Diabetes Management in Primary Care Essay Example | Topics and Well Written Essays - 2000 words - 1

Diabetes Management in Primary Care - Essay Example It is evident, that paying more attention to the way the management of diabetes is performed, may play for the benefit of the patient in the following ways: As diabetes is one of the most common diseases in the world, and is often hereditary, affecting people of all ages, social and other statuses, this chronic disease should acquire new approach in its primary care. Diabetes mellitus is caused by a deficiency of, or insensitivity to, the hormone insulin, resulting in an inability to control the use and storage of glucose - blood glucose levels therefore rise.   There are two main types of diabetes:    Type 2 diabetes, previously referred to as non-insulin-dependent diabetes mellitus (NIDDM), which results from a relative deficiency of, or insensitivity to, insulin and is more commonly diagnosed over the age of 40. In managing diabetes, especially in its primary care stage, it is essential to remember about the meticulous metabolic control, which is one of the principal ways of preventing the possible complications of diabetes, or at least delaying them. It is, of course, understood, that the bigger portion of these complications may be prevented at the early stage in case they are detected in time and are managed in the proper way. The aims of the primary care in diabetes may be defined in the following way. The main aim of any care system in relation to diabetes, or any other chronic disease, is to provide people suffering from this disease with chances to live quality life as well as to reduce the complications. The keys to achieve these aims are in metabolic control, which should be performed on the constant basis with deep analysis of the received results, as well as the maintenance of the normal glucose level in blood to prevent the complications of diabetes. Any metabolic crises should be avoided. In managing

Beauty and the Beast Essay Example | Topics and Well Written Essays - 1750 words

Beauty and the Beast - Essay Example In addition to women equality, Rich also broadened her writing to promote equality for gays, those disenfranchised by race and class (Rich 5). From the title â€Å"When we dead awaken: writing as a revision† it is practically difficult to believe how many people have been affected including women and those who don’t have an idea of what is happening (Rich 5). According to Rich, it is exhilarating to be alive at the time of awakening consciousness since it leads to confusion, disorientation and pain (Rich 7). By the virtue that the work is a revision, the main idea is to look back and seeing with fresh eyes of entering an old text from a new critical direction (Rich 7). Relatively, the main idea is to create self knowledge for women who keep searching for identity and refusal to self-destructiveness in the male dominated world (Rich 7). Cupid and Psyche is a well known tales written by Lucius Apuleius in C.E. 150 (Apuleius 1). The tale narrates about a major obstacle that was overcoming to the love between Psyche (which means breath of life or soul) and Cupid (which means desire) (Apuleius 3). The main obstacle was affecting the ultimate attachment of the two in marriage. The story elaborately describes theme of dangerous curiosity, punishment, tests and redemption through divine favor (Apuleius 5). Tiger’s bride by Angela Carter is another love story of a woman who moved in with a mysterious masked Milord (Carter 2). The Milord was a beast and the marriage ended up after her father lost in a gambled game of cards forcing him to award the Milord with his daughter (Carter 3). The Milord was eventually revealed to be a tiger (Carter 5). However, a happy ending is exhibited when â€Å"The courtship of Mr. Lyon,† the heroin transformed into a glorious tiger a proper mate to the beast (Carter 5). The lady and the lion is another short tale about a man who had three

Demand and Supply Planning Essay Example for Free

Demand and Supply Planning Essay Abstract This paper demonstrates the concept of Supply Chain and the understanding of its different parties. How existing practices in demand planning improve forecast accuracy with advanced statistical forecasting capabilities and how demand planning is different than other SCM parties in structuring flexible hierarchy models inventory integration. In addition to explore the Integrated Demand and Supply Planning for Consumer Goods and Services Companies, where we show a Case Study for Nestle Company using weather forecast data that shows a significant insight into the extent to which difference products and/or customer sales were impacted by weather. On the other hand, Globalization and the challenges of managing a global operation such as forecasting in the face of uncertainty and reducing inventories for improved cash flow. Introduction What is a supply chain? The supply chain concept arose from a number of changes in the manufacturing environment, including the rising costs of manufacturing, the shrinking resources of manufacturing bases, shortened product life cycles, the leveling of the playing field within manufacturing and the globalization of the market economies. At a high level, a supply chain is comprised of three fundamental processes which are integrated. Procurement process involves sourcing and designing supply contracts with vendors and also developing interfaces which act as a conduit for information. Production and inventory control encompasses the manufacturing, material handling and warehousing sub-processes. Distribution and logistics process deals with the retrieval and transportation of products to retailers, distribution centers or final customers. These processes interact with one another to produce an integrated supply chain. UNDERSTANDING THE SUPPLY CHAIN There are specific roles for each function in the Supply Chain that are supported by the activities of Demand Planning. At a basic level, the Supply Chain flow of a product looks like this, beginning with Create and ending with Deliver. Source Create Plan Sell Deliver Make Create: One level below the Create flow are individual departments that support these Supply Chain actions. Create involves Research Development, Regulatory Affairs, and Product Development as new formulas are discovered, tested and developed for the market. Sell: It is focused on introducing the product to market and driving consumption. Sales, Marketing, Category Management, Market Research, Marketing Services, and Trade Marketing are key departments that support this process. This phase is also a critical communication feed to the Plan phase as it is closest to consumption and customer needs. Plan: It is the center point of the Supply Chain responsible for the creation of inventory levels that coincide with the needs of customers or distributors, which is one step before consumption. It is also the point where financial planning is executed and PLs are managed. Demand Planning, Supply Planning, and Finance departments are usually found within this point in the Supply Chain. It is important to note that the position of Demand Planning here is the hand-off from Sales to Operations, giving it the unique opportunity to link the companys supply chain activities. This is the kick-off to execution of the companys strategic plan. Source: It is the first step in producing product for sale, as raw materials, packaging components and finished goods are procured. Purchasing and Contract Manufacturing take place here in preparation of the manufacturing process. Make: It is simply the manufacturing of materials and components that result in finished goods inventory. In a synchronized Supply Chain Manufacturing, Packaging, Quality Control, and Technical Operations execute the inventory plan developed upstream in the Plan phase. Deliver: It is the physical movement of finished goods from manufacturing points to the distribution network, and finally to customer distribution centers, ready for replenishment to store level locations for consumption by the public. Distribution, Transportation, Logistics, and Customer Service are the key organizations that reside in the final phase of the Supply Chain. Demand Planning At the front end of your supply chain, your demand plan accuracy drives your production, inventory, distribution, and buying plans. With Demand Planning, youll have the tools to improve forecast accuracy with advanced statistical forecasting capabilities. Youll get the sharpest, most accurate picture of customer demand as a solid foundation for your sales and operations plan, plus tools to help you extend beyond forecasting to create a fully synchronized demand-replenishment plan integrated with your ERP system. Demand Planning provides a single, global view of the truth to accurately predict and shape customer demand across your enterprise. It helps manufacturers and distributors like you understand your total demand plan to take into account: * Seasonality * Promotions and events * Product lifecycle changes Demand Planning contains three modules that you can deploy individually or combine to form a complete supply chain planning platform: I. Demand Planner—to deliver accurate self-learning forecasts for improved forecast accuracy. II. Inventory Planner—to optimize inventory at each distribution hub, ensuring the highest levels of available stock for a given customer service-level target. III. Replenishment Planner—to plan inventory and distribution movements through every node of your supply chain, from supplier through manufacturer and all levels of your distribution chain. More than 25 years of supply chain management experience built into Demand Planning, so you can be assured theres proven, rich functionality driving your global supply chain, with supply chain experts guiding you to best practices. Demand Planning provides advanced statistical capabilities combined with market knowledge gained through internal and external collaboration to bring pinpoint accurac y to your demand plans. With Demand Planning, you get: Demand forecasting: This powerful forecasting tool in a graphical environment automatically detects seasonality, trends, slow-moving items, unusual outliers, and step changes in demand. With the self-learning engine, you forecast demand at any combination of product group, customer, or channel. Model scenarios to see the effect of promotions and events and their future impact. Web-based collaboration: Share knowledge with every stakeholder in the demand planning process. Your internal sales and demand planners better shape demand. External customers contribute with visible input to improve your responsiveness. Suppliers upstream know your plans and improve their delivery performance. Inventory planning: Analyze, model, and strike the right balance between target service levels and your inventory investment. Redistribute inventory according to predicted demand to ensure it meets tailored service levels—and increase your stock turn rates. Replenishment planning: Automatically align supply replenishment with demand across your entire manufacturing and distribution network. Using different modeled scenarios, you can see results ripple through and quickly realign inventory, transport, manufacturing, and buying plans. The Demand Planning Difference Unlike other supply chain management systems, Demand Planning uniquely offers: * A self-learning statistical forecasting engine that improves accuracy over repeated forecasting periods by learning and continually adjusting its model between forecast and actual. * Collaboration with all stakeholders in the demand planning process through a web-based user experience. * Flexible hierarchies so you can properly model your physical and operational supply chain—and change the models as your business changes. * Integrated inventory planning and optimization for stock-based supply chains so you can balance investments in inventory with desired customer service level availability.* Replenishment planning across your entire distribution chain, ensuring inventory flows through the chain to protect customer-facing distribution hubs and ensuring the highest levels of availability. * Exception alerting to draw attention to potential shortfalls in availability so you can respond more quickly to re-flow supply from alternative sources. Integrated Demand and Supply Planning for Consumer Goods and Services Companies Accenture (Global Management Consulting) helps consumer goods and services companies with aligning customer expectations with supply chain plans through our integrated demand and supply planning approach.Overview According to Accenture research, high-performance businesses are much better and faster than their competitors at allocating resources and achieving superior return on investment. And that is largely because their approach to demand planning is highly sophisticated. Global operations call for a higher level of integration between demand and supply. Accenture helps consumer goods and services companies collect actionable insights on market trends and customer expectations and align them with supply chain plans to get the right products to the right consumers at the right time through our integrated demand and supply planning approach. Sales and Operations Planning (SOP) There are many ways to manage demand and supply planning activities. In most larger companies, the Sales and operations planning (SOP) process is the most common. SOP is at the heart of balancing supply and demand, and aligning the company around a common financial, demand and supply plan. It is an integrated business management process through which management continually works to achieve alignment among all functions of the organization. Smaller companies can benefit greatly from this approach. Most try to facilitate the process using spreadsheets and data pulled from the ERP. The problem, volatility of demand, uncertainty of supply, and increasing customer expectations are challenging companies in their goal to maximize business opportunities and minimize risk. There are many components to SOP plans. In most situations an SOP plan includes an updated sales plan, production plan, inventory plan, new product development plan, and a resulting financial plan. At the highest level, these plans are designed to achieve the financial and strategic objectives of the company. In most companies, the planning frequency is monthly and planning horizons are 12 months. Situations in which there are short product life cycles and high demand volatility require a more frequent SOP planning schedule. A properly implemented SOP process routinely reviews customer demand and supply resources and â€Å"re-plans† quantitatively across an agreed rolling horizon. The re-planning process focuses on changes from the previously agreed sales and operations plan. While it helps the management team to understand how the company achieved its current level of performance, its primary focus is on future actions and anticipated results. Demand Caster methodology includes all elements of a robust SOP process. It follows the traditional 5 step SOP process described below. Sales and Operations Planning Steps: 1. Data Gathering: Collect data on past sales, analyze trends, and report forecasts 2. Demand Planning: Validate forecasts, understand sources of demand, account for variability, and revise inventory and customer service policies. 3. Supply Planning: Assess the ability to meet demand by reviewing available capacity and scheduling required operations. 4. Reconciliation of Plans: Match supply and demand plans with financial considerations 5. Finalize and Release: Finalize the plan and release it to implementation

Modernism and Postmodernism in Shakespeares Othello Essay -- GCSE Eng

Othello teaches us much about our current postmodern culture. The play connects to our ideas of sexism, male-bonding, racism and capitalism. Shakespeare uses these universal and timeless flaws in humanity along with our use of language and truth to tell his tale. Iago, over a period of about three days, uses these facets of humanity to turn Othello against his wife Desdemona and his friend Cassio. Othello reveals both the struggle of the British people of the early 1600's and Americans in the late 1900's with sexism, capitalism and racism. In Othello men see women as objects to control, first by their father, and then by their husband. When Iago yells to Brabantio, telling him his daughter has gone off to marry Othello, he yells "Thieves, thieves! / Look to your house, your daughter, and your bags! / Thieves, thieves!" (Othello I.i.79-80). Othello has taken away Brabantio's property, his daughter, and is called a thief because of it. Desdemona refuses to be treated like property, however and makes "A gross revolt, / tying her duty, beauty, wit and fortunes" (Othello I.i.134-135) to Othello. Her marriage to Othello is not an act of a free woman, but a revolt by Brabantio's property. Desdemona is also incapable of independent feelings or thoughts. Othello must have "Enchanted her" (Othello I.ii.63), "In chains of magic" (Othello I.ii.65), because she could never make such a choice on her own. In Brabantio's mind, only he can know what is in Desdemona's best interest and then choose it for her. Brabantio tries to guard he r, but Desdemona has "Run from her guardage" (Othello I.ii.70). In Othello the culture of the time treats women as objects to be guarded and watched over, too tender and gentle to fend for themselves in a dang... ...hooses for her, this taking of a different role is similar to Othello's efforts to fit into the European world. Othello's lack of definitive truth is postmodern. Othello does have an emphasis of characters over environment. Although the characters represent different aspects of society, Shakespeare takes great care in developing them and their internal traits. The lack of definitive truth in Othello's world creates chaos, but Othello refuses to just accept this chaos, he chooses Iago over Desdemona's version of events. Othello combines modernism and postmodernism in its discussion of language and truth. Although Othello contains many elements from both periods, it is mostly modern, due to it's setting and need for characters. The characters decide to fight the chaos inside themselves and in the world. This fight leads to the tragic ending of the play. Â  

Cultural assessment Essay

A consideration of culture is essential in the process of the interview, case formulation, diagnosis, and treatment of culturally diverse indi ­viduals. The evaluation of these individuals raises many issues that clinicians need to address to formulate an accurate diagnosis and treatment plan that will be acceptable to the patient. A consideration of culture is essential in the process of the interview, case formulation, diagnosis, and treatment of culturally diverse indi ­viduals. The evaluation of these individuals raises many issues that clinicians need to address to formulate an accurate diagnosis and treatment plan that will be acceptable to the patient The American Psychological Association (1993) guidelines acknowledge the necessity of assessing individuals in the context of their ethnicity and culture, respecting their indigenous beliefs and practices (including those involving religion and spirituality), assessing the patients’ support systems, evaluating the pati ents in their primary language, and taking a history that accounts for immigration and acculturation stresses. In summary, the consideration of cultural factors in the assessment, diagnosis, and treatment of culturally diverse individuals has gained recognition in a variety of disciplines in the last decade.In this chapter, we present a brief history of psychiatric case formulation; define culture, ethnicity, and race; and focus on an explication and elaboration of the DSM-IV outline for cultural formulation. Aspects of cultural formulation include assessing a patient’s cultural identity and understanding how culture affects the explanation of the individual’s illness, support system, and the clinician-patient relation ­ship as well as understanding how culture affects the assessment and diagnosis of culturally diverse individuals From a clinical point of view, understanding the patient’s view of his or her illness helps determine our assessment and our treatment plan. Different cultures express their symptoms differently (Kleinman 1988), and concepts of illness also vary with culture. For example, for the Chinese in Hong Kong, Cheung (1987) found that patients had three explanatory models for mental disorders. They could explain their illness as based on psychological, somatic, or mixed factors. Their explana ­tion of the illness influenced how they went about getting help. The patients who had purely psychological explanations were the least likely to seek help. Because of this, Cheung recommended that clinicians specifically inquire about psychological symptoms, because these patients were not likely to volunteer them. Special Issues in Assessment Professionals working in systems that link treatment and corrections must be aware of a broad range of special issues in assessment related to clients’ gender, culture, ethnicity, sexual orientation, educational level, religious affiliation or spirituality, and other such sociocultural characteristics. Issues related to a number of these characteristics are discussed below. Language It may be necessary to perform the assessment in the primary language of the individual, which may not be English. Assessors should avoid the assumption that a speaker of any given language can also read that language. The client may not be functionally literate in any language. Another part of the staff member’s sensitivity to language should be an awareness that the client may need to communicate in â€Å"street language.† The assessor should be attentive to the kind of vocabulary that the individual client feels most comfortable using. To the extent possible, concepts should be stated in lay language, even street language, if appropriate, but not professional or clinical jargon. Using appropriate language is an essential part of making a true connection with the individual, so that he or she becomes engaged in the assessment process. While good assessment may be largely an intuitive process, specific assessment skills can be taught. Training can be provided in nonjudgmental interviewing techniques, rapport building, sensitive probing, and multicultural sensitivity. Cultural Identity and Ethnicity For appropriate assessment, it is critical that culturally and linguistically competent staff are available. The assessor must be aware of the importance of the client’s cultural identity and the extent of his or her acculturation into the dominant culture. Some programs attempt to draw on traditional cultural http://www.wikihow.com/Write-a-Mental-Health-Assessment strengths of the individual in specific ways; these may be appropriate for the individual who has a strong identification with his or her culture of origin, but it may be inappropriate for other individuals of the same group. It is necessary to gain some sense of the meaning that the individual’s culture holds for him or her personally, rather than relying on presuppositions. The client’s culture has many potential implications for the process of the assessment. Some cultures view direct questioning as inappropriate. Therefore, individuals from this type of culture may view the assessment process as highly intrusive. A goal of the assessment process is to understand the client’s world from his or her o wn cultural perspective. The importance of making appropriate inferences from information about an individual’s culture makes it imperative that programs involved in assessment exert a strong effort in good faith to hire assessors representative of the populations they serve. When qualified professionals from these cultural groups are not on staff, treatment programs can seek to employ counselors or support staff from these groups, in order to create a diverse multicultural program environment. For effective assessment and placement, it is necessary to recognize that institutional and individual discrimination may exist in the criminal justice system and other institutions, and that bias can negatively affect classification, screening, and assessment.

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