Fears and Health Needs of Patients with Diabetes: A Qualitative Research in Rural Population
Maria Papaspurou,1 Vasiliki C. Laschou,2 Paraskevi Partsiopoulou,3 Evangelos C. Fradelos,4 Christos F. Kleisiaris,5 Malamati A. Kalota,6 Anna Neroliatsiou,7 and Ioanna V. Papathanasiou8
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Abstract
Introduction:
Insulin-dependent patients are individuals with chronic disease who are well adapted to living and dealing with any health needs and fears arising. An important aspect in the process of adaptation to chronic illness is the provision of nursing care in the early stages of the disease, because this contributes to its acceptance and the early identification and management of potential complications.
Purpose:
To investigate the health needs and self-management problems faced by patients with diabetes daily, especially those who use insulin. Furthermore, purpose of this study was to investigate the fears experienced by patients in the early stage of the disease, but also in its subsequent development and to study possible differences between sexes.
Methodology:
This is a qualitative study, using interpretative phenomenological approach. Fifteen (nine women and six men) insulin-dependent patients, recounted their personal fears and their needs, through semi-structured interviews, which took place in Central Greece. The method used for processing the results is the Mayering one.
Results:
The analysis of the narratives showed that patients have a variety of fears and needs associated with the diagnosis, treatment, expected consequences, prognosis and everyday life in the management of the disease. Most patients express the concept of need as desire. Care needs, psychological support and education to recognize and prevent hypoglycemia.
Conclusions:
Insulin-dependent patients express fears and needs in their daily lives. Nurses providing care aimed at enhancing the level of health, while putting self-care information and training them. Patients want the nurse next to them, so that information is continuous and permanent.
Keywords: diabetes mellitus, fears, health needs, self-care, nursing care
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1. INTRODUCTION
Patients with type II diabetes, especially insulin-dependent are usually suffering from diabetes several years before the initiation of insulin therapy. Treatment of diabetes has now as a central character, the patient himself who co-decides with the physician-nurse team. The primary concern is the patient’s acceptance of the disease in the early stages and his gradual familiarization with the treatment (1).
According to International Diabetes Federation, at least 285 million people worldwide have diabetes and this number is expected to increase to 438 million by 2030, with two-thirds of all cases living in low or middle income countries (2, 3).
Apart from pharmaceutical care, the nurse also pr.
RunningHead: PICOT Question 1
RunningHead: PICOT Question 7
PICOT Question
Avery Bryan
NRS-433V
Professor Christine Vannelli
May 19, 2019
Clinical Problem
A report from the Center for Disease Control and Prevention in 2015 revealed that (9.4%) 30.3 million Americans are diabetic and 84.1 million have prediabetes. This is a total population of over 100 million is at risk of developing type 2 diabetes which is a growing health problem being the seventh leading cause of death in the U.S. An estimated 1.5 million new cases were among 18-year old bracket and the rates of diagnosed diabetes increased proportionally to age. Below 44 years accounted for 4%, below 64 years at 17 % and 25% for those above 65 years across both genders. One-third of adults in America has prediabetes but sadly, they are unaware despite reports released by The National Diabetes Statistics Report every year. These reports elaborate on prevalence and incidence, prediabetes, long-term complications, risk factors, mortality, and cost. Diabetes poses the risk of serious complications like death, blindness, stroke, kidney disorders, cardiac diseases and health problems that lead to amputation of legs. However, the risks can be mitigated through physical body activities, proper dieting and prescribed use of insulin and other related measures to control the blood sugar levels. Diabetes Prevention Program was funded by NIH to research a yearly evidence-based program to improve healthy weight loss through diet and physical activities. There also efforts to determine the effectiveness of public service campaigns in improving the real-life experience in the diagnosis and treatment of diabetes.
PICOT Question.
The population affected by diabetes cuts across all ages, gender, race, and ethnicity. The prevalence is significantly high from 18 years and it increases with age to about 25% above 65 years. In terms of gender, men are at higher risk accounting for 37% while women are at 30% across races and educational levels. On races, the rates were higher among Indians/Alaska natives at 15%, non-Hispanic blacks at 12.7% and Hispanics at 12%. Among Asians, the rates were lower at 8% and 7.4% for non-Hispanic whites.
Intervention indicator for diabetes shows that individuals who do not observe a healthy diet are more exposed to the disease. Some risk behaviors include lack of exercise and excessive intake of junk foods that lead to obesity and increased blood sugar levels. Diabetes prevalence varied according to education levels were those with less than high school education at 12.6% and 7.2% for those higher than high school education.
Comparison and use of a control group from the popularity of Complementary and Alternative Medicine and Traditional Chinese Medicine showed distinct knowledge of diabetes, blood sugar control, and self-care. The experimental group received education through interactive multimedia for three months while the control group received.
Australian Journal of Adult LearningVolume 57, Number 3, Nov.docxcelenarouzie
Australian Journal of Adult Learning
Volume 57, Number 3, November 2017
Learning to live with chronic illness in later life:
Empowering myself
Alexandra Withnall
University of Warwick, UK
Type 2 Diabetes is both an incurable illness and a hidden disability that
has reached epidemic proportions on a global scale. It has obviously
spawned a huge clinical literature, but no scholarly accounts of learning
to live with the illness on a daily basis from a feminist perspective.
As an older woman, I have made use of a somewhat controversial
autoethnographical approach to explore how far I consider myself
empowered to live with, and manage this condition for the rest of
my life. Self-management is an idea that is central to both the United
Kingdom (UK) National Health Service (NHS) philosophy of supporting
patient choice and within a feminist perspective on health care. Learning
to identify, access and use the necessary resources to manage my
condition suggests that there are regional differences within the UK as to
how much practical care diabetes patients are offered or can access. The
paternalistic nature of the health care team/patient relationship appears
to militate against the concept of patient empowerment.
Keywords: diabetes, autoethnography, feminism, learning, self-care,
lifestyle.
Learning to live with chronic illness in later life: Empowering myself 475
Introduction
As awareness of ageing populations grows across the world, enjoying a
sense of physical and mental well-being by remaining active in society
and retaining independence for as long as possible have come to be
seen as desirable aims. Adult educators have been especially persuasive
in emphasising the importance of continuing to learn throughout life
as an essential ingredient of healthy ageing. Indeed, there is growing
international evidence that learning in later life offers a whole range
of benefits not only to individual learners as they age but also to their
families, their communities and to the societies in which they live. Yet
we know that for many people, the later years can bring varying degrees
of ill health and the chances of growing older in good health vary greatly
between countries. From a European perspective, it is fortunate that
most people can generally still expect a good standard of health care in
later life. Nevertheless, poor health in later life can be compounded by
isolation or increasing poverty as well as by inequalities in accessing
good quality health care.
What is surprising is that those involved in researching or facilitating
later life learning rarely contemplate their own ageing or consider what
it might mean to be forced to live with an illness or disability as they
grow older. Yet as people approach their later years, some degree of
change in well-being is inevitable. Understanding the nature of such
changes is important in helping to cope with the challenges of daily life
and with maintaining a.
A study on awareness of diabetic complications among type 2 diabetes patientsiosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Health Seeking Behaviors following Diabetes Mellitus of Various Ethnic Groups...ijtsrd
The research on Health Seeking Behaviours following Diabetes Mellitus DM of various ethnic groups was conducted because different patients within a given ethnic group or cultural group have different options regarding actions to seek health care services. The purpose of this study was to determine the Health Seeking Behaviours HSB following DM patients from various ethnic groups and the roles of the Health Psychologists HP on the DM patients in Nkwen Health District of Bamenda III Subdivision within Mezam Division of the North West Region of Cameroon. A descriptive survey research design was conducted among 230 sampled DM patients from various ethnic groups in Nkwen Health District. A non probability purposive sampling technique was used to set the population under study. The data was collected using both Focus Groups Discussions FGDs and questionnaire for a period of two months during the period that the DM patients came to Nkwen Health District either to consult or to refill their drugs. The questionnaire were administered to 230 DM patients from the various ethnic groups which were Bali, Bafut, Banso, Bamendankwe, Babanki, Santa, Nkwen and Ndu during this period as well.. The data collected was analysed using both descriptive and inferential statistics with SPSS software tool version 20.0, following the objectives of the study. For HSB, 38.3 agreed that they sought health care from traditional medicine whereas 26.1 remained neutral on traditional medicine. On the other hand, 37.7 disagreed that they used traditional medicine. Cultural believes and distance deterred HSB which were statistically significant with P = 0.001 and P= 0.001 respectively. The options taken to seek health care from the hospital were influenced by family relatives with P=0.001. Therefore, HSB was found to be statistically significant for the first traditional medicine and second line hospital among the different ethnic groups with P = 0.001 and 0.001 respectively. These results showed that poor HSB following DM among the different ethnic groups was statistically significant in Nkwen Health District. Foncham Paul Babila "Health-Seeking Behaviors following Diabetes Mellitus of Various Ethnic Groups in Nkwen Health District of Bamenda III Subdivision, Mezam Division, North West Region of Cameroon" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-6 | Issue-5 , August 2022, URL: https://www.ijtsrd.com/papers/ijtsrd51783.pdf Paper URL: https://www.ijtsrd.com/humanities-and-the-arts/psychology/51783/healthseeking-behaviors-following-diabetes-mellitus-of-various-ethnic-groups-in-nkwen-health-district-of-bamenda-iii-subdivision-mezam-division-north-west-region-of-cameroon/foncham-paul-babila
RunningHead: PICOT Question 1
RunningHead: PICOT Question 7
PICOT Question
Avery Bryan
NRS-433V
Professor Christine Vannelli
May 19, 2019
Clinical Problem
A report from the Center for Disease Control and Prevention in 2015 revealed that (9.4%) 30.3 million Americans are diabetic and 84.1 million have prediabetes. This is a total population of over 100 million is at risk of developing type 2 diabetes which is a growing health problem being the seventh leading cause of death in the U.S. An estimated 1.5 million new cases were among 18-year old bracket and the rates of diagnosed diabetes increased proportionally to age. Below 44 years accounted for 4%, below 64 years at 17 % and 25% for those above 65 years across both genders. One-third of adults in America has prediabetes but sadly, they are unaware despite reports released by The National Diabetes Statistics Report every year. These reports elaborate on prevalence and incidence, prediabetes, long-term complications, risk factors, mortality, and cost. Diabetes poses the risk of serious complications like death, blindness, stroke, kidney disorders, cardiac diseases and health problems that lead to amputation of legs. However, the risks can be mitigated through physical body activities, proper dieting and prescribed use of insulin and other related measures to control the blood sugar levels. Diabetes Prevention Program was funded by NIH to research a yearly evidence-based program to improve healthy weight loss through diet and physical activities. There also efforts to determine the effectiveness of public service campaigns in improving the real-life experience in the diagnosis and treatment of diabetes.
PICOT Question.
The population affected by diabetes cuts across all ages, gender, race, and ethnicity. The prevalence is significantly high from 18 years and it increases with age to about 25% above 65 years. In terms of gender, men are at higher risk accounting for 37% while women are at 30% across races and educational levels. On races, the rates were higher among Indians/Alaska natives at 15%, non-Hispanic blacks at 12.7% and Hispanics at 12%. Among Asians, the rates were lower at 8% and 7.4% for non-Hispanic whites.
Intervention indicator for diabetes shows that individuals who do not observe a healthy diet are more exposed to the disease. Some risk behaviors include lack of exercise and excessive intake of junk foods that lead to obesity and increased blood sugar levels. Diabetes prevalence varied according to education levels were those with less than high school education at 12.6% and 7.2% for those higher than high school education.
Comparison and use of a control group from the popularity of Complementary and Alternative Medicine and Traditional Chinese Medicine showed distinct knowledge of diabetes, blood sugar control, and self-care. The experimental group received education through interactive multimedia for three months while the control group received.
Australian Journal of Adult LearningVolume 57, Number 3, Nov.docxcelenarouzie
Australian Journal of Adult Learning
Volume 57, Number 3, November 2017
Learning to live with chronic illness in later life:
Empowering myself
Alexandra Withnall
University of Warwick, UK
Type 2 Diabetes is both an incurable illness and a hidden disability that
has reached epidemic proportions on a global scale. It has obviously
spawned a huge clinical literature, but no scholarly accounts of learning
to live with the illness on a daily basis from a feminist perspective.
As an older woman, I have made use of a somewhat controversial
autoethnographical approach to explore how far I consider myself
empowered to live with, and manage this condition for the rest of
my life. Self-management is an idea that is central to both the United
Kingdom (UK) National Health Service (NHS) philosophy of supporting
patient choice and within a feminist perspective on health care. Learning
to identify, access and use the necessary resources to manage my
condition suggests that there are regional differences within the UK as to
how much practical care diabetes patients are offered or can access. The
paternalistic nature of the health care team/patient relationship appears
to militate against the concept of patient empowerment.
Keywords: diabetes, autoethnography, feminism, learning, self-care,
lifestyle.
Learning to live with chronic illness in later life: Empowering myself 475
Introduction
As awareness of ageing populations grows across the world, enjoying a
sense of physical and mental well-being by remaining active in society
and retaining independence for as long as possible have come to be
seen as desirable aims. Adult educators have been especially persuasive
in emphasising the importance of continuing to learn throughout life
as an essential ingredient of healthy ageing. Indeed, there is growing
international evidence that learning in later life offers a whole range
of benefits not only to individual learners as they age but also to their
families, their communities and to the societies in which they live. Yet
we know that for many people, the later years can bring varying degrees
of ill health and the chances of growing older in good health vary greatly
between countries. From a European perspective, it is fortunate that
most people can generally still expect a good standard of health care in
later life. Nevertheless, poor health in later life can be compounded by
isolation or increasing poverty as well as by inequalities in accessing
good quality health care.
What is surprising is that those involved in researching or facilitating
later life learning rarely contemplate their own ageing or consider what
it might mean to be forced to live with an illness or disability as they
grow older. Yet as people approach their later years, some degree of
change in well-being is inevitable. Understanding the nature of such
changes is important in helping to cope with the challenges of daily life
and with maintaining a.
A study on awareness of diabetic complications among type 2 diabetes patientsiosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Health Seeking Behaviors following Diabetes Mellitus of Various Ethnic Groups...ijtsrd
The research on Health Seeking Behaviours following Diabetes Mellitus DM of various ethnic groups was conducted because different patients within a given ethnic group or cultural group have different options regarding actions to seek health care services. The purpose of this study was to determine the Health Seeking Behaviours HSB following DM patients from various ethnic groups and the roles of the Health Psychologists HP on the DM patients in Nkwen Health District of Bamenda III Subdivision within Mezam Division of the North West Region of Cameroon. A descriptive survey research design was conducted among 230 sampled DM patients from various ethnic groups in Nkwen Health District. A non probability purposive sampling technique was used to set the population under study. The data was collected using both Focus Groups Discussions FGDs and questionnaire for a period of two months during the period that the DM patients came to Nkwen Health District either to consult or to refill their drugs. The questionnaire were administered to 230 DM patients from the various ethnic groups which were Bali, Bafut, Banso, Bamendankwe, Babanki, Santa, Nkwen and Ndu during this period as well.. The data collected was analysed using both descriptive and inferential statistics with SPSS software tool version 20.0, following the objectives of the study. For HSB, 38.3 agreed that they sought health care from traditional medicine whereas 26.1 remained neutral on traditional medicine. On the other hand, 37.7 disagreed that they used traditional medicine. Cultural believes and distance deterred HSB which were statistically significant with P = 0.001 and P= 0.001 respectively. The options taken to seek health care from the hospital were influenced by family relatives with P=0.001. Therefore, HSB was found to be statistically significant for the first traditional medicine and second line hospital among the different ethnic groups with P = 0.001 and 0.001 respectively. These results showed that poor HSB following DM among the different ethnic groups was statistically significant in Nkwen Health District. Foncham Paul Babila "Health-Seeking Behaviors following Diabetes Mellitus of Various Ethnic Groups in Nkwen Health District of Bamenda III Subdivision, Mezam Division, North West Region of Cameroon" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-6 | Issue-5 , August 2022, URL: https://www.ijtsrd.com/papers/ijtsrd51783.pdf Paper URL: https://www.ijtsrd.com/humanities-and-the-arts/psychology/51783/healthseeking-behaviors-following-diabetes-mellitus-of-various-ethnic-groups-in-nkwen-health-district-of-bamenda-iii-subdivision-mezam-division-north-west-region-of-cameroon/foncham-paul-babila
Running head CREATING A PLAN OF CARE .docxsusanschei
Running head: CREATING A PLAN OF CARE 1
CREATING A PLAN OF CARE 10
Creating a Plan of Care
South University
NSG4055 Illness & Disease Management across Life Span
Professor
Creating a Plan of Care
The chronic disease selected for the plan of care is cardiovascular disease. This disease continues to pose major challenges not only for patients and their family members but also to the nation’s health care system. The rationale for choosing cardiovascular disease is because of the high rates of mortality and the effects of the co-morbidities associated with the chronic illness. According to Santulli (2013), cardiovascular disease is the single leading cause of fatalities in the United States, accounting for approximately 600,000 deaths annually. In 2011, approximately 26.6 million Americans were living with the chronic disease. The health care costs associated with the disease account for more than $500 billion annually. There are also many disparities in prevalence of risk factors, mortality, access to treatment and treatment outcomes based on race/ethnicity, socioeconomic status, gender, age and geographic area. Hence, tackling the disease should be a major priority for the US government. The main objective of the Healthy People 2020 initiative for cardiovascular disease is “improving cardiovascular health through early detection, prevention and treatment of the risk factors for stroke and heart attack”. This report outlines a comprehensive plan of care that can help in addressing and mitigating cardiovascular disease.
Holistic Plan of Care
Creating a holistic plan of care will indeed be essential for ensuring that people with chronic conditions such as cardiovascular disease lead a healthy life. Cardiovascular disease has a significant impact on the patient and the health care system. Apart from the emotional distress, patients with this condition also face some financial burdens, social burdens and increased levels of discrimination (Earnshaw & Quinn, 2012). In the course of completing the project, I administered a questionnaire to a coworker by the initials C.K. during week 2 to find out how she deals with the condition.
The questionnaire looked into various aspects such as family history, related medical conditions, the risk factors of cardiovascular disease, lifestyle choices and the coping strategies or support received by the patient. Understanding all these aspects can help in developing a well-managed care plan (Larsen & Lubkin, 2013). The results of the questionnaire revealed that C.K. observes healthy lifestyle, has the right levels of support and adheres to the medication regimen. All these factors helped her to cope effectively with the condition. However, even though she attested to leading a healthy lifestyle, C.K. also revealed that her family faced s ...
How useful are advance directives in directing end of life care and do people really understand or want to know the true status of their health as the end nears?
Patient Directed Care; Why it’s important and what does it really mean?Spectrum Health System
Understanding the importance of effective patient centered communication for patient engagement and improved health outcomes. Will discuss the importance of patient directed care and its relationship to the quadruple aim. Will discuss the barriers and a framework for conversations that are critical to patient directed care and cultural competency.
Ethical consideration is important in nursing practice, especial.docxdebishakespeare
Ethical consideration is important in nursing practice, especially when providing care to patients from diverse sociocultural backgrounds. The population of the United States comprises various ethnic/racial groups with different cultural and social beliefs, practice, norms, and values. There is an increasing disparities on the incidence and prevalence of type 2 diabetes among different communities in the United States. According to the Center for Disease Control and Prevention (CDC), Hispanics and African Americans have the highest incidence and prevalence of type 2 diabetes in the country (Concha, Mayer, Mezuk, & Avula, 2016). Caring for patients from different ethnic/racial groups require consideration of ethical principles and concepts to prevent ethical issues that may arise during nurse-patient interaction.
Recently, I cared for patient with type 2 diabetes mellitus who had been hospitalized for more than two weeks due to acute hypertension, partial loss of vision. Also, the patient had a chronic diabetic foot ulcer. The analysis of his medical history revealed that the diabetic foot ulcer had developed in the last two years and had never healed. The patient was so worried about his health status and kept asking when he was going to be discharged from the hospital. The patient came from the Hispanic community, which is one of minority groups with the highest incidence and prevalence of type 2 diabetes mellitus in the country. Being a culturally competent registered nurse, I had an obligation to take into account the specific ethnic background of the patient when providing care. Considering patient’s ethnic/racial background is important in providing quality, holistic, and patient-centered care based their health concerns, preferences, and values (Concha et al., 2016).
When collecting subjective data for analysis and planning for the care. I asked the patient about his perceptions about the possible causes of type 2 diabetes that he was suffering from. Hispanics have different beliefs in the causation of diabetes mellitus (Frieden, 2016). First, the patient believed that diabetes is a temporary condition that is not fatal. Second, the patient narrated a story that attempts to identify the cause of diabetes and concluded that they believe that people with “good diabetes” do not experience a lot of complications. The Hispanics use the term “good diabetes” when referring to the type of diabetes that do not require insulin for therapeutic purposes; non-insulin-dependent diabetes mellitus (T2DM) (Frieden, 2016). Also, the patient had a fatalistic attitude and believed that his health condition is likely to be a punishment from God.
The patient had a low health literacy level because caregivers had encouraged him to engage in some physical exercise and adopt a self-management approach as a way of controlling and preventing complications related to his condition, but he never implemented them. Also, the pat.
Global Medical Cures™ | Epilepsy
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Feedback Assignment Set 4Great job on this assignment. I know yo.docxmglenn3
Feedback Assignment Set 4
Great job on this assignment. I know you know how to do WACC. I am not sure if you rushed on th second answer or if it was a typo but you did give an incorrect answer.
30 (30%)
Points Range:27 (27%) - 30 (30%)
Thoroughly calculated Bad Boys, Inc.'s cost of capital.
Feedback:
Great job showing your work and getting correct answer.
23.7 (23.7%)
Points Range:21 (21%) - 23.7 (23.7%)
Partially calculated Bad Boys, Inc.'s cost of capital.
Feedback:
In this section you provided the wrong answer.
30 (30%)
Points Range:27 (27%) - 30 (30%)
Thoroughly identified two corporations that have dealt with cannibalization and what steps were taken to overcome cannibalization. Thoroughly provided citations and references.
Feedback:
Great job explaining cannibalization and giving examples.
10 (10%)
Points Range:9 (9%) - 10 (10%)
0-2 errors present
Feedback:
no errors detected.
C y b e r A t t a c k s
“Dr. Amoroso’s fi fth book Cyber Attacks: Protecting National Infrastructure outlines the chal-
lenges of protecting our nation’s infrastructure from cyber attack using security techniques
established to protect much smaller and less complex environments. He proposes a brand
new type of national infrastructure protection methodology and outlines a strategy presented
as a series of ten basic design and operations principles ranging from deception to response.
The bulk of the text covers each of these principles in technical detail. While several of these
principles would be daunting to implement and practice they provide the fi rst clear and con-
cise framework for discussion of this critical challenge. This text is thought-provoking and
should be a ‘must read’ for anyone concerned with cybersecurity in the private or government
sector.”
— Clayton W. Naeve, Ph.D. ,
Senior Vice President and Chief Information Offi cer,
Endowed Chair in Bioinformatics,
St. Jude Children’s Research Hospital,
Memphis, TN
“Dr. Ed Amoroso reveals in plain English the threats and weaknesses of our critical infra-
structure balanced against practices that reduce the exposures. This is an excellent guide
to the understanding of the cyber-scape that the security professional navigates. The book
takes complex concepts of security and simplifi es it into coherent and simple to understand
concepts.”
— Arnold Felberbaum ,
Chief IT Security & Compliance Offi cer,
Reed Elsevier
“The national infrastructure, which is now vital to communication, commerce and entertain-
ment in everyday life, is highly vulnerable to malicious attacks and terrorist threats. Today, it
is possible for botnets to penetrate millions of computers around the world in few minutes,
and to attack the valuable national infrastructure.
“As the New York Times reported, the growing number of threats by botnets suggests that
this cyber security issue has become a serious problem, and we are losing the war against
these attacks.
.
Feedback Financial Research Report Part 1Thank you for redoing a.docxmglenn3
Feedback Financial Research Report Part 1
Thank you for redoing assignment so quickly. The only area that I see that you can add more that may help along the second section of your paper is your client profile section. I have made notes above for your review.
30 (30%)
Points Range:27 (27%) - 30 (30%)
Thoroughly provided a rationale for the stock that you selected, indicating the significant economic, financial, and other factors that led you to consider this stock.
Feedback:
Great job providing economic and financial factors.
26.7 (26.7%)
Points Range:24 (24%) - 26.7 (26.7%)
Satisfactorily suggested the primary reasons why the selected stock is a suitable investment for your client. Satisfactorily included a description of your client’s profile.
Feedback:
In this section you can provide more about the client. You stated what he is looking for but you did not state if client is married. You did not state if client has other liabilities that he is paying or what his overall financial situation is.
20.7 (20.7%)
Points Range:0 (0%) - 20.7 (20.7%)
No references provided
Feedback:
In this section you have reference but you do not have an annotated bibliography. It is incorrect.
10 (10%)
Points Range:9 (9%) - 10 (10%)
0-2 errors present
Feedback:
No errors detected.
Grading for this assignment will be based on answer quality, logic / organization of the paper, and language and writing skills, using the following rubric.
Points: 100
Assignment 1: Financial Research Report Part 1
Criteria
Unacceptable
Below 70% F
Fair
70-79% C
Proficient
80-89% B
Exemplary
90-100% A
1. Provide a rationale for the stock that you selected, indicating the significant economic, financial, and other factors that led you to consider this stock.
Weight: 30%
Did not submit or incompletely provided a rationale for the stock that you selected, indicating the significant economic, financial, and other factors that led you to consider this stock.
Partially provided a rationale for the stock that you selected, indicating the significant economic, financial, and other factors that led you to consider this stock.
Satisfactorily provided a rationale for the stock that you selected, indicating the significant economic, financial, and other factors that led you to consider this stock.
Thoroughly provided a rationale for the stock that you selected, indicating the significant economic, financial, and other factors that led you to consider this stock.
2. Suggest the primary reasons why the selected stock is a suitable investment for your client. Include a description of your client’s profile.
Weight: 30%
Did not submit or incompletely suggested the primary reasons why the selected stock is a suitable investment for your client. Did not submit or incompletely included a description of your client’s profile.
Partially suggested the primary reasons why the selected stock is a suitable investment for your client. Partially included a description of your client’s profile.
Satisfacto.
Feedback analysis, limitations of project approach, and conclusions .docxmglenn3
Feedback analysis, limitations of project approach, and conclusions drawn should be included. Discuss any concerns associated with the number of participants or reviewers. Share what your reviewers/participants said in the evaluation tool. Share actual quotes and how you organized the material. What conclusion can you draw from the feedback? Did it confirm or contradict research found in your literature review?
.
Federalist 51To the People of the State of New YorkHow shall .docxmglenn3
Federalist 51
To the People of the State of New York:
How shall we keep the necessary separation of power among the different parts of government? The only answer that is that the parts themselves keep each other in their proper places.
The separate use of different parts of government is needed to save liberty. As such, each department should have its own powers. The members of different parts should have as little power as possible in selecting members of the other branches. Ideally, this would be happen due to voters elect members of each department separately.
Such a plan would be difficult to carry out, however. Therefore, we must allow certain members of government to be selected by other ways. It would be useful to allow judges to be appointed by other government officials. Judges need special skills, so it is important that they be elected in a way that makes sure that only best candidates are chosen. Also, because judges are selected to the courts for life, they are less likely to be influenced by the men who select them.
"Power Is Divided"
Members of each government branch should be able to keep other parts from overtaking their power. The system should force individuals to defend their branch's powers.
In a perfect world, we would not need such protections. In creating a government that is to be ran by men over men, it must control itself. This can be done by separating and arranging the different offices of government so that each acts as a check on the others.
It is not possible to give to each part an equal ability to protect itself. In republican government, the lawmakers who make up the legislative branch will always have the most power. The cure to this problem is to divide them into two legislative branches. Each branch should be made different by different systems of election and different principles of action. They should be as little connected with each other as possible.
The division of power between the federal government and state governments offers another protection to the people. In the republic of America, power is divided between the states and the federal government. It is then divided again among the branches of each government. Therefore, government power is divided twice and can be controlled.
"To Guard Society"
It is important in a republic to guard society against its rulers. It also must guard one part of the society against the injustice of the other part. Different wants exist in different classes of citizens. If a majority is united by a common interest, the rights of the minority could be hurt.
To defend against this evil, we must make it unlikely that a bad party will gain a majority of support. The people should be broken into many parts, interests and classes of citizens. This will make sure that the rights of individuals, or of the minority, will not be in much danger from the will of the majority. The size of the United States, and the number of people under the same government, offers some prote.
Federalism Comparing Government Response in Hurricane Katrina v.docxmglenn3
Federalism: Comparing Government Response in Hurricane Katrina vs. Coronavirus
Submissions must be a minimum of 2 pages, in length. This does not include your bibliography or works cited. This should be attached and added on as the last page of your essay. Y ou will only have one attempt to upload and submit your paper. Your bibliography or works cited page, and your paper, must be uploaded as a single file. They cannot be uploaded separately. No e-mailed assignments will be accepted.
Your response should be your own thoughts and analysis. Research and resources should be incorporated with scholarly application. I.e. used as examples or evidence to support your analysis. Citations may be formatted in APA, MLA or Chicago style, as long as they are consistent throughout. You must include in-text (parenthetical) citations, as well as a bibliography.If you have questions about citation formatting, please ask me, or utilize the tool easybib.com. You must provide in-text citations, to show ownership of any information that you include, in your essay, which is either
1. not considered common knowledge
2. paraphrased
3. directly quoted
Failure to cite information, properly, will result in students receiving an automatic zero. Furthermore, to not do so is considered plagiarism, and will be treated, as such, in conjunction with HCC's policies.
Make sure to use complete sentences, and proper grammar. Your response to the prompt should focus on analyzing the information you gather and use to complete the constitutional chart through application. Incorporate the information you gathered by using it to provide examples and support for your response to the prompt.
Essay Topic and Objective:
You will be watching two 50 minute documentaries: The Storm and Coronavirus Pandemic in order to complete this essay.
1. The Storm: Hurricane Documentary (Links to an external site.)
2.
Coronavirus Pandemic Documentary (Links to an external site.)
Federalism Overview
: Considered together, Hurricane Katrina and Covid-19 both produced policy disasters in the United States that were both unnecessary and linked to federalism. These challenges produced by nature raise the question of whether certain disasters are beyond the capacities of state and local government.
Objective
: While watching these films, the central theme to take away from these videos is a better and more comprehensive understanding of Federalism, through real life evidence and explanation. Critically analyze each of the elements and consequences of each different national disaster, based on different level of government’s responses, actions. Leadership, communication processes, and decision-making. Despite, both Hurricane Katrina and Corona Virus being deemed as “national emergencies”, the power organization resulted in vastly different responses by each level of government’s leadership (across all levels: federal, state and local).
Introduction to Federalism:
State and Local governments.
Federalism is the structure where two or more levels of government.docxmglenn3
Federalism is the structure where two or more levels of government operate alongside each other with some autonomy, although they have overlapping jurisdiction and specific functions. During the formation of the U.S. Constitution, there were federalist and anti-federalist arguments being made. Explain the concept of federalism; use specific examples of federalism and anti-federalism in your posting.
Which group had the best arguments? Support your argument with examples. Incorporate some of the shifts that took place between both groups (federalists and anti-federalists) to support your response.
1-2 paragraphs
.
Federalism is the sharing of powers between the federal and state go.docxmglenn3
Federalism is the sharing of powers between the federal and state governments.
1. In discussing federalism, observers often concentrate on the tension over where national powers end and state powers begin. But state and federal governments have concurrent powers as well. How do some of these powers (e.g., law enforcement, taxation, general welfare) affect citizens?
In 3 to 5 paragraphs discuss ways in which federalism affect our lives. You may use a personal experience such as financial aid to pay for your education.
.
Federal judges do not have a mandatory retirement age, yet Arizona a.docxmglenn3
Federal judges do not have a mandatory retirement age, yet Arizona and 32 other states require all state judges to vacate their positions upon turning age 70. Should Arizona’s judges be forced to retire at age 70? Might this be considered age discrimination or is a necessary protection for the people?
.
Federal Budget SpeechDo you want to know who you are Dont.docxmglenn3
Federal Budget Speech
"Do you want to know who you are? Don't ask. Act! Action will delineate and define you."
- Thomas Jefferson
The federal budget spends close to four trillion dollars a year and is split between mandatory spending (what the federal government has to spend due to congressional legislation) and discretionary spending (what the federal government spends as a result of congressional allotment). Roughly speaking, mandatory spending accounts for two-thirds of the federal budget and discretionary spending accounts for one-third of the federal budget.
Every year the executive and legislative branches debate budgetary priorities for the federal bureaucracies such as the Department of Defense, the Pentagon, the Environmental Protection Agency, Veteran Affairs, the Department of Education, and others. Many of these debates occur within congressional committee meetings as members of Congress, federal employees, outside interests, and individual citizens articulate funding requests.
For this assessment you will compose a speech advocating why your chosen department, administration, or agency within the federal bureaucracy should receive additional funding.
Because the “world is a stage,” let us establish the setting, plot, and the ensuing action for your speech.
Setting:
Exterior: Washington D.C. State Capitol Building.
Interior: Room 221B. Congressional Hearing Room.
Plot:
Imagine that you are in a cavernous room. You sit before a large table facing twenty one senators from the Budget Committee. Photographers, more than you can imagine, squeeze between the space that separates you from the members of Congress. Behind you in the gallery, public policy wonks and regular citizens sit, awaiting your presentation.
You are a featured speaker from a citizen group that advocates a particular public policy funding concern for your federal department, administration, or agency. Prior to the meeting you have already read the president’s proposed federal budget for the upcoming year from the
Office of Management and Budget
and you have some budgetary concerns. You read in alarm how the upcoming federal budget request from the White House reduces funding for your federal department, administration, or agency. But, as you know, it is up to Congress to fund the executive bureaucracy. The executive branch requests funding and the legislative branch allocates funding. This is your chance to request more funding for your federal department, administration, or agency of choice.
Action
:
Equally eager and nervous you stand in front of a lectern. “Now,” you think, “now I am ready…” You click on the microphone, examine your prepared speech about your funding request, and you begin to speak with eloquence and passion!
Directions
: Compose a 400 word transcript of your public policy speech.
Select a specific example of public policy from one of the following fields:
Economic policy – for example, U.S. budget deficit spending.
Educ.
Federal Budget SpeechDo you want to know who you are Don.docxmglenn3
Federal Budget Speech
"
Do you want to know who you are? Don't ask. Act! Action will delineate and define you
." - Thomas Jefferson
The federal budget spends close to four trillion dollars a year and is split between mandatory spending (what the federal government has to spend due to congressional legislation) and discretionary spending (what the federal government spends as a result of congressional allotment). Roughly speaking, mandatory spending accounts for two-thirds of the federal budget and discretionary spending accounts for one-third of the federal budget.
Every year the executive and legislative branches debate budgetary priorities for the federal bureaucracies such as the Department of Defense, the Pentagon, the Environmental Protection Agency, Veteran Affairs, the Department of Education, and others. Many of these debates occur within congressional committee meetings as members of Congress, federal employees, outside interests, and individual citizens articulate funding requests.
For the Unit 9 Assignment you will compose a speech advocating why your chosen department, administration, or agency within the federal bureaucracy should receive additional funding.
Because the “world is a stage,” let us establish the setting, plot, and the ensuing action for your speech.
Setting:
Exterior: Washington D.C. State Capitol Building.
Interior: Room 221B. Congressional Hearing Room.
Plot:
Imagine that you are in a cavernous room. You sit before a large table facing twenty one senators from the Budget Committee. Photographers, more than you can imagine, squeeze between the space that separates you from the members of Congress. Behind you in the gallery, public policy wonks and regular citizens sit, awaiting your presentation.
You are a featured speaker from a citizen group that advocates a particular public policy funding concern for your federal department, administration, or agency. Prior to the meeting you have already read the president’s proposed federal budget for the upcoming year from the
Office of Management and Budget
and you have some budgetary concerns. You read in alarm how the upcoming federal budget request from the White House reduces funding for your federal department, administration, or agency. But, as you know, it is up to Congress to fund the executive bureaucracy. The executive branch requests funding and the legislative branch allocates funding. This is your chance to request more funding for your federal department, administration, or agency of choice.
Action:
Equally eager and nervous you stand in front of a lectern. “Now,” you think, “now I am ready…” You click on the microphone, examine your prepared speech about your funding request, and you begin to speak with eloquence and passion!
Directions
: Compose a 400 word transcript of your public policy speech.
Select a specific example of public policy from one of the following fields:
Economic policy – for example, U.S. budget deficit spending.
.
February is known as Black History Month. For 30 extra credit points.docxmglenn3
February is known as Black History Month. For 30 extra credit points address the following questions in 200 words or more:
Which African American artist(s) has had the most influence on you? Why? Be sure to organize your thought and ideas using paragraphs. Your response must be a minimum of 200 words or you will not receive any credit for the response.
.
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Federalist 51
To the People of the State of New York:
How shall we keep the necessary separation of power among the different parts of government? The only answer that is that the parts themselves keep each other in their proper places.
The separate use of different parts of government is needed to save liberty. As such, each department should have its own powers. The members of different parts should have as little power as possible in selecting members of the other branches. Ideally, this would be happen due to voters elect members of each department separately.
Such a plan would be difficult to carry out, however. Therefore, we must allow certain members of government to be selected by other ways. It would be useful to allow judges to be appointed by other government officials. Judges need special skills, so it is important that they be elected in a way that makes sure that only best candidates are chosen. Also, because judges are selected to the courts for life, they are less likely to be influenced by the men who select them.
"Power Is Divided"
Members of each government branch should be able to keep other parts from overtaking their power. The system should force individuals to defend their branch's powers.
In a perfect world, we would not need such protections. In creating a government that is to be ran by men over men, it must control itself. This can be done by separating and arranging the different offices of government so that each acts as a check on the others.
It is not possible to give to each part an equal ability to protect itself. In republican government, the lawmakers who make up the legislative branch will always have the most power. The cure to this problem is to divide them into two legislative branches. Each branch should be made different by different systems of election and different principles of action. They should be as little connected with each other as possible.
The division of power between the federal government and state governments offers another protection to the people. In the republic of America, power is divided between the states and the federal government. It is then divided again among the branches of each government. Therefore, government power is divided twice and can be controlled.
"To Guard Society"
It is important in a republic to guard society against its rulers. It also must guard one part of the society against the injustice of the other part. Different wants exist in different classes of citizens. If a majority is united by a common interest, the rights of the minority could be hurt.
To defend against this evil, we must make it unlikely that a bad party will gain a majority of support. The people should be broken into many parts, interests and classes of citizens. This will make sure that the rights of individuals, or of the minority, will not be in much danger from the will of the majority. The size of the United States, and the number of people under the same government, offers some prote.
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Federalism: Comparing Government Response in Hurricane Katrina vs. Coronavirus
Submissions must be a minimum of 2 pages, in length. This does not include your bibliography or works cited. This should be attached and added on as the last page of your essay. Y ou will only have one attempt to upload and submit your paper. Your bibliography or works cited page, and your paper, must be uploaded as a single file. They cannot be uploaded separately. No e-mailed assignments will be accepted.
Your response should be your own thoughts and analysis. Research and resources should be incorporated with scholarly application. I.e. used as examples or evidence to support your analysis. Citations may be formatted in APA, MLA or Chicago style, as long as they are consistent throughout. You must include in-text (parenthetical) citations, as well as a bibliography.If you have questions about citation formatting, please ask me, or utilize the tool easybib.com. You must provide in-text citations, to show ownership of any information that you include, in your essay, which is either
1. not considered common knowledge
2. paraphrased
3. directly quoted
Failure to cite information, properly, will result in students receiving an automatic zero. Furthermore, to not do so is considered plagiarism, and will be treated, as such, in conjunction with HCC's policies.
Make sure to use complete sentences, and proper grammar. Your response to the prompt should focus on analyzing the information you gather and use to complete the constitutional chart through application. Incorporate the information you gathered by using it to provide examples and support for your response to the prompt.
Essay Topic and Objective:
You will be watching two 50 minute documentaries: The Storm and Coronavirus Pandemic in order to complete this essay.
1. The Storm: Hurricane Documentary (Links to an external site.)
2.
Coronavirus Pandemic Documentary (Links to an external site.)
Federalism Overview
: Considered together, Hurricane Katrina and Covid-19 both produced policy disasters in the United States that were both unnecessary and linked to federalism. These challenges produced by nature raise the question of whether certain disasters are beyond the capacities of state and local government.
Objective
: While watching these films, the central theme to take away from these videos is a better and more comprehensive understanding of Federalism, through real life evidence and explanation. Critically analyze each of the elements and consequences of each different national disaster, based on different level of government’s responses, actions. Leadership, communication processes, and decision-making. Despite, both Hurricane Katrina and Corona Virus being deemed as “national emergencies”, the power organization resulted in vastly different responses by each level of government’s leadership (across all levels: federal, state and local).
Introduction to Federalism:
State and Local governments.
Federalism is the structure where two or more levels of government.docxmglenn3
Federalism is the structure where two or more levels of government operate alongside each other with some autonomy, although they have overlapping jurisdiction and specific functions. During the formation of the U.S. Constitution, there were federalist and anti-federalist arguments being made. Explain the concept of federalism; use specific examples of federalism and anti-federalism in your posting.
Which group had the best arguments? Support your argument with examples. Incorporate some of the shifts that took place between both groups (federalists and anti-federalists) to support your response.
1-2 paragraphs
.
Federalism is the sharing of powers between the federal and state go.docxmglenn3
Federalism is the sharing of powers between the federal and state governments.
1. In discussing federalism, observers often concentrate on the tension over where national powers end and state powers begin. But state and federal governments have concurrent powers as well. How do some of these powers (e.g., law enforcement, taxation, general welfare) affect citizens?
In 3 to 5 paragraphs discuss ways in which federalism affect our lives. You may use a personal experience such as financial aid to pay for your education.
.
Federal judges do not have a mandatory retirement age, yet Arizona a.docxmglenn3
Federal judges do not have a mandatory retirement age, yet Arizona and 32 other states require all state judges to vacate their positions upon turning age 70. Should Arizona’s judges be forced to retire at age 70? Might this be considered age discrimination or is a necessary protection for the people?
.
Federal Budget SpeechDo you want to know who you are Dont.docxmglenn3
Federal Budget Speech
"Do you want to know who you are? Don't ask. Act! Action will delineate and define you."
- Thomas Jefferson
The federal budget spends close to four trillion dollars a year and is split between mandatory spending (what the federal government has to spend due to congressional legislation) and discretionary spending (what the federal government spends as a result of congressional allotment). Roughly speaking, mandatory spending accounts for two-thirds of the federal budget and discretionary spending accounts for one-third of the federal budget.
Every year the executive and legislative branches debate budgetary priorities for the federal bureaucracies such as the Department of Defense, the Pentagon, the Environmental Protection Agency, Veteran Affairs, the Department of Education, and others. Many of these debates occur within congressional committee meetings as members of Congress, federal employees, outside interests, and individual citizens articulate funding requests.
For this assessment you will compose a speech advocating why your chosen department, administration, or agency within the federal bureaucracy should receive additional funding.
Because the “world is a stage,” let us establish the setting, plot, and the ensuing action for your speech.
Setting:
Exterior: Washington D.C. State Capitol Building.
Interior: Room 221B. Congressional Hearing Room.
Plot:
Imagine that you are in a cavernous room. You sit before a large table facing twenty one senators from the Budget Committee. Photographers, more than you can imagine, squeeze between the space that separates you from the members of Congress. Behind you in the gallery, public policy wonks and regular citizens sit, awaiting your presentation.
You are a featured speaker from a citizen group that advocates a particular public policy funding concern for your federal department, administration, or agency. Prior to the meeting you have already read the president’s proposed federal budget for the upcoming year from the
Office of Management and Budget
and you have some budgetary concerns. You read in alarm how the upcoming federal budget request from the White House reduces funding for your federal department, administration, or agency. But, as you know, it is up to Congress to fund the executive bureaucracy. The executive branch requests funding and the legislative branch allocates funding. This is your chance to request more funding for your federal department, administration, or agency of choice.
Action
:
Equally eager and nervous you stand in front of a lectern. “Now,” you think, “now I am ready…” You click on the microphone, examine your prepared speech about your funding request, and you begin to speak with eloquence and passion!
Directions
: Compose a 400 word transcript of your public policy speech.
Select a specific example of public policy from one of the following fields:
Economic policy – for example, U.S. budget deficit spending.
Educ.
Federal Budget SpeechDo you want to know who you are Don.docxmglenn3
Federal Budget Speech
"
Do you want to know who you are? Don't ask. Act! Action will delineate and define you
." - Thomas Jefferson
The federal budget spends close to four trillion dollars a year and is split between mandatory spending (what the federal government has to spend due to congressional legislation) and discretionary spending (what the federal government spends as a result of congressional allotment). Roughly speaking, mandatory spending accounts for two-thirds of the federal budget and discretionary spending accounts for one-third of the federal budget.
Every year the executive and legislative branches debate budgetary priorities for the federal bureaucracies such as the Department of Defense, the Pentagon, the Environmental Protection Agency, Veteran Affairs, the Department of Education, and others. Many of these debates occur within congressional committee meetings as members of Congress, federal employees, outside interests, and individual citizens articulate funding requests.
For the Unit 9 Assignment you will compose a speech advocating why your chosen department, administration, or agency within the federal bureaucracy should receive additional funding.
Because the “world is a stage,” let us establish the setting, plot, and the ensuing action for your speech.
Setting:
Exterior: Washington D.C. State Capitol Building.
Interior: Room 221B. Congressional Hearing Room.
Plot:
Imagine that you are in a cavernous room. You sit before a large table facing twenty one senators from the Budget Committee. Photographers, more than you can imagine, squeeze between the space that separates you from the members of Congress. Behind you in the gallery, public policy wonks and regular citizens sit, awaiting your presentation.
You are a featured speaker from a citizen group that advocates a particular public policy funding concern for your federal department, administration, or agency. Prior to the meeting you have already read the president’s proposed federal budget for the upcoming year from the
Office of Management and Budget
and you have some budgetary concerns. You read in alarm how the upcoming federal budget request from the White House reduces funding for your federal department, administration, or agency. But, as you know, it is up to Congress to fund the executive bureaucracy. The executive branch requests funding and the legislative branch allocates funding. This is your chance to request more funding for your federal department, administration, or agency of choice.
Action:
Equally eager and nervous you stand in front of a lectern. “Now,” you think, “now I am ready…” You click on the microphone, examine your prepared speech about your funding request, and you begin to speak with eloquence and passion!
Directions
: Compose a 400 word transcript of your public policy speech.
Select a specific example of public policy from one of the following fields:
Economic policy – for example, U.S. budget deficit spending.
.
February is known as Black History Month. For 30 extra credit points.docxmglenn3
February is known as Black History Month. For 30 extra credit points address the following questions in 200 words or more:
Which African American artist(s) has had the most influence on you? Why? Be sure to organize your thought and ideas using paragraphs. Your response must be a minimum of 200 words or you will not receive any credit for the response.
.
FEATURE ARTICLE Creating and Capturing Value Through Susta.docxmglenn3
FEATURE ARTICLE
Creating and Capturing Value Through Sustainability
The Sustainable Value Analysis Tool
A new tool helps companies discover opportunities to create and capture value through sustainability.
Miying Yang, Doroteya Vladimirova, and Steve Evans
OVERVIEW: Recent research and practice have shown that business model innovation can be one way to create and
capture new value and drive production and consumption toward sustainability. However, business model tools typically
do not create a space to consider how sustainability concerns may be integrated into the innovation process. To address
this gap, this article describes a tool that can help companies identify new opportunities to create and capture value
through sustainability by analyzing value captured and uncaptured for key stakeholders across the product life cycle.
The Sustainable Value Analysis Tool is shown to help companies recognize value uncaptured and turn it into opportunities;
it facilitates sustainability-focused business model innovation by identifying value uncaptured—and hence, opportunities
for innovation—associated with environmental and social sustainability in production, use, and disposal.
KEYWORDS: Sustainable Value Analysis Tool, Sustainability, Business model innovation, Sustainability-focused innovation
In recent years, as companies have been challenged by
environmental legislation and societal pressures (Elkington
1997), sustainability has become a key factor in long-term
business success. As a result, innovation for sustainability
has received much attention from researchers and practi-
tioners (Nidumolu, Prahalad, and Rangaswami 2009; Boons
et al. 2013). However, although technological approaches to
promote sustainability have been thoroughly investigated
(Camarinha-Matos 2011), comparatively little work has been
done to understand how innovation in business models can
support sustainability across the product life cycle, including
manufacturing, operation, and disposal.
Business model innovation looks at how companies create
and capture value at every stage of a product’s journey to
market. While business model innovation has been the
subject of much discussion and research, very few tools have
been developed to help companies integrate sustainability
into the business model innovation process (Evans et al., in
press). Existing tools for business model innovation either
do not consider sustainability (for instance, Osterwalder
and Pigneur’s [2010] Business Model Canvas) or do not
address all of the elements of the business model (for
example, lifecycle assessment tools [Tukker 2000]). Thus,
sustainability considerations and business model innovation
are often not well integrated, with sustainability being
treated as an add-on rather than as a core source of value.
Considering sustainability in the process of business
model innovation can provide entirely new ways to create .
FEATUREASSOCIATION FORUMHiring tiie Very BestHow to in.docxmglenn3
FEATURE
ASSOCIATION FORUM
Hiring tiie Very Best
How to increase your employees' morale and productivity
By Tracy Mullin
Tracy Mullin is
president and
CEO, Nationai
Retail
Federation,
Washington,
D.C,
[email protected]
I
remember a quote from former ABC execu-
iive Thomas Murphy, who said. "If you hire
the best people and leave them alone, you
don't need to hire very many." While I think re-
tailers should be hiring the best people possible,
and treating them well, it may not always be best
to leave them alone. Especially during the holi-
day season.
With the holidays almost upon us, retailers are
scrambling to hire the best seasonal workers—
more than 520,000 of them—while retaining
their top performers. And during the most cru-
cial selling period of the year, there is no time
for mistakes. Executives know that good em-
ployees ean bolster the image of a store and
unsatisfactory employees can be disastrous.
More often than not. finding good workers is
high on the list of challenges facing retail exec-
utives. And keeping those people is even more
difficult.
Turnover in the retail industry is nothing new,
and it is not a problem that will disappear any-
time soon. After Sept. 11, many retailers experi-
enced low turnover as employees waited for the
job market to improve. Now that the economy is
back on traek, workers are keeping an eye out
for new opportunities, and many are moving on.
Statistics reinforce that theory: According to
the 2005 NRF/Mercer Retailer Compensation
and Benefits survey, released last month, turn-
over for store managers rose 20% last year over
2003.
Leading HR experts seem to agree that tradi-
tional approaches to management haven't been
working. Author Bruce Tulgan. a consultant
who spoke in June at the National Retail Eed-
eration's Loss Prevention Conference, talked
about the mind-set of the new American worker
and said that the best way retailers could keep
their employees was to find out what people
want and use it to drive performance.
Best Buy is one of those retailers. Nearly half
of the 3.500 employees at Best Buy headquarters
have embarked on a radical strategy that enables
employees to work where and when they
as long as their job gets done. The approach
seems to be working, as executives maintain that
this new program has reduced turnover and
increased productivity at the same time.
Other retailers, such as Costco, believe that
the way to their workers" hearts is through their
wallets. Costco's employees earn an average of
$17.41 an hour and receive some of the most
generous health benefits in the industry. Perhaps
that's why they are able to maintain a low
turnover rate of about 17% per yean
However, money isn't everything. In his pre,s-
entation, Tulgan also featured several non-finan-
cial elements, such as people needing to be sat-
isfied with their jobs. One of those basics, giving
employees control over tasks, is an area where
Trader Joe's has an upper hand. Instead of giv-
ing employees.
FEATURED ESSAYThe Ecstatic Edge of Politics Sociology and.docxmglenn3
FEATURED ESSAY
The Ecstatic Edge of Politics: Sociology and Donald Trump
ARLIE RUSSELL HOCHSCHILD
University of California-Berkeley
[email protected]
The day before the Louisiana Republican
primary in March 2016, I watched Donald
Trump’s Boeing 757 descend from the sky
at the Lakefront Airport in New Orleans,
Louisiana. Inside the crowded hangar, Elton
John’s ‘‘Rocket Man’’ was playing. Red,
white, and blue strobe lights roved sideways
and up. Cell phones snapped photos of the
blond-haired candidate as he stood before
thousands waving and shaking signs that
read MAKE AMERICA GREAT AGAIN. A
small, wiry man bearing this sign with
both hands, eyes afire, called out to all with-
in earshot, ‘‘To be in the presence of such
a man! To be in the presence of such
a man.’’ There seemed in this man’s call, I
wrote in my field notes—part of a five year
ethnographic study of Tea Party supporters
in Louisiana—a note of reverence, even
ecstasy (Hochschild 2016:224). How do we
understand the states of mind and situations
of those to whom Donald Trump appeals?
How does such emotional appeal work?
Whatever Trump’s future, he has touched
a cultural nerve we sociologists need to
study. In this essay, I explore illuminating
works in and around sociology before ven-
turing an interpretation of my own.
In The Paranoid Style in American Politics,
the historian Richard Hofstadter (1996)
traced the relationship between paranoid
political rhetoric and ‘‘style of mind’’ as
these periodically emerged in the United
States through the nineteenth and twentieth
centuries. The leader expressing such a style,
he says, ‘‘does not see social conflict as some-
thing to be mediated and compromised, in
the manner of the working politician. Since
what is at stake is always a conflict between
absolute good and absolute evil, what is nec-
essary is not compromise but the will to fight
things out to a finish. . . . This demand for
total triumph leads to the formulation of
hopelessly unrealistic goals, and since these
goals are not even remotely attainable, fail-
ure constantly heightens the paranoid’s
sense of frustration. Even partial success
leaves him with the same feeling of power-
lessness with which he began, and this in
turn only strengthens his awareness of the
vast and terrifying quality of the enemy he
opposes’’ (p. 31).
Propelling such movements, he argues, is
not just economic deprivation as narrowly
conceived, but the loss of an older America,
inward-turned, Protestant, secure, busy
turning the wheel of a thriving local capital-
ism. As one of the original so-called birthers
(who questioned President Obama’s place of
birth and religion) and as one who has
extended this suspicion to Hillary Clinton’s
religion, Donald Trump fits in Hofstadter’s
‘‘paranoid style.’’ Still, Trump’s appeal
reaches far beyond the style of mind through
which it is expressed.
Updating Hofstadter, the excellent The Tea
Party and the Remaking of Republican Conser-
vatism by Theda Skocpol and V.
Featherfall has recently violated several government regulations.docxmglenn3
Featherfall has recently violated several government regulations regarding the current state of its technology and how it is being used. The technology system is vastly out of date, and staff are not always using the technology that is in place or they are using the technology inappropriately. These problems have lost the institution lots of money for not meeting government regulations and have caused operational and ethical problems from inefficient and ineffective use of technology.
The staff at Featherfall are not well-trained on the use of technology and do not communicate appropriately about technology use. The roles that pertinent to your consult are the health information management team, the clinical staff (doctors, nurses, etc.), and administrative staff. The health information management team uses proper coding practices, and the current technology system serves them well, despite its age. However, other roles in the hospital have had issues with the system. Clinical staff, for instance, have had record-keeping issues both due to lack of training on the system and the system itself being out of date. Administrative staff within the organization have taken issue with the lack of communication about the technology and its use between the various roles. When the current technology system was chosen many years ago, the needs of these various roles were not considered.
Assignment link :
https://learn.snhu.edu/d2l/lor/viewer/viewFile.d2lfile/243073/1720,1/
.
FEATURE - ‘Overtourism’ Worries Europe. How Much Did Technol.docxmglenn3
FEATURE - ‘Overtourism’ Worries Europe. How
Much Did Technology Help Get Us There?
By Farhad Manjoo, The New York Times Aug. 29, 2018
Reference: Manjoo, F. (2019, Aug. 29). ‘Overtourism’ Worries Europe. How Much Did
Technology Help Get Us There? The New York Times. Retrieved from
https://www.nytimes.com/2018/08/29/technology/technology-overtourism-europe.html
By Farhad Manjoo
Over the summer, my wife and I traveled with our two young kids on a two-week
vacation through Europe.
It wasn’t as highfalutin as it sounds. In London, our Airbnb had ample skylights —
which rendered the place all but uninhabitable during Europe’s heat wave. In Paris, our
charming home-share had a cavernous hole in the ceiling of the entryway, revealing
load-bearing beams that appeared to have been rotting since Napoleon’s reign. And in
Amsterdam, our Airbnb advertised a kids’ bedroom stocked with toys — but failed to
mention the mosquitoes and mice.
I’m not complaining. If travel mishaps are the stuff of memory, my vacation was
unforgettable. And without home-sharing services like Airbnb, review sites like
TripAdvisor and conveniences like Uber, OpenTable and Expedia, the trip would have
been far more expensive, less accessible and, in a strange way, less authentic.
But my tech-abetted trip was illuminating, too, because it provided a firsthand look into
a vexing problem that has gripped much of Europe lately — the worry of “overtourism,”
and the rising chorus that blames technologies like Airbnb, Uber and other internet-
enabled travel conveniences for the menace.
Every summer, the most popular European destinations get stuffed to the gills with
tourists, who outnumber locals by many multiples, turning hot spots into sweaty, selfie-
stick-clogged, “Disneyfied”towns. They offer a taste of a growing global threat: Across
the world, thanks in part to rising affluence, travel is becoming a more widely shared
pastime. International trips were up 6 percent in the first half of the year, surpassing
experts’ forecasts, according to the United Nations’ World Tourism Organization.
This growth might once have been considered unambiguously good news. But the
world’s most popular destinations cannot expand to accommodate an infinite flood of
visitors. Advocates of curbing tourism say too many visitors are altering the character of
historic cities, and making travel terrible, too.
“It’s a level of tourism which is degrading the enjoyment that residents have, but it’s also
degrading the tourist experience, because the tourist who is endlessly queuing behind
backpacks of hundreds of other tourists is not discovering the real or the authentic
place,” said Justin Francis, the chief executive of Responsible Travel, a company that
arranges “sustainable” travel for customers.
What’s to blame? In addition to broad prosperity, there’s technology, defined very
broadly.
Over the last few decades, innovations in aviation — wider, more e.
FEASIBILITY REPORT1
FEASIBILITY REPORT6
Feasibility Report
MEMO
TO: Manager
FROM:
DATE:
SUBJECT:
This memo is meant for introducing the feasibility report that aims at providing a solution to the cases and nation problems about the cybercrime and the potential proposed solution to curb up the challenge. These feasibilities we are identified by studying various critical factors such as the social effects, legal issues, technical problems, and the economic impact. Therefore, this memo is very vital for an individual to read and understand various aspects.
Feasibility Report
It takes much time in planning and preparing to implement a solution to the major problem in society. During the planning and preparation process, the proposed solution should be tested and determined if it is feasible to provide the solution or not. Cybercrime in united states has been a significant problem and need to be addressed and solution provided to reduce the cybercrime.
One of the proposed solutions to this major problem is providing cybersecurity among very individual. This will enable most of the people to understand and know the importance of cybersecurity and thus leading to the reduction of the negative loses that is caused by the cybercrime in society every year. Another thing that will ensure that the individuals in the nation are protected from the impact of the cybercrime is educating them on ways they can protect themselves over the cybercrime attempts.
This report will majorly focus on looking at the proposed solution provided and determine if the answers are feasible or need some changes. The essential aspects that the story will focus on include the social impact, the economic effect, and other elements which will be determined if it can provide a solution to the problem.
The Social Impact
When looking for a potential solution to be implemented to solve a specific major problem in society, a positive impact is always the main objective. When the proposed solution is applied, such as implementing cybersecurity in the daily lives of the individuals in the society it will bring a lot of positive impacts on them. For instance, when the cybersecurity is made the main focus in the in every place, i.e. schools and workplace, majority of the individuals will be aware of these threats and ways of preventing them from affecting their daily lives. This will also reduce the loss that most of the individuals incur due to the cybercrime and lack of security in their day-to-day business operations (Help Net Security, 2015).
When the cybersecurity is introduced in society It will bring much social impact to the life of the individuals since it will educate people about the dynamic changes that occur in uses of the technology. When this provides a solution to the cybercrime problem in the society, it will be adopted by every nation, and thus the cybercrime problem is reduced and making every country secure and safe from the cybercrime prob.
Fear-Based Research Paper Topics1. Is it more regressive or prog.docxmglenn3
Fear-Based Research Paper Topics
1. Is it more regressive or progressive that humans have come to fear less than they once did?
2. Do humans depend on fear for survival?
3. In which ways do societies depend on fear as a control mechanism?
4. Is Carl Jung correct in his theory that death drives every human decision?
Get Out Research Paper Topics
1. Using Joseph Campbell’s theory of the Hero’s Journey, argue whether Rod or Chris is the hero of the film. Does either interpretation come with it a sense of a new cinematic hero?
2. When considering the film’s two endings, in which ways do the two differ in terms of the interpretations they offer?
3. Using Get Out, what can you argue to be the dangers of living in a “post-racial” society?
The VVitch Research Paper Topics
1. Using Dante’s representation of the different levels of Hell, map/argue which of the film’s characters to be the film’s central sinner.
2. In which ways did the phenomenon of witches come to be? How did the witch devolve from Pagan traditions into the idea of a negative entity?
3. Can modern notions of gender inequality be traced back to the emergence of witches as a societal scapegoat?
4. Are any of the film’s characters justified in the ways in which they commit sin? Does the film have a central hero?
5. Using Joseph Campbell’s theory of the hero’s Journey, argue whether or not Thomasin exists as a feminine hero within the film?
“A Good Man is Hard to Find” Research Paper Topics
1. Does either the Grandmother or the Misfit change by the story’s end?
2. Argue whether or not Flannery O’Connor condemns nature or nurture within the story.
3. In which ways does the story condemn the futility of attempting to control nature?
4. In which ways does “A Good Man is Hard to Find” fit the bill of a typical Southern Gothic story?
.
Macroeconomics- Movie Location
This will be used as part of your Personal Professional Portfolio once graded.
Objective:
Prepare a presentation or a paper using research, basic comparative analysis, data organization and application of economic information. You will make an informed assessment of an economic climate outside of the United States to accomplish an entertainment industry objective.
Safalta Digital marketing institute in Noida, provide complete applications that encompass a huge range of virtual advertising and marketing additives, which includes search engine optimization, virtual communication advertising, pay-per-click on marketing, content material advertising, internet analytics, and greater. These university courses are designed for students who possess a comprehensive understanding of virtual marketing strategies and attributes.Safalta Digital Marketing Institute in Noida is a first choice for young individuals or students who are looking to start their careers in the field of digital advertising. The institute gives specialized courses designed and certification.
for beginners, providing thorough training in areas such as SEO, digital communication marketing, and PPC training in Noida. After finishing the program, students receive the certifications recognised by top different universitie, setting a strong foundation for a successful career in digital marketing.
The French Revolution, which began in 1789, was a period of radical social and political upheaval in France. It marked the decline of absolute monarchies, the rise of secular and democratic republics, and the eventual rise of Napoleon Bonaparte. This revolutionary period is crucial in understanding the transition from feudalism to modernity in Europe.
For more information, visit-www.vavaclasses.com
Welcome to TechSoup New Member Orientation and Q&A (May 2024).pdfTechSoup
In this webinar you will learn how your organization can access TechSoup's wide variety of product discount and donation programs. From hardware to software, we'll give you a tour of the tools available to help your nonprofit with productivity, collaboration, financial management, donor tracking, security, and more.
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.
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!
Introduction to AI for Nonprofits with Tapp NetworkTechSoup
Dive into the world of AI! Experts Jon Hill and Tareq Monaur will guide you through AI's role in enhancing nonprofit websites and basic marketing strategies, making it easy to understand and apply.
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.
Operation “Blue Star” is the only event in the history of Independent India where the state went into war with its own people. Even after about 40 years it is not clear if it was culmination of states anger over people of the region, a political game of power or start of dictatorial chapter in the democratic setup.
The people of Punjab felt alienated from main stream due to denial of their just demands during a long democratic struggle since independence. As it happen all over the word, it led to militant struggle with great loss of lives of military, police and civilian personnel. Killing of Indira Gandhi and massacre of innocent Sikhs in Delhi and other India cities was also associated with this movement.
Fears and Health Needs of Patients with Diabetes A Qualitative Re.docx
1. Fears and Health Needs of Patients with Diabetes: A Qualitative
Research in Rural Population
Maria Papaspurou,1 Vasiliki C. Laschou,2 Paraskevi
Partsiopoulou,3 Evangelos C. Fradelos,4 Christos F. Kleisiaris,5
Malamati A. Kalota,6 Anna Neroliatsiou,7 and Ioanna V.
Papathanasiou8
Author informationArticle notesCopyright and License
informationDisclaimer
This article has been cited by other articles in PMC.
Go to:
Abstract
Introduction:
Insulin-dependent patients are individuals with chronic disease
who are well adapted to living and dealing with any health
needs and fears arising. An important aspect in the process of
adaptation to chronic illness is the provision of nursing care in
the early stages of the disease, because this contributes to its
acceptance and the early identification and management of
potential complications.
Purpose:
To investigate the health needs and self-management problems
faced by patients with diabetes daily, especially those who use
insulin. Furthermore, purpose of this study was to investigate
the fears experienced by patients in the early stage of the
disease, but also in its subsequent development and to study
possible differences between sexes.
Methodology:
2. This is a qualitative study, using interpretative
phenomenological approach. Fifteen (nine women and six men)
insulin-dependent patients, recounted their personal fears and
their needs, through semi-structured interviews, which took
place in Central Greece. The method used for processing the
results is the Mayering one.
Results:
The analysis of the narratives showed that patients have a
variety of fears and needs associated with the diagnosis,
treatment, expected consequences, prognosis and everyday life
in the management of the disease. Most patients express the
concept of need as desire. Care needs, psychological support
and education to recognize and prevent hypoglycemia.
Conclusions:
Insulin-dependent patients express fears and needs in their daily
lives. Nurses providing care aimed at enhancing the level of
health, while putting self-care information and training them.
Patients want the nurse next to them, so that information is
continuous and permanent.
Keywords: diabetes mellitus, fears, health needs, self-care,
nursing care
Go to:
1. INTRODUCTION
Patients with type II diabetes, especially insulin-dependent are
usually suffering from diabetes several years before the
initiation of insulin therapy. Treatment of diabetes has now as a
central character, the patient himself who co-decides with the
physician-nurse team. The primary concern is the patient’s
3. acceptance of the disease in the early stages and his gradual
familiarization with the treatment (1).
According to International Diabetes Federation, at least 285
million people worldwide have diabetes and this number is
expected to increase to 438 million by 2030, with two-thirds of
all cases living in low or middle income countries (2, 3).
Apart from pharmaceutical care, the nurse also provides
psychological care which is necessary for the disease process,
both at the individual and the family level. Psychological
support for patients, may positively affect the acceptance, the
treatment and the course of the disease (4).
Patients have a number of care needs both in early as well as in
later stages of the disease. It is important for nurses not to treat
all patients with diabetes mellitus the same way, but, to
approach, at first the patient as an individual and then the
disease. In this way, we can see the specificities in each
individual-patient (5).
According to the literature, the diagnosis itself causes fear
which rises in the course of the disease as patients’ awareness
regarding the disease and its complications increases. The
holistic approach of diabetic patients produces positive results,
both in the acceptance of the disease, as well as to the
recognition of complications, and the protection from them.
Go to:
2. PURPOSE
The purpose of this qualitative study was to investigate the
fears of patients and their families, related to their disease and
their specified treatment. Also, we investigated the patients’
and their households’ needs and feelings regarding the care
provided by health professionals and where they consider
4. nursing care is necessary.
Go to:
3. MATERIAL AND METHODS
Semi-structured interviews with 15 patients with type II were
conducted, concerning, the fears that arose and who needed
nursing assistance when they were first diagnosed with the
disease as well as their decisions regarding to the treatment.
The approach and the localization of the participants took place
in the region hospitals, external Diabetes clinics and in private
outpatient clinics. The sample selection was based on criteria:
patients should have type II diabetes, be insulin dependent, by
both sexes and be able to cooperate in the interview. After the
patient selection, they were asked whether they accepted or not
to participate. Also we verbally explained to them the purpose
of the interviews. We approached 33 patients of which only 15
were positive to the research. Many of those who refused, had,
at first, been interviewed, but nonetheless, when the final
debate approached, they refused to participate. It was observed
that those who were more negative, were individuals who were
monitored in private clinics and had secretiveness against their
disease. They did not even mention the name of the disease, but
called it as “the bad” or “this” or “what I have”.
The interviews lasted for 20-30 minutes. The discussions were
not recorded as the patients reported that they feel comfortable
and therefore extensive notes were kept during the interview.
The questions asked were two:
· a)
Is there something that worried (scared) you when you were
diagnosed with diabetes?
5. · b)
Do you believe a nurse would be helpful for you?
Participants: 9 out of the 15 surveyed persons were women and
6 men. The oldest patient was 81 and the youngest 36 years old.
Of all participants, 12 were over 65 years old and 14 over 60
years old. From research conducted in America it is estimated
that by 2025 adults over age 60 will comprise two-thirds of the
population with diabetes (6).
By following the six steps of qualitative research, perceptual
outline of qualitative research (first step), research question
(Step 2), sample determination (Step 3), data collection (step 4),
data analysis (step 5), presentation / writing (step 6)}, an
attempt was made to investigate the problems as perceived by
the patients themselves (7).
Our sample members were residents of Central Greece which
was chosen because of its accessibility and its climate diversity.
The method used for processing the results is the Mayering
method for qualitative research (8).
Go to:
4. RESULTS
From the collected responses by the population under
investigation, we found that nursing care is necessary, both in
the early and in later stages of the disease. The patient feels
great safety and relief when the nurse is beside him to inform
and encourage him for any changes that will occur. The analysis
of both questions which were set showed the following:
A. Fears
6. Fears for life itself
Diabetes is related with a reduction in life expectancy and high
morbidity due to specific complications associated with micro
vascular (retinopathy, nephropathy and neuropathy), and
increased risk of macro vascular (ischaemic heart disease,
stroke and peripheral vascular disease) diseases and low quality
of life (9).
“I was worried …. If my condition will become worse …. I felt
very healthy … and I was afraid that I would not continue to be
so …”, “At first I was not scared at all ….because I did not
know … now that I learned the more anxious I have became…
for my life”.
According to researches, mortality is higher among people with
diabetes, and the rate varies with age, sex, time and cause of
death (10, 11).
Diabetic patients are individuals at high risk, studies support
the fact that vaccination against influenza should be offered to
all of them. Vaccination can greatly reduce the risk of serious
complications in people with diabetes. Influenza vaccine has
been shown to reduce diabetes-related hospital admission by as
much as 79% during flu epidemics (12).
Fears for Complications
Randomized clinical trials and prospective epidemiological
studies have shown that lifestyle changes, such as healthy
eating patterns, weight loss, quitting smoking, increased
physical activity and patient education can help delay or prevent
diabetes complications [13]. “I was very anxious. I knew from
my family…it harms nearly every organ of the body”.
“My mother went blind due to diabetes…she had retinopathy…I
7. am really scared… being unable to see is really bad”. Although,
persons with diabetes mellitus are 2.5 times more likely to have
retinopathy than non-diabetic, the actual number of individuals
with retinopathy is threefold higher in the non-diabetic (14).
One of the participants has both legs amputated and uses a
wheelchair. When asked about his initial fears he replied “…If I
knew my fate … and maybe a little fear could be good for me …
I did not expect to be so destroyed…” [15]. Another patient
recounts, “I was afraid … because diabetes brings other
problems … as hypertension… and in our family we have high
blood pressure”.
“.. My body will become more sensitive…. I will often get sick
… ”. The deregulation of diabetes associated with infection
requires special attention when treating patients with diabetes
(16).
Fears for work
Patients with diabetes are afraid of the social impact of the
disease such as deterioration of the economic and occupational
life situation. ‘When I first heard of diabetes diagnosis my mind
went to my business … would I be able to continue to work …?
“.Diabetes is a way of life and that’s how it should be treated by
everyone. Activities of daily living don’t stop with the
diagnosis of the disease; instead, patients should manage to
continue their daily lives and daily routines as before. But,
there are professions which have certain peculiarities that the
diabetic patients are prone to. “… I was a driver and I made
long trips ….immediately after I was diagnosed with my illness
… I stopped working … I could not drive…. I feared of
hypoglycemia …”. Research done, indeed, shows that drivers
with diabetes are vulnerable to face unfortunate incidents while
driving. These can be linked to hypoglycemia (17).
8. Fears for family
A great concern for most participants as they were all parents,
except the younger one who was expectant mother–was if their
children and grandchildren had inherited a predisposition to the
disease. “… We have now lived our lives ….should not to
happen to our children… ”.
“When I learned that I have diabetes, it was shortly after my
engagement …. I was afraid that would never have children … I
did not want to be guilty of the misfortunes of my fiancé…we
were informed and now we are happy … we expect to have our
baby. ”
Many diabetic women planning a pregnancy, exhibit increased
anxiety about their fertility. There is no reason to believe that
diabetic women with good glycemic control are less fertile than
non-diabetics. There are just some signs that poor glycemic
control can affect the regularity of ovulation. Maternal
morbidity is increased due to complications. “Hydramnios”, the
incidence of this state among diabetic pregnant women is 10
times higher than in the general obstetric population.
Another reason for being dominated by fear from the beginning
was their family; they did not want to be a burden to their
children. Most of them knew that their illness has a direct
impact on the whole family as in the province there is still the
institution of family, consisting of a grandfather, a
grandmother, a father, a mother and children living under one
roof. “I really tire my bride … she has never gone taken a
holiday, and has never left home …. She injects me…. I do not
know how ”.
Fears of stigmatization
Most of the patients we approached were negative to participate
9. in the survey. They avoided accepting that they suffered from
diabetes and even hardly they answered if they were insulin-
dependent. They didn’t answer to the question if something
scared them, because their biggest fear after the diagnosis was
not to be learned by the neighbors, the family and
acquaintances. In the province the patient’s stigmatization is a
bigger problem than the disease itself. “… I was ashamed of my
children…. What will the neighbors say? …I was strong … was
running for everyone …” are the words of one of the surveyed
women. Most participants had suspicions and fears during the
conversation if anyone was listening and find out their secret.
None of the patients mentioned the problems and fears that arise
in both men and women for the possible impairment in their
sexual life.
Fears for deprivations
Many of the patients participated in this study had related
diabetes with deprivations. With the main deprivation
considered was food. Mostly, the majority of women referred to
that. It was the nature of women to be occupied by food and the
kitchen that makes them more vulnerable and stressed about
food issues. “I was scared a lot!!!!…I panicked when I heard
it………the worst existing disease………to want to eat and that
to be prohibited……….in the summer you see the fruits and you
turn away…” (a big sigh and a long pause).
The limitation of food in diabetic patients shouldn’t be forced
for glucose regulation, although some limitations can be
imposed on them in order to control body weight mostly
concerning overweight patients. If the patient is overactive
some additional meals between the main ones is likely to be
needed. In the evenings close to bedtime, the overconsumption
of carbohydrates is usually discouraged (18).
10. B. Needs–Wishes
In the survey which was conducted in response to the question
“in what way they believe a nurse would be useful» most
patients, expressed this sense of the need mainly as a desire.
They expect nurses to be helpers in their Fight. They want them
not only as fully qualified professionals but also “as their own
person”, who will always be there for them.
Needs for Psychological Support
Nurses should understand the patient’s feelings and
expectations which might be hidden behind words and
sentences, as many times the cognitive and emotional content of
the patient’s words is presented verbally or non-verbally
disguised or completely falsified. “I want a person who I can
call mine…. with knowledge, who I can trust… always there
when I need him…”. Therefore, during their conversation, the
nurse should not just listen to what the patient says, but also to
understand the different tones and intensity of his voice and the
various nonverbal facial and eye expressions. For the above
purpose, devoting sufficient time and attention to the needs of
patients is required in order to express his thoughts, fears and
concerns about his condition. Psychological support, which is
also provided to certain groups of people with diabetes, during
visits at home is of very high importance. Such groups are
newly diagnosed insulin-dependent diabetes patients (which
usually develops in young people) during visits at home is of
very high importance. “… I started insulin last week …
everything is mountains to climb … I need support now at the
beginning …”. Additionally, the nurse who works and cares for
people with diabetes, should be a source of advice for other
nurses and health professionals, providing to them the necessary
information and alternatives useful for solving complex
problems with final aim the alleviation of mental stress of these
people (4).
11. Needs for training
The instruments that can be used by nurses for better education
of diabetics include : interview, speeches given to groups of
diabetic patients and their families, various forms and brochures
with pictures and detailed explanations provided in a language
understandable to the patient regardless of their educational
level and their social class.
The success of a diabetes-training program depends on the
willingness of the diabetic to be trained. Sometimes the trainer
comes across indifference, pessimism, negative mood or
psychological disruption which can impede knowledge
acquisition in patients with diabetes (19).
The success of an individualized diabetes care plan requires the
incorporation of training as an integral component of diabetes
therapy. The goal of each educational intervention is the
promotion of self-care and the prevention of complications (20).
Needs for technique learning
The term technique for many of the patients of this study,
especially those who were recently diagnosed, is referred to a
daily act and it needs some kind of training in order to perform.
Such actions are insulin injection, the self-examination for
blood glucose test even the urine test. Insulin-dependent patient
must on a daily and periodic bases undergo, in an outpatient
setting, with laboratory tests, such as:
Glucose of capillary blood, by a small device and the
appropriate test strips. The frequency of the tests depends on
the difficulty of regulation of diabetes. In some patients the
daily control is required, with 3-4 daily measurements. The
examination of urine sugar nowadays tends to be replaced by
capillary blood tests. Glycosylated hemoglobin every three
12. months (HbA1c). Many of the patients in the study were curious
about…. “What is Glycosylated hemoglobin”…………. Many of
them couldn’t pronounce it and referred to it as “……..the new
blood test…” Moreover, many patients of this study were asking
“…is it an important examination as blood sugar….”
The first thing that a diabetic must been trained to is the self-
examination for blood glucose test. It is a test that should be
conducted many times during the day and mostly when the
patient senses that something is wrong with his blood glucose
value. The majority of the patients always have questions about
this simple examination, “…can I have blood sample from all of
my fingers…?”. Regardless how simple the self-monitoring of
blood glucose is, there is always a technique that must be
applied. Washing hands with soap and water and drying them
out and using the first drop of blood. If washing the hands isn’t
possible and if there isn’t any visible stain or exposure to
product that contains sugar, then to use the second drop after
wiping the first drop is acceptable. The external pressure may
lead to unreliable results. It does matter which finger is used
(21).
“…I don’t need to check for my blood glucose …I can
understand either is very high or low…” is the most frequent
and dangerous excuse! In the best case only very high or very
low values can be perceived. “… I have an insulin injection five
times per day, I don’t do it on my thighs…because there
bleeding…”. Many of the patients expressed their need for
information regarding insulin injections, “ …are they any
secrets so they do not hurt….sometimes they can be very
painful…”.
“…What exactly happening to the point that insulin is injected
and it becoming red and itchy…” was the question of a young
patient who participated in this study.
Both, patient and his family should monitor injection areas
13. always, for differences in the points. Moreover, they should
inform the nurse about every minor or major difference
detected, because a slight impairment at an early stage can be
easily handled rather than a more extensive one. The main
problems are hypersensitivity, lipodystrophy and lipoatrophy
(19, 22).
Needs for diet and exercise
The diet of a patient with type II diabetes does not differ at all
from the diet of a healthy individual, if they are following the
traditional Greek lifestyle. According to this lifestyle, obesity
did not exist in Greek villages until a few decades ago. Many of
the patients who participated in this study were obese people,
especially women. The energy consumption includes the basic
metabolism, the caloric effect the metabolism of foods and
muscular work [23].
“… I want to learn how to eat correctly… I have to lose
weight…”, the most obese among patients states “I have to lose
a lot of weight…my feet are aching……….I find it hard to
walk…”.
Nurse must respect the religious specifics of each patient and its
fasting periods. “I want to fast … but I’m afraid that may turn
out to be harmful …” this is the desire of a patient who is
diabetic and is very religious person. We cannot depriving from
patients their desires and especially the religion ones. The Faith
of each person gives him strength, and by raising this force he
can overcome the difficult life events.
Need for knowledge about Hypoglycemia
Hypoglycemia is the most frequent and more severe side effect
of insulin therapy, but it can happen after the administration of
hypoglycemic tablets. The fear of hypoglycemia and the effects
14. of severe and extended hypoglycemia on the brains functions
that are reversible, but under certain circumstances may become
permanent, are a key obstacle in the regulation of diabetes. All
patients who participated in our study had a medical history
with enough episodes of hypoglycemia,,“I find it difficult to
calculate the dose …. I often have hypoglycemic episodes..…”.
Among patients with diabetes type II, the higher frequency of
hypoglycemic episodes is, in those who are using insulin and
less in those patients who are using tablets.”….. I often have
hypoglemic episodes … my jaw is numb or I’m sweating..…”.
In such a way a patient describes the hypoglycemic symptoms
(24).
The importance of every patient with diabetes to always carry a
badge or a feature that says he is diabetic should be noted. This
characteristic may save his life in an impending hypoglycemia.
Hypoglycemic symptoms can imitate those of alcohol abuse. “I
forget a lot and I want someone to remind me the time … and
what to do …”.
The patient was located at the city hospital and the cause of her
hospitalization was the deregulation of diabetes, due the fact
that she didn’t had been administrated with insulin for days.
When her insulin supplements had finished she and her relatives
weren’t able to replace them.
Dementia is a frequent phenomenon in diabetic patients,
especially in those with a certain age. According to research
that has been conducted, middle age patients with type II
diabetes, have a more severe reduction compared with those
without diabetes. Therefore cognitive function should be
evaluated and assessed in middle aged people with type II
diabetes (25, 26, 27).
15. Need for Communication
One of the essential points that indicated by this study was the
need for communication, expressed by all participants as well as
their relatives. Most of them wished if we could keep in touch
with them in the future. “.. Now that “help at home” ended……
those girls would come and helped us…. Now where do we find
some support …” The “Help at Home” program serves a large
number of people who are living in remote areas of large
municipalities. It offers nursing, household service’s and
entertainment and it make the best possible use of all resources
that are available. It is addressed to lonely people who are
facing various forms of difficulties and provides employment to
a significant number of people; in addition, it strengthens
incentives to remain in their place than seeking work in urban
centers. “… I do not want to leave my home…… There, a nurse
may come to help us …… with injections … the food … and
keep us company …” (28).
Many of participants had found in the face of the institution
“help at home”, willing nurses who visited them in their homes
daily, looked after them, and were give by them and their
families psychological support.
Needs for recognition and addressing complications
Another very common and important reason for hospitalization
is the diabetic foot. The patient needs to be aware for it
prevention and how to avoid this complication. “ … My feet are
frozen….and in pain for the last three days…..”, words of a
patient that is participating in this study. It would appropriate
point out some measures to prevent diabetic foot. As mentioned
above, nurses have an important role in the prevention of
complications in the lower limbs of patients with diabetes. For
this purpose, the provision of information and training of these
patients should focus to:
16. The daily control of lower limbs and foots, due to decreased
sensation, it is possible that the patient has injuries, which he
didn’t feel (10, 29, 30, 31, 32).
In conclusion, by adopting those instructions, diabetic patients
can prevent complications in the lower limbs, essentially. “I did
not believe all the problems that diabetes can bring…. … can
get to me …Now I have asthma………… I had a Coronary Stent
procedure … and now something is wrong with my
leg……………Why is it like this…” words of a patient that had
a diabetic foot. As we can see the complications don’t relate
different patients, but each patient can deal with several of the
known complications of diabetes.
Diabetic nephropathy complicates 20-40% of diabetics and is
the leading cause of end stage renal disease. “…… I have
kidney’s problem … my legs and hands are swelling … I’m
afraid that I going to be under dialysis … …”.
The everyday needs
“…I’m living in a village on a mountain … and we stay cut off
for may days during the winter…”, “… I can’t come often to the
city … It’s far away and it’s cold …”
The peculiarity of the region was expressed by three patients,
who there were living in mountainous villages. Those patients
did not have access to a nursing facility cause of the weather
conditions and they were remaining cut off by snow for weeks
thus without medical-nursing care and medication. The extreme
weather events that are prevailing in central Greece are making
the need for nursing care necessary.
“…..not to long ago I mistook my insulins and I got severe
hypoglycemia…… fortunately my son was there and rushed me
17. to the hospital …”, words from a patient, indicating how
crucial, the daily life of diabetics can be. Even a little mistake
can be very crucial for life. In province the institution of the
family is still preserved, and most diabetics, are still close to
their children. Those people have someone younger supervising
and helping them. But there are also people who are alone and
facing several daily problems.
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5. CONCLUSIONS
This study was conducted with semi-structured interviews and
with a few participants thus, the results cannot be generalized
for the overall population. However, this research’s findings are
supported by relevant studies, which are reporting similar
results. The results indicated that patients with diabetes are
exposed to a variety of fears and needs, related to the diagnosis,
treatment, expected impacts, prognosis and the daily
management of the disease. Their fears were related to the
complications and the effects on their lives like any other
chronic disease, which cause the patients to a diffuse fear for
their daily life and life in general.
The Chronically ill patients are people who have learned to
handle their disease better than anyone and often even than
scientists. “… I have become an expert…” those are words of
the chronically ill patients and of all of the participants of this
research. This phrase “I have become an expert” indicates the
patients’ development of skills in order to address their diseases
in an expert way. Self care and management are goals set by
care providers and especially nurses. A successful training
program is one that through it the patient was ready to take on
initiatives. Family support and the roles that family members
have is an integral part not only for the patients training but
also for the psychological support (33, 34). Women tend to be
more open to provide information and discuss regarding their
18. disease opposed to men who tend to be more cautious. The
elderly had to deal with complications and younger patients had
more hypoglycaemia. Men were more occupied by issues
regarding their work and the possibility o a disability or an
inability caused by the illness (17).
The fear of inheritance and for their family is the same for both
sexes; moreover a major question for the patient is whether
diabetes is a disease with no borders and limitations to societies
and all social groups (19).
Most of the patients were in need for psychological support
from nurses. Nurses were by their side, from the early stages of
their disease, providing information regarding self-care. Self-
care training is a continuous struggle in diabetic care. New
treatment methods, new medication, new formulations of
insulin, changes in the way of thinking, age perceptions and
specificities developed by alignment problems, makes us aware
that the skills acquired by diabetic patients are not permanent
but they are put under a continuous evaluation and modification
throughout the course of his life. The reduction of diabetes and
the prevention of his complications could also reduce the cost
of hospitalization. The gain that will come from such reduction
could be spent on research programs and drug discovery for
diabetes and other diseases that plague the modern era (6, 35,
36, 37).
Go to:
Footnotes
CONFLICTS OF INTEREST: NONE DECLARED.
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