of the present study was the small
sample size and short duration of interventions.
Conflict of interest
There was no conflict of interest in this study.
Author’s contributions
All the authors participated in writing the
scientific proposal, data collection and writing the
manuscript.
Acknowledgements
The present study is a master’s degree thesis
which has been approved and financed by Hamedan
University of Medical Sciences. This study has also
been registered in Iran Clinical Trial Center under
code no. 2012090110707. The authors would like to
thank the patients who cooperated with this study.
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