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Diabetes A Chronic Disease

Abstract

Diabetes is a condition in which a person has high blood glucose levels due to failure of the pancreas to produce enough insulin or as a result of body cells failing to respond to the insulin that is produced. Alternatively, there is another type of diabetes characterized by passage of large amounts of urine as a result of a deficiency secretion of anti-diuretic hormone. This type is otherwise called Diabetes insipidus. Diabetes mellitus has been linked to obesity although there are a variety of causes while Diabetes insipidus has often been linked to pituitary gland failure. A lot of dietary and chemical therapy has been used to control and maintain diabetes as complete eradication of the disorder from the body is not possible. Patients living with the condition are educated on ways of ensuring that it is under control at all times.

Discussion

Diabetes, characteristics and most affected group

The most common form of diabetes is Diabetes mellitus acondition that is characterized by very high blood sugar levels as a result of the body failing to maintain the correct level. The hormone that controls blood glucose is called insulin and it is secreted by the pancreas. This hormone converts excess glucose in the blood into glycogen or else turns it to energy which is utilized by the body Mayo Clinic Staff, 2010).

There are generally two categories of Diabetes mellitus namely type 1 and type 2. Type1 Diabetes mellitus is characterized by loss of the beta-cells of islets of Langerhans in the pancreas which produces insulin. Lack of insulin leads to hyperglycemia, which refers to, high than normal blood sugar levels. Traditionally, this was referred to as juvenile diabetes because it was common in children and adolescents and rare among adults.

Type 2 diabetes on the other hand is characterized by insulin resistance which may appear in combination with low insulin secretion. It is the common type of diabetes involving insulin receptors resistance to high blood sugar level. Type 2 diabetes is common among older people unlike type 1 which mostly affects young children Mayo Clinic Staff, 2010).

Symptoms portrayed by affected individuals

One of the most common characteristic of diabetic individuals is general body fatigue. Due to inability of the body to produce energy from glucose it switches to utilizing body fat which requires more energy to metabolize thus, leaving the body more fatigued (CDC,2009). Consequently, as the stored fat is used up in production of energy, the individual suffers from unexplained weight loss. In type 2 diabetes, the body resists the action of insulin such that the body ends up producing more and more to control loss of excess glucose such that the individual ends up feeling hungry at all times. This is as a result of the effect of insulin and even after eating high calorie foods very minimal weight is gained.

Prolonged healing of wounds due to inhibition of white blood cells to function normally is common as well as thickening of blood vessels thus, impairing transportation of the cells to injured spots. Sometimes presence of glucose in tissues encourages growth of bacteria hence, leading to infections in those tissues (Diabetes, 2010).

Causes of the diabetes and effect on body systems

Causes

Type 2 diabetes is caused by lifestyles activities such as leading a sedentary life, high alcohol intake as well as smoking and adoption of unhealthy diets together with habits. Individuals who are obese have increased levels of being diabetic especially in children and adolescents. Environmental pollution with bisphenol-A a component of plastics has been linked to increased diabetes cases especially in highly industrialized countries.A medical condition such as Cushing’s syndrome which increases the amount of cortisol in the body is closely linked to type 2 diabetes. Hypogonadism which leads to increased cortisol increases the sensitivity of insulin as well as reduced production of testosterone.

Genes are also lead to diabetic conditions to a certain extent although environmental stimuli are also required to trigger the genes. Certain HLA genotypes increase the susceptibility of individuals to Diabetes mellitus. The gene NOTCH2 and KCNJ11 when inherited regulates proglucagon gene expression thus leading to diabetes Mayo Clinic Staff, 2010).

Effect on body systems

When the blood sugar levels increase to dangerous levels while at the same time all of it is excreted, the body develops a deficiency otherwise called “hypoglycemia”. This condition leads to less glucose being availed for normal body functions. The nervous and skeletal systems require a lot of energy to carry out their designated functions such that if the nervous system does not have access to glucose, it may react by leading the body into a coma. The skeletal system may develop serious cramps in addition to failing to function normally. This may result in neurological disorders such as numbness due to death of cells and eventually amputation of limbs among other parts (Diabetes, 2010).

Diabetic retinopathy is a common effect on the eyes resulting to partial or total blindness in affected individuals.The general immune system of the body is weakened by diabetes due to inhibition of white blood cells and this increases the rate of infections from other diseases especially cardiovascular diseases (CDC,2009).

Diabetic risk factors

Risk factors which can be controlled

One of the risk factors that can be controlled is avoiding sedentary lifestyles. By participating in physical activities one is able to reduce the chances of being diabetic. Physically active individuals have lower rates of diabetic incidences than people who participate less in such activities. Obese people are encouraged to engage in physical exercises in addition to reducing their intake of high-fat foods. A combination of the two actions not only regulates their weight but also helps in controlling diabetes. Reducing the intake of alcohol and smoking are lifestyle factors which can be modified to control diabetes. Consequently, all lifestyle risk factors can be changed to control diabetes by adopting healthy eating habits and lifestyles (CDC,2009).

Risk factors which cannot be controlled

Hereditary factors such as inheritance of NOTCH2 and KCNJ11 may not be possible to control as an individual is born with the causative agent and in the presence of a conducive environment, the condition appears. In such a case, even the body’s immune system may not alter the genotypic constitution of the individual. Alternatively, risk factors such as environmental pollution and toxins may only be controlled if the whole world joins hands in the exercise. This is because some toxins are airborne and may affect individuals who are direct an indirect contact with them (CDC,2009).

Evolution of treatment procedures for diabetes

Over the years, diabetes has been treated using artificially prepared insulin which is intravenously injected into the bloodstream. This refers to insulin therapy and sometimes it can be inhaled to control diabetes but not curing. Individuals with morbid obesity have been subjected to gastric bypass surgery which has controlled the condition. However, diabetes is a chronic situation that cannot be cured and is only controlled (Diabetes, 2010).Before the discovery of insulin in 1922, diabetic patients were often advised to eat low-caloric food to evade death by ketoacidosis. Diets rich in fiber and proteins were recommended and even today, diabetic individuals live according to this diet to maintain the condition Mayo Clinic Staff, 2010).

Current treatment methods

Modern treatment methods include use of clinical insulin’s which are yeast based and being protein in nature they cannot be administered orally. Subcutaneous administration of insulin involves use of single-use of syringes fitted with needles or insulin pumps. This procedure has its own schedules which mimic the psychological secretion of insulin by the pancreas. Hypurin administration is common with this procedure while Exubera is administered by inhaling (CDC,2009).

Another option that is quite familiar is transplantation of the pancreas or beta-cells as opposed to periodic administration of insulin. This transplantation is rather complicated and it is done in conjunction with liver or kidney transplant so that a self-regulating source of insulin is obtained (Diabetes, 2010).

Medical tests and procedures in diabetes

There are two major procedures that are involved in testing blood sugar levels; the first procedure involves use of the enzymes hexokinase and glucose oxidase. A sample of blood is placed on a strip which is later inserted in a meter to obtain readings. This technique identifies presence of nonspecific reducing sugars in blood. The readings obtained will show the amount of glucose in the blood and from there the medical officer is able to make an informed diagnosis (CDC,2009).

Future treatment options

More research is being done on the possibility of transplanting technically engineered non-beta cells into diabetic patients to secrete urine. Other options of non-transplant methods in which insulin will be automatically delivered are also being developed to reduce complications associated with intravenous administration of insulin. Thus, the future looks bright for people with diabetes as a cure maybe discovered and severity of the condition minimized (Diabetes, 2010).Researchers are also working towards developing artificial pancreas which will be transplanted into the ailing individuals as well as using stem cells to genetically engineer normal pancreases (Diabetes, 2010).

References

CDC,(2009),Diabetes and me. Retrieved from: www.cdc.gov/diabetes

Diabetes, (2010), Journal of American Diabetic Association. Retrieved from: www.diabetes.org/

Mayo clinic staff, (2010), diabetes. Retrieved from: www.mayoclinic.com.

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Majority of the Americans believe in the American dream. The American dream is that the United States (U.S) is the land for life is fuller and better for every person, with opportunities for each based on achievement or ability irrespective of social class. Thus, the American dream is having opportunity for success and prosperity, supported with an upward social mobility for children, youth, and the family. Some of the primary elements of the American dream include education access, income equality, and higher economic growth.

Most of the Americans have perceived pursuing college education as the key to the American dream. Report by the University of California show that there is an increase demand for college education, but most colleges cannot accommodate them. For instance, “for fall 2014, the University of California admitted 86,865 applicants for freshman admission out of an applicant pool of 148,688” (University of California 1). This implies that majority of the Americans are not able to achieve their American dream because education systems cannot accommodate them all. Low income earning among students coupled with soaring student loan debt crisis are some of the challenges American low class and middle class citizens are facing while trying to achieve their American dreams.

In the second article, “In Climbing Income Ladder, Location Matters” David Leonhart attempts to show how some States in the U.S like New York and Boston have experienced a much higher income level compared to other regions such as Charlotte and Atlanta. Because of the low income and wage inequality gap, it has become difficult for lower income households in regions like Atlanta to climb the socio-economic ladder to reach middle class status and beyond (Leonhart 1). The upward mobility rates are lower in these regions and most children born in these areas trend to continue living under the same social and economic regions as their parents. Leonhart (1) adds that the level of unemployment is high, while the savings rates are very low in these regions. On the other hand, “those who live in areas with higher economic growth and better schools have a greater chance to climb the economic ladder” (Leonhart 1). The implication made is that upward mobility tends to be higher in those regions with better schools, economic prosperity, and high income Americans. Lastly, the American dream is not achievable for majority of Americans because upward mobility In the U.S is very low since unemployment is high, available jobs pay low, students debts have increased, and the possibility of children born in poor families rising to middle class is also smaller.

The third article “For richer, for poorer” by the Economist 2012 have explored the increasing income inequalities. Growing inequalities in the U.S has become one of the biggest political, economic, and social challenges of the contemporary America, which threatens the American dream achievement. This is because “disparities in wealth are less visible in Americans’ everyday lives today than they were a century” (Beddoes 1). The reason behind this change is because the highest income generated in the U.S goes to only 1 percent of Americans. With these disparities which continue to affect the U.S, the richer have continued to become richer while the poor continue to grow poorer (Beddoes 1).

The last article “Many Feel the American Dream Is out of Reach”, Andrew Ross Sorkin and Megan Thee Brenan has explained that the current pools indicate that many Americans feel that the American Dream is out of reach. For instance, among the participants, 64 percent of the respondents believed that the American dream was still achievable (Sorkin and Brenan 1). This is despite the increased wealth and income gaps between the wealth Americans and the middle class.

All the four sources used have showed that the opportunities for people to success in the U.S are still present. However, poverty, income and wealth disparities in some regions in the U.S, increased college debts, and inadequate access to education, supported with unemployment, and low pay are some of the challenges which hinder the realization of the American dream. The articles are different in the sense that some have addresses the factors which affect the American dream directly, while others have note.


Work Cited
Beddoes, Zanny Minton. “For richer, for poorer.” The Economists. 13 Oct. 2012. Web. 11 Aug. 2015. <http://www.economist.com/node/21564414>
Leonhardt, David. “In Climbing Income Ladder, Location Matters.” The New York Times. . 22 Jul. 2013. Web. 11 Aug. 2015. <http://www.nytimes.com/2013/07/22/business/in-climbing-income-ladder-location-matters.html?pagewanted=all>
Sorkin, Andrew Ross and Megan Thee Brenan. “Many Feel the American Dream Is out of Reach”, The New York Times. 10 Dec. Web. 11 Aug. 2015. <http://dealbook.nytimes.com/2014/12/10/many-feel-the-american-dream-is-out-of-reach-poll-shows/>.
University of California. “Fall 2014 Freshman Admissions to the University of California.” 2014. Web. 11 Aug. 2015. < http://www.ucop.edu/news/factsheets/2014/fall-2014-admits-summary.pdf>.





Cyberbullying
Cyber bullying is the process of using internet or mobile technology to harm, intimidate or harass people. In most countries, there are laws or policies which have been enacted to curtail this criminal act. In reference to New Zealand, the country has laws enacted to protect, parents and children. For instance, Education Law (Education Act 1998), especially the National Administrative Guideline 5 requires all schools in New Zealand to provide a safe emotional and physical environment for all students (Netsafe, n.d). The law addresses behaviors like cyber bullying taking place outside school but could have consequences on the well-being of the students while at school. The reason as to why bullying was incorporated in the Act was because cyber bullying is a method which destroys the well-being and confidence of young people (Netsafe, n.d). The law is in the process of being improved to ensure that people involved in cyber bullying are prosecuted.

New Zealand’s law is more defined compared to that of the United States (U.S) in regard to cyber bullying involving persons under 18 years. In addition, in U.S, each state has different laws and policies which provide measures on how to deal with cyber bullying. However, the new proposals to incriminate cyber bullying in New Zealand are to reduce the effects on students (New Zealand Herald, 2014). The proposed action is for New Zealand to have stricter anti-bullying legislation which mandates the schools to intervene in case a sign of cyber bullying in schools are noted. The policy could adopt the Californian law on cyber bullying in schools which requires schools administration to expel or suspend students harassing other students online, in addition to developing policies which address the issue.


References
Netsafe. (n.d). Cyberbullying information and advice for teachers and principals. Retrieved from http://www.cyberbullying.org.nz/downloads/teachers_cyberbullying_advice.pdf.
New Zealand Herald.(2014). New law sets a net for cyberbullies. Retrieved from www.nzherald.co.nz/bay-of-plenty-times/news/article.cfm?c_id=1503343&objectid=11213908



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Nursing Informatics
Evidence-based practice (EBP) provides required evidence which can be used to enhance knowledge and formalize principles and process which promote quality health care (Rodrigues, 2000). Information technology can be used to locate EBP which can be used to address concerns like how patient ratios and nurse work hours affects patient outcomes. The core issue of concern more evident in nursing is the effect inadequate staffing has on quality care in spite of existing evidence, low staffing continues to be a major problem. To locate evidence-based practices that address this concern, systematic literature search was conducted were different clinical databases, libraries, and online nursing bulletins were searched and most appropriate selected.

An evidence report compiled by Agency for Healthcare Research and Quality in 2007 on the relationship between nurse staffing and quality of patient care established that small nurse-patient ratios increase the rates of hospital-related mortalities and morbidities and increased adverse clinical events (Kane, Shamliyan, Mueller, Duval, & Wilt, 2007). Similarly, a published report in the National Center for Biotechnology Information by Garret (2008) indicate that inadequate staffing inherent in majority of the hospital wards undermines the delivery of holistic care because of increased nurse burnouts and fatigue which ultimately result to medical errors and adverse health outcomes. Thus, adequate nurse staffing is necessary to improve patient safety and healthcare. Lastly, information found in the Registered Clinical Nursing bulletin as provided by Gillen (2012) has showed that inadequate staffing hinders the ability to provide adequate care to patients.

Health information technology (HIT) supports EBP by capturing, transforming, and maintain data which can be used by healthcare providers to improve patient outcomes (Rodrigues, 2000). Through the use of HIT nurses and organizations can make best decisions based on existing scientific evidence and study.







References
Garrett, C. (2008). The effect of nurse staffing patterns on medical errors and nurse burnout. AORN Journal, 87(6), 1191-1204.
Gillen, S. (2012). Most nurses are struggling with inadequate staffing, survey shows. Nursing Standard, 26(34), 9.
Kane R. L., Shamliyan, T., Mueller, C., Duval, S., Wilt, T. (2007). Nursing staffing and quality of patient care. Evidence Report/Technology Assessment No. 151. Retrieved from http://archive.ahrq.gov/downloads/pub/evidence/pdf/nursestaff/nursestaff.pdf
Rodrigues, R. J. (2000). Information systems: the key to evidence based health practice. Bulletin of the World Health Organization, 78, 1344–1351.



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