Woodrow Wilson Essays (1311 words) - Freemen Of The City Of London

Woodrow Wilson The turn of century was an important time for pre-WWI America. National and international affairs were in full swing, just as ever. America was trying hard to remain with its Isolationism, yet could in no way thoroughly do so. Yet with this isolationistic stance, that was deteriorating daily, much emphasis was put onto national affairs of the United States by the government. Woodrow Wilson, the third president of this new century, also had great concern with the national affairs of the U.S. Elected in 1912, Wilson strongly believed in a government ?more concerned about human rights than property rights? (Comptons). Through these strong idealistic views, Wilson was in fact the ?president of the common people.? He proved this through his efforts for farmers and other laborers. This also seen through his ?New Freedom? basis of government, as opposed to President Roosevelt's ?New Nationalist? form of government. On top of this, Wilson's flood of social welfare legislation proved that he was definitely ?president of the common people.? One thing must be known about Wilson before anything else. That is the fact that he was a strong idealist. He had great visions of how to make the U.S. a better nation for all. This is illustrated trough his many Acts that he sent through congress. He put in place many systems that help benefit all the common people. Though he did not always follow all the way through with his plans (he more or less put them in place and left them), his strong devotion to the common people being treated equally cannot be overseen. The fact is that Wilson truly cared about the farmer and the working man. For example, it is known that he ?promised to return state government to the people? (Bailey 703). He believed in the struggles of people as a whole, rather than individually. One act that he put into place was the Federal Farm Loan Act. Here, Wilson made credit very easily accessible to those farmers in need. This law divided the country into twelve regions and opened a Federal Land Bank inn each one of these regions (McDuffie 139) Wilson also made the rate of interest towards these farmers very low and affordable. Wilson realized the importance of the farmer upon American society, a fact that many other politicians of the time easily ignored. So with his idealistic visions, Wilson brought a little ease upon the farmers of America. In 1916, Wilson helped get the Warehouse Act into effect. This act ?authorized loans on the security of staple crops? (Bailey 709). Both of these acts were in essence Populist ideas that the Populists wanted into effect for some number of years. And it was only President Wilson who brought these issues to light and made a difference for these common people. It is obvious that Wilson was concerned of the farmers and he therefore acted upon the concerns and made life that much easier for them. Wilson was also very concerned with the average workers of the U.S. His flood of social welfare programs was clearly send and felt by hard working American citizens all around the country. The combination of new acts being put in place targeting business in general, along with those targeted specifically for the betterment of the welfare of working Americans. In 1916, Wilson imposed the Workingman's Compensation Act. Under this Act, assistance was given to federal civil service employees in the time of disability. Also, Wilson put into place the Child Labor Act in the same year. Though this law was declared unconstitutional in 1918, it was a definite step in the right direction. For it did not allow the shipment of products that had been made by those under the age of fourteen or the age of sixteen (the age limit was different for different products). Also in that same year, the Adamson Act was put into effect. This law required a maximum of no higher than an eight hour work day. This law was mainly meant for railway workers. This law was considered ?a major victory for railroad unions, a averted a railroad strike in September 1916. Wilson's whole form of government during his first term was based on his ?New Freedom.? In this New Freedom, Wilson put in effect ?a program to liberate American economic energies by drastic tariff reduction, strengthening the antitrust laws, and reorganizing of the banking and the credit system? (Cink). This was in opposition to Teddy Roosevelt's ?New Nationalism? which looked ?toward sweeping

Factors Affecting Staffing in Australian Manufacturing Industry

Factors Affecting Staffing in Australian Manufacturing Industry Overview of Australian Manufacturing Industry The manufacturing industry in Australia has been recording impressive performance for many years now. The industry offers a lot of employment opportunities to Australians as well as individuals from other countries. The recent researches that have been conducted show that, Australian industry provides more than one million direct job opportunities.Advertising We will write a custom report sample on Factors Affecting Staffing in Australian Manufacturing Industry specifically for you for only $16.05 $11/page Learn More The industry constitutes about 14% of private sector employments and about 10% of all Australian jobs. From these researches too, the future of the industry is quite promising. For that reason, the government has invested a lot in the industry to assist in improving it accordingly (Dick 2007, p. 291). In addition, the effective communication between the local and the foreign manufacturers has also co ntributed to the success of the industry. These foreign manufacturers provide the local ones with the necessary information regarding the conditions of the global markets. This implies that, the manufacturing industry in Australia relies mostly on foreign supplies for its achievements (Dick 2007, p. 293). The report compiled in 2006 indicates that, the industry generated more than $448, 560 million to the Australian government. In that year, the industry was operating at a gross product of $ 94, 800 million. There are various components, which contributed to this gross product. They included enterprises with 320 units and establishments at over 460 units. The industry provided more than 210,100 units of job opportunities. The industry also contributed more than $231,560 and $52,530 respectively, to the Australian economy from goods manufactured locally as well as those sold in the global markets (Dick 2007, p. 294). In order to operate properly, the manufacturing industry requires w orkers with appropriate skills related to the industry’s activities. In other words, the industry requires individuals who have technical manufacturing know-how, mechanical proficiency and who can depict maximum loyalty to the manufacturing companies.Advertising Looking for report on business economics? Let's see if we can help you! Get your first paper with 15% OFF Learn More The industry obtains these workers locally as well as from other countries. This process of obtaining workers to help run the activities of these manufacturing companies is referred to as staffing (Cook 2009, p. 57). There are several aspects, which affect staffing in Australian manufacturing industry. These aspects include demographic, economic, socio-cultural and political factors among others. This paper is going to discuss how these factors influence the staffing process in the Australian manufacturing industry. It will also give recommendations on how staffing in the manufa cturing industry can be done to increase the productivity of the industry (Gatewood, Field Barrick 2011, p. 31). Change in Technology Technology defines the process by which a manufacturing plant transforms its raw materials to final products. Therefore, technology includes aspects such as machinery, work format, employees’ know-how, tools and equipment. As the world continues to change, technology also changes. Research has shown that technological changes impact greatly on the way manufacturers compete with one another, the way they market their products and more importantly, the way they recruit employees (Weihrich, Koontz Cannice 2010, p. 249). Technological improvement has been the main driving force in the creation of new markets for Australian manufactured goods. The advancement has equally resulted in the expansion of the existing markets. Manufacturing companies, which have already incorporated modern technologies into their production processes, produce goods that compete fairly in Australian local markets as well as the foreign ones (Weihrich, Koontz Cannice 2010, p. 251). Following the changes in technology and the quest of manufacturing industry in Australia to keep up with the changes, the industry requires individuals with new manufacturing skills. In other words, as these manufacturing companies struggle to adopt the new technologies, the need to recruit employees with new skills also arises.Advertising We will write a custom report sample on Factors Affecting Staffing in Australian Manufacturing Industry specifically for you for only $16.05 $11/page Learn More Other manufacturing companies have been training the existing employees on the new technologies. Establishing and implementing new technologies is the only way a manufacturing company in Australia can survive the current stiff competition (Ross, Verclas, Levine Levine 2009, p. 43). To some extent, technological advancement in Australia has resulted in under-staffing of the manufacturing companies in this country. It is a common knowledge that new technologies improve the economy of a country. Higher economic growth rates on the other hand, is a characteristic of higher rate of unemployment. Australian manufacturing companies, which use advanced technologies, have retrenched most of their employees who do not have the necessary skills. The companies find it expensive to train and retrain these employees on the aspects of the new technology (Weihrich, Koontz Cannice 2010, p. 256). Social and Cultural Factors The major social-cultural factors influencing the way manufacturing industry in Australia recruit their employees include Australian culture, discriminatory aspect and the size and composition of the Australian population (Vance Paik 2011, p. 180). Culture has great effects on the staffing process in the Australian manufacturing industry. It has been proved that, workers recruited into manufacturing industry with culture as one of the major bases, get assimilated faster, they record better performance, and are likely to stay longer in these companies (Vance Paik 2011, p. 182). Most of the Australian manufacturing companies prefer to employ individuals possessing Australian culture. The companies argue that, these kinds of workers are easy to train, are much familiar with the Australian environment and in most cases, are loyal to the rules of the companies. Employing such individuals also helps the manufacturing industry to improve its productivity. However, some of the companies hold a different opinion they employ people from different cultures. Incorporating foreign employees into the list of workers may help a company to discover new aspects that are crucial to the manufacturing activities (Vance Paik 2011, p. 182).Advertising Looking for report on business economics? Let's see if we can help you! Get your first paper with 15% OFF Learn More Discrimination may lead to a section of a population being denied the chance to work in certain manufacturing companies. It is a fact that some of the Australian manufacturing companies discriminate against some races, minority language group and castes among other groups of individuals. There are some companies, which specifically recruit people from a particular background (Klein 2007, p. 356). Discrimination has also been blamed in the recruitment of a particular sex. Most companies in the industry feel that women are not fit for the manufacturing activities. For that reason, the companies have a staff consisting of more males than females. This may be a draw back to the performance of these companies. Some women are more knowledgeable than their male counterparts and so, denying them the chance to work in the manufacturing industry is the same as preventing the knowledge they have from assisting the companies to achieve their objectives (Vance Paik 2011, p. 185). Demographic Fa ctors The major demographic factors that affect the way Australian manufacturing companies recruit workers include the level of education, age and sex (Caruth, Caruth Pane 2009, p. 118). The level of education is known to influence greatly the way manufacturing industry in Australia staff the companies. Most of these companies require that those interested in working for them be taken through a thorough training before being employed in the companies. Those companies, which deal in production of highly technological products such as motor vehicles require individuals with advanced skills and experience. For that reason, such companies only recruit individuals who have specific qualifications from college (Caruth, Caruth Pane 2009, p. 121). Age is also a major factor that the companies consider when hiring people to work for them. Since manufacturing activities involve mostly physical work, the manufacturing companies insist on recruiting individuals who are young, energetic and wi lling to work for extra hours in form of overtime. This has resulted in the companies having staffs that mainly comprise of individuals between 25 to 40 years of age. Old people are not hired since the nature of the manufacturing jobs is not suitable for them. The companies too have to follow the Australian government rules on employment and so, underage individuals are not employed to work in the companies (Caruth, Caruth Pane 2009, p. 122). Sex refers to either being male or female. The manufacturing companies prefer to hire male individuals to female ones. Since the government employment rules require that expectant women be given a three month-leave from work, the companies feel that, hiring a bigger number of women will interfere with their production pace. The companies also view it as a loss since the women on leave have to be paid without working. As a consequence, the manufacturing companies have staffs constituted by bigger number of men than that of women (Brown Swain 2 009, p. 28). Political Factors Political and governmental forces just like other factors influence the way companies hire employees. Government rules dictate companies to follow the laid down procedures when recruiting individuals to work for them. For instance, companies have to consider aspects such as age, ethnicity and sex while recruiting employees. Government requires that there has to be at least a third of each sex in the total number of employees in every company. It is also a criminal offence in Australia for a company to employ a minor to work for it (Gatewood, Field Barrick 2011, p. 37). There are some companies in Australia for which the government selects the senior staff. These are mostly public companies. In such cases, the dominant factor in the selection is politics. The individuals are purely chosen through parliament votes. Voting in parliament is an activity that is dictated upon by the majority. In some cases, the voting process provides outcome that are not r eally helpful to these public companies. Still, parliament’s decision in Australia is considered final and hence, irreversible (Gatewood, Field Barrick 2011, p. 40). Economic Factors Economy as a whole has great impact on the staffing of a company. The economy of Australia has been steady for the last ten years. In other words, the economy has been expanding rapidly. This has in turn compelled the manufacturing companies to find ways to maintain the expansion. One of the ways has been to intensify the use of modern technologies in production. Technology advancement combines several stages of production thereby minimizing the number of stages that are required in the production of a particular product. As a result, companies find it necessary to retrench some of the workers. In essence, the expansion in Australian economy has resulted in reduced staff in various manufacturing economies (Caruth, Caruth Pane 2009, p. 127). The State of the economy determines the amount of wage s and salaries that manufacturing companies offer their employees. Manufacturing companies would not want to run at a loss by offering huge wages than what the economy can support. This also applies to the Australian manufacturing companies. As a result, only individuals who accept the pay offered to them by the companies are employed and retained in the manufacturing industry (Cook 2009, p. 61). Recommendations Technology is an important factor in the manufacturing industry in Australia. It is a factor that helps a company to compete effectively in the Australian local markets as well as the markets abroad. However, advancement in technology leads to reduction in the number of staff. In other words, it leads to unemployment. It is therefore important that change in technology is designed in such a way that it either maintains the current status of employment or if possible, it increases the number of job opportunities in the manufacturing industry (Weihrich, Koontz Cannice 2010, p . 258). As much as the manufacturing companies feel that employing individuals with background knowledge of the country is more important, to a greater extent it hinders the introduction of new ideas into the industry. The companies should employ individuals with different backgrounds. This implies that the companies should not consider the place of origin during recruitment of employees. Foreigners are known to have new ideas, most of which may be quite crucial in the development of these companies (Koontz Weihrich 2010, p. 224). In order to allow the manufacturing industry in Australia to function independently, the Australian government needs to keep itself away from the industry. In most cases, politics have been proved to cause malfunctions in the operations of manufacturing companies especially the public ones. Since the government may not be in the best position to determine what is really required in a particular company, entirely leaving the decision making processes to th e companies’ board of directors will be the best thing to do (Koontz Weihrich 2010, p. 227). In conclusion, manufacturing industry in Australia plays a great role in boosting the country’s economy. Through the industry, the country has been able to create a lot of job opportunities to majority of Australians. The staffing of these companies is influenced by a number of factors. These factors include demographic, economic, change in technology, government and political influence and social-cultural forces. References Brown, JN Swain, A 2009, The professional recruiter’s handbook: delivering excellence in recruitment practice, Kogan Page, London. Caruth, DL, Caruth, GD Pane, SS 2009, Staffing the contemporary organization: a guide to planning, recruiting, and selecting for human resource professionals, Praeger Publishers, Westport, CO. Cook, M 2009, Personal selection: adding value through people, Wiley-Blackwell, Chichester, NH. Dick, H 2007, The international ization strategies of small-country firms: the Australia experience of globalization, Edward Elgar Publishing Ltd, Northampton, MA. Gatewood, RD, Field, HS Barrick, M 2011, Human resource selection, South-Western Cengage Learning, Mason, OH. Klein, SS 2007, Handbook for achieving gender equity through education, Routledeg, Mahwah, NJ. Koontz, H Weihrich, H 2010, Essentials of management: an international perspective, Teta McGraw-Hill, New Delhi. Ross, H, Verclas, K, Levine Levine, A 2009, Managing technology to meet your mission, a strategic guide for nonprofit leaders, Jossey-Bass, San Francisco, CA. Vance, CM Paik, Y 2011, Managing a global workforce: challenges and opportunities in international human resource management, Sharpe, Armonk, NY. Weihrich, H, Koontz, H Cannice, MV 2010, management: a global and enterprenuerial perspective, Teta McGraw-Hill, New Delhi.

Assignment Example | Topics and Well Written Essays - 250 words - 215

Assignment Example ible inconsistency between traits of God and existence of evil that people suffer has a solution and this clarifies the point that despite sufferings that people undergo, God is all-powerful and cares about people. While the omnipresent feature means that God knows everything that people go through and having authority and being a loving and caring God would mean that He foresees any calamity and can protect people from it, bad things still happen to people. While evil defines a bad thing that destabilizes a system, and this is evident in such phenomena as diseases and calamity, the concept of moral evil offers a solution to the problem of evil. Under the concept, a moral agent exist that causes evil and human actions identifies the agency. This, together with the fact that God gave human being authority on earth and the freedom of choice, means that God may foresee evil and have authority over it, but He grants human being the freedom to decide on acting as an agent of moral evil or not. If man chooses to act morally then God’s authority becomes effective and He protects people from evil. Otherwise, man causes evil (Klibengajtis 4- 6). God granted man freedom and authority in earth and human actions, in consistency with God’s authority, causes evil. People’s sufferings are therefore consistent with the belief that God is all-powerful and cares for people because God acts on people’s will to either allow of prevent evil depending on human

TSCA definitions Essay Example | Topics and Well Written Essays - 1000 words

TSCA definitions - Essay Example he various ways in which one can be exposed to PCBs include breathing air that contain PCBs, eating food that contain PCBs, or touching anything that contains them. PCBs usually remain in the environment for long periods of time, and for this reason, therefore, people can easily be exposed to them when they come in contact with things that contain them. Due to their long stay in the environment, one can easily be exposed to them by coming into contact with the equipment or any other thing that contain them like the, electrical transformers, capacitors, fluorescent lighting fixtures, and appliances. It is recommended by NIOSH that workers should not breathe air that contains 42 or 54% chlorine, i.e. PCB levels higher than 1 microgram per cubic meter of air (à ¯Ã‚ ¿Ã‚ ½g/m3) for a 10-hour workday, 40-hour workweek. EPA demands that companies that either transport, store, or dispose of PCBs adhere to the rules and regulations of the federal hazardous waste management program. Also, EPA limits the amount of PCBs put into public waste water treatment plants. Hexavalent chromium Cr(VI) is a valence state (+6) of the element chromium; there are many more valences of the element chromium. Cr(VI) is produced through an industrial process. One of the bad effects of Cr(VI) to human beings is that Cr(VI) is known to cause cancer. Also, Cr(VI) targets the respiratory system, liver, kidneys, skin and eyes. From the OSAH website we learn that approximately 558,000 workers are potentially exposed to Cr(VI) in the United States. Employees can be exposed to hex chrome in different was including breathing in of dusts, mists or fume, ingestion, or through dermal or eye contact . Wellbeing impacts related with presentation to hex chrome can include disturbance or harm to the skin and eyes.   Direct skin contact to Hex Chrome can bring about undesirable susceptible response known as contact dermatitis. Once an anaphylaxis grows, even concise skin contact can bring about manifestations.

Outline for Treatment Approaches Essay Example for Free

Outline for Treatment Approaches Essay There are types of approaches to help an individual with recovering from drug and substance abuse. The approaches that are being looked at to help someone recover is Cognitive Behavioral Therapy (CBT), Motivational Enhancement Therapy (MET), Medication Management, Community Reinforcement Approach (CRA), and Community Reinforcement and Family Training Approach (CRAFT). Cognitive-Behavioral Therapy Cognitive behavioral; therapy (CBT) was developed as an aide to prevent relapse when treating addiction. CBT is based on the principle that the learning process is important in dealing with male adaptive behaviors like substance abuse. It is a process of identifying problematic behaviors and corrects them with various skills to fight addiction. CBT is based on identifying an individual’s problems and helping the individual’s self-control by developing the ways to cope with the problems effectively. This is done by evaluating the consequences of the substance abuse positive and negative, self-monitoring and recognizing the cravings and their triggers, and developing strategies to cope with the cravings and the triggers. Avoiding the trigger situations also help. In CBT an individual may have a support group to depend on during the recovery process. Such a group is helpful while a person is struggling with solutions. The group also gives positive encouragement during stressful times. In CBT an individual addict is encouraged for positive thinking rather than dwelling in negative thought patterns. CBT can help addicts with low self-esteem to improve their self-esteem which helps in fighting addiction. In CBT an individual learns to resist peer pressure. During CBT an individual can continue his/her normal activities which avoids strained relationships and financial crises.  It is a gradual process both in learning, maintaining and being on their own. It is also very cost effective therapy(National Institute on Drug Abuse, 2014). Motivational Enhancement Therapy Motivational Enhancement Therapy (MET) is a counseling approach that helps individual’s confusing dilemma about the treatment of substance abuse and stopping substance abuse. MET is based on the principles of motivational interviewing. It draws self-motivational statements early on in early discussion and plan for change is built on that. This approach engages the addict in building the plan. Based on their own motivations as oppose to societal. People who cannot follow like 12 –steps may benefit from this therapy. Enlightenment can only occur if an individual wants to learn and MET is centered on this insight. Using peoples own statements about desired better outcomes initial resistance is countered after this is achieved an introduction of behavioral techniques can be introduced to support and individual’s ability to fend for him/herself. MET is often used with other cognitive behavioral approaches. MET could go a long way in offering insights for those effective by many mental illness. With this therapy one can heal from other associated problems like anxiety and depression for life style change (The Ranch, 2014). Medication Management Medication Management is when medical care is an option to help someone reduce the risk of drug abuse. It is usually a pharmacists or physicians that help with medication management by lowering the medications based on the side effects and how the person is with taking the medications. It is that the doctor will ask brief questions about the medications and the feel you need therapy or counseling that will then get set up (McNeece, 2012). Community Treatment Approach (CRA) The Community Reinforcement approach is an alcoholism treatment approach that aims to achieve the addict from looking at positive reinforcement for living a sober free lifestyle and to eliminate all enforcement or influences to drink or do drugs (Miller, 2014). This treatment approach embraces positive incentives to stop drinking or doing drugs verses punishing the addict for the continued abuse (Miller, 2014). Community Reinforcement Approach and Family Training Intervention (CRAFT) This approach is an intervention that is based scientifically on intervention strategies designed to help the family members or those concerned with the addict, (CSO), concerned significant others, to help in the facilitation of the addict entering treatment to gain sobriety (Meyers, 2014). This new intervention method was developed with the belief that since family members can, and do make important contribution in other areas of addiction treatment (Meyers, 2014). Conclusion Treatments for people with problems with drug and substance abuse can be helpful when it comes to recovery. The treatment approaches help with managing medications, giving the individual counseling, or even prevention from relapsing back to the addiction. All of these approaches help an individual become healthier and live a longer life. References McNeece, C. A., DiNitto, D. M. (2012). Chemical dependency: A systems approach (4th ed.). Upper Saddle River, NJ: Pearson National Institute on Drug Abuse. (n.n.). Retrieved from https://www.drugabuse.gov/ The Ranch. (2014). Retrieved from http://www.recoveryranch.com/ Meyers, R. (2014). CRAFT. Retrieved from http://http://www.robertjmeyersphd.com/craft.html Miller, W. (2014). The Community-Reinforcement Approach. Retrieved from http://http://www.addictioninfo.org/articles/381/1/The-Community-Reinforcement-Approach/Page1.html

Radio Frequency Identification (RFID) Essay -- Radio Frequency Identif

The innovation of the RFID chip or the Radio Frequency Identification has been a critical piece of technology that has been around since the early/mid 20th century (est 1938). Functions of a radio frequency identification (RFID) tagging system involves a tag and a reader. When scanned, the antenna within the tag picks up the radio wave and sends a response back to the reader. This technology is being used for both short range and also long range identification, in the short-range identification category, this innovation is used in practical applications like credit cards (pay wave, tap and go ect...), animal identification (domestic pets, farm animals). The long range applications of the RFID chip is used in aeroplanes to bounce back a signal to radio control signifying their plane identification, the long range application of the chip is used in many other systems for similar purposes. the RFID chip is used all around the would and has and is readily available for the past few decades. The RFID chip is used by many agencies including federal agencies and also used for municipal and state and also local agencies. E.G.. RFID for Federal Agencies * Border and Immigration Security * Cargo and Container Security * Food and Cold Chain Safety (Product Authentication and Temperature Tracking) * Livestock & AgricultureTracking * Military Personnel Relocation Services * Military Supply Chain (Supply chain Shipping, * Receiving and Logistics) * Pharmaceutical Track and Trace Trusted Traveler Control Systems aeroplane tracking/ID RFID for Municipal and State and Local Agencies * Asset & Inventory Control * Firefighter Locationing /Emergency Service Personnel Locationing * First Responder Evacuation Services * Lib... ...lter, 2001, pp. 445--456) Motorolasolutions.com. 2014. RFID Government Solutions - Motorola Solutions USA. [online] Available at: http://www.motorolasolutions.com/US-EN/Business+Solutions/Industry+Solutions/Government/Airports+and+Seaports/RFID_Government_Solutions_US-EN Wikipedia. 2014. Radio-frequency identification. [online] Available at: http://en.wikipedia.org/wiki/Radio-frequency_identification [Accessed: 11 Feb 2014]. Wikipedia. 2014. Digital Revolution. [online] Available at: http://en.wikipedia.org/wiki/Digital_Revolution Wikipedia. 2014. Near field communication. [online] Available at: http://en.wikipedia.org/wiki/Near_field_communication Idtechex.com. 2014. RFID Forecasts, Players and Opportunities 2012-2022: IDTechEx. [online] Available at: http://www.idtechex.com/research/reports/rfid-forecasts-players-and-opportunities-2012-2022-000322.asp

Diabetic Management Plan

Diabetes Mellitus is a disease known to humans since the ancient times. Hieroglyphics of Egypt, which dated back in 1500 BC, illustrated symptoms of diabetes. During this time, people depicted diabetes to be type 2 only and type 1 diabetes is a newly discovered disease. However, this has been made clear by researches and studies that type 2 diabetes is different from type 1 diabetes (Hanas 2007). In the present, cases of diabetes continuously rise especially cases of type 1 diabetes.Type 1 diabetes is an insulin dependent diabetes that is common to children and teenagers. Here, the body totally does not produce insulin rendering the glucose useless for an individual (Fox and Kilvert 2007). The glucose level on the blood rises and affects certain body functions making the individual seek medical attention. Diabetes has no cure. When one has diabetes, he or she has it for lifetime. However, certain ways in managing diabetes, whether it is type 1 or type 2, are found but with considerat ion to medication, activity, and diet.Strict adherence to medication regimen is useful in preventing the development of diabetic complications. Regular exercise or physical activity as well as proper eating habits is also proven to help lower blood sugar levels making it controllable. In addition, frequent monitoring of blood glucose will allow an individual to anticipate and act in response to the previously read glucose level. The Case of Jodie Jodie is a 17-year-old girl who has just been diagnosed with type 1 diabetes following admission to the local Emergency Department in DKA.She is currently studying year 12 at high school, plays netball every Saturday afternoon and enjoys going to parties with her friends. Jodie weighs 55kg with a BMI of 20. She lives happily at home with her parents and older brother. Jodie has been commenced on a basal bolus insulin regimen using Humalog and Levemir. Nutritional Management Managing diet is also a key factor in proper management of diabetes . It is important to emphasize to the client and the family that the client is not taking a diabetic diet but rather a balanced meal.Emphasis must also be considered on the ethnicity of the client as well as cultural and religious background of the patient. Before taking these into considerations, it is important to know the basic caloric intake of the client. By multiplying the weight of the Jodie in pounds (121 lbs) to 10 (constant multiplier for female), you will come up with a total of 1210. This is the basic caloric need of Jodie. Multiplying the basic caloric need (1210) with 0. 40 (constant multiplier for rigorous activity) will come up with a resulting activity based caloric needs (605).Calories for digestion can also be calculated by multiplying the sum of basic caloric intake and activity based caloric needs (1210 + 605) to 0. 10 (constant number). The result would be 181. 5. Lastly, compute for the total daily caloric intake by summing up the basic caloric intake, activit y based caloric intake, and calories needed for digestion (1210 + 605 + 181. 5). The result would be 1996. 5. This is the caloric needs of Jodie every Saturday since she is engaged in netball and partying with her friends. On the other hand, the caloric intake of Jodie from Monday to Friday and Sunday would be 1863. 4.Upon computing the daily caloric intake of Jodie, it can be concluded that energy needs varies among individuals on a daily basis, and depends greatly on the age, gender, and ethnicity (â€Å"How to Calculate Your Total Daily Calorie Needs † 2010). Smart, Aslander-van Vliet and Waldron (2009) proposed how total caloric intake must be distributed: Carbohydrates must constitute about 50-55%; fats must be 30-35%; protein must be 10-15%; and sucrose must be 10%.Therefore, Jodie must have a carbohydrate intake of 931. 7-1024. 87 calories (M-F, Sun) and 998. 25-1098. 08 calories(Sat); fat intake of 559. 02-654. 19 calories (M-F, Sun) and 598. 5-698. 78 calories (Sat); protein intake of 186. 34-279. 51 calories (M-F, Sun) and 199. 65-299. 48 calories (Sat); and sucrose intake of 186. 34 (M-F, Sun) and 199. 65 (Sat). When taking carbohydrate rich food, it might be necessary to include healthy sources like vegetables, fruits, legumes, whole grains, and low fat milk. Take into consideration other alternatives for the source of food by consulting the carbohydrate exchange table, cabohydrate counting and the use of glycemic load and index. In the consumption of fat, food with saturated fat must be limited to less than seven percent of total caloric intake.Every week, two or more servings of fish is permissible but with exemption to the commercially produced fish fillet (American Diabetes Association 2007). Replace saturated fats with monounsaturated fatty acids and polyunsaturated fatty acids through the use of low fat dairy products, lean meats, olive and sesame seed oil, sunflower oil, corn oil, and soybean oil. Encourage intake of protein from vege tables (legumes) and animals (lean meat, fish, low dairy products) because it promotes growth and is a good source of nitrogen for the body. Take also into consideration that the salt intake of the client must be less than 6 grams per day.Advise those individuals who prepare the food that they should avoid adding salt in cooking and in meals. In addition, excessive alcohol should be avoided because it interferes with gluconeogenesis resulting to prolonged hypoglycemia. The patient must also be advised to wear identifications about her diabetes, and consume carbohydrates before, during, and after drinking. Drinking, on the other hand, must be done in moderation and must consume drinks with reduced alcohol content. Prevent nocturnal hypoglycemia by consuming carbohydrate-rich bedtime snack.Blood glucose monitoring must be done more often at night until lunchtime of the following day (Smart 2009). Monitoring Patients with Diabetes Knowing that diabetes can lead to some serious complica tions, it is better if one should know the things that he/she should monitor in order to prevent these complications. One should have vigilant monitoring of blood sugar. Scientific evidence shows that tightly controlling blood sugar levels can prevent the development and progression of small blood vessel (microvascular) disease and nerve disease (neuropathy) (Wendt 2009).Since high blood sugar is considered as the culprit to most of the diabetic complications, monitoring blood glucose by the patient is extremely important to prevent consequences from unmonitored blood glucose. Low glucose level may lead to hypoglycemia. Mild hypoglycemia can cause a person to feel uncomfortable and can interfere with his normal functioning. However, severe hypoglycemia can cause seizure, loss of consciousness, and coma (Kelly 2006). Avoiding highs and lows in blood sugar will not only make the patient feel better, but will significantly reduce his/her risk of diabetes complications.Cholesterol level s should also be monitored. A test done to monitor the cholesterol level of a diabetic person is called fasting lipid profile. It is a blood test that measures the total cholesterol, HDL and LDL cholesterol levels, and triglyceride levels in the bloodstream. It is also used to assess the risk for the development of coronary artery disease, one of the predisposing factors for heart attack (Kaufman 2010). Knowing that cholesterol affects the blood vessels of the retina and the heart gives the health provider a clue that any significant increase in the level would necessitate immediate monitoring and intervention.If cholesterol is controlled, the risk of developing complications is greatly reduced. Keeping track of blood pressure is important because people who have diabetes tend to have more trouble with high blood pressure than people who do not have the disease. Having both diabetes and high blood pressure can pack a damaging one-two punch as far as increasing the risk of heart dise ase, stroke, and eye, kidney and nerve complications (Manzella 2006). Elevated blood pressure increases blood flow into the eye, accelerating diabetic retinopathy (Chous 2006). Knowing the early signs and symptoms are also key in preventing diabetic complications.However, diabetic retinopathy has no early signs and symptoms. Jodie then must be aware of the yearly eye examination that must be done after the preliminary examination within 5 years after the diagnosis of diabetes (â€Å"Diabetes† 2010). Dilated eye examination must be done every year by an optometrist or ophthalmologist knowledgeable about and experienced with diabetes and diabetic eye disease (Chous 2006) in order to know the extent of eye affectation. Both the patient and the health provider should also monitor some signs and symptoms to prevent blindness. Any concern with regard to the patient's vision must be taken seriously.Be aware if the patient complains of suspended dark spots that interferes with his/he r vision. It may indicate blood leak to the vitreous humor, which can lead to blindness. Also, take into consideration the increasing difficulty in performing things that require focus such as reading and sewing. Amputations can also be prevented if the patient has vigilant foot care. Foot care is important since the patient with diabetes has decreased sensation on the lower extremities. Preventive measures would include watching for signs and symptoms of impending ulceration.The patient and the health provider should be aware of any swelling, thick hard skin or corns, and any blisters or breaks on the skin. Take good care of small cuts and abrasions immediately. When choosing shoes, make sure that they fit well and allow the toes to move freely. Another complication of type 1 diabetes is diabetic ketoacidosis, the reason why Jodie was rushed to the emergency department. The goal for the management of DKA is the correction of fluid and electrolyte imbalances, restoration of circulat ing blood volume to normal, and identification and correction of factors that contributes to the development of diabetic ketoacidosis.Correction of circulating blood volume starts with the infusion of 1000 ml of 0. 9 percent sodium chloride for the first hour followed by the infusion of 2000 ml to 8000 ml for the next 24 hours. Assess client’s skin turgor, weight and hematocrit because these will serve as markers for the efficacy of intravenous therapy. Potassium must also be monitored because this electrolyte leaves the cells in ketoacidosis. When dealing with this, several points must be considered during the assessment and intervention phase. Frequently assess the patient’s urine output.Take note of the amount of urine when administering potassium to the client. If the urine is less than 30 ml per hour, halt the administration of the potassium and notify the physician immediately. Continuously monitor the client for signs of hyperkalemia (oliguria, weakness, bradyca rdia, cardiac arrest) and hypokalemia (weakness, paralytic ileus, cardiac arrest). Hyperkalemia may ensue for the first 4 hours of treatment while hypokalemia may develop after 4 hours up to 24 hours. Monitor the client’s ECG and take note of T wave.Its flattening or inversion may signify hypokalemia while peaking of T wave may indicate hyperkalemia (Brunner, O'Connell Smeltzer and Suddarth, 2008). Medications for Diabetes According to Hanas (2007), the American Diabetes Association instituted the individualization of blood glucose goals, with goals higher to those individuals with frequent hypoglycemic attacks. Suggestions were also made on the level of blood glucose for each age group. Jodie, a 17 year old teenager, belongs to the adolescent group (13-19). It was stated that before meals, an ideal blood glucose level is 5-7 mmol/L or 90-130 mg/dl.At bedtime or overnight, she must have a blood glucose level of 5-8 mmol/L or 90-150 mg/dl. To accomplish this goal, Jodie is pre scribed with Humalog and Levemir in order to facilitate the entry of glucose in the cells thereby preventing the increase of glucose level in the blood. Humalog is a fast- or rapid acting insulin analog that takes effect on the body after injecting it. Since it is an analog, it considered as a variation of human insulin and tends to mimic its action from the time it is secreted by the pancreas.When taking this drug, inform the client to use disposable, sterile needles or pen. Rotate the injection sites to prevent complications like lipodystrophy. Take this drug at the same time every day. Allot a 15 minute allowance before taking a meal prior to its administration. To prevent hyperglycemia, take this drug with long acting insulin such as the Levemir (Griffith and Moore 2006). Instruct the patient to seek medical attention immediately if she experiences symptoms such as rash, hive, intense itching, and difficulty in breathing after taking a dose.This suggests an anaphylaxis reaction and is life-threatening. Although infrequent, instruct the patient to take quick-acting sugar such as honey or fruit juice whenever she experiences excessive hunger, cold sweats, cold skin, shakiness, chills, or vision changes. This signifies that she is experiencing low blood sugar or hypoglycemia. On the other hand, Levemir is long-acting, man-made insulin that may last for 24 hours after administration. Instruct patient to use only Levemir when the vial appears to be colorless and clear. Presence of air bubbles is considered normal.However, do not administer the drug if it looks colored, cloudy or thickened. Inject drug into subcutaneous part of the body such as the stomach, thighs, and upper arms. Just like in Humalog, rotate the injection sites to prevent lipodystrophy. The patient may also experience hypoglycemia and its treatment is the same as those of Humalog (Novo Nordisk, Inc. 2009). When taking this drug, instruct her to avoid intake of alcohol as this may increase the e ffect of insulin resulting to blood glucose problems (Griffith 2006). One should also take note on the time Levemir will take effect.Levemir injected at bedtime or 10 pm (for multiple injection therapy) will have its effect during the night and breakfast. It can also be used as a two dose treatment: one in the morning and one in the dinner. Insulin injected in the morning will take effect on the lunch and afternoon while insulin injected during dinner will take effect on evening and night. Bedtime snack is necessary then to avoid night time hypoglycemia (Hanas 2007). It is also necessary to take insulin before meals. When taking Humalog as pre-breakfast insulin, it is better if Jodie should monitor her blood glucose.The time elapsed before the administration of pre-breakfast insulin depends on the level of blood glucose she has in the morning. Blood Glucose Levels Rapid Acting Insulin (Humalog) Ordinary or Short Acting Insulin mmol/L mg/dl < 3 < 55 After the meal Just before 3 †“ 5 55 – 90 Just before 15 minutes before 5 – 10 90 – 180 Just before 30 minutes before 10 – 14 180 – 250 10 minutes before 45 minutes before ? 14 ? 250 20 minutes before 60 minutes before Source: Hanas, R. (2007).Type 1 Diabetes in Children, Adolescents, and Young Adults: How to become an expert on your own diabetes (3rd ed. . United Kingdom: Class Publishing Ltd. Checking blood glucose before lunch is also necessary. When using rapid acting insulin, a blood glucose reading taken two hours after breakfast is enough. Blood Glucose Measure < 4 mmol/L < 70 mg/dl Decrease the insulin dose at breakfast by one to two units > 8 mmol/L > 145 mg/dl Increase the insulin dose at breakfast by one to two units Patient experiences cold sweat, hunger, shakiness (signs of hypoglycemia) between breakfast and lunch. Decrease the insulin dose at breakfast by one to two units Source: Hanas, R. (2007).Type 1 Diabetes in Children, Adolescents, and Young Adults: How t o become an expert on your own diabetes (3rd ed. ). United Kingdom: Class Publishing Ltd The Concept of Psychology in Diabetes Adolescence is the time during which an individual attempts to establish their identity and begin involving themselves into sexual relationships. As an adolescent grew, the client will begin to take responsibilities with his or her action. Add up to these responsibilities are those involving their management of diabetes. The challenge here does not only involve the adolescent but also the health care provider and the family itself.Adolescent are in the position wherein they are faced with developmental tasks needed to accomplish in addition to the need of managing their lives with diabetes. Health care providers and family must also consider their actions to make sure that treatment and regimens do not interfere with age-related activities of the adolescent thereby allowing growth and development (Snoek and Skinner 2005). Several complications in diabetes ar e also found to be associated with poor parental interaction of the adolescent’s diabetes management. DKA is one of these complications.Snoek and Skinner (2005) revealed that individuals belonging to a family that lacks support and warmth are typical to hose patients who have DKA. Moreover, diabetic individuals who have unresolved family problems and lack of parental participation in the treatment have a tendency to belong in this population with DKA. It was also linked that the possibility of child abuse (physical, sexual or social) may be triggering factor an adolescent ran away from home skipping his/her dose of insulin. Another possibility is that an adolescent is undergoing the phase of rebellion or rejection.Lifestyle management for teenagers with diabetes may result to resentful feelings as well as the stage of rejection. Consequently, the adolescent omits his/her insulin dose but this is considered to be part of how an adolescent adopts to his/her life of a diabetic p erson (Snoek 2005). To provide solutions with this problem, a scheduled telephone call every two to three weeks may be used to provide assistance and support to the patient through the use of problem solving techniques. Motivational interviewing (MI), which is a collaborative approach between patient and the health care provider, can also be utilized.It is a directive approach that aims to resolve patient’s anxiety and ambivalence regarding diabetic management by supporting the adolescent and respecting their decisions regarding diabetes management (Miller and Rollnick 2005). With this, an individual will report less worry and anxiety, and satisfaction with the present life and a more positive outlook (Snoek 2005). Patient Education Approach Educational tools are used to disseminate information and knowledge in order to maximize the management of blood glucose and prevent complications from it.Since no study shows which type of teaching methods is appropriate for education, i ts approach must be varied but is well adapted to the age of the child and the needs of the family. It must not be too rigid that it invokes confusion and failure resulting to distress and harm on the part of the adolescent and family (Funnel and Anderson 2004). Health education tools may include the use of food pyramid and plate models that will advocate the basics of nutrition and healthy eating habits.Extensive patient education may also be necessary for adolescents and the families to help them estimates the amount of carbohydrates in foods, its exchange or portions. Education can also include guides on how to read food labels and how to recognize the nutritional content of food. Several methods are also instituted to facilitate adolescent’s learning in measuring carbohydrates. Exchange or portion system, carbohydrate counting, and glycemic index and glycemic load are some of these methods (Smart 2009).