17
Barbara Fletcher, RN, MN, FAAN
Clinical Associate Professor
University of North Florida, Department
of Nursing
Jacksonville Beach, Florida
Meg Gulanick, PhD, RN
Associate Professor
Niehoff School of Nursing
Loyola University Chicago
Chicago, Illinois
Cindy Lamendola, RN, MSN, ANP
Adult Nurse Practitioner, Division of
Endrocrinology
Stanford University School of Medicine
Stanford, California
Genetic, environmental, and metabolic risk factors are interrelated and contribute to the
development of type 2 diabetes mellitus. A strong family history of diabetes mellitus, age, obesity,
and physical inactivity identify those individuals at highest risk. Minority populations are also at
higher risk, not only because of family history and genetics, but also because of adaptation to
American environmental influences of poor dietary and exercise habits. Women with a history of
gestational diabetes as well as their children are at greater risk for progressing to type 2 diabetes
mellitus. Insulin resistance increases a person’s risk for developing impaired glucose tolerance and
type 2 diabetes. Individuals who have insulin resistance share many of the same risk factors as
those with type 2 diabetes. These include hyperinsulinemia, atherogenic dyslipidemia, glucose
intolerance, hypertension, prothrombic state, hyperuricemia, and polycystic ovary syndrome. Cur-
rent interventions for the prevention and retardation of type 2 diabetes mellitus are those targeted
towards modifying environmental risk factors such as reducing obesity and promoting physical
activity. Awareness of risk factors for developing type 2 diabetes will promote screening, early de-
tection, and treatment in high-risk populations with the goal of decreasing both microvascular and
macrovascular complications. Key words: environmental factors, lifestyle, risk factors, type 2
diabetes
tries are at much higher risk. Ethnicity, ge-
netics, and lifestyle play an important role
in determining a person’s risk factors for
type 2 diabetes. The importance of risk fac-
tor identification is to promote diabetes
screening to initiate prevention measures.
Early detection and treatment of type 2
diabetes enhances prevention of micro-
vascular and macrovascular complications
associated with this disease.
Several terms require definition as a
basis for this article. Risk factors are those
aspects of an individual’s lifestyle, envi-
ronment, or genetic traits that are known
through epidemiologic study to be associ-
ated with occurrence of disease. Preva-
lence of disease is the number of people
known to have the disease (in this case,
type 2 diabetes), whether diagnosed or un-
diagnosed, at a particular time. Incidence
refers to the number of people diagnosed
with the disease for the first time within a
specific time frame.1
Identification of risk factors for type 2
diabetes has been challenging because the
genetic and lifestyle factors are interre-
lated and associated with insulin resis-
tance an.
Although type 1 diabetes continues to remain the most common form of childhood diabetes in most of the
countries including India, the prevalence of type 2 diabetes is increasing worldwide. This increase is attributed to the modern sedentary lifestyle causing a phenotype of insulin resistance in genetically predisposed individuals. The differentiation between type 1 and type 2 diabetes can be done in most of the cases but may be difficult in obese adolescents with relatively acute presentation. The demonstration of various antibodies is helpful in such circumstances. The earlier age of onset puts patients at risk of earlier age of complications. The management is very challenging as lifestyle modification by the patient and the family is the mainstay of the management. Emphasis should be done on primary prevention with a focus on
healthier lifestyles among children.
The Journal of NutritionSymposium Nutritional Experiences.docxarnoldmeredith47041
The Journal of Nutrition
Symposium: Nutritional Experiences in Early Life as Determinants of the
Adult Metabolic Phenotype
Mechanisms Linking Suboptimal
Early Nutrition and Increased Risk of
Type 2 Diabetes and Obesity1–3
Malgorzata S. Martin-Gronert and Susan E. Ozanne*
Institute of Metabolic Science-Metabolic Research Laboratories, University of Cambridge, Addenbrooke’s Hospital,
Cambridge CB2 0QQ, UK
Abstract
Epidemiological studies have revealed a relationship between poor early growth and development of type 2 diabetes and
other features of metabolic syndrome. The mechanistic basis of this relationship is not known. However, compelling
evidence suggests that early environmental factors, including nutrition, play an important role. Studies of individuals in
utero during a period of famine showed a direct relationship between maternal nutrition and glucose tolerance. Further
evidence has come from studies of monozygotic twins who were discordant for type 2 diabetes. Nutrition during the early
postnatal period has also been shown to have long-term consequences on metabolic health. Excess nutrition and
accelerated growth during the neonatal period has been suggested to be particularly detrimental. Animal models, including
maternal protein restriction, have been developed to elucidate mechanisms linking the early environment and future
disease susceptibility. Maternal protein restriction in rats leads to a low birth weight and development of type 2 diabetes in
the offspring. This is associated with b cell dysfunction and insulin resistance. The latter is associated with changes in
expression of key components of the insulin-signaling cascade in muscle and adipocytes similar to that observed in tissue
from young men with a low birth weight. These differences occur prior to development of disease and thus may represent
molecular markers of early growth restriction and disease risk. The fundamental mechanisms by which these
programmed changes occur remain to be fully defined but are thought to involve epigenetic mechanisms. J. Nutr. 140:
662–666, 2010.
Introduction
It is well established that poor growth in utero is associated with
increased risk of developing diseases such as type 2 diabetes in
later life (1). There is strong evidence from both human and
animal studies that the early environment and in particular early
nutrition play an important role. However, the molecular
mechanisms by which a phenomenon that occurs in early life
has a phenotypic consequence many years later are only just
starting to emerge.
Epidemiological data
The first study to link birth weight to increased risk of type 2
diabetes was conducted in a group of men born in Hertfordshire,
UK, who were 64 y old at the time of the study. Those men who
had the lowest birth weight were 6 times more likely to currently
have either impaired glucose tolerance or type 2 diabetes than
those men who were heaviest at birth (2). These findings have
been reproduce.
Although type 1 diabetes continues to remain the most common form of childhood diabetes in most of the
countries including India, the prevalence of type 2 diabetes is increasing worldwide. This increase is attributed to the modern sedentary lifestyle causing a phenotype of insulin resistance in genetically predisposed individuals. The differentiation between type 1 and type 2 diabetes can be done in most of the cases but may be difficult in obese adolescents with relatively acute presentation. The demonstration of various antibodies is helpful in such circumstances. The earlier age of onset puts patients at risk of earlier age of complications. The management is very challenging as lifestyle modification by the patient and the family is the mainstay of the management. Emphasis should be done on primary prevention with a focus on
healthier lifestyles among children.
The Journal of NutritionSymposium Nutritional Experiences.docxarnoldmeredith47041
The Journal of Nutrition
Symposium: Nutritional Experiences in Early Life as Determinants of the
Adult Metabolic Phenotype
Mechanisms Linking Suboptimal
Early Nutrition and Increased Risk of
Type 2 Diabetes and Obesity1–3
Malgorzata S. Martin-Gronert and Susan E. Ozanne*
Institute of Metabolic Science-Metabolic Research Laboratories, University of Cambridge, Addenbrooke’s Hospital,
Cambridge CB2 0QQ, UK
Abstract
Epidemiological studies have revealed a relationship between poor early growth and development of type 2 diabetes and
other features of metabolic syndrome. The mechanistic basis of this relationship is not known. However, compelling
evidence suggests that early environmental factors, including nutrition, play an important role. Studies of individuals in
utero during a period of famine showed a direct relationship between maternal nutrition and glucose tolerance. Further
evidence has come from studies of monozygotic twins who were discordant for type 2 diabetes. Nutrition during the early
postnatal period has also been shown to have long-term consequences on metabolic health. Excess nutrition and
accelerated growth during the neonatal period has been suggested to be particularly detrimental. Animal models, including
maternal protein restriction, have been developed to elucidate mechanisms linking the early environment and future
disease susceptibility. Maternal protein restriction in rats leads to a low birth weight and development of type 2 diabetes in
the offspring. This is associated with b cell dysfunction and insulin resistance. The latter is associated with changes in
expression of key components of the insulin-signaling cascade in muscle and adipocytes similar to that observed in tissue
from young men with a low birth weight. These differences occur prior to development of disease and thus may represent
molecular markers of early growth restriction and disease risk. The fundamental mechanisms by which these
programmed changes occur remain to be fully defined but are thought to involve epigenetic mechanisms. J. Nutr. 140:
662–666, 2010.
Introduction
It is well established that poor growth in utero is associated with
increased risk of developing diseases such as type 2 diabetes in
later life (1). There is strong evidence from both human and
animal studies that the early environment and in particular early
nutrition play an important role. However, the molecular
mechanisms by which a phenomenon that occurs in early life
has a phenotypic consequence many years later are only just
starting to emerge.
Epidemiological data
The first study to link birth weight to increased risk of type 2
diabetes was conducted in a group of men born in Hertfordshire,
UK, who were 64 y old at the time of the study. Those men who
had the lowest birth weight were 6 times more likely to currently
have either impaired glucose tolerance or type 2 diabetes than
those men who were heaviest at birth (2). These findings have
been reproduce.
Diabetes is the condition in which the body does not properly process food for use as energy. Most of the food we eat is turned into glucose, or sugar, for our bodies to use for energy.
The pancreas, an organ that lies near the stomach, makes a hormone called insulin to help glucose get into the cells of our bodies. When you have diabetes, your body either doesn't make enough insulin or can't use its own insulin as well as it should. This causes sugars to build up in your blood.
This is why many people refer to diabetes as ―sugar‖ Diabetes can cause serious health complications including, heart disease, blindness, kidney failure, and lower-extremity amputations.
There has been an increase in the predominance of diabetes mellitus over the past 40 years worldwide. The worldwide occurrence of diabetes in 2000 was approximately 2.8% and is estimated to grow to 4.4% by 2030. This data interprets a projected rise of diabetes from 171 million in 2000 to well over 350 million in 2030. The presence of hypertension in diabetic patients substantially increases the risks of coronary heart disease, stroke, nephropathy and retinopathy. Indeed, when hypertension coexists with diabetes, the risk of CVD is increased by 75%, which further contributes to the overall morbidity and mortality of an already high risk population. Patients with type 2 diabetes mellitus have a considerably higher risk of cardiovascular morbidity and mortality, and are disproportionately affected by cardiovascular disease. Most of this excess risk is associated with high prevalence of well-established risk factors such as hypertension, dyslipidaemia and obesity in these patients. Hypertension plays a major role in the development and progression of microvascular and macrovascular disease in people with diabetes. Lifestyle Modifications and pharmacotherapy are the choice for the Management of Hypertension in Patients with Diabetes.
Running Head Obesity, Healthy Diet and Health .docxtodd581
Running Head: Obesity, Healthy Diet and Health 1
Obesity, Healthy Diet and Health 19
Obesity, Healthy Diet and Health
PUH 6301 Public Health Research
Abstract
Having a good nutrition habit, healthy body weight, and physical activities are essential aspects of good health and wellness. The combination of all three factors is critical in reducing the chances of getting severe health complications such as diabetes, hypertension, high cholesterol, cancer, stroke, and heart complications. Managing a good health condition also relies on how one adhere to regular physical exercises, a well-maintained body weight, and a healthy diet. However, according to (Healthy People 2020), most Americans don't check their menu and are lazy in taking apart in physical activities to the required levels as a way of maintaining proper health.
According to CDCP (2013), fruit consumption among adults is 1.1 times in a day, and the use of vegetables on a daily scale is 1.6, with adolescents recording the lowest use of both fruits and vegetables. The statistic shows that the average daily consumption of both fruits and vegetables among Americans doesn't meet the recommended intake of fruits and vegetables. About 81.6% and 81.8% of American adults and adolescents respectively don't take part in physical activities on a recommended daily scale. These behaviors are among the leading factors that contribute to the rising cases of Obesity. Approximately 1 out of 3 US adults, which represents 34 % and 1 out of 6 adolescents and children, which is 16.2 %, are obese.
Obesity-related complications include stroke, heart disease, and type two diabetes. The current in death cases is as a result of the obesity-related complications. Besides the death cases, obesity-related diseases cots this country millions of money annually, making it one of the most significant burdens that this country is struggling with regards to the health care system.
Introduction
Maintaining a healthy diet is an essential factor that determines how healthy our bodies become. We must retain less sugar, salt, and fats diet daily. Cases associated with obesity are not causing deaths but also taking so much of this country's financial resources. Every year both the federal, state, and county governments invest million into the health sector as a way of improving the infrastructures required to deal with obesity-related complications. Any healthy combines a variety of foods such as cereals, legumes, proteins, fruits, and vegetables. Research shows that obesity is gradually grown into a global crisis with WHO initiating campaigns aimed at establishing the importance of maintaining a healthy diet (Abidin, 2014).
The love for foods prepared away from homes is another challenging factor in dealing with obesity complications. Fast foods contain .
Running Head Obesity, Healthy Diet and Health .docxglendar3
Running Head: Obesity, Healthy Diet and Health 1
Obesity, Healthy Diet and Health 19
Obesity, Healthy Diet and Health
PUH 6301 Public Health Research
Abstract
Having a good nutrition habit, healthy body weight, and physical activities are essential aspects of good health and wellness. The combination of all three factors is critical in reducing the chances of getting severe health complications such as diabetes, hypertension, high cholesterol, cancer, stroke, and heart complications. Managing a good health condition also relies on how one adhere to regular physical exercises, a well-maintained body weight, and a healthy diet. However, according to (Healthy People 2020), most Americans don't check their menu and are lazy in taking apart in physical activities to the required levels as a way of maintaining proper health.
According to CDCP (2013), fruit consumption among adults is 1.1 times in a day, and the use of vegetables on a daily scale is 1.6, with adolescents recording the lowest use of both fruits and vegetables. The statistic shows that the average daily consumption of both fruits and vegetables among Americans doesn't meet the recommended intake of fruits and vegetables. About 81.6% and 81.8% of American adults and adolescents respectively don't take part in physical activities on a recommended daily scale. These behaviors are among the leading factors that contribute to the rising cases of Obesity. Approximately 1 out of 3 US adults, which represents 34 % and 1 out of 6 adolescents and children, which is 16.2 %, are obese.
Obesity-related complications include stroke, heart disease, and type two diabetes. The current in death cases is as a result of the obesity-related complications. Besides the death cases, obesity-related diseases cots this country millions of money annually, making it one of the most significant burdens that this country is struggling with regards to the health care system.
Introduction
Maintaining a healthy diet is an essential factor that determines how healthy our bodies become. We must retain less sugar, salt, and fats diet daily. Cases associated with obesity are not causing deaths but also taking so much of this country's financial resources. Every year both the federal, state, and county governments invest million into the health sector as a way of improving the infrastructures required to deal with obesity-related complications. Any healthy combines a variety of foods such as cereals, legumes, proteins, fruits, and vegetables. Research shows that obesity is gradually grown into a global crisis with WHO initiating campaigns aimed at establishing the importance of maintaining a healthy diet (Abidin, 2014).
The love for foods prepared away from homes is another challenging factor in dealing with obesity complications. Fast foods contain .
Running Head Obesity, Healthy Diet and Health .docxjeanettehully
Running Head: Obesity, Healthy Diet and Health 1
Obesity, Healthy Diet and Health 19
Obesity, Healthy Diet and Health
PUH 6301 Public Health Research
Abstract
Having a good nutrition habit, healthy body weight, and physical activities are essential aspects of good health and wellness. The combination of all three factors is critical in reducing the chances of getting severe health complications such as diabetes, hypertension, high cholesterol, cancer, stroke, and heart complications. Managing a good health condition also relies on how one adhere to regular physical exercises, a well-maintained body weight, and a healthy diet. However, according to (Healthy People 2020), most Americans don't check their menu and are lazy in taking apart in physical activities to the required levels as a way of maintaining proper health.
According to CDCP (2013), fruit consumption among adults is 1.1 times in a day, and the use of vegetables on a daily scale is 1.6, with adolescents recording the lowest use of both fruits and vegetables. The statistic shows that the average daily consumption of both fruits and vegetables among Americans doesn't meet the recommended intake of fruits and vegetables. About 81.6% and 81.8% of American adults and adolescents respectively don't take part in physical activities on a recommended daily scale. These behaviors are among the leading factors that contribute to the rising cases of Obesity. Approximately 1 out of 3 US adults, which represents 34 % and 1 out of 6 adolescents and children, which is 16.2 %, are obese.
Obesity-related complications include stroke, heart disease, and type two diabetes. The current in death cases is as a result of the obesity-related complications. Besides the death cases, obesity-related diseases cots this country millions of money annually, making it one of the most significant burdens that this country is struggling with regards to the health care system.
Introduction
Maintaining a healthy diet is an essential factor that determines how healthy our bodies become. We must retain less sugar, salt, and fats diet daily. Cases associated with obesity are not causing deaths but also taking so much of this country's financial resources. Every year both the federal, state, and county governments invest million into the health sector as a way of improving the infrastructures required to deal with obesity-related complications. Any healthy combines a variety of foods such as cereals, legumes, proteins, fruits, and vegetables. Research shows that obesity is gradually grown into a global crisis with WHO initiating campaigns aimed at establishing the importance of maintaining a healthy diet (Abidin, 2014).
The love for foods prepared away from homes is another challenging factor in dealing with obesity complications. Fast foods contain ...
Diabetes Type 1 Sara MartinezChamberlain College of Nursing.docxlynettearnold46882
Diabetes Type 1
Sara Martinez
Chamberlain College of Nursing
NR 507 Advanced Pathophysiology
2018
1
1
What is Diabetes
Body Does not make or properly use insulin: (ADA,2005)
No insulin production
Insufficient insulin production
Resistance to insulin’s effects
No insulin to move glucose from blood into cells
High blood glucose means:
Fuel loss, cells starve
Short and long term complications
2
Diabetes is a chronic disease in which the body does not make or properly
use insulin, a hormone that is needed to convert sugar, starches, and other
food into energy by moving glucose from blood into the cells ( American Diabetes Association, 2005).
People with diabetes have increased blood glucose (sugar) levels for one or
more of the following three reasons: Either
No insulin is being produced,
Insulin production is insufficient, and/or
The body is resistant to the effects of insulin.
As a result, high levels of glucose build up in the blood, and spill into the
urine and out of the body. The body loses its main source of fuel and cells
are deprived of glucose, a needed source of energy. High blood glucose
levels may result in short and long term complications over time ( Centers for Disease Control and Prevention, 2017).
2
Understanding Diabetes Type 1
Auto immune disorder
Insulin – producing cells destroyed
Daily insulin replacement necessary
Age of onset: usually childhood, young adults
Most prevalent type of diabetes in children and adolescent’s
(CDC,2017)
3
Diabetes mellitus (DM) is a group of diseases characterized by high levels of blood glucose resulting from defects in insulin production, insulin action, or both (CDC,2017).
The term diabetes mellitus describes a metabolic disorder of multiple aetiology characterized by chronic hyperglycaemia with disturbances of carbohydrate, fat and protein metabolism resulting from defects in insulin secretion, insulin action, or both.
The effects of diabetes mellitus include long–term damage, dysfunction and failure of various organs.
Diabetes is a condition where the body fails to utilize the ingested glucose properly. This could be due to lack of the hormone insulin or because the insulin that is available is not working effectively. Diabetes is the fastest growing long term disease that affects millions of people worldwide (CDC,2017). According to the charity Diabetes UK, more than two million people in the UK have the condition and up to 750,000 more are unaware of having the condition. In the United States 25.8 million people or 8.3% of the population have diabetes. Of these, 7.0 million have undiagnosed diabetes. In 2010, about 1.9 million new cases of diabetes were diagnosed in population over 20 years. It is said that if this trend continues, 1 in 3 Americans would be diabetic by 2050 (Mayo Clinic, 2017).
Type 1 diabetes is a disease of the immune system, which is the body’s system for fighting infection.
In people with type 1 diabetes, the .
2/21/2020 Soil Colloids (Chapter 8) Notes - AGRI1050R50: Introduction to Soil Science (2020S)
https://gotoclass.tnecampus.org/d2l/le/content/8094442/viewContent/60403389/View 1/12
Soil Colloids (Chapter 8) Notes
Soil Colloids (Chapter 8) Notes
Did you know ....
Did you know soil fertility or the ability for a soil to provide nutrients is seated in the type of minerals it
contains? Chapter 8 will cover the various types of soil colloids including all the layer and non-layer
silicates, cation exchange, anion exchange, and sorption.
Lecture content notes are accompanied by videos listed below the notes in each submodule (e.g. Soil
Colloids (Chapter 8) Videos A though H). Print or download lecture notes then view videos in
succession alongside lecture content and add additional notes from each video. The start of each
video is noted in parenthesis (e.g. Content for Video A) within each lecture note set and contains
lecture content through the note for the next video (e.g. Content for Video B).
Figures and tables unless specifically referrenced are from the course text, Nature and Property of
Soils, 14th Edition, Brady and Weil.
Content Video A
Soil Colloids
Smallest soil particles < 1 µm
Surface area - LARGE
Surface charge - CEC
Adsorb water
AGRI1050R50: Introduction to Soil Science (2020S) LH
https://gotoclass.tnecampus.org/d2l/le/content/8094442/navigateContent/176/Previous?pId=60403304
https://gotoclass.tnecampus.org/d2l/le/content/8094442/navigateContent/176/Next?pId=60403304
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2/21/2020 Soil Colloids (Chapter 8) Notes - AGRI1050R50: Introduction to Soil Science (2020S)
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Types of Colloids
Crystalline Silicate clays: ordered, crystalline, layers
Non-crystalline silicate clays: non-ordered, layers, volcanic
Iron/Aluminum Oxides – weathered soils, less CEC
Humus – OM, not mineral or crystalline, high CEC
Soil Colloids
Content Video B
Layer Silicates - Construction
Phyllosillicates
Tetrahedral Sheets
1 Si with 4 Oxygen
Share basal oxygen
Form sheets
Octahedral Sheets
6 Oxygen with Al3+ or Mg 2+
Di T i O t h d l b d # f di ti i
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2/21/2020 Soil Colloids (Chapter 8) Notes - AGRI1050R50: Introduction to Soil Science (2020S)
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Di or Tri Octahedral based on # of coordinating ions
http://web.utk.edu/~drtd0c/Soil%20Colloids.pdf
http://web.utk.edu/~drtd0c/Soil%20Colloids.pdf
2/21/2020 Soil Colloids (Chapter 8) Notes - AGRI1050R50: Introduction to Soil Science (2020S)
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Size .
More Related Content
Similar to 17Barbara Fletcher, RN, MN, FAANClinical Associate Profe.docx
Diabetes is the condition in which the body does not properly process food for use as energy. Most of the food we eat is turned into glucose, or sugar, for our bodies to use for energy.
The pancreas, an organ that lies near the stomach, makes a hormone called insulin to help glucose get into the cells of our bodies. When you have diabetes, your body either doesn't make enough insulin or can't use its own insulin as well as it should. This causes sugars to build up in your blood.
This is why many people refer to diabetes as ―sugar‖ Diabetes can cause serious health complications including, heart disease, blindness, kidney failure, and lower-extremity amputations.
There has been an increase in the predominance of diabetes mellitus over the past 40 years worldwide. The worldwide occurrence of diabetes in 2000 was approximately 2.8% and is estimated to grow to 4.4% by 2030. This data interprets a projected rise of diabetes from 171 million in 2000 to well over 350 million in 2030. The presence of hypertension in diabetic patients substantially increases the risks of coronary heart disease, stroke, nephropathy and retinopathy. Indeed, when hypertension coexists with diabetes, the risk of CVD is increased by 75%, which further contributes to the overall morbidity and mortality of an already high risk population. Patients with type 2 diabetes mellitus have a considerably higher risk of cardiovascular morbidity and mortality, and are disproportionately affected by cardiovascular disease. Most of this excess risk is associated with high prevalence of well-established risk factors such as hypertension, dyslipidaemia and obesity in these patients. Hypertension plays a major role in the development and progression of microvascular and macrovascular disease in people with diabetes. Lifestyle Modifications and pharmacotherapy are the choice for the Management of Hypertension in Patients with Diabetes.
Running Head Obesity, Healthy Diet and Health .docxtodd581
Running Head: Obesity, Healthy Diet and Health 1
Obesity, Healthy Diet and Health 19
Obesity, Healthy Diet and Health
PUH 6301 Public Health Research
Abstract
Having a good nutrition habit, healthy body weight, and physical activities are essential aspects of good health and wellness. The combination of all three factors is critical in reducing the chances of getting severe health complications such as diabetes, hypertension, high cholesterol, cancer, stroke, and heart complications. Managing a good health condition also relies on how one adhere to regular physical exercises, a well-maintained body weight, and a healthy diet. However, according to (Healthy People 2020), most Americans don't check their menu and are lazy in taking apart in physical activities to the required levels as a way of maintaining proper health.
According to CDCP (2013), fruit consumption among adults is 1.1 times in a day, and the use of vegetables on a daily scale is 1.6, with adolescents recording the lowest use of both fruits and vegetables. The statistic shows that the average daily consumption of both fruits and vegetables among Americans doesn't meet the recommended intake of fruits and vegetables. About 81.6% and 81.8% of American adults and adolescents respectively don't take part in physical activities on a recommended daily scale. These behaviors are among the leading factors that contribute to the rising cases of Obesity. Approximately 1 out of 3 US adults, which represents 34 % and 1 out of 6 adolescents and children, which is 16.2 %, are obese.
Obesity-related complications include stroke, heart disease, and type two diabetes. The current in death cases is as a result of the obesity-related complications. Besides the death cases, obesity-related diseases cots this country millions of money annually, making it one of the most significant burdens that this country is struggling with regards to the health care system.
Introduction
Maintaining a healthy diet is an essential factor that determines how healthy our bodies become. We must retain less sugar, salt, and fats diet daily. Cases associated with obesity are not causing deaths but also taking so much of this country's financial resources. Every year both the federal, state, and county governments invest million into the health sector as a way of improving the infrastructures required to deal with obesity-related complications. Any healthy combines a variety of foods such as cereals, legumes, proteins, fruits, and vegetables. Research shows that obesity is gradually grown into a global crisis with WHO initiating campaigns aimed at establishing the importance of maintaining a healthy diet (Abidin, 2014).
The love for foods prepared away from homes is another challenging factor in dealing with obesity complications. Fast foods contain .
Running Head Obesity, Healthy Diet and Health .docxglendar3
Running Head: Obesity, Healthy Diet and Health 1
Obesity, Healthy Diet and Health 19
Obesity, Healthy Diet and Health
PUH 6301 Public Health Research
Abstract
Having a good nutrition habit, healthy body weight, and physical activities are essential aspects of good health and wellness. The combination of all three factors is critical in reducing the chances of getting severe health complications such as diabetes, hypertension, high cholesterol, cancer, stroke, and heart complications. Managing a good health condition also relies on how one adhere to regular physical exercises, a well-maintained body weight, and a healthy diet. However, according to (Healthy People 2020), most Americans don't check their menu and are lazy in taking apart in physical activities to the required levels as a way of maintaining proper health.
According to CDCP (2013), fruit consumption among adults is 1.1 times in a day, and the use of vegetables on a daily scale is 1.6, with adolescents recording the lowest use of both fruits and vegetables. The statistic shows that the average daily consumption of both fruits and vegetables among Americans doesn't meet the recommended intake of fruits and vegetables. About 81.6% and 81.8% of American adults and adolescents respectively don't take part in physical activities on a recommended daily scale. These behaviors are among the leading factors that contribute to the rising cases of Obesity. Approximately 1 out of 3 US adults, which represents 34 % and 1 out of 6 adolescents and children, which is 16.2 %, are obese.
Obesity-related complications include stroke, heart disease, and type two diabetes. The current in death cases is as a result of the obesity-related complications. Besides the death cases, obesity-related diseases cots this country millions of money annually, making it one of the most significant burdens that this country is struggling with regards to the health care system.
Introduction
Maintaining a healthy diet is an essential factor that determines how healthy our bodies become. We must retain less sugar, salt, and fats diet daily. Cases associated with obesity are not causing deaths but also taking so much of this country's financial resources. Every year both the federal, state, and county governments invest million into the health sector as a way of improving the infrastructures required to deal with obesity-related complications. Any healthy combines a variety of foods such as cereals, legumes, proteins, fruits, and vegetables. Research shows that obesity is gradually grown into a global crisis with WHO initiating campaigns aimed at establishing the importance of maintaining a healthy diet (Abidin, 2014).
The love for foods prepared away from homes is another challenging factor in dealing with obesity complications. Fast foods contain .
Running Head Obesity, Healthy Diet and Health .docxjeanettehully
Running Head: Obesity, Healthy Diet and Health 1
Obesity, Healthy Diet and Health 19
Obesity, Healthy Diet and Health
PUH 6301 Public Health Research
Abstract
Having a good nutrition habit, healthy body weight, and physical activities are essential aspects of good health and wellness. The combination of all three factors is critical in reducing the chances of getting severe health complications such as diabetes, hypertension, high cholesterol, cancer, stroke, and heart complications. Managing a good health condition also relies on how one adhere to regular physical exercises, a well-maintained body weight, and a healthy diet. However, according to (Healthy People 2020), most Americans don't check their menu and are lazy in taking apart in physical activities to the required levels as a way of maintaining proper health.
According to CDCP (2013), fruit consumption among adults is 1.1 times in a day, and the use of vegetables on a daily scale is 1.6, with adolescents recording the lowest use of both fruits and vegetables. The statistic shows that the average daily consumption of both fruits and vegetables among Americans doesn't meet the recommended intake of fruits and vegetables. About 81.6% and 81.8% of American adults and adolescents respectively don't take part in physical activities on a recommended daily scale. These behaviors are among the leading factors that contribute to the rising cases of Obesity. Approximately 1 out of 3 US adults, which represents 34 % and 1 out of 6 adolescents and children, which is 16.2 %, are obese.
Obesity-related complications include stroke, heart disease, and type two diabetes. The current in death cases is as a result of the obesity-related complications. Besides the death cases, obesity-related diseases cots this country millions of money annually, making it one of the most significant burdens that this country is struggling with regards to the health care system.
Introduction
Maintaining a healthy diet is an essential factor that determines how healthy our bodies become. We must retain less sugar, salt, and fats diet daily. Cases associated with obesity are not causing deaths but also taking so much of this country's financial resources. Every year both the federal, state, and county governments invest million into the health sector as a way of improving the infrastructures required to deal with obesity-related complications. Any healthy combines a variety of foods such as cereals, legumes, proteins, fruits, and vegetables. Research shows that obesity is gradually grown into a global crisis with WHO initiating campaigns aimed at establishing the importance of maintaining a healthy diet (Abidin, 2014).
The love for foods prepared away from homes is another challenging factor in dealing with obesity complications. Fast foods contain ...
Diabetes Type 1 Sara MartinezChamberlain College of Nursing.docxlynettearnold46882
Diabetes Type 1
Sara Martinez
Chamberlain College of Nursing
NR 507 Advanced Pathophysiology
2018
1
1
What is Diabetes
Body Does not make or properly use insulin: (ADA,2005)
No insulin production
Insufficient insulin production
Resistance to insulin’s effects
No insulin to move glucose from blood into cells
High blood glucose means:
Fuel loss, cells starve
Short and long term complications
2
Diabetes is a chronic disease in which the body does not make or properly
use insulin, a hormone that is needed to convert sugar, starches, and other
food into energy by moving glucose from blood into the cells ( American Diabetes Association, 2005).
People with diabetes have increased blood glucose (sugar) levels for one or
more of the following three reasons: Either
No insulin is being produced,
Insulin production is insufficient, and/or
The body is resistant to the effects of insulin.
As a result, high levels of glucose build up in the blood, and spill into the
urine and out of the body. The body loses its main source of fuel and cells
are deprived of glucose, a needed source of energy. High blood glucose
levels may result in short and long term complications over time ( Centers for Disease Control and Prevention, 2017).
2
Understanding Diabetes Type 1
Auto immune disorder
Insulin – producing cells destroyed
Daily insulin replacement necessary
Age of onset: usually childhood, young adults
Most prevalent type of diabetes in children and adolescent’s
(CDC,2017)
3
Diabetes mellitus (DM) is a group of diseases characterized by high levels of blood glucose resulting from defects in insulin production, insulin action, or both (CDC,2017).
The term diabetes mellitus describes a metabolic disorder of multiple aetiology characterized by chronic hyperglycaemia with disturbances of carbohydrate, fat and protein metabolism resulting from defects in insulin secretion, insulin action, or both.
The effects of diabetes mellitus include long–term damage, dysfunction and failure of various organs.
Diabetes is a condition where the body fails to utilize the ingested glucose properly. This could be due to lack of the hormone insulin or because the insulin that is available is not working effectively. Diabetes is the fastest growing long term disease that affects millions of people worldwide (CDC,2017). According to the charity Diabetes UK, more than two million people in the UK have the condition and up to 750,000 more are unaware of having the condition. In the United States 25.8 million people or 8.3% of the population have diabetes. Of these, 7.0 million have undiagnosed diabetes. In 2010, about 1.9 million new cases of diabetes were diagnosed in population over 20 years. It is said that if this trend continues, 1 in 3 Americans would be diabetic by 2050 (Mayo Clinic, 2017).
Type 1 diabetes is a disease of the immune system, which is the body’s system for fighting infection.
In people with type 1 diabetes, the .
2/21/2020 Soil Colloids (Chapter 8) Notes - AGRI1050R50: Introduction to Soil Science (2020S)
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Soil Colloids (Chapter 8) Notes
Soil Colloids (Chapter 8) Notes
Did you know ....
Did you know soil fertility or the ability for a soil to provide nutrients is seated in the type of minerals it
contains? Chapter 8 will cover the various types of soil colloids including all the layer and non-layer
silicates, cation exchange, anion exchange, and sorption.
Lecture content notes are accompanied by videos listed below the notes in each submodule (e.g. Soil
Colloids (Chapter 8) Videos A though H). Print or download lecture notes then view videos in
succession alongside lecture content and add additional notes from each video. The start of each
video is noted in parenthesis (e.g. Content for Video A) within each lecture note set and contains
lecture content through the note for the next video (e.g. Content for Video B).
Figures and tables unless specifically referrenced are from the course text, Nature and Property of
Soils, 14th Edition, Brady and Weil.
Content Video A
Soil Colloids
Smallest soil particles < 1 µm
Surface area - LARGE
Surface charge - CEC
Adsorb water
AGRI1050R50: Introduction to Soil Science (2020S) LH
https://gotoclass.tnecampus.org/d2l/le/content/8094442/navigateContent/176/Previous?pId=60403304
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2/21/2020 Soil Colloids (Chapter 8) Notes - AGRI1050R50: Introduction to Soil Science (2020S)
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Types of Colloids
Crystalline Silicate clays: ordered, crystalline, layers
Non-crystalline silicate clays: non-ordered, layers, volcanic
Iron/Aluminum Oxides – weathered soils, less CEC
Humus – OM, not mineral or crystalline, high CEC
Soil Colloids
Content Video B
Layer Silicates - Construction
Phyllosillicates
Tetrahedral Sheets
1 Si with 4 Oxygen
Share basal oxygen
Form sheets
Octahedral Sheets
6 Oxygen with Al3+ or Mg 2+
Di T i O t h d l b d # f di ti i
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Di or Tri Octahedral based on # of coordinating ions
http://web.utk.edu/~drtd0c/Soil%20Colloids.pdf
http://web.utk.edu/~drtd0c/Soil%20Colloids.pdf
2/21/2020 Soil Colloids (Chapter 8) Notes - AGRI1050R50: Introduction to Soil Science (2020S)
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Size .
20 Other Conditions That May Be a Focus of Clinical AttentionV-c.docxRAJU852744
20 Other Conditions That May Be a Focus of Clinical Attention
V-codes and z-codes
V-codes and Z-codes are conditions that may be the focus of clinical attention but are not considered mental disorders. They correspond to International Classification of Diseases, Ninth Revision, Clinical Modification ICD-9-CM (V-codes) and International Classification of Diseases, Tenth Revision, Clinical Modification ICD-10-CM (Z-codes that become effective in 2015. In most instances, third-party payers do not cover charges for delivering services to an individual if the diagnosis is solely a V- or Z-code alone. If the V- or Z-code is not the primary diagnosis then it should be documented following the primary diagnosis. In addition, when writing the psychosocial assessment any psychosocial and cultural factors that might impact the client's diagnosis should be documented. The psychosocial stressors reflected in these diagnoses are widespread across all classes and cultures and have been shown to impact all aspects of an individual's life from the physical and psychological to the financial. Furthermore, these conditions have been shown to significantly impact the diagnosis and outcome for a multitude of mental and medical disorders. V- and Z-codes are grouped into numerous categories including: relational problems, problems related to abuse/neglect, educational and occupational problems, housing and economic problems, problems related to the social environment, problems related to the legal system, other counseling services, other psychosocial, personal and environmental problems, and problems of personal history (APA, 2013).
Broadly speaking, the category “Relational Problems” describes interactional problems between family members (e.g., parent/caregiver-child) or partners that result in significant impairment of family functioning or development of symptoms in the distressed individual, spouses, siblings, or other family members. Relational problems are broken down into two categories, Problems Related to Family Upbringing and Other Problems Related to Primary Support Group. For example, in the first category a Parent-Child Relational Problem involves interactional problems between one or both parents and a child that lead to dysfunction in behavioral (e.g., inadequate protection, overprotection), cognitive (e.g., antagonism toward or blaming of the other) or affective (e.g., feeling sad and angry) realms. Here, the critical factor is the quality of the parent-child relationship or when the dysfunction in this relationship is impacting the course and outcome of a psychological or medical condition. Other examples include Sibling Relational Problem, Upbringing Away from Parents, and Child Affected by Parental Relationship Distress. Similarly, family relationships and interactional patterns leading to problems related to primary support group include Partner Relational Problem, Disruption of Family by Separation/Divorce, High Expressed Emotion Level with.
223 Case 53 Problems in Pasta Land by Andres Sous.docxRAJU852744
223
Case 53
Problems in Pasta Land
by
Andres Sousa-Poza
Old Dominion University
The Food Factory has been operating in an underdeveloped country for approximately 10
years.1 Its parent corporation specializes in wheat milling, and it started the pasta factory as a
“side-line” operation to process lower quality wheat flour, which is a by-product of the
normal milling process. This low-gluten flour is generally not suitable for the production of
bread or for direct sale to consumers.
In 2009, the pasta division is confronted with a major problem. It is too successful!
The factory was designed around the mill. Production capacities matched the amount of
effluent from the mill rather than coming from a sound marketing strategy. As shown in
Table 53-1, by 2006, the pasta plant was no longer able to effectively serve existing
customers. The plant that was designed to produce 600 tons of pasta per month on two
production lines is now facing average monthly orders of approximately 800 tons.
Furthermore, the corporate director of marketing estimates that orders could easily be
increased to 1400 to 1800 tons per month.
1 All monies used in this case are in the local currency, which is one of the more than 40 countries in
the world that use the $ symbol and most of which are called dollars.
Cases in Engineering Economy 2nd by Peterson & Eschenbach
224
Table 53-1 Average Monthly Orders/Production
0
100
200
300
400
500
600
700
800
900
Year
A
ve
ra
ge
m
on
th
ly
o
rd
er
s/
pr
od
uc
tio
n
Orders 200 280 360 490 450 580 620 710 760 800
Production 200 270 365 500 440 575 590 610 580 570
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009
Another challenge facing the factory is that the initial equipment was refurbished, not
new, and it is now antiquated and seriously dilapidated. Unless the plant is shut down,
equipment replacement is going to be required. The existing equipment was already a
technological generation behind when it was bought. During the last 10 years a new
generation of equipment has been developed based on high-temperature drying. The new
technology is much more suited for use with low-quality (low-gluten) flour and semolina.
New machinery is significantly more efficient. It requires fewer workers, has lower relative
energy consumption, and produces less waste. The pasta plant still maintains a price lead
through the low cost at which it is able to obtain raw materials from the corporate wheat mill,
but this barely compensates for the plant’s low efficiency.
The new technology is also enabling competitors to use low-quality, low-cost raw
materials and still produce a reasonably high-quality end product. Ultimately, this means that
the cost of higher quality pasta has dropped significantly in price, and the quality of the low-
cost pasta is increasing significantly. The pasta factory’s market is customers wit.
2
2
2
1
1
1
Organization Name: Insta-Buy
Insta-Buy is an E-Commerce Multinational American company. It was founded in 2010 and is based in Atlanta, Georgia. It mainly operates with grocery delivery and pick up and it offers services through web application and mobile application to various states in United States. It is one of the major online marketplaces for grocery delivery. The company is valued at $1 billion worth and has partnership with over 150 retailers. It is known for its fresh produce and timely delivery and pickup.
Predictive Analysis at Insta-Buy:
The predictive analytics is termed as what is likely to happen in the future. The predictive analytics is based on statistical and data mining technique. The aim of this technique is to predict the future of the project such as what would be the customer reaction on project, financial need, etc. In developing predictive analytical application, a number of techniques are used such as classification algorithms. The classification techniques are logistic regression, decision tree models and neural network. Clustering algorithms are used to segment customers in different groups which helps to target specific promotions to them. To estimate the relationship between different purchasing behavior, association mining technique is used (Mehra, 2014). As an example, for any product on Amazon.com results in the retailer also suggesting similar products that a customer might be interested in. Predictive analytics can be used in E-commerce to solve the following problems
1. Improve customer engagement and increase revenue
1. Launch promotions that target specific customer group
1. Optimizing prices to generate maximum profits
1. Keep proper inventory and reduce over stalking
1. Minimizing fraud happenings and protecting privacy
1. Provide batter customer service at low cost
1. Analyze data and make decision in real time
TOPICS:
Student: Ahmed
Topic: Bayesian Networks (Predicting Sales In E-commerce Using Bayesian Network Model)
Student: Meet
Topic: Predictive Analysis
Student: Peter
Topic: Privacy and Confidentiality in an e-Commerce World: Data Mining, Data Warehousing, Matching and Disclosure Limitation
Student: Nayeem
Topic: Ensemble Modeling
Student: Shek
Topic: L.Jack & Y.D. Tsai, Using Text Mining of Amazon Reviews to Explore User-Defined Product Highlights and Issues.
Student: Suma
Topic: Deep Neural Networks
REFERENCES:
Olufunke Rebecca Vincent, A. S. (2017). A Cognitive Buying Decision-Making Process in B2B E-Commerce Using Analytic-MLP. Elsevier.
https://www.researchgate.net/publication/319278239_A_Cognitive_Buying_Decision-Making_Process_in_B2B_E-Commerce_Using_Analytic-MLP
Wan, C. C. (2017). Forcasting E-commerce Key Performance Indicators
https://beta.vu.nl/nl/Images/stageverslag-wan_tcm235-867619.pdf
Fienberg, S. (2006). Privacy and Confidentiality in an e-Commerce World: Data Mining, Data Warehousing, Matching and Disclosure Limitation. Statistical Science, .
22-6 Reporting the Plight of Depression FamiliesMARTHA GELLHOR.docxRAJU852744
22-6 | Reporting the Plight of Depression Families
MARTHA GELLHORN, Field Report to Harry Hopkins (1934)
1. From Martha Gellhorn to Harry Hopkins, Report, Gaston County, North Carolina, November 11, 1934, Franklin D. Roosevelt Library, Harry Hopkins Papers, Box 66. Online transcript available at http://newdeal.feri.org/hopkins/hop08.htm.
Journalist and novelist Martha Gellhorn’s heartrending field report describing impoverished Gastonia, North Carolina, families vividly captures the desperate hope of depression-era families. Hired by Harry Hopkins, Franklin Roosevelt’s point man for federal relief efforts, Gellhorn detailed the enormous challenge facing the administration. Compounding the epic humanitarian crisis she encountered was the political opposition, which she singled out as one among many obstacles hampering relief efforts.
All during this trip [to North Carolina] I have been thinking to myself about that curious phrase “red menace,” and wondering where said menace hid itself. Every house I visited — mill worker or unemployed — had a picture of the President. These ranged from newspaper clippings (in destitute homes) to large colored prints, framed in gilt cardboard. The portrait holds the place of honour over the mantel. . . . He is at once God and their intimate friend; he knows them all by name, knows their little town and mill, their little lives and problems. And, though everything else fails, he is there, and will not let them down.
I have been seeing people who, according to almost any standard, have practically nothing in life and practically nothing to look forward to or hope for. But there is hope; confidence, something intangible and real: “the president isn’t going to forget us.”
Let me cite cases: I went to see a woman with five children who was living on relief ($3.40 a week). Her picture of the President was a small one, and she told me her oldest daughter had been married some months ago and had cried for the big, coloured picture as a wedding present. The children have no shoes and that woman is terrified of the coming cold as if it were a definite physical entity. There is practically no furniture left in the home, and you can imagine what and how they eat. But she said, suddenly brightening, “I’d give my heart to see the President. I know he means to do everything he can for us; but they make it hard for him; they won’t let him.” I note this case as something special; because here the faith was coupled with a feeling (entirely sympathetic) that the President was not entirely omnipotent.
I have been seeing mill workers; and in every mill when possible, the local Union president. There has been widespread discrimination in the south; and many mills haven’t re-opened since the strike. Those open often run on such curtailment that workers are getting from 2 to 3 days work a week. The price of food has risen (especially the kind of food they eat: fat-back bacon, flour, meal, sorghum) as high as 100%. It is getting cold;.
2018 4th International Conference on Green Technology and Sust.docxRAJU852744
2018 4th International Conference on Green Technology and Sustainable Development (GTSD)
130
�
Abstract - The Vietnamese government have plan to develop the
wind farms with the expected capacity of 6 GW by 2030. With the
high penetration of wind power into power system, wind power
forecasting is essentially needed for a power generation
balancing in power system operation and electricity market.
However, such a tool is currently not available in Vietnamese
wind farms as well as electricity market. Therefore, a short-term
wind power forecasting tool for 24 hours has been created to fill
in this gap, using artificial neural network technique. The neural
network has been trained with past data recorded from 2015 to
2017 at Tuy Phong wind farm in Binh Thuan province of Viet
Nam. It has been tested for wind power prediction with the input
data from hourly weather forecast for the same wind farm. The
tool can be used for short-term wind power forecasting in
Vietnamese power system in a foreseeable future.
Keywords: power system; wind farm; wind power forecasting;
neural network; electricity market.
I. NECESITY OF WIND POWER FORECASTING
Today, the integration of wind power into the existing
grid is a big issue in power system operation. For the system
operators, power generation curve of wind turbines is a
necessary information in the power sources balancing. From
the dispatchers’ point of view, wind power forecast errors
will impact the system net imbalances when the share of
wind power increases, and more accurate forecasts mean less
regulating capacity will be activated from the real time
electricity market [1]. In the deregulated market, day-ahead
electricity spot prices are also affected by day-ahead wind
power forecasting [2]. Wind power forecasting is also
essential in reducing the power curtailment, supporting the
ancillary service. However, due to uncertainty of wind speed
and weather factors, the wind power is not easy to predict.
In recent years, many wind power forecasting methods
have been proposed. In [3], a review of different approaches
for short-term wind power forecasting has been introduced,
including statistical and physical methods with different
models such as WPMS, WPPT, Prediktor, Zephyr, WPFS,
ANEMOS, ARMINES, Ewind, Sipreolico. In [4], [5], the
methods, models of wind power forecasting and its impact on
*Research supported by Gesellschaft fuer Internationale
Zusammenarbeit GmbH (GIZ).
D. T. Viet is with the University of Danang, Vietnam (email:
[email protected]).
V. V. Phuong is with the University of Danang, Vietnam (email:
[email protected]).
D. M. Quan is with the University of Danang, Vietnam (email:
[email protected]).
A. Kies is with the Frankfurt Institute for Advanced Studies, Germany
(email: [email protected] uni-frankfurt.de).
B. U. Schyska is with the Carl von Ossietzky Universität Oldenburg,
Germany (email: [email protected]).
Y. K. Wu i.
202 S.W.3d 811Court of Appeals of Texas,San Antonio.PROG.docxRAJU852744
202 S.W.3d 811
Court of Appeals of Texas,
San Antonio.
PROGRESSIVE COUNTY MUTUAL INSURANCE
COMPANY, Appellant,
v.
Hector Raul TREVINO and Mario Moyeda,
Appellees.
No. 04–05–00113–CV.
|
June 28, 2006.
|
Rehearing Overruled July 31, 2006.
.
200 wordsResearch Interest Lack of minorities in top level ma.docxRAJU852744
200 words
Research Interest: Lack of minorities in top level management positions
Describe why and how a qualitative approach may be appropriate for your area of interest for your research. Include a rationale for each proposed use of qualitative inquiry.
.
2019 14th Iberian Conference on Information Systems and Tech.docxRAJU852744
2019 14th Iberian Conference on Information Systems and Technologies (CISTI)
19 – 22 June 2019, Coimbra, Portugal
ISBN: 978-989-98434-9-3
How ISO 27001 can help achieve GDPR compliance
Isabel Maria Lopes
Polytechnic Institute of Bragança, Bragança, Portugal
UNIAG, Polytechnic Institute of Bragança, Portugal
ALGORITMI Centre, Minho University, Guimarães,
Portugal
[email protected]
Pedro Oliveira
Polytechnic Institute of Bragança, Bragança, Portugal
[email protected]
Teresa Guarda
Universidad Estatal Península de Santa Elena – UPSE, La
Libertad, Ecuador
Universidad de las Fuerzas Armadas – ESPE, Sangolqui,
Quito, Equador
ALGORITMI Centre, Minho University, Guimarães,
Portugal
[email protected]
Abstract — Personal Data Protection has been among the most
discussed topics lately and a reason for great concern among
organizations. The EU General Data Protection Regulation
(GDPR) is the most important change in data privacy regulation
in 20 years. The regulation will fundamentally reshape the way in
which data is handled across every sector. The organizations had
two years to implement it. As referred by many authors, the
implementation of the regulation has not been an easy task for
companies. The question we aim to answer in this study is how far
the implementation of ISO 27001 standards might represent a
facilitating factor to organizations for an easier compliance with
the regulation. In order to answer this question, several websites
(mostly of consulting companies) were analyzed, and the aspects
considered as facilitating are listed in this paper.
Keywords - regulation (EU) 2016/679; general data protection
regulation; ISO/IEC 27001.
I. INTRODUCTION
In recent years, data protection has become a forefront issue
in cyber security. The issues introduced by recurring
organizational data breaches, social media and the Internet of
Things (IoT) have raised the stakes even further [1, 2]. The EU
GDPR, enforced from May 25 2018, is an attempt to address
such data protection. The GDPR makes for stronger, unified data
protection throughout the EU.
The EU GDPR states that organizations must adopt
appropriate policies, procedures and processes to protect the
personal data they hold.
The International Organization for Standardization (ISO)
/International Electrotechnical Commission (IEC) 27000 series
is a set of information security standards that provide best-
practice recommendations for information security management
[3].
This international standard for information security, ISO
27001, provides an excellent starting point for achieving the
technical and operational requirements necessary to reduce the
risk of a breach.
Not all data is protected by the GDPR, since it is only
applicable to personal data. This is defined in Article 4 as
follows [4]:
“personal data” means any information relating to an
identified or identifiable natural person (’data subject’); an
identifiable.
200520201ORG30002 – Leadership Practice and Skills.docxRAJU852744
20/05/2020
1
ORG30002 – Leadership Practice
and Skills
Topic: Cross-cultural Leadership
Week 10
Readings for this week….
◦ Week 10 Topic: Cross-Cultural Leadership
◦ Chapter 11, Daft
◦ Javidan, M., Dorfman, P.W., De Luque, M.S. & House R.J. (2006). In the eye of the beholder:
Cross cultural lessons in leadership from Project GLOBE - Academy of Management Perspect ive,
20(1), 67-90
http://ezproxy.lib.swin.edu.au/login?url=http://search.ebscohost.com/login.aspx?direct=true&db
=bth&AN=19873410&site=ehost-live&scope=site
◦ Randel, A.E., et al. (2018). Inclusive leadership: Realizing posit ive outcomes through
belongingness and being valued for uniqueness, Human Resource Management Review, 28:190-
203. http://ezproxy.lib.swin.edu.au/login?url=https://doi.org/10.1016/j.hrmr.2017.07.002
◦ Hoffman, R., Yeh, C. & Casnocha, B. (2019). Learn from People, Not Classes Whom do you know,
and what can they teach you? Harvard Business Review, Mar – Apr 2019.
http://ezproxy.lib.swin.edu.au/login?url=http://search.ebscohost.com/login.aspx?direct=true&db
=bth&AN=134875248&site=ehost-live&scope=site
Work Force Trends
With more multi generational workplaces, work forces are becoming more
diverse and cultures of inclusion more common
Women leaders in Global Businesses showing an increasing trend
Globalization is compelling businesses to send more workers to other countries
Leaders are traveling and working abroad in greater numbers
Workers with international experience and skills are increasingly more sought-
after in the workplace
Visualising the Iceberg Model of Culture
(source:http://opengecko.com/interculturalism/visualising-the-iceberg-model-of-
culture/) The iceberg model of culture
has been arrived at through
the work of many theorists,
including those referenced
below:
◦ French, W., & Bell, C. (1995).
Organization development.
(5th Ed.). [Englewood Cliffs,
NJ: Prentice-Hall
International]
◦ Hall, E. T. (1976) Beyond
Culture [New York:
Doubleday]
◦ Selfridge, R., Sokolik, S.
(1975) “A comprehensive
v iew of organizational
management”. MSU
Business Topics, 23(1), 46-61
◦ Weaver, G. R. (1986).
“Understanding and coping
with cross-cultural
adjustment stress”. In Paige
R. M. (Ed.), Cross-Cultural
Orientation, New
Conceptualizations and
Applications. [Lanham, MD:
University Press of America]
https://monash.rl.talis.com/items/C3CF1A2F-948C-AA0D-89D9-8498251A8662.html?referrer=/lists/86EF2F87-E1BB-F832-BEB3-34F354D3DAC6.html?draft#item-C3CF1A2F-948C-AA0D-89D9-8498251A8662
http://ezproxy.lib.swin.edu.au/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=bth&AN=19873410&site=ehost-live&scope=site
http://ezproxy.lib.swin.edu.au/login?url=https://doi.org/10.1016/j.hrmr.2017.07.002
http://ezproxy.lib.swin.edu.au/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=bth&AN=134875248&site=ehost-live&scope=site
20/05/2020
2
Who is a Multicultural Leader?
A leader with skills.
2/18/2020 Sample Content Topic
https://purdueglobal.brightspace.com/d2l/le/content/115691/viewContent/9226875/View 1/1
Trouble at 3Forks
Introduction: The foreclosure process can differ for deeds
versus mortgages. You will conduct research to determine
these differences since it is not only covered in the real estate
exam, but it is important to know this process in professional
practice.
Scenario: Henri and Lila own a restaurant which the
government has caused to close due to widening the road in
front of their establishment. Since this is the main source of
their income, and has caused Lila and Henri to stop payments
on their mortgage, address the following questions.
Checklist:
Explain the action that Henri and Lila should expect from the
bank regarding their property.
Describe how the banks actions would differ if it was a deed of
trust rather than a mortgage.
Respond in a minimum of 600–850-word essay with additional
title and reference pages using APA format and citation style.
Access the Unit 4 Assignment grading rubric.
Submit your response to the Unit 4 Assignment Dropbox.
Assignment Details
https://kapextmediassl-a.akamaihd.net/business/MT431/1904c/rubrics/u4_rubric.pdf
Mitchell, Taylor N.
Donaldson, Jayda N
Recommended Presentation Outline
My Name is …
The title of my article is…
I found it in…
My article is relevant and interesting because….
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Economics
The study of the allocation of scarce resources: implies a cost to every action
Basic assumption
People are rational
People act to maximize their happiness
Economics is predictive
5
Economic Modeling
"The theory of economics does not furnish a body of settled conclusions immediately applicable to policy. It is a method rather than a doctrine, an apparatus of the mind, a technique of thinking which helps its possessor to draw correct conclusions." (John Maynard Keynes)
P
Q
S
D
Q*
P*
7
Demand
Function of
Income
Tastes
Prices of Substitutes
Prices of Compliments
8
P
Q
D
Q*
P*
Q**
P**
9
P
Q
D
D1
P1
P2
Q1
Q2
Q1
Q2
10
Price Elasticity of Demand
A measure of sensitivity of quantity demanded to a change in price
Q/Q)
(P/P)
Inelastic demand means that E is small
11
Supply
Function of
Costs of Production
Input Prices
Technology
12
P
Q
S
S1
P1
P2
Q1
Q2
Q1
Q2
13
P
Q
S
D
Q*
P*
S``
Q**
P**
14
Utility Maximization
MAX U(F, N)
Subject to the budget constraint:
PnN + PfF = I
(with a little algebra)
N= I/Pn - (Pf / Pn) F
15
Good X
Y
I/PY
U2
U1
U3
16
Theory of the Firm
Firm Maximizes profits
Max: p = Revenue - Costs
Max: p = P(Q)* Q- C(Q)
First Order Conditions:
dp/dQ = P’(Q)*P + P(Q) - C’(Q) =0
P’(Q)*P + P(Q) = C’(Q)
Marginal Revenue = Marginal Costs
17
X
$
0
AC
MC
P1
Po
X1
Xo
18
Assumptions of Perfect Competition
Free Entr.
21 hours agoMercy Eke Week 2 Discussion Hamilton Depression.docxRAJU852744
21 hours ago
Mercy Eke
Week 2 Discussion: Hamilton Depression Rating Scale
COLLAPSE
Top of Form
Depression or Major Depressive Disorder is considered as a mental health disorder that negatively impacts how an individual feel, think and behave. Individuals who suffer from depression exhibit feelings of sadness and loss in interest in once enjoyed activities (Parekh. 2017). It can cause different kinds of emotional and physical problems and can minimize an individual’s ability to be functional in their daily routines. Annually, approximately 6.7% of adults are impacted by depression. It is estimated that 16.6% of individuals will experience depression at some time in their life (Parekh. 2017). Depression is said to manifest at any time, but on average, the first manifestation occurs during the late teens to mid-20s. The female population is susceptible to experience depression than the male population. Some research indicated that one-third of the female population would experience a major depressive episode in their lifetime (Parekh. 2017).
Among all the mental disorders, depression is one of the most treatable. It is estimated that between 80-90 % of individuals suffering from depression respond well to treatment and experienced remission of their symptoms (Parekh. 2017). As a mental health professional, prior to deciphering diagnosis and initiating diagnosis, it is paramount to conduct a complete diagnostic evaluation, which includes an interview and, if necessary, a physical examination (Parekh. 2017). Blood tests can be conducted to ascertain that depression is not precipitated by a medical condition like thyroid dysfunction. The evaluation is to identify specific symptoms, medical and family history, cultural factors, and environmental factors to derive a diagnosis and establish a treatment plan (Parekh. 2017). One of the assessment tools for depression is the Hamilton Depression Rating Scale. In this discussion, I will be discussing the psychometric properties of the Hamilton Depression Rating Scale and elaborate on when it is appropriate to utilize this assessment tool with clients, including whether the tool can be utilized to evaluate the efficacy of psychopharmacologic medications.
The Hamilton Depression Rating Scale (HDRS) was introduced in early 1960. It has been considered as a gold standard in depression studies and a preferred scale in the evaluation of depression treatment. It is the most vastly utilized observer-rated depression scale worldwide (Vindbjerg.et.al., 2019). The HDRS was initially created to measure symptoms severity in depressed inpatient; however, the 17-item HAM-D has advanced in over five decades into 11 modified versions that have been administered to various patient populations in an array of psychiatric, medical, and other research settings (Rohan.et.al., 2016). There are two most common versions with either 17 or 21 items and is scored between 0-4 points. Each item assists mental health professionals or c.
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Spring 2020 - InfoTech Import in Strat Plan (ITS-831-08) - First Bi-Term • Week 4 Assignment
%81Total Score: High riskMohana Murali Krishna Karnati
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Running Head: SERVER VIRTUALIZATION 1
SERVER VIRTUALIZATION 8
Week 4 Assignment
Technet Case Study for Virtualization Mohana Murali Krishna Karnati
University of the Cumberlands
Technet Case Study for Virtualization
Technet is a hypothetical business in the storage manufacturing industry. This paper intend to elaborate the server virtualization concept using Microsoft
virtualization software from Windows server 2012R2. Organization’s Preparedness for Virtualization. As of now, the IT system design is a mishmash of old
frameworks that were obtained through various acquisitions of different providers in the storage industry. In any case, these old frameworks are aging and will soon
need to be upgraded. Generally, these old frameworks support applications that have been in service for about 10 years. The IT system situated in one of Technet
branch in Asia for instance comprise of old servers that have been in service for the last 5 years. These old servers were launched to support production and
productivity applications. The expense for permit of these old applications are presently being inspected to check whether they can be dropped and the
information moved to current Technet Enterprise Resource Planning (ERP) applications. Consequently, since several IT related components are potential
contender for upgrading, this makes the likelihood of changing over current physical server farms into virtualized computing resources appropriate. Microsoft
Licensing of Virtualized Environments
Datacenter and the Standard edition are the two license version for Windows Server 2012R2 offered by Microsoft. There is likewise a free version called
Hyper-V Server which is an independent system that only contains the Windows hypervisor, a driver model as well as virtualization modules. Every window
version underpins Hyper-V, which is Microsoft's Type-1 hypervisor offering, likewise referred to as a bare-metal installation, and each Hyper-V server is known as a
Host (Portnoy, 2012). The Windows Server.
20810chapter Information Systems Sourcing .docxRAJU852744
208
10
chapter Information Systems
Sourcing
After 13 years, Kellwood, an American apparel maker, ended its soups!to!nuts IS outsourcing
arrangement with EDS . The primary focus of the original outsourcing contract was to integrate
12 individually acquired units with different systems into one system. Kellwood had been satis-
" ed enough with EDS ’ s performance to renegotiate the contract in 2002 and 2008, even though
at each renegotiation point, Kellwood had considered bringing the IS operations back in house,
or backsourcing. The 2008 contract iteration resulted in a more # exible $105 million contract that
EDS estimated would save Kellwood $2 million in the " rst year and $9 million over the remaining
contract years. But the situation at Kellwood had changed drastically. In 2008, Kellwood had been
purchased by Sun Capital Partners and taken private. The chief operating of" cer (COO), who was
facing a mountain of debt and possibly bankruptcy, wanted to consolidate and bring the operations
back in house to give some order to the current situation and reduce costs. Kellwood was suffering
from a lack of IS standardization as a result of its many acquisitions. The chief information of" cer
(CIO) recognized the importance of IS standardization and costs, but she was concerned that the
transition from outsourcing to insourcing would cause serious disruption to IS service levels and
project deadlines if it went poorly. Kellwood hired a third!party consultant to help it explore the
issues and decided that backsourcing would save money and respond to changes caused by both the
market and internal forces. Kellwood decided to backsource and started the process in late 2009. It
carefully planned for the transition, and the implementation went smoothly. By performing stream-
lined operations in house, it was able to report an impressive $3.6 million savings, or about 17% of
annual IS expenses after the " rst year. 1
The Kellwood case demonstrates a series of decisions made in relation to sourcing. Both the
decision to outsource IS operations and then to bring them back in house were based on a series of
This chapter is organized around decisions in the Sourcing Decision Cycle. The ! rst question
regarding information systems (IS) in the cycle relates to the decision to make (insource) or
buy (outsource) them. This chapter ’ s focus is on issues related to outsourcing whereas issues
related to insourcing are discussed in other chapters of this book. Discussed are the critical
decisions in the Sourcing Decision Cycle: how and where (cloud computing, onshoring,
offshoring). When the choice is offshoring, the next decision is where abroad (farshoring,
nearshoring, or captive centers). Explored next in this chapter is the ! nal decision in the
cycle, keep as is or change in which case the current arrangements are assessed and modi-
! cations are made to the outsourcing arrangem.
21720201Chapter 14Eating and WeightHealth Ps.docxRAJU852744
2/17/2020
1
Chapter 14
Eating and Weight
Health Psychology (PSYC 172)
Professor: Andrea Cook, PhD
February 18, 2020
The Digestive System
– Food nourishes the body by providing energy for
activity
– Digestion begins in the mouth
• Salivary glands provide moisture that allows food to
have taste
• Importance of good mastication
The Digestive System
The Digestive System
– Food is swallowed and then moves through the
pharynx and esophagus
– Peristalsis moves food through the digestive
system
– In the stomach, food is mixed with gastric juices
so it can be absorbed by the small intestine
– Most nutrients are digested in the small intestine
– Digestion process is complete when waste is
eliminated
The Digestive System, Continued
2/17/2020
2
Microbiome
4YouTube: What is the human microbiome?
Supporting the Gut Microbiome
Dysbiosis = unbalanced gut microbiome
• associated with weight gain, insulin resistance,
inflammation
Probiotics
• contain live microorganisms
• maintain or improve the "good" bacteria (normal microflora)
in the body
• e.g., fermented foods, yogurt, sauerkraut, kimchi
Prebiotics
• act as food for human microflora
• helps improve microflora balance
• e.g., whole grains, bananas, greens, onions, garlic
5
https://www.mayoclinic.org/healthy-lifestyle/consumer-health/expert-
answers/probiotics/faq-20058065
Supporting the Gut Microbiome
Medication overuse
• anti-inflammatories, antibiotics, acid blocking drugs, and
steroids damage gut or block normal digestive function
Stress
• chronic stress alters the normal bacteria in the gut
Lifestyle
• plenty of fiber, water, exercise and rest
Healthy Defecation
• three bowel movements a day to three each week
• no intestinal pain or bloating
• no straining
6
https://drhyman.com/blog/2014/10/10/tend-inner-garden-gut-flora-may-
making-sick/
2/17/2020
3
Bristol Stool Chart
7
Factors in Weight Maintenance
– Stable weight occurs when calories eaten equal those
expended for body metabolism and physical exercise
[OLD THINKING]
– Complicated interplay of nutrients, hormones, and
inflammation
• Metabolic rates differ from person to person
• Ghrelin, a hormone, stimulates appetite
• Leptin, a protein, signals satiation and fat storage
• Insulin, a hormone produced in pancreas
– unlocks cells for glucose use for energy
– cues hypothalamus for satiation and decreased appetite
Factors in Weight Maintenance
What is obesity?
– Overeating is not the sole cause of obesity
– Various methods to assess body fat
• Skin-fold technique
• Percentage body fat
• Body mass index (BMI)
– Can also be thought of in terms of social and
cultural standards
– ideal body = thinner in past 50 years
What is Obesity?
2/17/2020
4
BMI
10
– Obesity rates have increased, especially
“extreme” obesity
• past 30 years obesity rates have nearly doubled to
600 million
• 37.8% of US adults are obese and an additional 32.6%
are over.
2020/2/21 Critical Review #2 - WebCOM™ 2.0
https://smc.grtep.com/index.cfm/smcc/page/2criticalreviews 1/10
Santa Monica College Democracy and Di�erence Through the Aesthetics
of Film
Tahvildaran
Assignment Objectives: Enhance and/or improve critical thinking and
media literacy skills by:
1. Developing a clear and concise thesis statement (an
argument) in response to the
following question: Does the �lm have the power to
transform political sensibilities?
2. Writing an outline for a �ve paragraph analytical essay
building on a clear and
concise thesis statement, including topic sentences and
secondary supports.
3. Identifying and explaining three scenes from the �lm text in
support of the thesis
statement/argument.
4. Writing an introductory paragraph for the outlined analytical
essay
Be sure to read thoroughly the writing conventions below before beginning this
assignment.
Note: You are NOT writing a full essay; rather, you are outlining an analytical
essay by completing the dialogue in the boxes below.
Writing a Critical Review (analytical) Essay
2020/2/21 Critical Review #2 - WebCOM™ 2.0
https://smc.grtep.com/index.cfm/smcc/page/2criticalreviews 2/10
1. Every essay that you write for this course must have a clear thesis, placed
(perhaps) somewhere near the end of the introductory paragraph. Simply
stated, a THESIS (or ARGUMENT) expresses, preferably in a single sentence,
the point you want to make about the text that is the subject of your essay. A
THESIS should be an opinion or interpretation of the text, not merely a fact or
observation. The best possible THESIS will answer some speci�c questions
about the text. Very often the THESIS contains an outline of the major points
to be covered in the essay. A possible thesis for an essay on character in
Perry Henzell’s The Harder They Come might read somewhat as follows:
The protagonist of THTC is not a hero in the epic sense of the word, but a
self-centered young man bred of economic oppression and cultural
dependency. The characters in this �lm have no real psychological depth, but
are markers for a society of consumption and momentary glory.
(You might then go on to exemplify from the text and argue in favor or
against this interpretation: your essay need not hold to only one perspective.)
What single, clear QUESTION does the above THESIS attempt to answer?
2. Each essay should be organized into �ve (5) paragraphs, each based on one
of two to four major ideas, which will comprise the BODY of the essay. Each
paragraph must have a topic sentence, often (but not always) towards the
beginning of the paragraph, which clearly states the ARGUMENT or point to
be made in the paragraph. Following the thesis set forth.
Read| The latest issue of The Challenger is here! We are thrilled to announce that our school paper has qualified for the NATIONAL SCHOOLS PRESS CONFERENCE (NSPC) 2024. Thank you for your unwavering support and trust. Dive into the stories that made us stand out!
Unit 8 - Information and Communication Technology (Paper I).pdfThiyagu K
This slides describes the basic concepts of ICT, basics of Email, Emerging Technology and Digital Initiatives in Education. This presentations aligns with the UGC Paper I syllabus.
Honest Reviews of Tim Han LMA Course Program.pptxtimhan337
Personal development courses are widely available today, with each one promising life-changing outcomes. Tim Han’s Life Mastery Achievers (LMA) Course has drawn a lot of interest. In addition to offering my frank assessment of Success Insider’s LMA Course, this piece examines the course’s effects via a variety of Tim Han LMA course reviews and Success Insider comments.
Francesca Gottschalk - How can education support child empowerment.pptxEduSkills OECD
Francesca Gottschalk from the OECD’s Centre for Educational Research and Innovation presents at the Ask an Expert Webinar: How can education support child empowerment?
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.
Embracing GenAI - A Strategic ImperativePeter Windle
Artificial Intelligence (AI) technologies such as Generative AI, Image Generators and Large Language Models have had a dramatic impact on teaching, learning and assessment over the past 18 months. The most immediate threat AI posed was to Academic Integrity with Higher Education Institutes (HEIs) focusing their efforts on combating the use of GenAI in assessment. Guidelines were developed for staff and students, policies put in place too. Innovative educators have forged paths in the use of Generative AI for teaching, learning and assessments leading to pockets of transformation springing up across HEIs, often with little or no top-down guidance, support or direction.
This Gasta posits a strategic approach to integrating AI into HEIs to prepare staff, students and the curriculum for an evolving world and workplace. We will highlight the advantages of working with these technologies beyond the realm of teaching, learning and assessment by considering prompt engineering skills, industry impact, curriculum changes, and the need for staff upskilling. In contrast, not engaging strategically with Generative AI poses risks, including falling behind peers, missed opportunities and failing to ensure our graduates remain employable. The rapid evolution of AI technologies necessitates a proactive and strategic approach if we are to remain relevant.
1. 17
Barbara Fletcher, RN, MN, FAAN
Clinical Associate Professor
University of North Florida, Department
of Nursing
Jacksonville Beach, Florida
Meg Gulanick, PhD, RN
Associate Professor
Niehoff School of Nursing
Loyola University Chicago
Chicago, Illinois
Cindy Lamendola, RN, MSN, ANP
Adult Nurse Practitioner, Division of
Endrocrinology
Stanford University School of Medicine
Stanford, California
Genetic, environmental, and metabolic risk factors are
interrelated and contribute to the
development of type 2 diabetes mellitus. A strong family
history of diabetes mellitus, age, obesity,
and physical inactivity identify those individuals at highest risk.
Minority populations are also at
higher risk, not only because of family history and genetics, but
also because of adaptation to
American environmental influences of poor dietary and exercise
habits. Women with a history of
2. gestational diabetes as well as their children are at greater risk
for progressing to type 2 diabetes
mellitus. Insulin resistance increases a person’s risk for
developing impaired glucose tolerance and
type 2 diabetes. Individuals who have insulin resistance share
many of the same risk factors as
those with type 2 diabetes. These include hyperinsulinemia,
atherogenic dyslipidemia, glucose
intolerance, hypertension, prothrombic state, hyperuricemia,
and polycystic ovary syndrome. Cur-
rent interventions for the prevention and retardation of type 2
diabetes mellitus are those targeted
towards modifying environmental risk factors such as reducing
obesity and promoting physical
activity. Awareness of risk factors for developing type 2
diabetes will promote screening, early de-
tection, and treatment in high-risk populations with the goal of
decreasing both microvascular and
macrovascular complications. Key words: environmental
factors, lifestyle, risk factors, type 2
diabetes
tries are at much higher risk. Ethnicity, ge-
netics, and lifestyle play an important role
in determining a person’s risk factors for
type 2 diabetes. The importance of risk fac-
tor identification is to promote diabetes
screening to initiate prevention measures.
Early detection and treatment of type 2
diabetes enhances prevention of micro-
vascular and macrovascular complications
associated with this disease.
Several terms require definition as a
basis for this article. Risk factors are those
aspects of an individual’s lifestyle, envi-
4. interrelationships are depicted in Fig 1.
Groups at highest risk are those persons
with a strong family history, persons of
older age, those who are obese, and those
who are physically inactive. Type 2 dia-
betes is known to be more predominant in
the Native American, Hispanic American,
African American, Pacific Islander, and
Asian American populations versus those
from European descent.2 Since type 2 dia-
betes is characterized by insulin resis-
tance, people with this disease have the as-
sociated metabolic abnormalities, such as
hypertension, elevated triglycerides, and
low HDL cholesterol, that are also identi-
fied as risks factors for type 2 diabetes.3
Women with a history of gestational dia-
betes mellitus, or who delivered a baby
weighing more than 9 lbs., have greater
risk for developing type 2 diabetes as well
as persons with impaired glucose toler-
ance (IGT) or impaired fasting glucose
(IFG).1,2,4 The greater the number of risk
factors an individual has, the greater the
chance of developing type 2 diabetes and
its associated complications. This article
will highlight the more traditional risk fac-
tors for diabetes.
FAMILY HISTORY
5. It is well accepted that type 2 diabetes is
an inherited condition. Though a specific
gene has yet to be found, the nearly 100%
concordance rates of diabetes seen in iden-
tical twins, the aggregation in families, and
the high rates seen in ethnic and racial
populations lend strong support for this
hypothesis. The Framingham Offspring
Study found that the risk for type 2 dia-
betes among offspring with a single parent
with diabetes was 3.5 fold greater, and for
18 THE JOURNAL OF CARDIOVASCULAR
NURSING/JANUARY 2002
Fig 1. Risk factors for developing type 2 diabetes mellitus and
the metabolic abnormalities associ-
ated with insulin resistance. Note: * GDM (gestational diabetes
mellitus) may be influenced by ge-
netics, lifestyle, insulin resistance, or a combination thereof.
Source: Data from American Diabetes
Association, Clinical Practice Recommendations 2001, vol. 24:
S21–S24.
Article 2 11/21/01 7:19 PM Page 18
those with two diabetic parents was 6-fold
greater when compared with offspring
without parental diabetes.5 No differences
were noted in maternal versus paternal
risk of transmission, though interestingly
the offspring with maternal diabetes were
more likely to have milder forms of glu-
cose intolerance as compared to paternal
6. transmission.
AGE
Type 2 diabetes has been known for
years as “adult onset,” or “maturity-onset,”
emphasizing that the prevalence of type
2 diabetes increases with age. Of persons
65 years or older, 18.4% of all people in this
age group have diabetes.1 Many surveys re-
port a leveling off or slight decline at age 75
or greater.6 It is noteworthy that in the past,
the age of 45 years has been used as an im-
portant cut-off point in estimating the
prevalence of diabetes. However, in the last
eight years, younger adults between the
ages of 30–39 have had a startling 70% rise
in type 2 diabetes.1 Rates for the next age
group, 40– 49 years, rose a dramatic 40%.
These startling statistics are blamed on cur-
rent lifestyle patterns that result in excess
body weight and less physical activity.
RACIAL/ ETHNIC
Minorities in the United States exhibit
higher prevalence for diabetes (2–6 times
greater than that of white persons)7. The
Third National Health and Nutrition Sur-
vey—1988–1994 (NHANES III) showed the
prevalence rate of diabetes to be 1.7 times
higher for non-Hispanic blacks than for
whites of similar age.1,6 Controlling for obe-
sity did not affect this increased risk.7 One
in four black women aged 55 years or older
has diabetes. This is twice the rate for age
7. matched white women. Black females have
the highest diabetes related deaths com-
pared with other minorities.1
All Hispanic populations, who com-
prise the fastest growing minority popula-
tion in the United States, have greater
prevalence rates of type 2 diabetes than
non-Hispanic whites.6 Statistics vary de-
pending on the communities studied. Over-
all, diabetes prevalence rates for Mexican-
Americans are estimated at 2 to 5 times
that of the non-Hispanic white population,
with the greatest prevalence rates found
for Puerto Ricans and Hispanics living in
the southwest, where half of the adults are
affected in some cities.6–8 Limited data are
available for prevalence rates for Asian
Americans and Pacific Islanders.
According to the Centers for Disease
Control and Prevention (CDC), Native Amer-
icans have a disproportionately higher
prevalence of diabetes—2.8 times that of
whites of similar age.7,9 Indeed, the highest
prevalence of diabetes in the world has
been found among the Pima Indians in
Arizona, where approximately 1 of every
2 adults has type 2 diabetes. The CDC study
of all Native Americans across the United
States conducted between 1990–1997 re-
ported that the prevalence of diabetes in-
creased almost 30% during that time pe-
riod. These increases were evident across
all age groups.9 But even within the high
risk populations differences in rates of
8. type 2 diabetes may vary depending on
modifiable risk factors such as exercise and
weight. For example, the prevalence of
type 2 diabetes is six times higher in the
Pima Indians living in Arizona than the
Pima Indians living in Rural Mexico.
One explanation may be that the mean
body mass index is 8 kg/m2 greater among
the Pima Indians living in Arizona.3
These minority populations are at higher
risk, not simply because of their family
history and genetic heritage, but because
of the increased number of environmental
risk factors they exhibit from having
“westernized” and taken on the American
habits of high calorie diets and sedentary
lifestyle.7,9 Other contributing factors, such
Risk Factors 19
Article 2 11/21/01 7:19 PM Page 19
as lower economic status and access barri-
ers to health care, may negatively impact
these groups.7–8 This remains an under-
studied topic. NHANES III data were ex-
amined for racial and ethnic differences in
health outcomes for persons with type 2
diabetes.10 Though small differences by
race and ethnicity were found in health
care access and utilization, along with
health outcomes, the most striking finding
was the overwhelming suboptimal health
9. status for all diabetics, regardless of race or
ethnicity. Socioeconomic status was not a
major variable; rather a multiplicity of fac-
tors impacted these outcomes.
GESTATIONAL DIABETES MELLITUS
(GDM)
Women who have a history of GDM are at
greater risk for future diabetes as are their
children. Gestational diabetes is defined as
any degree of glucose intolerance with its
onset or first recognition occurring during
pregnancy.11 This definition does not ex-
clude the possibility that undiagnosed glu-
cose intolerance may have preceded the
pregnancy. The incidence of GDM averages
around 4% of all US pregnancies, though
the range is much wider (1–14%) depend-
ing on the racial or ethnic groups studied,
as well as the prevalence of obesity.12–13 The
progression from GDM to diabetes may be
partly explained by more universal screen-
ing and detection along with the trend
for older women to have children.14 The
Nurses Health Study examined pregravid
determinants of GDM. A family history of
diabetes, advanced maternal age, nonwhite
ethnicity, higher BMI, weight gain in early
adulthood, and cigarette smoking were
found to predict a woman’s risk for GDM.13
Rates of progression of GDM to diabetes
varies, with a 5% risk of type 2 diabetes
during the 3–6 month postpartum period,
increasing up to 47% at 5-year follow-
10. up.15 Review of additional studies reported
a 40% occurrence of diabetes at 15 years
in women with prior GDM.1,15 The devel-
opment of postpartum diabetes is influ-
enced by the degree of obesity prior to preg-
nancy, the need for insulin treatment dur-
ing pregnancy, and higher glucose readings
during oral glucose tolerance testing.15 Eth-
nicity also strongly affects progression to
diabetes after a GDM pregnancy, with high-
risk ethnic groups often reporting 50% of
women becoming diabetic within 5 years.14
Of course, the confounding variables of
obesity and physical inactivity reported
in these ethnic groups, as well as in all
women, affect progression to diabetes.
IMPAIRED FASTING GLUCOSE (IFG)
AND IMPAIRED GLUCOSE
TOLERANCE (IGT)
The American Diabetes Association de-
fines IFG and IGT as an intermediate cate-
gory between normoglycemia and diabetes.
Criteria for IFG include individuals with
a fasting blood glucose level of 110 mg/dl
to 125 mg/dl. IGT is determined from a
2 hour oral glucose tolerance test reading of
$140 mg/dl but ,200 mg/dl.11 Individuals
with IGT demonstrate normal glycemic
levels throughout most of their daily lives,
with the metabolic impairment only noted
during glucose tolerance testing. IGT indi-
cates a higher than normal risk of progres-
11. sion to type 2 diabetes, ranging from 2.3 to
11% per year, especially among nonwhite
racial and ethnic groups. Prevalence is
greater among women in each minority
group.6,7,11 Insulin resistance and sub-
sequent IGT are directly involved in the
pathogenesis of diabetes. Data from six
prospective studies among diverse popula-
tions revealed that the strongest predictors
of progression from IGT to type 2 diabetes
were elevated fasting and 2-hour post chal-
lenge glucose levels.16 The detection of IGT
is particularly significant since it signals
long standing insulin resistance and is a
strong risk factor for type 2 diabetes.
INSULIN RESISTANCE
Insulin resistance is a defect in the abil-
ity of insulin to take up glucose into the
20 THE JOURNAL OF CARDIOVASCULAR
NURSING/JANUARY 2002
Article 2 11/21/01 7:19 PM Page 20
muscle cell. Despite being genetically de-
termined, it is greatly aggravated by obesity
and physical inactivity.17 During the initial
phases of insulin resistance, the pancre-
atic beta cells are able to maintain normal
glycemic control through an increased pro-
duction of insulin, thereby making these in-
dividuals hyperinsulinemic.18–19 However,
12. when individuals can no longer maintain
normal glycemia from this compensatory
mechanism, they progress to development
of type 2 diabetes.18
Research suggests that insulin resistance
is a multi-system disorder that is corre-
lated with multiple metabolic abnormali-
ties. It is not surprising that those individu-
als who are insulin resistant share the
same risk factors as those who are at risk
for type 2 diabetes. Indeed, insulin resis-
tance predisposes individuals to both dia-
betes and CVD.18–20 Factors that contribute
to insulin resistance are genetics,21 obe-
sity,22 physical inactivity,23 and age.24 Ab-
dominal obesity often accompanies in-
sulin resistance.25 Although there is a
strong correlation with insulin resistance
and obesity, not all obese people are in-
sulin resistant.26–27 Metabolic risk factors
that commonly occur in persons with
insulin resistance are hyperinsulinemia,
atherogenic dyslipidemia (elevated tri-
glycerides and low HDL-C), glucose intol-
erance, hypertension, prothrombotic state,
hyperuricemia, and polycystic ovary syn-
drome.19,20,28 The clinical picture of insulin
resistance is depicted in Fig l. Refer also to
Quinn’s excellent description of the three
stages of insulin resistance in the pathogen-
esis of type 2 diabetes in the lead article
of this issue.
OBESITY AND PHYSICAL INACTIVITY
13. An estimated 97 million US adults are
overweight (body mass index (BMI 5 25–
29.9 kg/m2) or obese (BMI 30 kg/m2 or . ).29
Despite current recommendations to exer-
cise at a moderate level for 30–45 minutes
on most days of the week, 75% of US
adults engage in minimal physical activity
(such as walking only 15 to 20 minutes a
day on a regular basis) or less.30 These life
habits, along with the aging of the popula-
tion, contribute to the growing prevalence
of diabetes.31 Obesity alone, especially ab-
dominal adiposity, is a major determinant
of the development of type 2 diabetes,
causing it to occur at an earlier age.32 When
obesity is compounded by physical inac-
tivity, the risk for type 2 diabetes dramati-
cally increases.33 People who are obese
and have insulin resistance can increase
insulin sensitivity by weight loss; however
those people who are obese without in-
sulin resistance do not improve their in-
sulin sensitivity with similar weight loss.34
Mechanisms for the improvement in in-
sulin sensitivity with weight loss are com-
plex and not completely understood at this
time.35–36
Limited data in men with type 2 diabetes
show that a low level of physical activity is
an independent predictor of all cause mor-
tality.37– 39 Exercise increases insulin sensi-
tivity and glucose tolerance, as well as im-
14. proves blood lipid profiles in persons with
type 2 diabetes.40– 42 Exercise as an adjunct
to diet yields greater and more sustained
weight loss in obese subjects with type 2
diabetes43 and exercise improves insulin
sensitivity and reduces body weight.44 The
combination of weight loss and exercise
enhances insulin sensitivity and improves
glucose control, thus facilitating the risk
reduction in type 2 diabetes.
In summary, the profile of individuals
most at risk for developing type 2 diabetes
is clear. Although genetic predisposition
exhibits the strongest influence, attention
to the modifiable risk factors is strongly
warranted. It is clear that physical activity
and weight management have a positive
influence on retarding or halting the pro-
gression to type 2 diabetes. As nurses, our
role is to be to be aware of what popula-
tions will be at higher risk for developing
type 2 diabetes and to be proactive in pro-
moting influential lifestyle habits with the
goal of reducing the incidence of IGT and
type 2 diabetes and its complications.
Risk Factors 21
Article 2 11/21/01 7:19 PM Page 21
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Article 2 11/21/01 7:19 PM Page 23
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Task 1: 150 words with reference and link to e-business
Offer enhancements to an existing e-business, explain exactly
how the enhancements would work and describe they are
needed. Provide a link to that e-business.
Forum Reply 1: 100--125 words with reference. Professional
and Critical reply.
Forum Topic:
As our reading make quite clear there are problems with the use
of passwords for security. A long enough password to be truly
hard to use (I once had a 16 digit random generated password.
Anyone think I could remember it?). Passwords short enough to
be usable (typically 8-11 digest) are not very strong. For this
question do not consider badges, tokens or biometrics).
Discussion question:
23. What can we do to make passwords a stronger authentication
mechanism. (Consider length, complexity, character sets,
challenge response etc --- anything but cards, tokens and
biometrics).
Forum Discussion:
Typically, a password’s security has been determined by its
complexity. A password’s complexity is determined by many
factors, namely the variety of characters that are used and the
length of the password. However, the practice of using lengthy
passwords that are comprised of a wide variety of random
characters has largely fallen out of favor. The password
guidelines as defined in the NIST 800-63-3 standard have
removed the requirement for very complicated passwords and
instead recommends that passwords be easier to remember, have
no preset expiration date, and have the ability to use longer
passphrases (Brown, 2019). The previous requirement that
called for complex passwords does not make passwords a very
strong authentication system. This is largely because humans
have difficulties remembering long, randomized strings of
characters, resulting in them writing down the passwords or
having their devices remember the passwords for them (Brown,
2019). In turn, these passwords are even weaker for
authentication purposes. By removing the complexity
requirement and encouraging users to make passphrases that are
memorable, lengthy, and unique, an organization can ensure that
passwords are a much stronger means of authentication.
References
Brown, M. (2019, June 25). Unpacking the NIST Password
Requirements in 2019. Retrieved February 24, 2020, from
https://blog.24by7security.com/unpacking-the-nist-password-
requirements-in-2019
Reply needed for discussion:
Forum Reply 2: 100--125 words with reference. Professional
and Critical reply.
Forum Topic:
24. Describe ONE benefit and ONE risk associated with moving to
cloud computing or services. Next, explain how you would
mitigate that risk.
Forum Discussion:
Many of the risks frequently associated with cloud computing
are not new, and can be found in enterprises today. Well,
planned risk management activities will be crucial in ensuring
that information is simultaneously available and protected
(ISACA). A well-structured risk management methodology,
when used effectively, can help management identify
appropriate controls for providing the mission-essential security
capabilities. In cloud computing environment is available in
several service models and different models have various ways
to mitigate vulnerabilities and threats, as this paper provides a
comprehensive framework for better understanding enterprise
security. Cloud providers can be applied to this framework to
organizations to do risk mitigation.
Cloud providers must development of risk treatment plans with
multiple options (avoidance, transfer, retention, reduction, and
acceptance). The outcomes of risk treatment plans should be
incorporated into service agreements. Because different models
of cloud computing have various ways to mitigate vulnerability
and threat.
REFERENCES
ISACA, “Cloud Computing: Business Benefits with Security,
Governance and Assurance Perspectives,” An ISACA Emerging
Technology White Paper, pp 7
Reply needed for discussion: