Practices of Lifestyle Modification Regarding T2DM

Practices of Lifestyle Modification Regarding T2DM Chapter 5 Discussion, Recommendation Conclusion 5.1 Introduction Most studies on the KAP on diabetes both in developing and developed countries targeted patients with diabetes. (Ben Abdelaziz, Thabet, Soltane, Gaha K, Gaha R, et al., 2007). Unlike these, this study targeted the general population. Therefore adequate comparative data is lacking for the study and the discussion is based on knowledge, attitudes and practices of the population of Saint Lucia. There is no study concerning KAP regarding T2DM available in Saint Lucia, hence, this study is an attempt to gather the data regarding the same. This chapter discusses a collaboration of major finding of the study, the relevant discussion, recommendation and conclusion. The study was a cross-sectional study in an attempt to collect sufficient information on knowledge, attitudes and practices of lifestyle modification regarding T2DM among the population of Saint Lucia. 5.1.1 Demographic Majority of the participants in this study were in the age group 25-34 years (39.5%). This in general accordance with the national census which conducted in the 2015 (Department of Statistic, 2015) In regard to participants with no formal education was very low 1.3%, and participants with primary , secondary and tertiary level together constituted an overwhelming (98.7%) of the participants in this study. This indicates that most participants are well educated, a finding which is similar to the results of another study conducted by Karir Consultant Limited. A majority of the participants were poverty-stricken (34.1%) earning between $0.00 $1,499.99 eastern Caribbean dollars per household. Poverty could limit accessibility to and affordability of a well-balanced diet and healthy food. And this could explain why a large percentage of the participants had low level of practice towards T2DM regarding regular doctor visits. The finding is in keeping with a survey conducted by KAIRI Consultant Limited where 43.8% of the population was shown to have very low income (KAIRI, 2007). 5.1.2 Knowledge In this study it is found that knowledge is statistically high amongst the respondents. 76.1% of the respondents had good knowledge of T2DM. The results also indicated that the respondents were very knowledgeable on the general awareness of T2DM such as the symptoms, complications and prevention of the specific disease. The result was consistent with a study done by Ambigapathy and colleagues found in their study that majority of respondents (67.0%) were knowledgeable about lifestyle modifications. The respondents scored 50% and above of the total score for all the categories of questions asked (Ambigapathy R. et al, 2006). In contrast R. Malathy and colleague in their study concluded low education amongst majority of their respondents. 83.3% had poor knowledge of the benefits of exercise, weight loss and healthy diet (R. Malathy et al, 2011). 5.1.3 Attitude Majority of the respondents agreed that it is important to engage in regular exercise, to follow a controlled diet and to maintain a healthy lifestyle. Results indicated that 90.5% of the respondents had positively agreed that regular exercise is necessary to help manage T2DM. While 80.9% agreed that diet modification is essential to control the disease by getting correct advice and clarification. These findings imply that the respondents had good attitude towards diabetes prevention and control practices. This finding is similar to that of Mukhopadhyay P et al in which majority of the respondents 82.3% had positive attitude towards lifestyle modifications (Mukhopadhyay P et al, 2010). Similar results were revealed in a study conducted by Upadhyay DK et al 60.3% of the respondents had positive attitude towards lifestyle modifications (Upadhyay DK et al, 2008). 5.1.4 Practice Results indicated that the respondents had poor practices towards regularly exercise and diabetes preventative measure such foot and eye examinations. This was evidenced by results which indicated that the respondents did not exercise regularly while majority of the respondents never visited heath care provider for diet advice, never checked their blood pressure and never checked their blood sugar level. This finding is similar to those of W.M Kiberenge and colleagues in which majority of respondents (75.6%) had bad practices in relation to lifestyle modifications (W.M Kiberenge et al, 2010). 5.1.5 Variables Combined The association between KAP in this study was selectively determined; that is only specific questions were used. These questions comprise of two aspects diet modification and practice question such as regular exercise, maintaining healthy lifestyle and regular doctor visits respectively. There was a significant positive correlation (r= 0.233, p=0.000) and (r=.201, p=0.000) between the knowledge level and the attitude level of respondents in this study. This means that the better respondents were knowledgeable, the better they were willing to observe healthy lifestyle habits. There was a very weak, non-significant positive correlation (r=-0.064, p=0.259) between the knowledge level and practice level of respondents. This means that being knowledgeable did not necessarily translate to healthy lifestyle practices. The results found in this study were similar to those in the study by Ambigapathy R. and colleagues in which a significant positive correlation (r=0.536, p 5.2 Recommendation The government must take a lead in creating awareness about diabetes disease country wide and in the counties that are adversely affected. In addition to developing the Saint Lucia national diabetes center, a community awareness program targeting rural and semi-urban communities should be developed using a multi-sectoral approach in order to address the knowledge gaps and influence behavior towards diabetes prevention. Given the low and uncertain incomes characteristic among the people, free screening for chronic diseases should be availed to the residents by the county government to increase their knowledge level on diabetes status. This can be done in a similar manner to the ante natal care program targeting all government facilities right from level 2 health facilities. In order to ensure that once a community member seeking for health care services is managed well right from the start, there is a need for an increase in the awareness of diabetes management and its complications in the primary healthcare sector especially at level two facilities such as dispensaries and health care centers due to their proximity to members of the public. Thus, continuous education on diabetes mellitus and its complications for primary healthcare providers should be accompanied by regular assessments on the knowledge level. Screening for diabetes is important, but equally crucial is patient education and counseling. The following measures are recommended to address the knowledge and practice deficits uncovered in this study: 1. There is need for the implementation of community or national based lifestyle intervention program to improve the knowledge of patients regarding healthy lifestyle and emphasize the importance of exercise and weight loss in the management of type 2 diabetes mellitus. This should be extended to the primary health care clinics where the majority of patients are seen. 2. Medical nutrition intervention program should be implemented with a multidisciplinary team (Doctor, dietician, social worker, psychologistà ¢Ã¢â€š ¬Ã‚ ¦) 3. Empower Mamelodi healthcare workers with motivational interviewing knowledge and skills to promote behavior change and adoption of healthy lifestyle practices by patients 5.3 Conclusion The knowledge and attitude levels of lifestyle modifications among the population of Saint Lucia was generally high. Nevertheless, majority of these people have poor practices toward healthy lifestyle habits. Majority of the respondents had poor practices such as regularly exercise, checking their blood glucose level, and visiting the doctor for regular check-ups. This implies that there is need to develop community based health promotion programs to bring about paradigm shifts that will promote healthily choices and behavior as well as understand the impact of culture and beliefs to these practices. The low incomes suggest the respondents inability or difficulties in meeting health care costs when they arise, this may explain the poor practice of visiting health facility for regular check-ups. References Ben Abdelaziz A, Thabet H, Soltane I, Gaha K, Gaha R, et al. (2007) Knowledge of patients with type 2 diabetes about their condition in Sousse, Tunisia. East Mediterr Health J May-Jun; 13 (3) 505-14.) Department of Statistics. Unpublished data. Saint Lucia; 2013

Loopholes in the Audit Procedure

If Gray had more knowledge regarding JAZZ Best, he would have realized that this was an evident situation where an independent specialist should have been used to perform the audit procedure. These problems hindered the gathering of several types of audit evidence. Because Larry Gray did not do an adequate Job getting to know Barry Mellow and JAZZ Best, he evidence gathered through â€Å"client inquiry† was not reliable. This type of evidence personnel to answer the auditor's questions. Because Gray did not do enough research, he did not reveal the fact that Minnow was fraudulent and dishonest.Client inquiry is rarely adequate as the only supporting piece of evidence for an audit objective and usually must be backed up by additional evidence. However, because Minnows and JAZZ Bests integrity were such a problem, basically every other piece of evidence gathered was untrustworthy. The evidence gathered through â€Å"confirmation† was greatly impacted as well. This evidenc e is obtained with questions asked by the auditor, either written or oral, to a third party and the answers are given directly to the auditor.However, this evidence was made useless because Assured Property Management Inc. And Interstate Appraisal Services directly affiliated with JAZZ Best for the sole purpose of generating fake restoration contracts. However, Gray did not do enough research to figure this out. Furthermore, evidence gathered through â€Å"physical examination of tangible assets† and â€Å"documentation or inspection of records and documents† were rendered useless because they were fraudulent and not independent of the provider.The management assertions relating to this evidence is existence/occurrence and rights and obligations. Rights and Obligations is how management asserts that the recorded and disclosed assets are the rights of the entity and the liabilities are the obligations of the entity at a given date. Existence/Occurrence is when managemen t asserts that the recorded assets or liabilities of the entity that are disclosed on the balance sheet exist at a given date and that the recorded transactions disclosed on he income statement have actually occurred during a given period.The fabricated occurrence of the restoration activity, and the rights and obligations to the building could have been uncovered if Gray had done more research on JAZZ Bests internal controls and Minnows integrity. The evidence obtained during their visit to the restoration site was unreliable due to independence of the provider, a factor of competent evidence. When information is obtained from someone independent of the company and transactions being investigated, the evidence is more reliable. Assured Property Management Inc. AndInterstate Appraisal Services were created by Minnow for the sole purpose of generating fake restoration contracts. However, Gray did not do enough research to figure this out. This influenced the tour of the restoration s ite in Sacramento, CA because they were not independent of the provider. Another problem that lacked independence of the provider was the evidence Gray obtained regarding documents. Because these three companies were directly associated to each other's fraudulent activity, none of the documents received were reliable. Evidently, independence of the provider is a crucial factor and this was lacking in this audit procedure.

Paul’s Rhetoric at Mars Hill

Verses 16 and 17 of the passage that the speaker here is the Apostle Paul. He had been caught in this rhetoric with some Jews and devout persons whose background the Bible is silent and provides no elaboration [Verse 17]. According to Verse 18, there were also some Epicurean and Stoic philosophers. While the Jews follow Judaism as their religion and uphold belief in a coming Messiah, their religion traditionally emphasizes ethical conduct and the treatment of others as one would for one's self.Jewish law is based on the Torah, which essentially s the Five Books of Moses. On the contrary, the Epicureans were rivaled by the Stoics. The Stoics upheld a philosophy that life was about living in harmony with Nature. They encouraged self- control and saw courage as a means of monopolizing harmful emotions. Again, while the Jewish religion has thrived over the years, the Epicurean and Stoic philosophies faded out around the Third Century. It was wealth these deleting religious and philosophi cal backgrounds that the Apostle Paul had to address his audiences.Theirs was both a religious and heathen culture which one could identify more as a Gentile environment that knew nothing about the new faith the Apostle was trying to portray. Hence, his attempt to present what he believed in was met with hostility. To them it was a new teaching that they considered strange ideas as stated in Verse 18. It is obvious that, although a heathen society, it was equally religious as would be found in every human society. They knew about gods. In Verse 18, it is reported that, some of the people confronting the Apostle said that he seemed to be advocating foreign gods.Paul was definitely aware of their false religious beliefs. He capitalized on this when he addressed them. For when he was brought before the Reappears he told the people of Athens that he could see that they were very religious. He mentioned in Verses 23, 24 that as he walked around and looked carefully at their objects of wo rship, he even found an altar with the inscription. That to the Apostle meant that they were not ignorant of the very things they worshipped. Cleverly, he informed them that it was exactly what he was going to proclaim to them.Having opened up like this, it was apparent that the Apostle caught their attention and then charged on with his presentation of the Gospel. Essentially, the Apostle wanted to let them know that there was no hope of salvation for them In the gods In whom they had chosen to put their trust. Those were Just false gods that had no power to deliver them. In the end, the Apostle's persuasion became followers of Paul and believed. Among them was Dionysus, a member of the Reappears, also a woman named Dammars, and a number of others.

How Top Companies are Still Keeping Women out of the Most Senior Positions Free Essay Example, 1500 words

When something goes wrong at home, women workers remain preoccupied with the stress all day long which declines their efficiency and productivity in the workplace. It is hard for women workers to keep their personal life and work life separate. Likewise, when something bad happens at the workplace, e.g. insult from senior or sexual harassment by a colleague, their personal life is also disturbed. In short, it is difficult for the women workers to balance their personal life and work life and the two also intertwine. While these problems overall decline the productivity of the women workers, they also make the women workers quite untrustworthy as they can break off any time. Women workers cannot be trusted to be permanent as they can leave the job at any time as a result of the pressure upon them by their families. When something goes wrong at home, women workers remain preoccupied with the stress all day long which declines their efficiency and productivity in the workplace. It is hard for women workers to keep their personal life and work life separate. We will write a custom essay sample on How Top Companies are Still Keeping Women out of the Most Senior Positions or any topic specifically for you Only $17.96 $11.86/page During pregnancy, women are recommended bed-rest and the pressure upon them by their families to leave work for the sake of work also increases. In 2005, 4,449 pregnancy discrimination charges were filed with the commission or state and local employment agencies around the country. Half were related to unlawful dismissals either during pregnancy or immediately after returning from maternity leave (Paul). Pregnancy also declines women workers physical and mental efficiency. While women workers may be able to continue working with equal efficiency with pregnancy as they worked before, it becomes all the more difficult to do justice with their job in professions where the looks of the employees matter a lot. This is particularly the case with such professions as air-hostess, a nurse, a television show host or compare, or even a teacher. Even if it does not make any difference to the customers or audiences whether or not the woman worker is pregnant or not, the pregnant women workers internally feel this consciousness and guilt that they are not looking the way they should be, and this psychological distress has a negative effect on their efficiency in work.