A Short Note On Diabetes And Its Effects On The Body Essay

Type 2 Diabetes is a medical condition in which sugar, or glucose, levels build up in your bloodstream. What is happening in your body is that there is not enough insulin to move the sugar into your cells, which is where the sugar is located that is used for energy. This causes your body to rely on alternative energy sources in your tissues, muscles, and organs. This is a chain reaction that can cause a variety of symptoms. Type 2 diabetes can develop slowly and symptoms may be mild and easy to dismiss at first, which makes this disease hard to diagnose early on because a lot of people do not know that they have it. The early symptoms may include: lack of energy, constant hunger, itchy skin, and frequent urination. As the disease progresses, the symptoms become more severe and potentially dangerous due to the effects it has on the body. Diabetes has a severe effect on your heart which can cause your body to become resistant to in sulin. Insulin is a naturally occurring hormone which your pancreas produces it and releases it when you eat. Insulin helps transport sugar from your bloodstream to cells throughout your body, where it’s then used for energy. Diabetes causes your body to no longer use the hormone efficiently and this forces your pancreas to work even harder to make more insulin. Over time, this can damage cells in your pancreas and eventually your pancreas may not be able to produce any insulin whatsoever.Show MoreRelatedA Brief Note On Diabetes And The Treatment Of Type 1 Diabetes Mellitus921 Words   |  4 PagesReview Article Introduction: Type 1 diabetes, also known as insulin-dependent diabetes, is a chronic condition in which body produces little to no insulin due to autoimmune destruction of the beta cells of the pancreas. Patient with Type 1 diabetes are mainly treated with subcutaneous insulin injection, along with dietary and lifestyle modification. 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The Nurse Managers Role Free Essays

The nurse manager is vital in creating an environment where nurse-physician collaboration can occur and is the expected norm. It is she, who clarifies the vision of collaboration, sets an example of and practices as a role model for collaboration. The nurse manager also supports and makes necessary changes in the environment to bring together all the elements that are necessary to facilitating effective nurse-physician collaboration. We will write a custom essay sample on The Nurse Managers Role or any similar topic only for you Order Now Many authors (Alpert, Goldman, Kilroy, Pike, 1992; Baggs Schmitt, 1997; Betts, 1994; Evans, 1994; Evans Carlson, 1993; Keeman, Cooke, Hillis, 1998; Jones, 1994) have indicated that nurse-physician collaboration is not widespread and a number of barriers exist. The following will discuss the necessary ingredients for creating a nursing unit that is conducive to nurse-physician collaboration and supported through transformational leadership. The first important barrier according to (Keenan et al. (1998) is concerned with how nurses and physicians have not been socialized to collaborate with each other and do not believe they are expected to do so. Nurse and physicians have traditionally operated under the paradigm of physician dominance and the physician†s viewpoint prevails on patient care issues. Collaboration, on the other hand, involves mutual respect for each other†s opinions as well as possible contributions by the other party in optimizing patient care. Collaboration (Gray, 1989) requires that parties, who see different aspects of a problem, communicate together and constructively explore their differences in search of solutions that go beyond their own limited vision of what is possible. Many researchers have argued (Betts 1994; Evans Carlson, 1993; Hansen et al. , 1999; Watts et al. , 1995) that nurses and physicians should collaborate to address patient care issues, because consideration of both the professions concerns is important to the development of high quality patient care. Additionally, effective nurse-physician collaboration has been linked to many positive outcomes over the years, all of which are necessary in today†s rapidly changing health care environment. One study by (Baggs Schmitt, 1997) found several major positive outcomes form nurses and physicians working together, they were described as improving patient care, feeling better in the job, and controlling costs. In another study (Alpert et al. , 1992) also found that collaboration among physicians and nurses led to increased functional status for patients and a decreased time from admission to discharge. Along with improved patient outcomes, nurse-physician collaboration has several other reasons why it has become significant in today†s health care environment. Several examples of which are, as identified by (Jones, 1994) the cost containment effort, changing roles for nurses and physicians, the Joint Commission on Accreditation of Health Care Organizations focus on total quality management, and emphasis by professional organizations and investigators have focused attention on this area. The challenge of creating an environment for patient care in which collaboration is the norm can be difficult and belongs to the domain of the nurse manager. In order to create a collaborative work environment several conditions must be achieved and several natural barriers to nurse-physician collaboration must be overcome. In creating this environment for collaborative practice, (Evans, 1994) identified several more barriers to overcome. She expresses that the most difficult to overcome is the time-honored tradition of the nurse-physician hierarchy of relationships, which encourages a tendency oward superior-subordinate mentality. Keenan et al. (1998) found that nurses expect the physicians to manage conflict with a dominant/superior attitude. They also found that nurses are oriented towards being passive in conflict situations with physicians. A second barrier to collaboration is a lack of understanding of the scope of each other†s practice, roles, and responsibilities. Evans (1994) feels that one cannot appreciate the contribution of another individual if one has only limited understanding of the dimensions of that individual†s practice. It is equally true that appreciation of one†s own contribution is blurred if the understanding of one†s own role is limited. A third constraint to collaborative practice might be related to this perceived constraint on effective communication. Although there might be individual differences causing restraint in communication, the organizational and bureaucratic hierarchies of most hospitals hinders lines of communication. Several final factors cited by (Evans, 1994) as barriers to collaborative practice include immaturity of both physician and nurse groups, coupled with unassertive nurse behavior and aggressive physician behaviors. Factors that promoted collaboration between nurse and physicians were identified by (Keenan et al, 1998). She explained that nurse education was sighted as one of the most outstanding variables that promoted collaboration. The more educated a nurse was the more likely they were to take action in disagreements with physicians. Additionally, when nurses expected physicians to collaborate and to not exhibit strong aggressive behaviors or controversial styles, they were more likely to approach and discuss patient conditions with them. Researchers also found that male nurse were more likely than female nurses to confront physicians and not avoid dominant or aggressive behavior. Expectations for physicians to collaborate and to not handle situations aggressively appeared to be a stronger predictor of nurse-physician collaboration than any expected normative beliefs. The first step a nurse manager should take in the process of achieving a practice environment that facilitates collaboration is to conduct an assessment of the presence or absence of barriers leading to collaborative practice. According to (Evans, 1994), the environmental and role variables to assess include role identification and the professional maturity of both the nurses and physicians, communication patterns, and the flexibility of the organizational structure. By assessing the work environment for barriers and facilitators to collaborative practice, the nurse manager can achieve a general idea of how ready the unit is to begin a collaborative practice. The next step would be to plan an effective way to initiate a collaborative practice model of delivering health care on the unit. This can be done by establishing what is called a Joint Practice Committee, and including nurses and physicians to be a part of this work group. Its purpose would be to examine the needs assessment results of the unit†s readiness for collaborative practice, designing, implementing, and evaluating the process of transforming the unit. This step is an integral part of the process of establishing a collaborative practice and was identified by the National Joint Practice Commission (NJPC) as a necessary element in the process. The NJPC began in 1971 and the commission was dissolved in 1981. The commission†s work resulted in the publication of guidelines for collaborative practice in hospitals. The NJPC defines a joint-practice committee with a composition of equal number of nurses and physicians who monitor the inter-professional relationships and recommend appropriate strategies to support and maintain those relationships. The NJPC identifies four other structural elements necessary for a collaborative practice as primary nursing, integrated patient care records, joint patient care reviews, and emphasis on and support of nurse independent clinical decision making. These elements are an important cornerstone for creating a successful collaborative practice unit. In addition, several other factors have been identified by the NJPC as beneficial to maintaining an effective support systems when developing a collaborative practice such as appropriate staffing, committed medical leadership, standardized clinical protocols, and most importantly communication. Although a successful collaborative practice model has is a planned event. According to (Evans, 1994), it is important to realize that a collaborative relationship cannot be legislated, dictated, or mandated by anyone. It must be agreed upon and accepted by individuals who share responsibility for patient care outcomes. The third step in the process would be to empower the nursing staff with beliefs that fulfill their higher order of needs such as achievement, self-actualization, concern for others, and affiliation. Because of nursings normative behavior as passive, caring, and subservient the staff must learn to overcome expectations to identify with this role expectation. The nurse manager must support, coach, and instill a sense of empowerment into her staff in order for them to depart from those stereotypes. The idea is to fill the nursing staff with a sense of self-confidence and to lose thoughts of self-doubt, inequality, and subservience. To implement this new paradigm of nurse empowerment can be a challenge for the nurse manager within any typical hospital beaurocracy. That is why it is important to choose the correct style of leadership to guide the staff through this process of empowering or transforming. The leadership model best suited for this type of task and the most congruent with empowerment is the transformational model. Transformational leadership is a process in which leaders seek to shape and alter the goals of followers. Cassidy Koroll (1994) describe the process as incorporating the dimensions of leader, follower, and situation. The leader motivates followers by identifying and clarifying motives, values, and goals that contribute to enhancing shared leadership and autonomy. Transformational leaders are usually charismatic so they enhance energy and drive people towards a common vision and shifting the focus of control from leaders to followers. It is the transformational nurse manager that will be able to empower her workers to facilitate nurse-physician collaboration, for the common good of the patient. The nurse manager using transformational leadership would set the direction for the rest of the unit to follow. She would be able to charismatically appeal to the medical staff as well as the nursing staff and create collaboration beyond the daily frustrations of arguing about to which domain a certain patient care issues belong. Further more the nurse manager would have to work hard at decreasing the seeds of distrust and disrespect that have been planted between our colleagues in medicine, and vice versa with nursing. Corley (1998) described several behaviors that the transformation nurse manager would need to exhibit in supporting her staff in such a role transition. The behaviors are as follows: stimulate creativity, establish an environment that facilitates team work and learning, implement change, motivate staff to assume increased responsibility, help develop employees† awareness of organizational goals, delegate responsibility appropriately, communicate openly and directly with staff, and collaborate with peers. The significance of these behaviors in facilitating empowerment is seen as fundamental to creating collaborative practice environment. The final step in the process is to evaluate its effectiveness. In order to provide a clear and concise evaluation of the collaborative process one must look at all structural elements and all indicators of collaboration as previously discussed. Once accurate measures are identified and assessed the collaborative practice committee can discuss their outcomes and effectiveness. Over time, nurses and physicians may be able to articulate more clearly the changes in their practice and beliefs that have been affected by collaborating on patient care. Several of these key areas to examine would be: length of stay, patient and provider satisfaction, number of return visits, and changes in supply costs. Improvements in any of these areas could be due to favorable results from collaborative practice between nurses and physicians. In conclusion, many problems related to nurse physician collaboration are typically blamed on physicians. However the reality is that many of the barriers can be traced back to nursing as well. Collaboration is a process by which members of various disciplines share their expertise. Accomplishing this requires that these individuals understand and appreciate what it is that each professional domain contributes to the â€Å"whole†. The nurse manger plays a pivotal role in establishing an environment that is conducive to collaboration among the disciplines. Although it is a difficult road to follow the benefits of an effective collaborative unit out-weigh the difficulties of establishing such a practice. However, the nurse manager has an excellent vehicle for which to begin her journey and that is the use of transformation leadership, an empowering tool for change. How to cite The Nurse Managers Role, Essay examples

Paris Agreement on Climate Change †Free Samples to Students

Question: Discuss about the Paris Agreement on Climate Change. Answer: Introduction: Every country presents on the earth is being affected by the change in climate management. Due to the climate change economies of the world is getting affected, at the cost of the lives of people, communities and nations. The emissions of greenhouse gas due the activities of humans is causing the change in climate and rise in temperature. A warning was issued by The United Nations Intergovernmental Panel on Climate Change (IPCC), about the rise in global temperature, which was above pre industrial times, i.e., at least 2 degree Celsius and its consequences on the nature and world. It was highlighted that this rise in temperature will lead to climate changes which will be irreversible as well as it will pose a great threat to the very survival of living beings (Telegraph Media Group, 2017). To provide a solution to such issues, it became necessary for countries to meet at an international level and by cooperating and coordinating with each other to start a campaign. On 12th Decemeber 2015, to address the issue of climate change, 195 countries met in Paris and adopted the Paris Agreement at the COP21. After a year, the Agreement came into existence. It was decided that all the countries will agree to work towards the betterment of environment control management and providing a sustainable life to its habitants. It was agreed by all the countries that to work to limit the rise in global temperature to below 2 degrees Celsius and if necessary to 1.5 degree Celsius. Other than this, the member nations are forced to act and address any kind of damage and loss done by them due to climate impacts. It also asks the developed member nations to help the developing countries members financially so as they can tackle the issues and can adapt to climate change (Lewis, 2017). Almost every country was ready to adopt clean energy and to curb the issue like phasing out fossil fuel, which is the basic framework of Paris Climate Accord. A climate Action plan which focuses on how the members will achieve their goals, were submitted by the countries. Out of the 195 member countries, the member who has ratified their accord are 175 in number. In the Agreement it is said that developed member countries due to their industrial growth, need to take the accountability for cutting the emissions as minimum as possible. Whereas, developing member nations encouraged to use the renewable sources of energy to meet the needs and demands of their large population. Few important points under the Paris Climate Agreement are: The Paris Climate Agreement urges and requests all its member nations that by the year 2020, they need to do an updating of their pledges. Whereas in 2018 and after every five years, every member need to review its efforts and actions which it is taken in minimizing global warming. The emissions curbing targets are different from most of the countries depending on their abilities and resources management at disposal. For eg. It is 2025 for few countries where as may be a developing nation has set its target for the year 2030 and all these category need an updating after every five years. Member countries who are developed and have funds at their disposal are asked to provide funds to less developing member countries in order to help them fight against the cause of global warming (Plumer, 2017). It is the obligation of every member to put their efforts toward the contribution of mitigation of climate change and adaptation. It is for the first time, that every member country is developing plans on its contribution to climate change mitigation. They will also communicate nationally determined contributions to the Convention Secretariat (Trust, 2017). In the June 2017, in a statement, the President of The United States of America, Donald Trump announced that they will be not supporting the Paris Climate Accord anymore and -also they will after sometimes begin the re-negotiations, talks to make a re-entry in the Paris Accord on their own terms and policies which are beneficial for its country. By the withdrawal of the United States of America, the efforts put in by every member country to reduce pollution and to keep a check on climate change, will be seriously weakened globally. Earlier the United States of America pledged to bring emissions below 2005 levels by 2025 which was 26 to 28 percent, but now it will be approximately will fall from 15 to 19 percent (Harrington, 2017). After China, the second biggest country who contribute in the emission of pollution worldwide is the United State of America. The exit of the United States of America has left people wondering that the goals which were formulated by the Paris Climate Agreement can still be achieved or not. According to the experts worldwide, the United States withdrawal will lead to destroying its international credibility and will be outcast. They think that the withdrawal will pose a threat to the US environment as well national security. More than a million jobs in clean energy are at risk and it will cost the job of the people due to the decision. While signing the Agreement. The United States committed to carbon emissions reduction by 26 to 28 percent in a period of ten years, which now looks like will take a number of years to achieve that goal (CDP, 2017). The withdrawal of the United States of America from the Paris Climate Agreement raise an important question that as the member countries are leaving or ratifying the accord according to their own terms, so could the policy networking and policy transfer will help and enable the Paris Climate Agreement to succeed. Before answering the above question it is very necessary to understand the concept of policy networking and policy transfer (The Washington Post, 2017). When one place or times information and knowledge about institutions, policies management and administrative arrangements are used in another time or place policies development, administrative arrangements etc., it is known as Policy Transfer. What happens here is an organization tries to use policy on the other through force. It includes the transfer of policy goals, ideas, concepts, attitudes, administrative techniques, etc. In short, it means that an organization is superior to the other organizations present in an agreement. Whereas Policy networking is related to the issue of keeping focus on the interdependence and links in between sections of government and different element of a society, in order to understand the process of making policy and outcomes of public policy. The United States of America, being the worlds largest economy and who contribute in the emission of carbon mono oxide and stood second in it, might ask other friendly countries to do so. The United States of America says that it is doing its part, but other members specially the developed nations are not anywhere close to it (Horam, 2017). The Paris Agreement asked every country to set a number as its target for curbing emissions. For eg. Members like China and India have their own emissions cutting targets. The United States targets are much higher than what the countries like China and India have projected. The Paris Climate Agreement through its policy networking and policy transfer can succeed no matter countries like United States of America leave it or stay. One country cannot dictate an entire organization on how it functions or how the member country wants to operate the organization. An agreement comes into existence when two parties mutually agree on something and then they decide to work for achieving the objectives mutually and together. The Goodwill is based upon which the Paris Climate Agreement is formed. The Paris Climate Agreement can be successful if it relies on the pledge, for the creation of political pressure keep reviewing its process and drive low carbon investment (Serrat, 2017). There are few factors which need to be dealt in order to let the Paris Climate Agreement become successful and achieve its target. For instance, by 2018 is the deadline for the Agreements books of rule operationalizing finalizing. There is a need for setting a framework which encourages transparency and accountability, which in turn will ensure that member countries are feeling trustworthy and also dont promote any free riding. Most of the countries are still making rules and policies for the implementation in their native country. Developing countries dont have sufficient resources at their disposal, so they are lacking behind. The Committee for Paris Climate Agreement need to promote and provide a mechanism through which there is coordination of efforts in between various agencies and which in turn help the member countries as and when required (Center for Climate, 2015). Member countries of Europe and South Asia like China and India are few major active members of the organization wherein they are committed to the Agreement by renewable energy adaptation and fighting against the issue of climate change. There has been a rise in the investment of renewable energy in countries like Japan, China, and India. Development of renewable friendly policies has been done by many European countries wherein, in 2016 around 90% of new capacity was contributed by renewable energy in Europe. The leaders of these member countries have refused to renegotiate the Agreements of Paris, which is a positive sign. Though with the withdrawal of the United States of America, has hampered the growth of the Paris Climate Agreement working, but many member countries see this event as an opportunity to lead the organization. The Paris Climate Agreement clearly states that its purpose is not only to see the climate change, but environmental sustainability as well as including factors like eradication of poverty, sustainable development, security of food, equity depending on the needs and demands of different member nations. The Paris Climate Agreement breaks new ground by taking into account the differentiated responsibilities. The Paris Agreement is an alternative approach for every member countries and especially the developing nations wherein it establishes a model structure for differentiation (Bodle et al., 2016). The Paris Climate Agreement policies focus on the transparency of member nations, combined efforts put in by the members and to work towards a common cause and contributing towards it. Many technical details are left for future decisions in multilateral treaty like the Paris Climate Agreement, which is a normal situation, but due to its approach which is procedural it makes the Paris Climate Agreement special, which means that for safeguarding the ambitions, further details can play a crucial role. It has moved beyond the UNFCCCs differentiation which are mainly bifurcated by taking small and decisive steps which makes it a landmark agreement. The policies of the Paris Climate Agreement are designed in a manner wherein every member is aware about its targets and the methods to achieve those targets. It is very essential for the Paris Climate Accord to follow the principle of implementation in its long term success. It makes sure that below mentioned points are taken in making the organization and its efforts successful: The momentum which the committee gained during its initiation should be maintained. A powerful level of influence in politics need be involved, so that the Paris Climate Agreement Committee and the member countries can be connected. This will ensure that there is a smooth transition of finance as well as political help to make ensure that the members are working towards the common cause (Selin Najam, 2015). For the preparation, which are progressive and implementation of technology for the Nationally Determined Contributions, capacity needs to be created. The transparency needs to be maintained throughout the tenure. While doing the negotiations in the future, it has to be ensured that technical details, which are still to be negotiated, in relation to nationally Determine Contributions are determined (Willliams, 2017). The policies of the Paris Climate Agreement are crystal clear and it was built on an honest attempt. Due to this, a new line has been added in the Article 2 of the Agreement holding the increase in the global average temperature to well below 2C above pre-industrial levels and to pursue efforts to limit the temperature increase to 1.5C above pre-industrial levels The Paris Climate Accord is based on two pillars of universal participation and acceptance of responsibility. Its policies are way different from its predecessor 1997 Kyoto Protocol, which focussed mainly on the countries who were emitting most of the carbon mono oxide and greenhouse gases. Also in comparison to Copenhagen Accord of 2009, it is way different and important, the earlier focussed only on a small number of developed and influential countries leaving aside the rest of the countries of the world. Though it is too early to say that the Paris Climate Accord is successful or not, but one can say that it as an accomplishment toward bringing the world closer and making them work collectively toward the achievement of saving the world and restoring the balance. It is a long process step, but it is one of the best methods to tackle changing climate. As mentioned earlier, one of the main reasons for the Copenhagen failure was that, the developing nations were not willing to come into an agreement which can damage their chance of progress. The policies of the Paris Climate Agreement make ensure that such mistake is not repeated. The aim given to its member countries is to stay well below 2 degree Celsius instead of 2 degree Celsius as well as to aim to keep working in the direction toward keeping the warming below 1.5 degree Celsius. Through a smart system of national plans, which are developed by countries, modified according to their own circumstances, an agreement has been made, thus making it flexible to work with. With the help of the process of transparency wherein, the member countries commitments and working can be measured, as well as any member developing country can become ambitious and achieve its target by getting proper aid from developed countries. It shows that international cooperations and global dimensions are also present in the issues like climate adaptation. Because of the policy transfer and networking of the Paris Climate Agreement, many corporate leaders contribute to the global causes (Kuylenstierna, 2016). Withdrawal of the United States of America will initially hamper the working of the Paris Climate Agreement, but it will have no long lasting effects. Because by learning from past mistakes and experiences, this time the world has formed a committee which works for the betterment of every living being involved as well as nature itself. A politically defined objectives which are applicable globally forms a basis to support investments and development. With the exit of the United States of America, other countries will become more responsible towards the cause and will be more accountable (Plumer, 2017). At this point of time it is very essential for the Paris Climate Agreement to do policy networking and transfer of policy to make it a successful event not for its own benefit but for the world as whole. A clear path toward the reduction of emissions has been set by the world. References Bodle, R., Donat, L. Duwe, M., 2016. The Paris Agreement: Analysis, Assessment and Outlook, Available at: CDP, 2017. Statement from CDP on US withdrawal from Paris Agreement on climate change, Available at: https://www.cdp.net/en//articles/climate/statement-from-cdp-on-us-withdrawal-from-paris-agreement-on-climate-change?gclid=Cj0KCQjw9afOBRDWARIsAJW4nvzi4zUAvuLY3bS6hQGRh0Ihl28TvmgYvE4-MPq9LkQIzZ-_mAB5iv8aAp2zEALw_wcB Center for Climate, 2015. Outcomes of the U.N. climate change conference in Paris, Available at: Harrington, R., 2017. Here are all the countries that signed on to the Paris climate agreement, Available at: https://www.businessinsider.in/Here-are-all-the-countries-that-signed-on-to-the-Paris-climate-agreement/articleshow/58936031.cms Horam, P., 2017. Climate change challenges post-U.S. exit from Paris Climate Agreement, Available at: https://medium.com/thebeammagazine/climate-change-challenges-post-u-s-exit-from-paris-climate-agreement-f1dcf9391bdb Kuylenstierna, J., 2016. The Paris Agreement: a success for international cooperation and good for business, Available at: https://www.sei-international.org/cop-21-news-opinion/3300-the-paris-agreement-a-success-for-international-cooperation-and-good-for-business Lewis, A., 2017. What is the Paris climate agreement and why does it matter?, Available at: https://www.wired.co.uk/article/what-is-paris-agreement-on-climate-change Plumer, B., 2017. How Can U.S. States Fight Climate Change if Trump Quits the Paris Accord?, Available at: https://www.nytimes.com/2017/09/20/climate/paris-climate-accord-trump.html Selin, H. Najam, A., 2015. Paris Agreement on climate change: the good, the bad, and the ugly, Available at: https://theconversation.com/paris-agreement-on-climate-change-the-good-the-bad-and-the-ugly-52242 Serrat, C., 2017. Highlights of the Paris Agreement, Available at: https://phys.org/news/2017-05-highlights-paris-agreement.html Telegraph Media Group, 2017. What is the Paris Agreement on climate change? Everything you need to know, Available at: https://www.telegraph.co.uk/business/0/paris-agreement-climate-change-everything-need-know/ The Washington Post, 2017. These experts say it may actually be best if the U.S. left the Paris climate agreement, Available at: https://www.washingtonpost.com/news/energy-environment/wp/2017/05/31/these-experts-say-it-may-actually-be-best-if-the-u-s-left-the-paris-climate-agreement/?utm_term=.2bc6b60d0b79 Trust, F.o.t.E., 2017. The Paris Agreement: will it help tackle climate change?, Available at: https://www.foe.co.uk/climate-change/paris-agreement-will-it-help-tackle-climate-change Willliams, T., 2017. Was the Paris Agreement on Climate Change a success?, Available at: https://alevelpolitics.com/was-the-paris-agreement-on-climate-change-a-success/