Self Management of Diabetes Essay Example | Topics and Well Written Essays - 1500 words

Self Management of Diabetes - Essay Example Obesity is a major risk factor for the development of diabetes and the numbers of people that are becoming obese is increasing rapidly. It is the major cause of premature mortality and morbidity due to cardiovascular, renal, ophthalmic and neurological disease. It is widely accepted that control of the lifestyle situation including diet and exercise decrease the risk of complications and control the Hg1c (Porth & Matfin, 2007). This paper will discuss recent studies affecting the overall Hg1c with combined strength and aerobic exercise programs. Self management of diabetes includes diet, exercise, medication, and blood sugar control. Exercise, however has been shown to be highly important. Lean muscle mass improves Hg1c (Sigal, Kenny, Boule et.al. 2007). There has been some controversy in determining whether that exercise should be aerobic or strength or both. In researching this, studies relating to diet and other controls were eliminated and a search was conducted for supporting evidence that both types of exercise included in routines for these patients improved overall blood glucose control and limited complications from the disease. Five peer reviewed studies were retained from many found as they included both exercise routines against controls. Historically, aerobic exercise has been used to attempt to improve glucose levels in diabetic patients. However, there is a great deal of literature available now that shows a great deal of merit for adding resistance exercise to this routine for control. It appears that glucose control is only one of the benefits of this kind of routine for diabetic patients. Strength, endurance, and power are benefits received (Marcus, Smith, Morrell, 2008). There is also an increase in lean tissue mass which creates an increase in metabolic rate. The importance of physical activity in these patients cannot be denied. It is considered not only preventative but also therapeutic (Tokmakidis, Zois, Votaklis, et.al. 2004). The change that occurs in muscle mass coupled with effects on glucose uptake are the reasons for better control. This occurs even in people with insulin resistance. In operationalizing this data, education is the key. Over the past years, diabetics have been taught that walking is the perfect exercise to control their HgA1c and to some point that is true, it is the perfect exercise. However, there is a gap in the education as far as adding the needed strength training. It may be clearly important, due to the large numbers of diabetics now, to design and implement diabetic exercise programs that are couple with regular education programs. Certainly controlling blood sugar and preventing complications of this disease proves to be financially needed for both the patients and the healthcare system. Sigal, Kenny, & Boule et.al. (2007) published a study in the Annuls of Internal Medicine on this very issue. Previous studies evaluated by them determined that the effects of aerobic exercise alone provided for better glucose control. They felt that there was likelihood that a combination of aerobic and strength exercises would lead to better control. They performed a randomized control trial set in 8 community based facilities. Included in this study were 251 adults age 39 to 70 with type 2 diabete (Sigal, et.al., 2007). Patients were

Cultural Diversity Essay Example | Topics and Well Written Essays - 750 words

Cultural Diversity - Essay Example Young ladies were groomed not for successful careers but to be wives of eligible and economically stable men, so they are not encouraged to pursue their education, as this will not be of benefit to them anyway. This cult of domesticity has been practiced for ages, so it was already something that most women accepted and became accustomed to. However, a growing number of women felt they were too constrained to be anything more than a housewife and longed to maximize their potentials as women. In raising these concerns, feuding groups of women fought for opposite beliefs. Those who yearned for freedom and equal rights with their male counterparts, led by Elizabeth Cady Stanton and Lucretia Mott, staged a convention to launch the women’s rights movement. For two days in July in 1848, they convened in the low-key town of Seneca Falls in New York. This small group of people were instrumental in uplifting the position of women in society. In the convention, they argued for equality with men and fought for greater legal rights, especially the right of suffrage. They also voiced out their need for more professional and education opportunities (McMillen, 2008). These women were courageous to fight for reform that was considered radical at that time, especially since their opponents were also women who embraced domesticity. Out of that convention came the Declaration of Rights and Sentiments as drafted by Elizabeth Cady Stanton. The document demanded women’s voting and property rights as well as equal economic and educational opportunities with men. Eventually, in 1920, after more than seventy years, women got what they fought for with the Nineteenth Amendment to the U.S. Constitution, which reads: â€Å"The right of citizens of the United States to vote shall not be denied or abridged by the United States or by any State on account of sex. Congress shall have power to enforce this article by appropriate legislation.† This amendment empowered women w ith certain rights and privileges that allows them to pursue an education, vote, and seek employment outside the home, and even work alongside men. It was a long wait, but it was truly worth it! Work Cited McMillen, Sally. Seneca Falls and the Origins of the Women's Rights Movement., Oxford University Press, 2008. 2. Institutionalized Heterosexism From time immemorial, the belief that there are only two genders: male and female, has been propagated by society. This meant that each gender was endowed with its own roles, rights and privileges. Over the years, the fact that some people have differing sexual orientations that did not conform to the two that are upheld, was not welcomed, as discomfort in even accepting such differences prevailed. Although homophobia, or the â€Å"irrational fear of, aversion or discrimination against homosexuality or homosexuals† (Merriam Webster Online, 1969) has been viewed negatively, it has somehow persisted albeit in a more subtle manner. Ind ividuals who pursued their sexual preferences as lesbians, gays, bisexuals and transgenders (LGBT) usually suffer discrimination in many facets of society. They are seen as those who go against the norm, and certain rights, opportunities and privileges that heterosexuals enjoy are usually not extended to these LGBTs. This kind of prejudice against LGBTs has been labelled heterosexism. It deprives many of society’s privileges from those who â€Å"

Classical and Operant Conditioning for Maladaptive Behaviour

Classical and Operant Conditioning for Maladaptive Behaviour Applying classical and operant conditioning therapies  to change maladaptive human behaviour Psychologists who study the behaviourism approach suggest that behaviours of a human are learnt through either classical or operant conditioning. These behaviours can be changed through therapies. This assignment assesses the values of applying classical and operant conditioning therapies to change maladaptive human behaviour. Operant conditioning is when behaviours are learnt through consequences; doing something to get something. â€Å"Operant conditioning creates a higher probability of repeated behaviour through reinforcement† (Collin et al, 2012). A human would receive positive or negative reinforcement or even punishment for their behaviour. Consequently this would lead to repeated behaviour, changed behaviour or even stop the behaviour depending on the reinforcement received. B.F Skinner explained operant conditioning by conducting experiments in a box that he designed called the ‘Skinner box’ (1948, cited in Barker, 2002). For example a hungry rat was placed in a box, there was only a lever and a food dish inside. The rat knocked the lever and soon learnt that he received food for his action and kept repeating the behaviour to gain more food. This is an example of positive reinforcement because the rat received food for its action. Skinner (1948, cited in Collin, 2012) later int roduced electric grids to the Skinner box which would give the rat an electric shock when the lever was activated. The rat’s behaviour of pressing the lever decreased. This experiment showed that the receiving of negative reinforcement caused the rat to change its previous behaviour. There are several therapies that use operant conditioning, one is called token economy. Behaviour is modified through reinforcement and also punishment; it has been used in many types of care units, such as mental hospitals, eating disorder clinics or even juveniles acting up (Barker, 2002). The patients involved in token economy would receive rewards in forms of tokens or points for good behaviour, this is positive reinforcement. On the other hand if bad behaviour was shown by the patients tokens would be taken away, this is negative reinforcement. Tokens can then be used for outings, privileges, goods, food or even extended visits with their family (Allen, 2013). When patients demonstrate good behaviour and are therefore rewarded with tokens it is hoped that the positive behaviour would be repeated with the aim of gaining more rewards. Eventually their pattern of behaviour would consequently change and would happen naturally. However if tokens were taken away for bad behaviour this would be negative reinforcement. The patient would realise that if they behaved badly, negative consequences would follow such as less tokens to spend on privileges or extra food. Eventually this would hopefully change the behaviour of the patient and their bad actions would decrease. One study that showed token economy was carried out in an adolescent service at Boston hospital by Kris and Schiff (1968, cited in Thomas, 1974). They delivered the token economy therapy in the hospital for adolescents in the form of point cards. Each point gained was worth one penny which then could be accumulated and spent on food, privileges and outings. Each patient had a small plastic point card with their name and identification number embossed. Each time a patient earned points they would be given a point’s receipt and their point card would be stamped. All points would be added up at the end of the week and the reward of money would be given. The adolescents could gain 30 points by carrying out room maintenance such as bed making and also 10 points for arriving on time for lessons. Points would be taken away for lateness and untidy rooms. The study demonstrated positive and negative reinforcement. The adolescents learnt that the cleaner their room and the quicker they went to class the more points they received, this is positive reinforcement. The behaviour would change and they would be better behaved and follow instructions. When points were taken away for lateness or no room maintenance being completed they would learn that these actions needed to be completed and they would change their behaviour and start showing up for lessons and also making their beds, this is negative reinforcement. This interesting study showed improvement in adolescent’s behaviour at the hospital however it should be noted that in some cases the adolescents were seen to steal receipt books and point stamps to try and give themselves points. The disadvantages for this study was that it wasn’t very cost affective, the printing of point cards and receipts was very expensive. Also there was over a hundred staff members employed at this hospital and it was hard to train each staff member properly on the token economy point system and some staff would feel harassed and under pressure if working alone which meant they would give points out just so the adolescents would stop harassing them. (Thomas, 1974). Another research was completed by Allyon and Azrin (1968, cited in Allen, 2013) who used token economy therapy to control the behaviour of 45 people with schizophrenia who had been in an institution for roughly sixteen years. The patients were given tokens for combing their hair or even making their own beds. The results of the therapy showed patients’ chores each day rise from five a day to over forty. The patients that were receiving positive reinforcement by gaining tokens for completing more chores each day. Token economy has positive and negative points to change maladaptive human behaviour. Token economy may work inside clinics or institutions but may not necessarily relate to life at home and living independently. Going from being praised for good behaviour and then having no one at home praising them may let the person slip back into their old way of behaving. Token economy may hide the underlying reason for someone’s behaviour. It may make the behaviours and actions go away for a short period due to the person wanting to receive tokens to use for food and privileges but the underlying reason why they are behaving in the first reason will still be there. Using this therapy in institutions and clinics would require a lot of commitment and training from staff. It may not be cost effective to put every staff member through training. Also some staff may not be as committed as others and give out tokens to favoured patients or give out tokens to stop feeling harassed or under press ure. It would be important for staff to be consistent in their actions. Corrigan (1995, cited in Allen, 2013) claims that the therapy is humiliating and abusive to patients and is unethical. Token economy does change behaviour quickly and is good at changing unwanted behaviour which shows in the study completed by Allyon and Azrin (1968, cited in Allen, 2013). Classical conditioning is learning through association. Behaviours are learnt by associating one thing with another. Pavlov (1902, cited in Collin, 2012) showed classical conditioning by experimenting on dogs and their responses to food. He carried out several tests which involved dogs and the salivation glands. He used dogs and put them in restraints, when the dog salivated at different times he measured the amount of saliva produced. An unconditioned stimulus such as food was presented to the dogs which then provoked an unconditioned response; salivation. Pavlov then introduced a neutral stimulus such as a bell with the unconditioned stimulus; the food. The dogs started to salivate at the noise of the bell which was accompanied by food. After repeated tests the dogs started to salivate at the sound of the bell without any food which was a conditioned response; salivation without no food presented. This means the dog had learnt to associate the bell with food and would salivate befo re the food was given. Systematic desensitisation (SD) therapy uses the principle of classical conditioning to reduce people’s fears and phobias. Through several sessions a client would go through relaxation and becomes aware of the bodily cues associated with relaxation. The client then has more sessions to be trained step by step on how to relax in the presence of their fear. (Barker, 2002) One study which was carried out was by Lang and Lazovik (1963, cited in Banyard and Grayson, 2000) which was called ‘Fear today, gone tomorrow’. The study was a simple experiment which used twenty four students who had a strong phobia of snakes. The students were given a list of twenty situations, including holding a snake to seeing a picture of a snake and were told to list them from least feared to most feared in a fear hierarchy. The students then started there SD, which included eleven forty five minute sessions which started with hypnosis and deep muscle relaxation and then slowly they worked through their fear hierarchy by imagining them. They were allowed to move onto the next fear once they could show they were relaxed during and after the previous one. Once all the sessions were completed the students had to carry out the ‘snake avoidance test’. A snake was placed in a glass box 15 feet away and the students got marked out of 19 on how close they co uld get to the snake or to see if they could touch it. The results were compared to students that hadn’t received SD therapy and they showed that the students that had completed the sessions could stand much closer to the snake and even some students could hold or touch the snake. The idea of SD therapy is to associate the fear with relaxation. In the above study it shows that the students that went through SD could associate the deep relaxation with the snakes and in some cases even hold them. The students remaining calm meant they associated there calmness with a fear, which in turn the students could move on to their next fear and keep moving through them. SD is effective where the behaviour is a learned phobia or anxiety of a specific thing, McGrath et al (1990, cited in Allen, 2013) claims that SD works for around seventy five percent of people with phobias that are specific. However it only treats symptoms of the phobia or anxiety and doesn’t help the underlying issue or reason and other therapies would need to be used to look into these reasons. It doesn’t work well with depression or schizophrenic clients. SD is a very slow process due to the amount of sessions needed to work through the relaxation process and then the fear its self but t he longer the therapy and technique take the more effective it is. Overall token economy and systematic desensitisation therapies do work but do have their negative points. Both therapies only resolve the symptoms and don’t resolve the underlying reasons why the person’s behaviour happened originally. This means eventually they could stop working especially if their environment changes and the treatment stops. Other therapies for other approaches would need to be considered to really understand and change the maladaptive behaviours of a person. Reference List Allen C. (2013). Psychopathology and Treatment Workbook. Northampton College. Northampton. Banyard P and Grayson A. (2000). Introducing Psychological Research. Second Edition. Palgrove Publishers. New York Barker L. Psychology. (2002). Pearson Education Inc. New Jersey Collin C. (2012). The psychology book. New York. DK Pub. Thomas E. J. 1974. Behavior modification procedure. Chicago. Aldine Pub. Co. [Online]. Accessed from: http://books.google.co.uk [20/3/14] Bibliography List Cardwell M and Flanagan C. (2012). Psychology AS – The Complete Companion Student Book. 3rd Edition. Oxford University Press. Oxford. Comer R. J. (1992). Abnormal psychology. New York. Freeman Rebecca Sharp

William Wallace :: essays research papers fc

William Wallace is considered to be â€Å"Scotland’s greatest hero† (McHale). In order to appreciate the true value of freedom one must understand the hardships and trials people faced in order to obtain that freedom. William Wallace was a freedom fighter. He went through many trials and tribulations during his life. William Wallace’s family came from Wales. William was not even Scottish (Fish). Yet he had the strength and courage to stand up for what he thought was right. William Wallace was born in a little town called Elerslie, in Scotland, around January 1272. â€Å"He was the second of three sons to Sir Malcolm Wallace† (Waters). His mother taught him his basic education, until he was six to seven years of age (Chung). At this time and age, the second male son of a family was obligated, by tradition, to obtain education by a clergy member of a monastery, and eventually become a clergy member himself. It is unknown, by historians, how William averted this tradition (Ewart). During this time the English king, Edward Plantagenet I, also called Edward de Longshanks (McHale), was taking over Scotland. The king of England issued all the people of Scotland to pay homage to him. Sir Malcolm Wallace was entirely against this. He made this widely known. He eventually became titled as an outlaw by King Edward, and was on the run from the English along with his oldest son Malcolm. Sir Reginald de Crauford, William’s grandfather, administered the homage to be paid to Edward I and noticed that his son-in-law’s name did not appear on the list that he compiled (Chung). He sent his daughter and grandsons to Cambuskenneth Abbey in Dunipace to live with Sir Malcolm’s younger brother who was a cleric there. This is where William received the remainder of his education. â€Å"His uncle instilled in him moral maxims compactly framed in Latin, and referred frequently to the great classic authors† (McHale). At the monastery he learned the passion a nd love of liberty he so frequently displayed as an adult. By the time William completed his education his father died. Sir Malcolm was murdered by an English knight, named Fenwick. The news of William’s father’s death spread quickly. A few months after, William was branded an outlaw, because he killed a man taunting him of his father’s death. This started whole slew of killings and Wallace’s rebellion against the English. Williams Wallace first appears in history early in 1297.

“Coming Back” by David Hill and “Tully” by Paullina Simons

‘Teenagers don’t always know all the answers. Texts can offer important lessons, which may assist responders in reflecting their own values’.Ignorant, unknowledgeable nature of youth exists as a naturalistic quality amongst teenagers; characters within the texts ‘Coming Back’ by David Hill and ‘Tully’ by Paullina Simons further endorse this characteristic. The themes of guilt and recovery as well as Pain and friendship provide insight into fundamental lessons that attest the responder’s values.A central concern addressed in ‘Coming back’ by David Hill is the primary battle existent within Ryan, which is endorsed in a series of actions that Hill associates with guilt. Both Ryan and Tara are heavily affected by the results of a tragic, traffic accident that hospitalized Tara Gower due to the negligence and recklessness of Ryan and his peers.Ryan foreshadows the car accident; repetition, short sentences and colloquial lan guage- â€Å"If only. Two little words with one massive bloody meaning. If only† emphasizing Ryan’s guilt and regret in conjunction with the accident. Direct language, low modality, negative connotations- â€Å"I had to punish myself. Hurt myself.† Forceful, objective tone and repetition in Ryan’s speech reiterate his guilt, as self- harmful thoughts began to justify his physical actions and behavior. Self -harm is a common result of pain amongst youth, which is demonstrated through the insightful texts of both ‘Coming Back’ and ‘Tully†, evidently guidance is often essential for teenagers during adolescents.Unknowing nature can result in fear, hence freezing recovery processes. Tara Gower’s recovery was often simultaneously affected by her fears and fears of the unknown. The enormity of Tara’s recovery is continuously illustrated throughout the text; demonstrated by the use of formal jargon- â€Å"An impact severe e nough to cause brain injury may also cause damage to other organs resulting in contusions of the heart† reflecting the serious notions of Tara’s condition, whilst providing facts and extenuating the trauma of the car accident.Medical context also reflects Ryan’s fears, providing dense, factual realizations that he unfortunately caused. Imagery, personification, metaphorical language-â€Å"I was too tired to fight it. All around me the river kept eating away.† Demonstrating Tara’s dream like state and reflecting her  fears of fading away. Initially Tara’s language is figurative and short, however her language develops over time. First person, imagery, positive connotations, high modality- â€Å"I felt myself swallowing. Orange Juice. A chocolate milkshake-my favorite!† indicating she was able to distinguish taste, but not able to feed herself during this point of recovery. Some of the most tragic issues are best conveyed in the depth of a novel, as they provide insight into fundamental lessons that attest the responder’s values.Pain is an explicit theme present in the text ‘Tully’ by Paullina Simons; how Tully copes with pain is a fundamental aspect of this text. The full horrors of Tully’s childhood are slowly unveiled; although the narrative begins when she is 17, flashbacks and accounts of her torn experiences as a child characterize her behavior and beliefs. She was abandoned by her father and unwanted by her abusive mother from a young age; repetitive clauses, negative connotations, recurring motif- â€Å"From the time Tully was two, she learned fear and with fear she learned hate, and with hate she learned silence† demonstrating she was raised in an atmosphere of neglect and unpredictable violence.Her pain resulted in self harm; metaphor, imagery, personification- â€Å"I do it because I want to feel what death feels like. I just want unconsciousness to wash over me- to h eal myself† illustrating the irony and juxtaposed nature of healing and death, provoking feelings of anxiety, portraying how damaged Tully has become. ‘Tully’ offers important lessons, which are relevant to societies concerns and beliefs.Friendship that endures through life times is a bold theme explicit in ‘Tully’. Regardless of her pain she found refuge in friendship with Jennifer and Julie, until Jennifer committed suicide in their senior year. She wrote a letter to Tully prior to her death; religious references, high modality, colloquialisms, metaphorical language- â€Å"God is going to call upon you to summon all your strength, all your iron clad, gritted teeth, clenched fists will to pull you through† demonstrating Jennifer believes Tully is unbreakable and will overcome her death, however, Tully sees it as an act of betrayal and is shattered by the harsh loss of Jennifer.Tully spent many hours compulsively cleaning the bathroom afterâ₠¬ ¦ and the unforgettable expressionless face of Jen’s father; low modality, emotive language,  imagery- â€Å"he is still stunned, yet I’m already falling, already can’t breathe without her† illustrating her affection towards Jennifer. Jennifer’s death had a huge impact on Tully, which reflects her future behavior and values.The themes of guilt, recovery, pain and friendship are undying concepts present in many teenagers lives, the notions of these themes are universal as ignorant, unknowledgeable nature of youth exists as a naturalistic quality amongst teenagers; characters within the texts ‘Coming Back’ by David Hill and ‘Tully’ by Paullina Simons further endorse this characteristic, demonstrating that teenagers do not always know the answers.

Queen Elizabeth’s Speech To Her Troops

To lead a country there are certain traits that you must obtain. These include poise, confidence, trustworthiness, and ambition. As the ruler of England Queen Elizabeth I possessed all of these qualities and made them apparent when she addressed her troops as the Spanish Armada crept closer to the shores of England in 1588. In this compelling speech she delivers a clear purpose to her troops that she is dedicated to them in every way possible.Through her diction, ethos, and pathos Queen Elizabeth I successfully displays her dedication giving her troops the confidence to rally and attack the enemy. Queen Elizabeth I uses diction that exhibits her trust and dedication towards her troops. She praises her â€Å"faithful and loving people† and emphasizes the â€Å"loyal hearts and good-will of my subjects†. The queen chose these words because they show what her people mean to her. She could have chosen to simply call them her subjects.This is a much more derogatory and imper sonal way of addressing them. Instead she approaches them in a way that exposes how much she cares about them which in turn shows her dedication. Even though Queen Elizabeth I was far removed from the daily lives of her troops and people in her speech she speaks to them as if they are her own family. The Queen does not limit her use of diction to only praising her troops though. She also uses selective word choice to portray how much her country means to her.She refers to Spain invading England as â€Å"to invade the borders of my realm. † This statement asserts her protectiveness over her country. The Queen makes it clear that if anyone is to dishonor her country she will personally see that they receive a repercussion. The diction selected by Queen Elizabeth I tactfully presents her dedication to her troops and citizens. As the ruler of England, Queen Elizabeth I already possesses a certain amount of credibility and trustworthiness to her subjects.While speaking to the troo ps at Tilbury she exerts more ethos to prove her dedication. One thing that the Queen makes very clear is that she is willing to die for her country. She states â€Å"in the midst and heat of the battle, to live and die amongst you all, to lay down for God and my kingdom, and my people. † Even though she may not actually fight on the battlefield, just by asserting that she would be willing to risk her life for her kingdom of England if the time ever came proves her immense dedication to her people.She furthers her credibility by saying, â€Å"In the mean time, my lieutenant general shall be in my stead. † The Queen would be fighting if she could, but instead she is â€Å"fighting† through one of her generals, but we know she is dedicated at heart. She also simulates loyalty when she says, â€Å"I myself will take up arms, I myself will be your general, judge, and rewarder. † Queen Elizabeth gains trustworthiness because she is willing to do anything for h er troops and people that will better their lives. The ethos that is professed advances the Queens dedication.When addressing troops that are about to enter into a life-threatening battle, as a speaker you need to calm their nerves, while also showing that you trust them. Queen Elizabeth successfully uses pathos to accomplish this task. The Queen renders, â€Å"we shall shortly have a famous victory over those enemies of my God, of my kingdom and of my people. † This statement demonstrates her confidence in the troops. Then, the troops realizing that their queen has so much faith towards them will possess the strength and courage to succeed in battle.