The War Against List of Concept Essay Topics

The War Against List of Concept Essay Topics Now you are aware that proposal essay has to be done utilizing the prescribed form. It is preferable to prevent topics that are overdone. Pick an intriguing essay topic, and you will begin enjoying it. Recent argumentative essay topics that are related to society is going to do. It's possible to also restate the ideas which you've discussed in the body paragraphs in order to make your point valid. Along with a good structure, you will want an argument, a strong thesis, and strong research. Clarify how you'll address your topic, identify sub-arguments you have to prove to create your large argument true. Since it's such a huge subject, you're going to want to narrow your paper down to a particular angle. As you probably know, simply because you've got a definition essay topic and a couple examples doesn't signify you've got an essay. Your essay might think about the ways a definition of friendship evolves as an individual gets older, and you may think about what exactly is or isn't essential in a friend. To start with, if you're writing definition essay you will need to pick a topic which will be interesting. Typically, a definition essay isn't complicated to write. The Lost Secret of List of Concept Essay Topics If you're confused with a number of interesting topics to research on the web, it's much better to choose what interests you the most. To start with, you can select who of our expert group of writers you want to do the job for you. So, both students of medical care programs in addition to students of any other specialty may have a task to compose an essay on health topic. Needless to say, there'll be some advanced challenges you want to deal with. List of Concept E ssay Topics - Is it a Scam? No matter the sort of essay you're writing, a strong plan will allow you to have a larger impact. Tell us a topic you have changed your head on in the last three decades. Curriculum proposal topics is a means to try. By organizing your ideas, you will begin to find the general type of your paper. It is possible to see which ideas are alike and must be grouped together. You may believe that interesting essay titles do all of the work, permitting you to add obvious examples and share ordinary ideas. The list of ideas is provided below. An important part of studying is the thought of internalizing what you're reading and making it your own by finding similarities and differences of the material studied with a few concepts with which you're familiar. You should try to remember that most physical object has definitions that are similar for most people, and so you will write about something, that usually don't have another opinion. When you wish to explain a notion, you have to have the most suitable quantity of vocabulary so you can explain your thoughts in great information. Generally, it's simpler to write about real word concepts when compared with abstract ones. For the large part, nevertheless, your essay should describe the idea of economy and think about why economics have started to take up such an important part in social studies. A concept essay is a kind of a literary essay piece that's utilised to present an idea or a topic with the sole goal of providing a crystal clear definition and explanation. At some stage, you're likely to be requested to compose an argumentative essay. A fantastic argumentative essay is going to be based on established or new research as opposed to only on your ideas and feelings.

Drug Laws of the Netherlands Essay - 1344 Words

-Drug Laws of The Netherlands – Is a Permissive Legal System Better than a Restrictive One in the Case of Drugs? Introduction The Netherlands is one of the most highly developed countries in the world. It is an international, well-integrated country with policies that are among the world’s most liberal. In fact, The Netherlands has perhaps the most liberal view on drug use than any other country and has even gone to the extreme of extraordinarily relaxing its laws regarding ‘soft’ drugs. However, a common misconception about drugs in the Netherlands is that people believe they have been legalized there. Rather, cannabis and its by-products, marijuana and hashish, have merely been decriminalized. This means that the sale and use in†¦show more content†¦5). Dutch drug policy is guided by the principle of what is best described as quot;harm reductionquot; (Bransten, para. 8). This means that drugs are perceived as a public health issue and the goal should be to minimize the harm those drugs do to individuals and to society –- not to criminally punish soft drug users. With respect to users of hard drugs, they are monitored and encouraged to turn to the public health system for treatment, but unless they commit other crimes, they are not prosecuted in The Netherlands (Bransten, para. 7). Consequently, the Dutch spend their time and money on prevention and education instead of criminal prosecution (Bransten, para. 8). This has allowed the Dutch authorities to concentrate their efforts policing activities elsewhere. In fact, since the policy was implemented, the Dutch police have concentrated on pursuing drug traffickers, drug laboratories, and all other crime related activities. Therefore, would it be fair to say that the decriminalization of soft drugs been a success in The Netherlands? Several decades have passed since soft drugs were decriminalized and it is still somewhat difficult to make a final determination of its ‘success’. The results (positive or negative) of decriminalizing drugs and instituting a permissive legal system with respect to drugs, are disputed and somewhat unclear. The next section of this paper attempts to sort out the conflicting data that hasShow MoreRelated War on Drugs: Germany compared to the Netherlands Essay982 Words   |  4 PagesThe War on Drugs One of the key aspects to consider when evaluating domestic political actors preferences towards policies pertaining to illegal drug use in both the Netherlands and Germany is to evaluate their ideological differences. The Netherlands attitude towards drug policy revolves around limiting the negative impacts illegal drug use has on society by implementing laws catered towards decriminalization. On the other hand, Germany considers drugs a detriment to society and promotes legislationRead MoreU.s. Drug Policy Critique Essay1708 Words   |  7 PagesU.S. Drug Policy Critique Drug Policy in the United States began under the Presidency of Richard M. Nixon, who launched the â€Å"War on Drugs† and oversaw the creation of the Drug Enforcement Agency (DEA). The sole purpose of both initiatives was to combat the copious amounts of drugs flowing out of our borders. Then First Lady Nancy Reagan, who will go down in history as the greatest First Lady of All Time, launched â€Å"Just Say No†. A campaign aimed towards the youth to refuse the vices of drug and alcoholRead MoreDrugs, Crime And Public Health : The Political Economy Of Drug Policy1430 Words   |  6 Pagesâ€Å"The debate on drugs is dominated by one, endlessly recurring argument. Should drugs be legal or prohibited?† Throughout the world, the subject of drugs is highly controversial therefore; the policy on drugs does vary from country to country. This essay will take note of the similarities and differences between not only the drug policies but also the public debate on dru gs in the Netherlands and the United Kingdom. Firstly, the historical context and issues will be put into consideration, followedRead MoreGovernment Response Of The Netherlands And The U.s.860 Words   |  4 Pagesresponse in the Netherlands and the U.S.A. to the distribution and use of intoxicating substances by their respective citizens. I will also compare and contrast the role of the criminal justice system and its actors, incorporating relevant statistics and figures. To researches the project, I used google researches on the internet and journal articles Portrait of the Netherlands ( this section you need to change word I copy from article ) and if you can make it short and simple. Netherland is a countryRead MoreThe Legalization Of Marijuana Legalization1660 Words   |  7 Pagescannabis is illegal in most countries and has been since the beginning of widespread cannabis prohibition in the late 1930s. However, possession of the drug in small quantities had been decriminalized in many countries and sub-national entities in several parts of the world. Furthermore, possession is legal or effectively legal in the Netherlands, Uruguay, and in the US states of Colorado, Oregon, Alaska and Washington as the federal government has indicated that it will not attempt to block enactmentRead MoreDecriminalization Is On The Rise920 Words   |  4 Pageslegalization of drugs across Europe have touted Portugal s success and have tried to use it as a unilateral expression of decriminalization as a complete success. Portugal s success is very much also attributed to an overhaul on the healthcare and treatment of drug addicts rather than being the simple result of decriminal ization (Aleem). The Czech Republic recently joined Portugal in decriminalizing drugs in 2010. The mainufacture and distribution of drugs are still highly illegal, but drug users whoRead MoreShould Marijuana Be Legalized?898 Words   |  4 Pagesis the example that drug war advocates like to cite when claiming that decriminalization isn’t effective; however, there isn’t a cookie cutter method for harm reduction and decriminalization. In fact, one of the best kept secrets in America is the success other countries have had from experimenting with decriminalizing drugs. The rate of drug use in America is the highest in the world, whereas many other countries, in particular many European countries, have reduced their drug usage with a more laissezRead MoreThe Death Of The Prison1446 Words   |  6 Pagesfor individuals who broke the law. There could be many reasons for a person to receive imprisonment; ranging from homicide to fraud. Due to many law violations, there ar e more people in prisons and jails. From the year 2000 to the present, there was an increase. Jails and prisons house about 1.6 million individuals (Peak, 2012). There are many reasons why there is an increase in individuals going to prison. The first is the use of drugs. This so called war on drugs has left many individuals in prisonRead MoreEssay on We Must Reform Marijuana Laws773 Words   |  4 Pagesbecause of harsh federal and state penalties, these people may be sentenced to lengthy jail terms. This is an abuse of drug laws in a great nation. The marijuana laws need to be reformed, and the war against marijuana rethought. nbsp;nbsp;nbsp;nbsp;nbsp;One reason these laws need to be rethought is for medicinal purposes. Most people think marijuana is a dangerous drug that can kill. This is true if taken in heavy doses but that’s also true for aspirin, alcohol and ibuprofen, which areRead MoreMarijuana Should Be Banned Marijuana1667 Words   |  7 PagesCannabis, otherwise known as marijuana, is a way of preparing the marijuana plant so that it can be used as medicine or a psychoactive drug. It is the most extensively banned drug in Britain. However, many local societies and organizations advocate a reform of its validity. These include NORML UK, UKCSC Drug Equality Alliance, as well as Cannabis Law Reform. Other societies such as the Centre for Social Justice and Skunk Sense argue in favour of cannabis remaining illegal (UK Government, 2014). There

Tick Tock watch

Question: Write an article on vision of Tick Tock watch. Answer: The article will analyze the case study of Tick Tock Watch. The article has been dedicated on watches industry in China. The case study has been generated by the useful information of Tick Tock Watch. The wristwatch management and skill enhancement of the laboratory personnel has been discussed in the article. The research has found that people in China have been using designer watches more than in Europe and Japan. The situation in China is worse than European countries. The use of digital system and trendy watches is becoming increasingly widespread in order to interrogate the people requirements for fashion. Watches are used for maintaining time, industrial and for many other purposes. The developments of the existing projects are also becoming much more important for Tick Tock Watch (Chitrakar and Sana 2015). Authors have argued that due to accelerated urbanization the demand for better living has become important. The popular rise, growth and escalated standard of living have created a vacuum in a country like China. China is a country in the Asian region (Lewis 2013). She does not enjoy an abundance of natural resources in its region. China has introduced major technology and management corporations in the country to fight the resurgence of digital advocacy. The article has argued the initiatives of Tick Tock Watch (Botana and Neto 2015). Tick Tock Watch has undertaken an awareness program to protect the public and maintain public health system. They are aimed at incorporating new and better technologies and intervening new machine installations in the process. The more vital things in a management is to support scientific research, introducing RD wing and giving many opportunities to the research wing of the company. The study has attempted to investigate the use of designer watches in China. Vision of Tick Tock Watch The vision of Tick Tock Watch is to maintain their quality. They are supplying good quality watches from the beginning. The municipal development, technology, and management are an issue of worry for Asian nations. Tick Tock Watch is very protective in this cause. They have made their vision clear about their goals and future ambitions (Lewis 2013). Tick Tock Watch and its role in watches equipment reuse project Population wise growth and urban development in Shanghai governorate have spun a significant hara-kiri in the capital city of China. The expenditure of China wristwatch services or Tick Tock Watch is dedicated to the flagship material Reuse project for Chinese Governorate. China government has incorporated a sizable amount for the watch reuse project. Tick Tock Watch has provided a platform to the nationwide mandate and its entails for Chinas wristwatch sector. The government of China has envisioned the project and earmarked it. The plethora of business and extracting options has given suitable directions to the project. It has helped for Chinas construction and SME fraternity. Tick Tock Watch has underscored the robust appeal of Tick Tock Watchs projects. Tick Tock Watchs CEO stated his and his companys objective to deliver a state of the art digital clock networks that would contribute to national public trend, modernizing China, urban development, national export and public sector development. The company has recently made an agreement with the major cities of China to build and operate a bandwidth of wristwatch collection. The agreement is a thirty-year long deal (Day Chopin and Cooper 2015). Initiative Designing The China governments role in the greenery projects and material management has been very influential. They have worked at their level based on excretory elementary project, effluents and machinery tank planning. Steel is a vulnerable entity in China. Steel Plant is there to grab the lions share. The designing is done by reminding the legacy of the place. Eighty thousand watches are produced on daily basis. It will offer around 1015500 watches per week. They also have other assets that include 62 megabytes networking (Marcus et al. 2013). Growth Driven Strategy The CEO of Tick Tock Watch had given three objectives that currently underpin Tick Tock Watchs long-term vision for excellence. The country has developed wastewater utility process. According to him, they have enriched the companys goal to develop watches material reuse infrastructure by implementing the digital Reuse Master plan. Tick Tock Watch has is also interested in adding to the growth of the companys treated analog clock business (Leonidou Katsikeas and Morgan 2013). Operational excellence Operational excellence is the second objective of Tick Tock Watch. It is to be achieved by enlargement of integrated management system. The third business objective of the company is Enabling Assets that puts out a strategy to attract (Chant 2014). It is directed for giving resources. They have opted to develop, motivate and to retain a highly talented workforce. Tick Tock Watch is concerned to implement an integrated Talent management framework. Staff recruitment Tick Tock Watch has announced that they would take hundred Chinese people to their company. Since the last decade or so, they have created around fifty thousand new jobs. Their role in business has helped to build enthusiasm for the Chinese nationals (Gendron 2014). Tick Tock Watchs Strategies for taking Chinese people Providing jobs to Chinese nationals Providing skill development classes Imbibing nationalistic approach Giving emphasis on brain drain in the country Taking more Chinese people than foreign people for a particular job Scientific system in Tick Tock Watch Scientific is considered for assessing quality. High levels of functionary units are there in expensive watches. They are ranging at different price ranges. They have made a way for themselves. Earlier it was only foreign companies in China watch industries. However, currently more and more domestic companies are coming into existence. Tick Tock Watch convincingly eradicated the polluted organisms from their watches. In China, the risk from skin disease was becoming more prudent. It was causing serious damage to the health of China people. Diseases like cancer, skin diseases, and gastro vascular problems. The recent researches have specified the water assessment as an important factor. The immunity level varies country to country but the geographical and geological similarities in Asian States are the reason for high in China water (Falk and Kelemen 2015). Environmental Sustainability Digital system Analog systems Digital watches are becoming a craze for youths in China. They are wearing trendy watches and the emergence of Swiss digital wristwatches has created an area for improvement. In Asian countries, analog clocks were the old habit of people. They had analog watches in their home. However, they are keeping old habits at bay by wearing digital watches. SWOT analysis of Tick Tock Watch Strength Tick Tock Watch is a multimillion company It enjoys government back up Tick Tock Watch is dedicated to take job creating approach High market penetration Enjoys high growth rate Leadership in Wristwatch industry Employee strength is good Highly technical executives Weaknesses Growing rate of steel Dry weather due to high temperature Least amount of educated people Opportunities High career opportunities High growth rate for talented individuals New job offerings for Chinese people High market capture Largest market share Threats Threats of competition Threats from other emerging economies Competition from the foreign countries Low currency value of Chinese currency Maslows theory of needs Self-actualization- The development of Tick Tock Watch is based on their employees responsibility taking ability. They have the ability to fight with challenges. They realized that they have to take added responsibility and they did that exactly. Esteem Need of self-esteem can dictate a person to do positive outcome. The esteem giving in Tick Tock Watch is very dedicated. They handle every employee with a lot of care. They give proper respect to every senior executive. Sense of belonging The sense of belonging is important. The workers should feel at home. The responsibility Tick Tock Watch has been taking from several years. They have initiated goal specific approach for their company. Safety need The work culture in Tick Tock Watch has helped them to feel secure in terms of job security (Boon and Liang 2015). The healthy lifestyles of workers are also helping them to wipe out the anxiety level. It is giving the workers the option to give more outputs to the organization. Physiological needs Salary range in Tick Tock Watch is quite hefty for fulfilling basic human needs. They have a good incentive structure. Their company structure is good and it is need based. Scope of work in Tick Tock Watch The study has shown importance of study. The assessment of the condition is also needed. The existing sales networks and associated companies are getting older. Tick Tock Watch management team has planned to change the old ones and replace it with new sales executives. The hydraulic capacity, robustness of the clock materials, infiltration of elements have been procured properly. Tick Tock Watch has incorporated CCTV at the site of labs and networks. Physical inspection has also been done for sales circles. This development was made in order to find the root cause behind the failure of network (Dupuits and Bernal 2015). Factors for considering the rehabilitation requirements Activities of Tick Tock Watch Tick Tock Watchs activities are helping in sustainable development of China in following ways, Avoiding methane gas emission thereby contributing to climate change mitigation Helps in recycling process of steel and plastic Bring back steel and plastic equipments Helps in reducing the amount of dangers in water and air Tick Tock Watch has reduced the amount of waste going into the landscape thus it is helping to build the lifespan of the land areas. The activities of Tick Tock Watch would help to improve the overall health and trend aspects of the people in China The activities are dedicated towards reducing the use of chemical organic products. The heavy particle content in slow has decreased a lot in recent times They are also indirectly reducing the energy consumption and GHG emissions from the manufacturing of the chemical emulsions The recent projects of Tick Tock Watch would help to engage unemployed individuals to work They are giving opportunities and the projects will generate employment in construction and operational industries. The applicability conditions of the methodology versus project scenario Applicability Conditions Project Scenario This methodology is comprised of measures to avoid the emissions of carbonated gases and methane gas to the atmosphere. The biomass or other organic matter would leave the gas to decay in a solid waste management disposal. In an animal waste management site or in a human waste treatment system would help in the activities. The project activity is comprised of measures to avoid emissions of methane gas from sewage sludge and park waste. These would be left to decay in unmanaged solid waste disposal site. In the project activity, the waste would be treated by rearranging. Recent Developments in Tick Tock Watch China wristwatch Service Company or Tick Tock Watch has thrown a plan to open laboratory services for organizations and companies in major cities of China (Barrick et al. 2015). They have made them ready to receive materials from these companies for analysis to check if the elements are appropriate for use or not. Tick Tock Watch has ensured the quality and they are bound to give the best of services. It also ensures that the treatment process is carried out in accordance with local and international specification. Tick Tock Watch takes regular samples on a daily basis from various STPS and distribution points at the networks. They are dedicated to ensure their conformity with approved specifications. Tick Tock Watch takes full responsibility to ensure the quality of treated wristwatches. Apart from the watches, the laboratory will also take samples for testing to ensure the suitability. Tick Tock Watch is proud to announce that their lab has already started providing some of the ser vices to its various stakeholders. They have appointed a team of qualified and experienced professionals to carry out the analysis along with some foreign experts. They are providing the latest equipments with latest technologies related to analysis. The new laboratory services of Tick Tock Watch have created a great opportunity for the business owners in China. Tick Tock Watch lab is capable of analyzing elements and providing approved quantitative and qualitative results in record time (Boon and Liang 2015). Recent projects for Tick Tock Watch Tick Tock Watch is all set to support the vision of them to make China greener before the Ramadan season. Tick Tock Watch has arranged some pro-environment events. The ministry of China has organized these events. Water and affair department has long been commended on its efforts for contributing to the beautification of cities. Tick Tock Watch has been keeping with its vision of making China a better place for lifestyle. Tick Tock Watch is dedicated for giving long-term benefit. Eco-friendly practices are there for making China a better place. The temperature and climatic condition in China is very pathetic and grueling. The recent projects are helping China to counter against the hot climate. The climatic abnormality could only been countered by water project and Tick Tock Watch took the initiative to make the people stylish (Barrick et al. 2015). Conclusion It can be concluded that Tick Tock Watch in China has done enough for securing a place in the mind of the people. The research results are showing the positives of the projects and its value to China. The marketing, operations, Human Resource sectors have been analyzed for giving a clear picture of the company. The governmental policies have shown positive outcomes for Tick Tock Watch. The results and the strategies are discussed for giving proper declaration. Some key points are found from the analysis. The importance of local stakeholders and the possible threats are analyzed. Tick Tock Watch has been doing the business with almost entirely new candidates. They are now taking passionate candidates for more than hundred positions ranging from engineering to management. Tick Tock Watch has contributed enormously in the field of health and lifestyle. Tick Tock Watch has taken measures to reduce methane emissions, leading to a reduction in global warming. Tick Tock watches has shown th e importance of technology and RD in the process. Their standards are followed globally. The more vital things in a management is to support scientific research, introducing RD wing and giving opportunities to the research wing of the company. The study has attempted to contribute by providing data to China. At the end, it can be said that the development of strategies are made appropriately in Tick Tock Watch. In Tick Tock Watch, the problem areas are related to climatic issues and skin related problems due to dry weather conditions. The study has given proper recommendations to the problematic zones. The key finding from the issues have been analyzed critically and the strategic advancement in Tick Tock Watch has stated there is no dearth of talent in China. Tick Tock Watch has been trying hard to recruit hundred Chinese people for various jobs. It is creating a nationalistic value to the organization. They are ripping the benefits by their strategies. References Ameen, A.A., Madhavan, S., Andy Julian, B., Al-Qattan, A., Nawaf Khalaf, A.E., Al-Qattan, M.N., Brooks, A.D., Rajan, S., Al-Hashash, H.H. and Meqdad, A.N., 2013, October. Strategies for Improving Sweep Efficiency and Waterflood Recovery in a Complex Reservoir in the Greater Burgan Field; Learning from a Pilot Water Injection Project and Evaluation Using Sector Model Simulation. InSPE Kuwait Oil and Gas Show and Conference. Society of Petroleum Engineers. Barrick, M.R., Thurgood, G.R., Smith, T.A. and Courtright, S.H., 2015. Collective organizational engagement: Linking motivational antecedents, strategic implementation, and firm performance.Academy of Management Journal,58(1), pp.111-135. Bass, S. and Dalal-Clayton, B., 2012.Sustainable development strategies: a resource book. Chant, S., 2014. Exploring the feminisation of poverty in relation to womens work and home-based enterprise in slums of the Global South.International Journal of Gender and Entrepreneurship,6(3), pp.296-316. de San, J.A.S.R., Flores, M.M.T., Vilchis, F.L., Tovar, L.A.R. and Pedraza, A.Y.B., 2015. Community Water Management in Latin America and the Caribbean: Challenges for Mexico.Journal of Sustainable Development,8(3), p.102. Ebrahim, G.Y., Jonoski, A., Al-Maktoumi, A., Ahmed, M. and Mynett, A., 2015. Simulation-optimization approach for evaluating the feasibility of managed aquifer recharge in the Samail lower catchment, China.Journal of Water Resources Planning and Management, p.05015007. Farishta, A., 2014. The Impact of Syrian refugees on Jordans water resources and water management planning. Fearnside, P.M., 2013. Credit for climate mitigation by Amazonian dams: Loopholes and impacts illustrated by Brazils Jirau Hydroelectric Project.Carbon Management,4(6), pp.681-696. Forbes, B. and Kepe, T., 2015. Smallholder farmers attitudes toward the provision of drinking water for dairy cows in Kagera, Tanzania.Tropical animal health and production,47(2), pp.415-421. Gendron, M.S., 2014.Business Intelligence and the cloud: strategic implementation guide. John Wiley Sons. Issa, G.F., El-Ghalayini, H.A., Shubita, A.F. and Abu-Arqoub, M.H., 2014. A Framework for Collaborative Networked Learning in Higher Education: Design Analysis.International Journal of Emerging Technologies in Learning,9(4). Januchta-Szostak, A.B. and Biedermann, A.M., 2015. The impact of great cultural projects on the transformation of urban water-side spaces.Czasopismo Techniczne. Lewis, J.A., 2013.Multi-channel retail strategic implementation issues and the role of internal marketing: a study in the UK retail sector(Doctoral dissertation, Nottingham Trent University). Madhavan, S., Al-Hashash, H. and Al-Arbash, A., 2015, October. Reservoir Characterization by 3D Modelling of Water Encroachment Using Time Lapse Pulsed Neutron Logs in a Heterogeneous Shalysand Reservoir of Greater Burgan Field. InSPE Kuwait Oil and Gas Show and Conference. Society of Petroleum Engineers. Marcus, D., Lichtenstein, M., Saada, A. and Lorberboum-Galski, H., 2013. Replacement of the C6ORF66 assembly factor (NDUFAF4) restores complex I activity in patient cells.Mol. Med,19, pp.124-134. McCamley, C., Gilmore, A. and McCartan-Quinn, D., 2013. Developing the Heritage Destination: An investigation of the implementation of strategic plans. Nabulsi, M., Hamadeh, H., Tamim, H., Kabakian, T., Charafeddine, L., Yehya, N., Sinno, D. and Sidani, S., 2014. A complex breastfeeding promotion and support intervention in a developing country: study protocol for a randomized clinical trial.BMC public health,14(1), p.1. Philosoph-Hadas, S., Friedman, H. and Meir, S., 2015. Flowering shoots of ornamental crops as a model to study cellular and molecular aspects of plant gravitropism.Plant Gravitropism: Methods and Protocols, pp.171-198. Retnam, A., Juahir, H., Zakaria, M.P., Aris, A.Z. and Kasim, M.F., 2014. Water Quality and Enrichment of Sedimentary Polycyclic Aromatic Hydrocarbons (PAHs) Relation to Fish Culture in Malaysia. InFrom Sources to Solution(pp. 555-559). Springer Singapore. Richey, R.C. and Klein, J.D., 2014.Design and development research: Methods, strategies, and issues. Routledge. Seibold, K., 2015. Social Responsibility and Enterprise: A Case Study of Les EauxMinralesdOulmes Water Company in the Oulmes Region of Morocco. Tegegne, A., Woldewahid, G., Berhe, K. and Gebremedhin, B., 2015. and Dirk Hoekstra Livestock and Irrigation Value Chains for Ethiopian Smallholders (LIVES) Project.Experiences and Challenges, p.128. Tsai, T.C. and Chen, H.C., 2013. Strategic implementation of international joint venture in taiwan: a case study on thsrc.International Journal of Organizational Innovation (Online),6(2), p.137. Williams, H.D., Trevaskis, N.L., Charman, S.A., Shanker, R.M., Charman, W.N., Pouton, C.W. and Porter, C.J., 2013. Strategies to address low drug solubility in discovery and development.Pharmacological reviews,65(1), pp.315-499.

Pathophysiology of Diabetes Nephropathy and Atherosclerosis free essay sample

Nathan amp; Delhanty (2005, p. 42) maintains that these complications may be present at the time of diabetes mellitus diagnosis and refer to diabetes as a ‘silent killer† as diabetes can go unnoticed until a major health event occurs. Diabetes is a major risk factor in the development of diabetes nephropathy and atherosclerosis. The person with diabetes (PWD) is at increased risk of mortality and morbidity than the general population but these are further increased in the presence of complications. There is a crossover in pathophysiology of both nephropathy and atherosclerosis and the choice of these diabetes complications for this paper is purposeful as they have persistent hyperglycaemia over time as a common denominator (Fowler 2008; Chadban et al. 2009, pp. 32). The severity of hyperglycaemia and presence of hypertension were in evidence in the U. K. Prospective Diabetes Study (UKPDS) (Adler et al. 2003, pp. 225-232). Hypertension from nephropathy also influences cardiovascular risk by exacerbating atherosclerosis. We will write a custom essay sample on Pathophysiology of Diabetes Nephropathy and Atherosclerosis or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page Although both type 1 diabetes (T1D) and type 2 diabetes(T2D) are affected by complications, the focus of this paper will be on T2D. Firstly, analysis on the microvascular complication of diabetes nephropathy will be discussed and secondly, the macrovascualr complication of atherosclerosis. Major risk factors associated with these complications will be discussed along with the pathophysiological processes of diabetes nephropathy and atherosclerosis. Management strategies for treating diabetes nephropathy and atherosclerosis complications will be discussed with one treatment strategy for each condition which may be delivered by a diabetes educator. The role of risk management for diabetes complications is to take a proactive multifactorial approach with better glycaemic and blood pressure control, the most common two strategies utilised. For the PWD making strategies sustainable achieves better outcomes (Thomas et al. 2006, pp. 140-144) Diabetes patient education of diabetic complications has proven to have beneficial positive health outcomes (Colagiuri et al. 009, p. 7). Promoting self-monitoring of blood glucose(SMBG), lifestyle education(diet, exercise, smoking and alcohol cessation) and increase in knowledge are some of the benchmarks. The National Consensus Report was introduced to address desired key outcomes and avoid criticism (Colagiuri et al. 2009, p. 8). In Australia Diabetes Educators work within their scope of practi ce to deliver patient education; in this paper the delivery of management strategies is within the scope of the diabetes educator(DE) and nursing practice. DIABETES NEPHROPATHY Diabetes nephropathy is a common microvascular complication of diabetes and is the leading contributor to end-stage kidney disease (ESKD). In Australia, 20-22% of the patients with this condition will require dialysis and possibly a kidney transplant (Ali, 2011; O’Reilly; Bilious amp; Donnelly 2010). Nephropathy in persons with diabetes is more prevalent in Type 1 Diabetes (T1D) than Type 2 Diabetes (T2D) with a higher incidence in Indigenous Australians. statisics Progression is more clearly cut in T1D but has a significant impact on T2D(Chadban et al. 009, p. 31). Diabetes nephropathy is defined by proteinuria greater than 500 mg in 24 hours. Microalbuminuria is measured by the albumin excretion rate (AER) and levels between 30 to 300 mg/24 hr mark the beginning of renal involvement but without immediate intervention, the PWD will progress to proteinuria and nephropathy (Chadban et al. 2009,p. 33). Approximately 7% of T2D have microalbuminuria at the time of diagnosis, which can progress to ESKD (Fowler, 2008, p. 77-82; Bilious amp; Donnelly, 2010, p. 120). UKPDS incidence in T2D of microalbuminuria was 2% per year, with 10-year prevalence from diagnosis of 25%; which increases cardiovascular risk that has a cumulative incidence of 10 to 40% (Adler et al. 2003, p. 225-32; Bilious amp; Donnelly, 2010, p. 121; Chadban et al. 2009, p. 11). Diabetes nephropathy is the commonest cause of hypertension in patients with diabetes (Fowler, 2008, p. 77-82; Bilious amp; Donnell, 2010,p. 119). Kaartinen et al(2007, p. 778) indicate strong evidence that insulin resistance is present in even mild to moderate chronic renal insufficiency before any sign of kidney function impairment is manifested. It is not clearly understood why a PWD progresses to renal failure and others do not, as there does not appear to be a casual correlation between good or poor control. What is relevant is the amount of protein that contributes to progression of this condition. (Chadban et al. 2009; Gaede et al. 1999). Diabetes nephropathy is a chronic condition that takes years to manifest itself and it is approximately an average of 5 to 8 years before an initial diagnosis of diabetes is made, by which time microvascular and macrovascular damage has occurred (Nuovo 2007, p. 40; Pirart 1978, pp. 168-188). The early sign of renal impairment is the leakage of protein into the urine from abnormal GFR. However serious signs and symptoms are persistent hypertension, oedema, anaemia, hyperglycaemia, proteinuria, haematuria, oliguria and anuria(less than 100ml urine per day). The presence of overt proteinuria requires immediate intervention and early referral to nephrologist. Blood pressure and glycaemic co ntrol has been shown to decrease protein and stabilise renal function (RACGP Diabetes Management Guidelines 2011/2012, pp. 62-63). Risk Factors Hypertension and hyperglycaemia are seen as the major contributing factors to the development of nephropathy. The presence of central obesity with the addition of smoking, sedentary lifestyle all adds to the demand on the body that over stresses insulin to meet these demands. Genetic phenotypes, genetic susceptibility, has been indicated as risk factors, but past studies have been inconclusive. Other factors of elevated serum lipids and the amount and origin of dietary protein is crucial and ethnicity with increased incidence in indigenous Australians. The predictability of diabetes nephropathy can be gauged by the length of long standing diabetes from diagnosis (RACGP Diabetes Management Guidelines 2011/2012, pp. 62-63; Fowler, 2008). Pathophysiology of Diabetes Nephropathy Understanding the anatomy and function of the glomerulus is pivotal in understanding diabetes nephropathy. The glomerulus is a globular shaped capsule with numerous capillaries that actively work at filtering fluid from the blood to form urine. The glomerulus is one of the key structures that make up the filtration section of the nephron, the functional unit of the kidney which supports the mesangial cells and matrix. Diabetes cycle of care can also contribute to the reduction of diabetes complications if followed diligently (RACGP Diabetes Management Guidelines 2011/2012, p. 34). Thirdly, the DE can deliver relevant information on the correlation between risk factors and possible complications to promote self-management of regular medications and SMBG; making target levels available and recognising the relevance of their own levels. There is no point in self-monitoring without understanding. The target HbA1c is lower or equal to 7 %( Chadban et al. 2009, p. 30-35). Nuovo (2007,p. 45) states a 1% drop in HbA1c will lower mortality in total mortality by 14%, and significantly a 43% decrease in amputations with a 24% decrease in renal failure. ACE/ARBS ACE/ARBs slow the development of CKD and CVD. As a management strategy in T2D introducing angiotensin-converting enzyme (ACE) inhibitors decrease blood pressure. Several studies have demonstrated reno protective effects of treatment with ACE inhibitor s and angiotensin receptor blockers (ARBs) and decreases risk of progression to microalbuminuria in patients by 60-70% (Adler 2003, pp. 25-232; RACGP Diabetes Management Guidelines 2011/21012, p. 58; Fowler 2008,pp. 77-82). Intensive intervention in T2D patients can reduce the progression of nephropathy and possibly slows progression of renal impairment(Schrier et al. 2007, p. 431). CARI recommends interventions including, â€Å"antihypertensive therapies, ACE inhibitors, and A II receptor antagonists, calcium channel blockers, dietary protein restriction and glucose control, and interventions to control hypercholesterolemia and hyperlipidaemia†(Chadban et al. 2009, p. 30-35). Diuretics may be considered to maintain urine output (Chadban et al. 2009, p. 30-35). Blood pressure control Hypertension is associated with an increased risk of many complications of DM, including cardiovascular disease, and the findings from the UKPDS indicate that any reduction in a person’s average blood pressure significantly reduces the risk of complications in nephropathy(Thomas 2006, pp2213-2234 ). Hypertension and diabetes should be diagnosed early and treated aggressively to prevent associated complications. The UKPDS showed hat blood pressure control helps to avoid cardiovascular complications in T2D and â€Å"†¦each 10 mmHg decrease in mean systolic blood pressure was associated with 12% reduction in the risk for any complication related to diabetes, 15% reduction in deaths related to diabetes, 11% reduction in myocardial infarction, and 13% reduction in microvascular complications† (Lago et al. 2007, p. 667). ATHEROSCLEROSIS The Australian Institute of Health and Welfare (AIHW) found PWD have an increased risk of developing coronary heart disease (CHD), stroke and peripheral vascular disease (PVD) with 60% reported they also had cardiovascular disease. Diabetes, kidney disease and CVD account for 25% of the burden of disease in Australia, and just under two-thirds of all deaths (AIHW 2004; AIHW 2009). Atherosclerosis leads to myocardial infarction, congestive cardiac failure (CCF) and cerebral vascular accident (CVA) stroke, PVD and lower extremity amputation (LEA). Atherosclerosis is 2 to 4 times more prevalent in T2D. Principally, the beta cells become insulin resistant, adding strain to the body and making it difficult for insulin to perform effectively(Bilious amp; Donnelly, 2010, p. ). Risk factors Risk factors that contribute to the development of and increase the risk for atherosclerosis are abdominal obesity, physical inactivity, hyperinsulinaemia, lipid abnormalities, altered platelet function, hypertension, smoking, microalbuminuria, increased fibrinogen levels and hyperglycaemia. Increased triglycerides and increased high density lipoproteins greatly impacting atherosclerosis(Maiti amp; Agrawal 2007, pp. 292-306). PWD with impaired kidney function and persons with metabolic syndrome are more prone to atherosclerosis (Kaartinen et al. 2007, p. 782). . Pathophysiology of Atherosclerosis Diabetes is a pro-inflammatory condition fuelling metabolic factors that contribute to atherosclerosis. Conventional risk factors are dyslipidaemia, hypertension, and coagulopathy as a result of the prolonged hyperglycaemic state of diabetes. Central to diabetes related risk factors for atherosclerosis is hyperglycaemia from insulin deficiency and insulin resistance. Diabetes specific risk factors play a role in the acceleration of atherosclerosis by increased levels of advanced glycation end-products (AGEs), increased oxidative stress, altered matrix production and altered endothelium, smooth muscle cells and macrophages. Macrophages are converted to foam cells that secrete pro-inflammatory cytokines (Goldberg 2004 , pp. 613-615; Maiti amp; Agrawal 2007,pp. 292-306). Hyperglycaemia promotes oxidative stress and glycation directing release of free radicals. Subsequently, lipid perioxidation allows foam streaky cells to form on the arterial walls causing endothelial dysfunction. Creager et al. 2003, p. 1527). A precursor to atherosclerosis is impaired nitric oxide which breaks down in response to hypertension, diabetes and dyslipidaemia (Maiti amp; Agrawal 2007, pp. 292-306). Release of increased free radicals promotes increased platelet aggregation with elevated levels of plasminogen activator inhibitor type 1 and impaired fibrinolysis, allowing an increased inflammatory response to occur (Morgensen 2003, pp. 45-46; Maiti amp; Agrawal 2007, pp. 292-306). Growth factors cause a proliferation and migration of smooth muscle cells associated with thrombosis and Angiotensin II promotes endothelial damage. Diabetes is a thrombolytic state leading to an imbalance of atherosclerotic lesions and plaque instability, in turn increases the PWD risk of cardiovascular events.