The Health Promotion Project Plan Essay - 1182 Words

Introduction The Health Promotion Project Plan focuses on one of the topic of Healthy People 2020 (HP) that is â€Å"HP2020 - Heart Disease and Stroke†. Heart disease and stroke are both preventable diseases that share many common risk factors including high blood pressure, high cholesterol, diabetes, unhealthy diet, sedentary life style, stress, and cigarette smoking. Stroke is the fourth cause of death and a leading cause of disability in the United States (American Heart Association, 2016). According to Center for Disease Control and Prevention (CDC) (2015), on average, one American dies from stroke every 4 minutes. Every 43 seconds, someone in the United States has a heart attack (CDC, 2015). General public knowledge about stroke definition is sufficient, however the knowledge about stroke warning signs is usually poor. That is why many people do not seek medical attention during occurrence of the first signs and symptoms of stroke. Awareness of these facts and knowledge a bout prevention, detection, risk factors, and treatments can reduce not only the number of disabilities and death causes by these cardiovascular diseases, but also decrease the money spent on the treatment of stroke. According to Center for Disease Control and Prevention (2015), stroke costs the United States an estimated $34 billion each year including the cost of health care services, medications, and missed days of work. 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Language Cannot Be Devoid Of The Social Context Of Its

Language cannot be devoid of the social context of its creation and use, as this would dislocate it from the field of human interaction, within which language derives the full quality of its meaning. Social context of language is the way in which we understand novels, stories, conversations and other people; as it is embedded in everything about the ways in which we communicate. To view language in the absence of social context creates significant limitations in its real-world application. The reason for this is that for language to have any meaning then context is essential. The source of this context is quite varied, the origin of the language is from the originator with its own context, however, the receiver also places their own†¦show more content†¦This could lead to quite a different perspective to any individual’s present for the whole conversation. 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Decision Analysis For Management Judgment â€Myassignmenthelp.Com

Question: Discuss About The Decision Analysis For Management Judgment? Answer: Introduction: Decision can be defined as the ultimate destination or the point reached after taking into consideration many aspects to resolve an issue. It is the action that is taken in account of solving the problem or initiating something. Decision making is the process that has been followed at the time of making the decisions (Dooley Fryxell, 1999). It is considered as the very important part in management. This is one of the most important function of management as all the other functions and all the operations that the company does depends on the decision making of the management. As far as the role of managers are considered, it has been analysed that decision making is one of the key roles as managers have to make decision over the things on daily basis.in management terms, a decision making process can be defined as the set of action that are being followed to take out the alternatives in order to achieve the objectives of the organizations. Decisions are required to be made at every le vel of the organization (Mel, 2010). The organizations need to implement different strategies in their decision making process so that the decisions can be made effective and efficient. It is that function that is the most important drivers of the organization as decision has been made at every point and all the process further in the organization are conducted according to the decision that has been made. Decision making is not the only function that has been conducted by the managers these days but it is the most important function and also the most effective way of achieving the objectives of the organization. In todays organizations, decision making is so important that it can be used as the replaceable word for management. This is because management means making decision now and then. It is not the scene that only the managers have to make the decision but the employees working under them also have to make decisions in order to manage their work (Aharoni, Tihanyi Connelly, 201 1). As far as the hierarchy of the organizations is considerd, managers have to manage their team and the resources under them. Those human resources also have to manage their work and thus have to prioritize their work accordingly so that they can be completed on time. This requires them to make the decision in order to prioritize (Schweiger, Sandberg Ragan, 1986). Thus, it is required to assess the factors and the aspects associated with the element on which the decision has been made and also on the situation in which the individual is making the decision. This depicts that decision cannot be made without proper investigation of the associated aspects. The data has been collected and then assessed to make the final decision considering all the aspects that affects the decision making process. It is the futuristic approach and thus it is also required to consider the future aspects to make the decision and it cannot be made considering only the present situations (Dexter, Willems en-Dunlap Lee, 2007). This is the report that discusses about various aspects of decision marketing in management. There are different external factors that can affect the decision making process by the managers in the company. The discussion is also made on some of those factors that ah severe impact on the decisions and have the potential to deviate the decisions. Some of the factors such as heuristics speed up the decision making while other such as social influences and biasness may deviate the decisions made by the managers. This report provides in depth understanding of these concepts and the intensity of the effect of these elements on decision making. Heuristics that can assist the decision maker in speeding up the decision making process: Making decision in the organizations requires an approach to be followed. These approached have some or the other basis. It has been analysed that at the tie of making decision. The mind applies logic, statistics or heuristics. All these elements are the mental tools that are assessed and used to make a decision (Gigerenzer Gaissmaier, 2011). Logic and statistics are considered as the rational approach of making decision which heuristics falls under the irrational approach of decision making. The rational theory or approach of making decision argues that every element or the aspects needs to be considered at the time of making the decision. The decision can be taken at its best at the situation when all the aspects of the problem has been considered ad various solutions have been made to choose the best one. However, it has been argued that evidences are not always act as the best basis to take the decision. They are not always justifiable. Simon was the one who questioned this theo ry of rationality among the decision making process and its application in the practical world (Slovic, Finucane, Peters MacGregor, 2007). Some authors argue that humans at the time of making decision try to opt the easy and simpler method to resolve the issue and not the complex ones. At the time of taking the decision, they generally use to avoid the complex method and go for the simple ones that can provide them better and sorted condition to make the decisions. This method of rationality among the decision making process have been replaced by the researchers with the method of rule of thumb also called as heuristic approach. This approach allows the decision makers to make the decision in simpler circumstances by following the rule of thumb. Approaches to decision making: There are different approaches that have been identified in order to make the decision in management. Rational model: it is the model that is based on theories. It is the model that supports the decision making that is optimal in nature (Marewski Gigerenzer, 2012). In this, the manager needs to make alternative decision and then the optimal is used to be implemented. For this, the managers have to assess all the information and the aspects related to the problem. Administrative model: It is the model that supports the decision making process based on limited information. In it also called as the model of bounded rationality in which the related information is not present with the decision maker they try to make the good decision but it cannot be optimal one. Image theory: It is the theory that deals with intuitions. This theory argues that considering all the aspects of the problem to take the decision is not always possible and feasible thus making decisions in the simpler way by considering only the problem is most rapid way to make the decision. What is heuristics? Heuristics can be defined as the simple rule of thumbs for resolving the issues and making the decisions. Heuristics is the strategy of making the decision that partly ignores the information to reduce the decision making efforts. The gaols of considering the heuristics in making decisions results in considering less cues and information at the tie of making decision so that the decision can be made quickly (Birnbaum, 2008). There are different types of heuristic such as availability and representative heuristics that are most commonly used in the management to make the decisions. Representative heuristics is generally used when the characteristics of the individual is involved and the judgement needs to be given for a person while availability heuristics deals with ignoring one or the other information that is not available to make the decision. Heuristics in decision making: Sometimes, it is known that what will be the exact probability that leads to best outcomes. In that case, the judgment can be made by taking heuristic in considerations. These are the general strategies that are used to resolve the problems (Shah Oppenheimer, 2008). Till 1970s, it is the approach that was found to be very effective in making decisions in case where the logics cannot work. From the last 25 years, it has been analysed that heuristics definition had changed over the time. It has been considered as the most unreliable method of making the decisions. The study of logics in decision making has found that using heuristics results in inappropriate decisions that do not consider the related aspect of the problem. It has been believed that heuristic in the decision making restrict the managers to take the correct decisions. Although heuristics are making deviation in the decisions but still some of the recent researchers suggests that the decision makers in the management are using such approach to take the decisions. It is accounting that heuristics cannot provide the optimal solution for the problem but have accuracies that are very much close to the more complex decision rules. It has been analysed that the most usable heuristics these days is the Fast and frugal approach of decision making (De Martino, Harrison, Knafo, Bird Dolan, 2008). This is the heuristic approaches that speed up the cycle of making decision reduce the efforts in the cycle. It has been said that in this world of dynamic environment, it is not always feasible to use complex tools and method to resolve the complex problems. Sometimes, simple methods can also do wonders. For example, Apple Inc. is the company that always consider only the latest technology to make the products and not the customer related issues. Many a times, man agement needs to make the decisions in highly uncertain situations. These situations have so many attributes associated with them (Dean Sharfman, 1996). Many of the decision makers generally make decision by considering some of the most relevant attributes whose information easily available to them. Samsung is the company that has faced the issue of battery explosion in one of its mobile device. The company immediately took the action of replacing the devices without considering other factors. In addition to it, it is not necessary that they will use systemic approach always to make the decision. They just rely on the information that is with them and go with their gut feeling that is farmed after analysing the information available. It has been analysed that considering this approach results in reduced efforts of the decision maker that makes the decision making process fast and quick. This is because the decision maker is not wasting time in finding the data related to all to att ributes while making the decision based on the most relevant attributes and the information available (Hilbig, Erdfelder Pohl, 2010). The result of using heuristics is effort-accuracy and time trade-offs. This is because using this approach helps in reducing the time and efforts of making decision but at the cost of accuracy. Thus, it can be said that using this approach helps in speeding up the process of making the decision. As far as the type of heuristics is considered, it has been analyse that availability heuristics is the best approach to use at the time if the decision need to be quickly taken. Common Biases that can skew the decision making process Resolving the issues is the very common practice that is conducted by every organization at every level of management. This practice of resolution of the issues requires the management to make the decisions. It has been analysed that there are gaps between theory and practice of effective decision making process (Strough, Karns Schlosnagle, 2011). In actual practice of the decision making process, there are some assumptions and biases that affect the process and deviates the decision that has been made. Traditional methods that were related to decision making considers logic and rationality. Although these methods provides better ad accurate outcomes to the management but it is rarely practiced these days. This is because of the external factors that somehow affect the decision making in this dynamic organizational environment. It has been analysed that decision making process at the organizations vary according to the situation and the type of problem that needs to be resolved (Mas icampo Baumeister, 2008). There are different kinds of biases that affect the decision making process and deviates the decision of the management. Some of them are discussed below: Salience and vividness effects: It has been analysed that it is not possible for the mangers to attend all the information that is available for them at the time of making the decisions. They generally believe in focusing on the information that is interesting and related to the issue. Information that has direct impact on the decision maker is more vivid in nature and thus decision maker tries to take that information and consider the same for making the decision (Cokely Kelley, 2009). When managers have to make the decision, they usually consider the information that has been heard and seen by them rather than by others. The information that is heard and see by self remains in the memory for long time but it is not possible for the manger to rely on the information that has been observed by the This generates biasness among the managers regarding the information. Anchoring bias: Most of the time when the decision has been quickly then the managers have to rely on the first piece of information they get (Bryant, 2007). It may be possible that it gives a wrong impression but it becomes the mind-set of the manager and he or she makes the decision considering only that information. It has been analysed that this acts as the bias that deviates the actual result or decision. Bandwagon effect: It has been analysed that when a similar type of information is provided by the different people again and again it become reliable even if it is wrong or not appropriate. This can be termed as the power of group thinking. If in a group, most of the people have similar thinking then it affects the thinking of all the people and also a type of biasness have been created in the decision that has been made in the end (Gigerenzer, 2008). Blind spot biasness: It is the major and the most important bias that generally develops at the time of making decisions sometimes, the managers themselves does not have any idea about their own biasness. This also becomes a bias itself and affects the decision every time. Heuristics related biasness: As discussed above that heuristics are the strategies that deviates the decision from the actual as it does not consider every attribute that is associated with the issue (Weber Johnson, 2009). It has been discussed that heuristics speeds up the decision making process but also introduce errors in the decisions. It is the not always true that if something has worked in the past situation then the same approach can be implanted to the resent situation. Relying on those existing heuristics results in deviated outcomes. Representative heuristic biasness: it is the approach that is related to comparing the present situation with the past situations. In this type of approach, the managers compare the issues occurred in the past with the present ones and apply the approach that was used in past if there is similarity in the issues has been found (Wilson Dowlatabadi, 2007). This creates biasness as it is not necessary that the other factors that area associated with the issue are also similar. The availability heuristics: This is also the factors that create biasness in the decision. It is the situation where the managers take the information that is available to make the decision and does not try to collect the information from other sources. The information that is easily came to mind is more relevant can be taken to make the decision over the issue (Hilbert, 2012). There are some other heuristics such as simulation heuristics, adjustments heuristics etc. also create and develop biasness in the decision making process. Choice supportive bias: It is the bias developing situation where the choice deviates the decision. If a person has a particular choice then he made the decision in favour of that choice always even if the choice has flaws. Those flaws can be neglected at the time. Thus, the decision that has been made by the mangers is biased in this case. For example, if a manager has to take decision over the increment, he prefers to give high increment to the employees of his choice and thus a biased decision is being made (West, Toplak Stanovich, 2008). Clustering illusion: this is the situation where the decision maker used to rely on the random events to determine a pattern that can be followed. This also creates a bias as every situation is not same and every problem cannot be solved with the random pattern game. Confirmation bias: every person has some preconception in about some of the issues. When the individual or the manager has to deal with that issue having a preconceived view about the same. They manage will definitely listen to the things that is relevant to this perception and make the decision accordingly (Botvinick, 2007). This generates a biased decision. Outcome bias: It is the type of bias in which the managers of the company made the decision according to the outcome of the issue. Taking the decision as per the outcomes may be wrong. The decision but the managers should be taken according to the situation and not the outcome. The dilution effect: It has been analysed that if the decision needs to be made by the management, they should consider only the important and the relevant information. This is because the non-relevant information dilutes the effect of the relevant information. For example, it has been announced in the company that everyone is going to get the appraisal on the basis of their performance. One of the employees is performing very well but has some issues in the social interaction with the other employees (Han, Lerner Keltner, 2007). This may portray him as a bad person and it may be possible that the manager takes decision against him and he may not get the appraisal according to his performance. Thus suggests that the irrelevant information about his personal relation has diluted the relevant information of performance in the company All the above discussed bias suggests that there are various outside factors other than the issue and the related attributes that affect the decision of the management in the organization. This is because even though these factors do not affect the decision directly but they somehow affect the decision making process and thus the final decision get affected by that (Gold Shadlen, 2007). Social influences that might skew the decision making process It has been analysed that decisions cannot be made in vacuum. The organizational decision as well as the individual decision made in the context of the environment surrounding the decision makers. Thus, the decision makers have to take into consideration many factors that are directly or indirectly affect the decision issue (Brodbeck, Kerschreiter, Mojzisch Schulz-Hardt, 2007). One of the factors that have the major impact on the decision making of the organization or the management is social context. How social factors affect the decision: As the decision makes in the organization get the information from other social elements either by the facial expression of the other person or by directly getting the information. The decision makers have to consider such aspects of social interaction in their decision making process (Green, Carney, Pallin, Ngo, Raymond, Iezzoni Banaji, 2007). Decision making is not only the process of logics and simulation but the social factors such as emotions of the person, the impact of the colleagues and other stakeholders of the company etc. There are different social factors that can affect different types of decisions made in the organization. Social factors that affect the decision making: Social beliefs of the stakeholders: There are many stakeholders to the company such as employees, customers, shareholders etc. every individual have different social beliefs and thus the decision that are being made in the organization have to be such that does not hurt the sentiments of any of these stakeholders of the company (Saaty, 2008). Thus, the management has to consider their point of view in the decision. Different stakeholders and their impact on decisions making: Employees: employees are the biggest asset to the organization. It has been analysed that management has to consider the conditions and the situations of the employees at the time of making any decision (Hwang Lin, 2012). Various examples can be quoted to understand the same. Suppose, if the manager has to train and motivate the employees, he has to make the training or motivational plan for the employees. It is not necessary that every employee can be motivated by on factor or plan thus a plan that has been executed needs to involves all the aspects so that an optimum plan can be made (Tzeng Huang, 2011). Customer behaviour: Behaviour of the customers is also a social factor that affects the decision making criteria of the management. It has been analysed that customers behaviour change according to their beliefs. The organizations that operate in multiple countries found it as the challenge etc. takes decision over the strategies that need to take in order to release the products and the marketing practices. This is because the social values and beliefs of different country people are different and thus this affects the strategic decision of the company. When the company has to take the products decision, it is required to keep in mind the choice of the customer at that place where the products will release. It is also required at the same time to market the products in a way that does not harm any of the ethical values and moral values of the people (Zanakis, Solomon, Wishart Dublish, 1998). Shareholder role: It has been analysed that shareholders are the biggest part of the company that provides support to the business practices. Several decisions have been made in the company but consideration of the shareholders value is also very important. Income distribution: It is also another social factor that can affect the decision of the company or the management. This is the factors that affect the strategic decision of the company that needs to be taken regarding the products and the services offered to the market by the company (Eisenhardt Zbaracki, 1992). Other competitors: The Company operates in the industrial environment. That environment has various factors and these factors have their impact on the decision making. Suppose of the company has good relation with one of its competitors, them the management has to make such decisions that does not harm that particular company (Xu, 2015). On the other hand if the company has personal rivalry with another company then it may be possible that management of the company make such decision that attacks that particular company of the industry. Group think: group think is the process in which members of the team sits together and take out the decision (Lunenburg, 2011). This helps the organizations come up with many alternatives to solve the issue but it has been observed that the decision of majority become the thing of all. This may skew the actual outcome that should be made. This is because the people who are more influencing influence other people also to support their views (Trevino, 1986). This influence deviate the decision of the members as well as the whole group. Why social factors affect the decision making: Above all factors suggests that there is an impact of external factors on the management decision. This is because the management of the company has to take into consideration many attributes that are associated with the issue on which the decision has been made. It has been analysed that only the logics and the quantitative simulation cannot be problem to take the decision. The people around the decision makers and the social beliefs deviate and skew the decision making process irrespective of which type of decision is been taken. Intuition also plays major roles in decision making (Jones, 1991). The experiences of the person develop kind of perception in them that integrates with the decision process and thus skew the decision at the end. Social factors affect the decision making process because it is the major factors that is considered at all the levels of life. Even the personal and individual decision is greatly affected by the social factors. Different people have different be liefs and thus decision that has been made in the organizations having diverse workforce should be efficient enough and should consider all the social views bad beliefs of the people (Simon, 1979). Conclusion: The report concludes that decision making is the process that deals with making the decisions and taking out the solution of the issues available. It has been analysed from the report that decision making is the very important function of the management in the company but is cannot be taken in vacuum (Hambrick Snow, 1977). The decision making process gets affected by many of the factors. Heuristics is one of the approaches that have been discussed that skew the management decisions. Heuristics is defined as the conditions that are the simple rule of thumbs that solve the problems. There are different types of heuristics discussed in the report such as representative, availability etc. These heuristics are considered as the element that speeds up the process of decision making by eliminating the steps of considering all the data and information associated with the issue. Another part of the report concludes that heuristics also develops biasness in the decisions. Other than heuristic s there are some other cognitive biases that affect the decision making such as group think, anchoring bias, vividness bias etc. Biasness skew the decision and the change its meaning. It has been analysed that decision that are taken under biasness are not that much effective and fair. In the organizational point of view, it has been analysed that the decision maker should try to understand the factors that develops bias for them and should remove the same. Some of the social factors also affect the decision making process of the management. This is because the decision is made for the society only and any of the decision that is made should not be against the society. It has been analysed that only the logics and the quantitative simulation cannot be problem to take the decision. The people around the decision makers and the social beliefs deviate and skew the decision making process irrespective of which type of decision is been taken. Intuitions also play a major role in decision making. References: Aharoni, Y., Tihanyi, L., Connelly, B. L. (2011). Managerial decision-making in international business: A forty-five-year retrospective.Journal of World Business,46(2), 135-142. Birnbaum, M. H. (2008). Economics of the priority heuristic as a descriptive model of risky decision making: Comment on Brandsttter, Gigerenzer, and Hertwig (2006). Botvinick, M. M. (2007). Conflict monitoring and decision making: reconciling two perspectives on anterior cingulate function.Cognitive, Affective, Behavioral Neuroscience,7(4), 356-366. Brodbeck, F. C., Kerschreiter, R., Mojzisch, A., Schulz-Hardt, S. (2007). Group decision making under conditions of distributed knowledge: The information asymmetries model.Academy of Management Review,32(2), 459-479. Bryant, P. (2007). Self-regulation and decision heuristics in entrepreneurial opportunity evaluation and exploitation. Management Decision,45(4), 732-748. Cokely, E. T., Kelley, C. M. (2009). Cognitive abilities and superior decision making under risk: A protocol analysis and process model evaluation.Judgment and Decision Making,4(1), 20. Dane, E., Pratt, M. G. (2007). Exploring intuition and its role in managerial decision making.Academy of management review,32(1), 33-54. De Martino, B., Harrison, N. A., Knafo, S., Bird, G., Dolan, R. J. (2008). Explaining enhanced logical consistency during decision making in autism.Journal of Neuroscience,28(42), 10746-10750. Dean, J. W., Sharfman, M. P. (1996). Does decision process matter? A study of strategic decision-making effectiveness.Academy of management journal,39(2), 368-392. Dexter, F., Willemsen-Dunlap, A., Lee, J. D. (2007). Operating room managerial decision-making on the day of surgery with and without computer recommendations and status displays.Anesthesia Analgesia,105(2), 419-429. Dooley, R. S., Fryxell, G. E. (1999). Attaining decision quality and commitment from dissent: The moderating effects of loyalty and competence in strategic decision-making teams.Academy of Management journal,42(4), 389-402. Eisenhardt, K. M., Zbaracki, M. J. (1992). Strategic decision making.Strategic management journal,13(S2), 17-37. Gigerenzer, G. (2008). Why heuristics work.Perspectives on psychological science,3(1), 20-29. Gigerenzer, G., Gaissmaier, W. (2011). Heuristic decision making.Annual review of psychology,62, 451-482. Gold, J. I., Shadlen, M. N. (2007). The neural basis of decision making.Annu. Rev. Neurosci.,30, 535-574. Green, A. R., Carney, D. R., Pallin, D. J., Ngo, L. H., Raymond, K. L., Iezzoni, L. I., Banaji, M. R. (2007). Implicit bias among physicians and its prediction of thrombolysis decisions for black and white patients.Journal of general internal medicine,22(9), 1231-1238. Hambrick, D. C., Snow, C. C. (1977, August). A Contextual Model of Strategic Decision Making in Organizations. InAcademy of management proceedings(Vol. 1977, No. 1, pp. 109-112). Academy of Management. Han, S., Lerner, J. S., Keltner, D. (2007). Feelings and consumer decision making: The appraisal-tendency framework.Journal of consumer psychology,17(3), 158-168. Hilbert, M. (2012). Toward a synthesis of cognitive biases: how noisy information processing can bias human decision making.Psychological bulletin,138(2), 211. Hilbig, B. E., Erdfelder, E., Pohl, R. F. (2010). One-reason decision making unveiled: A measurement model of the recognition heuristic.Journal of Experimental Psychology: Learning, Memory, and Cognition,36(1), 123. Hwang, C. L., Lin, M. J. (2012).Group decision making under multiple criteria: methods and applications(Vol. 281). Springer Science Business Media. Jones, T. M. (1991). Ethical decision making by individuals in organizations: An issue-contingent model.Academy of management review,16(2), 366-395. Lunenburg, F. C. (2011). Decision making in organizations.International journal of management, business, and administration,15(1), 1-9. Marewski, J. N., Gigerenzer, G. (2012). Heuristic decision making in medicine.Dialogues in clinical neuroscience,14(1), 77. Masicampo, E. J., Baumeister, R. F. (2008). Toward a physiology of dual-process Mel, D. (2010). Practical wisdom in managerial decision making.Journal of Management Development,29(7/8), 637-645. Saaty, T. L. (2008). Decision making with the analytic hierarchy process.International journal of services sciences,1(1), 83-98. Schweiger, D. M., Sandberg, W. R., Ragan, J. W. (1986). Group approaches for improving strategic decision making: A comparative analysis of dialectical inquiry, devil's advocacy, and consensus.Academy of management Journal,29(1), 51-71. Shah, A. K., Oppenheimer, D. M. (2008). Heuristics made easy: an effort-reduction framework.Psychological bulletin,134(2), 207. Simon, H. A. (1979). Rational decision making in business organizations.The American economic review,69(4), 493-513. Slovic, P., Finucane, M. L., Peters, E., MacGregor, D. G. (2007). The affect heuristic.European journal of operational research,177(3), 1333-1352. Strough, J., Karns, T. E., Schlosnagle, L. (2011). Decision?making heuristics and biases across the life span.Annals of the New York Academy of Sciences,1235(1), 57-74. Trevino, L. K. (1986). Ethical decision making in organizations: A person-situation interactionist model.Academy of management Review,11(3), 601-617. Tzeng, G. H., Huang, J. J. (2011).Multiple attribute decision making: methods and applications. CRC press. Weber, E. U., Johnson, E. J. (2009). Mindful judgment and decision making.Annual review of psychology,60, 53-85. West, R. F., Toplak, M. E., Stanovich, K. E. (2008). Heuristics and biases as measures of critical thinking: associations with cognitive ability and thinking dispositions.Journal of Educational Psychology,100(4), 930. Wilson, C., Dowlatabadi, H. (2007). Models of decision making and residential energy use.Annual review of environment and resources,32. Wright, G., Goodwin, P. (2009).Decision analysis for management judgment. John Wiley and sons. Xu, Z. (2015).Uncertain multi-attribute decision making: Methods and applications. Springer. Zanakis, S. H., Solomon, A., Wishart, N., Dublish, S. (1998). Multi-attribute decision making: a simulation comparison of select methods.European journal of operational research,107(3), 507-529.

Type 1 and Type 2 Diabetes Free Samples †MyAssignmenthelp.com

Question: Discuss about the Type 1 and Type 2 Diabetes. Answer: Pathophysiology of Diabetic Ketoacidosis- DKA is a major, acute life threatening condition that is normally associated to patients with type 1 diabetes. It is rarely seen in patients having Type 2 diabetes. DKA is normally caused due to the active or the relative deficiency of insulin, accompanied by the increase of counter regulatory hormones involved in DKA, such as cortisol, glucagon, epinephrine growth hormone (Atkinson et al., 2014). This type of imbalance of the hormones of our body leads to hepatic gluconeogenesis (generation of glucose from non carbohydrate substrate), lypolysis (breaking down of lipids) (Knip Siljander, 2008). The excessive counter regulatory hormones, hepatic gluconeogenesis, glycogenolysis leads to severe hyperglycemia. Lack of insulin results in the release of fatty acid from the adipose tissue (lypolysis), increasing the amount of free fatty acids in the serum. Hepatic Metabolism of the fatty acids leads to the formation of the acidic intermediates and metabolites such as ketones and ketoacids (Atkinson et al., 2014). Hormonal imbalance causes increased gluconeogenesis, renal and hepatic production of glucose and impaired utilization of glucose by the peripheral tissues. This results in hyperglycaemia and hyperosmolarity. Studies have revealed that the inflammatory biomarkers (e.g., C-reactive protein [CRP], oxidative stress markers, pro-inflammatory cytokines, cardiovascular risks and, lipid peroxidation is also associated with hyperglycemic risks. when the accumulated ketone bodies in the body exceeds the maximum capacity they are then found in the urine (Ketonuria) (Knip Siljander, 2008). Greater accumulation of the acids leads to acidosis, which can cause respiratory distress such as shallowed breathing (Kassmaul respiration). Normally kidney has a low threshold value for the keto-acids which gets excreted out through the urine. More amount of ketoacids leads to electrolyte loss resulting in acute dehydration with a large loss of sodium ions. Signs and symptoms The common early signs and symptoms associated to DKA is polyuria. other signs and symptoms of this clinical condition involves malaise, fatigue, vomiting ,nausea, can have abdominal or muscular cramps, anorexia, loss of appetite, drastic weight loss in some patients, reduces perspiration, coma can occur at severe stages of the disease (Padgett et al., 2013). Fever, chills, chest pain, arthralgia and dyspnea can also occur. Unusual smell in the breadth is often found. Difference between Type 1 and Type 2 diabetes Causes Type 1 diabetes is an autoimmune disease, where the immune system of the body mistakenly attacks the beta cells of the pancreas that is responsible for producing insulin. There are some genetic markers that are responsible for the T1D. In type 2 diabetes the beta cells are not attacked by the immune system of the boy, rather the body normally stops responding to the secreted insulin and becomes insulin resistance. The body tries to compensate this condition and tries to produce more insulin, eventually it creates stress on the beta cells which may lead to their destruction, ceasing insulin production (Knip Siljander, 2008). T2D is a life style disease and is mainly caused due to improper diet, obesity, use of alcohol, excessive consumption of the fatty food, excessive consumption of carbohydrate rich food. Stress can worsen the effects of T2D. Patients having family history of T2D are more likely to have T2D in future. Genetic factors obviously play a role in diabetes, although 2 persoms having same genetic mutation might not have the same effects of diabetes as diabetes largely depends on the life style. Pathophysiology Type 1Diabetes T1D is an autoimmune disease caused due to the development of an autoimmune response against the Beta cells antigen due to which very less amount of insulin is produced inside the body, due to which the plasma glucagon level is increased. Increase in the counter regulatory hormones causes volume depletion of the extracellular fluids, hyperglycemia, and decreased potassium ions in the body. Hormonal imbalance increases the rate of gluconeogenesis, renal and hepatic glucose production, impaired utilization of glucose by the body tissues leads to hyper glycemia (Knip Siljander, 2008). Free fatty acids are released into the serum from the adipose tissues. Hepatic metabolism of the fatty acids leads to the formation of the ketone bodies. Greater accumulation of the acids leads to acidosis, which can cause respiratory distress such as shallowed breathing or Kussmaul respiration. Type 2 Diabetes- T2D is mainly caused due to the combination of insulin resistance and decreased secretion of insulin by the beta cells of pancreas, impaired regulation of glucose production in the liver. Beta cell glucotoxicity is caused by the inhibitory effect of the glucose secretion upon the release of insulin. Glycogen is accumulated in the beta cells due to prolonged glycemia (Kahn et al., 2014). Medicinal, dietary exercise recommendations T1D Medications such as Insulin, short acting insulin like novolog and humulin, rapid acting insulins such as insulin aspart, Angiotensin converting enzyme can be given. Amylinomimetic drugs such as pramlintide acetate can be given that elicit endogenous amylin by decreasing the postprandial glucagon release. (Padgett et al., 2013). Fibrous food, cereal with milk without fat, whole grain fibers, carbs, fruits, and lentils can serve to be best for the type 1 diabetes patients. Sugary drinks, trans-fats, simple carbohydrates like processed and refined sugars, foods containing saturated fats should be avoided should be avoided. It is advisable to eat smaller portion of well balanced meals for about six times a day (Knip Siljander, 2008). Aerobic exercises like walking, jogging, strength training exercises for about 30-40 minutes a day can be done for efficient muscles and strong bones. Stretching exercises can be done to maintain flexibility in the body. Other than this, games such as badminton, volleyball can be played to maintain fitness and to burn the extra calories. T2D Oral hypo-glycaemic class of medications is used in case of T2D. Alpha glucosidase inhibitors like acarbose and miglitol, which helps to break down the starchy food. Biguanides, dopamine agonist, DPP-4 inhibitors like alogliptin, Incretin mimetics increases the B- cell growth, meglitinides, sodium glucose transporter (SGLT) 2 inhibitor. Sulphonylureas stimulates the pancreas for secreting insulin, thiazolidinediones (Knip Siljander, 2008). Food- diet for Type 2 diabetes includes carbs, non-starchy vegetables, and complex carbohydrates such as brown rice, whole wheat, lentils beans and fruits. Sugary beverages, high-calorigenic food, saturated and Trans fats should be avoided. It is advisable to avoid alcoholic drinks (Padgett et al., 2013).Repeated eating with balanced meal is advisable rather than large single meal. Exercises- Daily exercises such as running, aerobics and yoga for about 30-40 minutes in about 5 days a week can be done to maintain T2D. Diabetic Keto-acidosis This condition occurs when the body cannot produce enough insulin. Absence of insulin and the increase in the glucagon level results in the release of glucose by the liver. Insufficient insulin does not allow enough glucose to enter the cells, as a result the fatty acids are broken down as an alternative energy source, producing acidic ketone bodies. DKA is mainly caused in people with T1D (Kahn et al., 2014).It can cause excessive urination, flushed and dry skin, drowsiness and rapid breathing, fruity smell breath. It can also cause severe illness or coma. Hyperglycemic Hyperosmolar state This condition occurs when there is extremely high blood sugar level (Plasma glucose level of 600mg/dL or more) caused due to insulin deficiency. Due to this the serum osmolarity level is greater than 320 mOsm. Excessive urination occurs due to this condition, which leads to hemo-concentration and volume depletion that further increases the blood sugar concentration (Padgett et al., 2013). It can cause motor and sensory impairment. Hyper viscosity can increase the risk of clotting of bloods, which can be linked to cardiovascular diseases. In this case ketoacidosis does not occur because the insulin inhibits the fatty tissue breakdown by the hormone sensitive lipase. It is found mainly in patient with type 2 diabetes. Different procedures to measure the blood glucose level OGTT Procedures for OGTT (Stumvoll et al., 2010) The patient should be abstained from food 8 hours before the test. Patient should fast for 8-12 hours before the conduction of the test. A fasting sample of venous blood is extracted in a vial and tested for glucose level. The patient is given aqueous solution of glucose of about 50 gram. The time is noted. 6. A fasting blood glucose is at first taken. The patient is then administered glucose drink orally and then after 2 hours another blood sample is taken and measured. The blood sample is tested in the laboratory and a curve is plotted by taking time on the x axis and plasma glucose level on the Y axis and a glucose tolerance curve is made. Normal range level of glucose in blood Normal range Fasting 110mg/dl ( 1 hour after glucose administration ( 2 hours after glucose administration ( Positive diagnostic marker Fasting glucose level is higher than 110mg/dl or 6.1mmol/L in the blood. The highest value of the curve is reached within 1.5 hours. The blood glucose level does not match the fasting level even after the 2.5 hours. Over 11.0 mmol/L of Glucose is found in the blood sample. Fasting blood glucose test Procedure (Rohlfing et al., 2002) The patient should not consume any food or drink for at least 8 hours before the collection of the blood sample. Blood is collected from the patient and is stored in a vial for the testing of glucose. Normal range level A blood glucose level of 100125 mg/dL (5.54 6.9mmol/L) determines prediabetes. Positive diagnostic marker Blood glucose level of 126 mg/dL (Over 11.0 mmol/L) and higher indicates diabetes. HbA1c Test Glycated hemoglobin (A1C) test helps in indicating the average blood sugar level for the past two to three months. It helps to assess the amount of blood sugar linked to hemoglobin. More the hemoglobin with sugar attached, more is the blood sugar level. Procedure Blood sample is collected from the patient. They can be tested for the presence of glucose with the help of these 3 methods- Chromatography based HPLC assay (Newman Turner, 2005). Antibody based immunoassay Enzyme based enzymatic assay (International Expert Committee, 2009). Normal range levels The normal range for the hemoglobin A1c level for people without diabetes is between 4% and 5.6%. Positive diagnostic marker Hemoglobin A1c levels between 5.7% and 6.4% indicates higher chance of gettingdiabetes. 6.5% or higher levels that the patient is having diabetes. Multidisciplinary approach to manage type 1 diabetes In the following case study, James has been newly diagnosed with TID. Management of TID can be done with effective collaborative approach (Barlow et al., 2002) Diabetes educator- Diabetes educators are the members of the multidisciplinary team who impart education to the patient regarding the pathophysiology and the self management of diseases. A diabetes educator will be able to provide all the information regarding diabetes, to the patient and would help the patient in the self management of diabetes.(Zurich et al., 2003). Oral care professionals People suffering from diabetes bears greater chance of periodontal diseases such as dry mouth, gingivitis, thrush .Therefore a dental care doctor would be able to help the patient in managing oral health by frequent checkups such as once in every three months. (Maahs et al., 2010). Dieticians- The dieticians help to prepare proper diet chart for the diabetic patient. Since diabetes can be managed at large by controlling the food habits and proper exercises, a dietician is professionally qualified to prepare a suitable diet chart for the diabetes patient consisting of non -glycemic food such as fibers, proteins; switching the meal plan from white bread and flour to whole grain, bran, barley, oats and lots of vegetables and maintenance of the electrolyte balance in the body by the intake of oral fluids. Eye care professionals- They are responsible for taking care of the eyes, as eyes are largely affected due to diabetes. Persistently high blood sugar level can cause eye diseases such as retinopathy, muscular degeneration, cataract, glaucoma. (Maahs et al., 2010). It is advisable to have an eye check up at least once in every 6 months. Podiatrist- They mainly study disorders related to foot, ankle and lower extremities of the leg. James with diabetes can be vulnerable to nerve damage in his feet, so podiatrists will assess his general foot health and function. They educate him how to prevent feet problem and keeping him healthy. Foot ulcers can cause amputation, so for someone like James it is very important to check his feet regularly. The examination should be done every two to three months. The items to monitor and manage diabetes at home are as follows- Traditional home monitoring device-Blood glucose meters contain a test strip for taking the blood and a meter that will calculate the glucose levels (Orchard et al., 2015). Some glucose monitoring devices tests blood from other parts of the body other than finger tips, although the results are not much reliable. Continuous glucose monitoring system combined with insulin pumps. Monthly blood glucose monitoring diary A daily monitoring diaries to record the doses of the medications. Suitable syringes (4-5mm long) Injection aids such as automatic injectors or temporary injection ports (For those who are afraid of needles) Insulin pen (Prefilled pens- which are disposable insulin pens or Durable pens- they contain replaceable insulin cartridges) 6 National Diabetes Services Scheme (Australia) The National Diabetes Services Scheme (NDSS) is an initiative taken up by the Australian government in collaboration with the diabetes Australia (Rabi et al., 2006). The main aim of NDSS is to impart knowledge to the Australian regarding the self management of diabetes. They have also taken initiatives to support the people by providing timely care and management to the patients (Lee et al., 2013). Registering under NDSS helps the patient to access a wide range of service. For the member ship cost it is advisable to contact the territory organization. Registration to NDSS is free of cost and requires only one time registration (Lee et al., 2013). Eligibility criteria (Lee et al., 2013) The patient should be a resident of Australia. If someone is visiting from the other country, he should have a health agreement visa. The patient should have diabetes confirmed by a doctor. They should hold a Department of Veteran's affairs card or a Medicare card. One is not eligible to register if he has impaired glucose tolerance and pre-diabetes. References Atkinson, M. A., Eisenbarth, G. S., Michels, A. W. (2014). Type 1 diabetes.The Lancet,383(9911), 69-82. Barlow, J., Wright, C., Sheasby, J., Turner, A., Hainsworth, J. (2002). Self-management approaches for people with chronic conditions: a review.Patient education and counseling,48(2), 177-187. International Expert Committee. (2009). International Expert Committee report on the role of the A1C assay in the diagnosis of diabetes.Diabetes care,32(7), 1327-1334. Jurik, F. A., Stubbs, A., Dao, M. D., Chang, C. (2000).U.S. Patent No. 6,162,397. Washington, DC: U.S. Patent and Trademark Office. Kahn, S. E., Cooper, M. E., Del Prato, S. (2014). Pathophysiology and treatment of type 2 diabetes: perspectives on the past, present, and future.The Lancet,383(9922), 1068-1083. Knip, M., Siljander, H. (2008). Autoimmune mechanisms in type 1 diabetes.Autoimmunity reviews,7(7), 550-557. Lee, C. M. Y., Colagiuri, R., Magliano, D. J., Cameron, A. J., Shaw, J., Zimmet, P., Colagiuri, S. (2013). The cost of diabetes in adults in Australia.Diabetes Research and Clinical Practice,99(3), 385-390. Maahs, D. M., West, N. A., Lawrence, J. M., Mayer-Davis, E. J. (2010). Epidemiology of type 1 diabetes.Endocrinology and metabolism clinics of North America,39(3), 481-497. Newman, J. D., Turner, A. P. (2005). Home blood glucose biosensors: a commercial perspective.Biosensors and Bioelectronics,20(12), 2435-2453. Orchard, T. J., Nathan, D. M., Zinman, B., Cleary, P., Brillon, D., Backlund, J. Y. C., Lachin, J. M. (2015). Association between 7 years of intensive treatment of type 1 diabetes and long-term mortality.Jama,313(1), 45-53. Padgett, L. E., Broniowska, K. A., Hansen, P. A., Corbett, J. A., Tse, H. M. (2013). The role of reactive oxygen species and proinflammatory cytokines in type 1 diabetes pathogenesis.Annals of the New York Academy of Sciences,1281(1), 16-35. Rabi, D. M., Edwards, A. L., Southern, D. A., Svenson, L. W., Sargious, P. M., Norton, P., ... Ghali, W. A. (2006). Association of socio-economic status with diabetes prevalence and utilization of diabetes care services.BMC Health Services Research,6(1), 124. Rohlfing, C. L., Wiedmeyer, H. M., Little, R. R., England, J. D., Tennill, A., Goldstein, D. E. (2002). Defining the relationship between plasma glucose and HbA1c.Diabetes care,25(2), 275-278. Shaw, J. E., Sicree, R. A., Zimmet, P. Z. (2010). Global estimates of the prevalence of diabetes for 2010 and 2030.Diabetes research and clinical practice,87(1), 4-14. 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