Monday, December 23, 2019

Intensive Glucose Control Of Patients With Type 1 Diabetes...

Topic Intensive glucose control of patients with type 1 diabetes mellitus to maintain blood glucose levels (BGLs) near normal range Introduction Type 1 diabetes is an autoimmune disorder which can occur from insufficient insulin secretion. Insulin is a hormone which is secreted by the pancreas and regulates BGLs (Loghmani, 2005; Nussey Whitehead, 2001). Type 1 diabetes is also known as insulin dependent diabetes mellitus (IDDM). In this, the body produces no, or very little, insulin which can lead to chronic hyperglycaemia. Thus the chances of microvascular, metabolic and infectious complications increase, which can result in increased incidence of retinopathy, neuropathy, nephropathy, cardiovascular diseases and cerebrovascular mortality (Diabetes Mellitus Type 1 [DM Type 1], 2014). It usually appears during childhood and adolescence but may occur at any age. The chances of IDDM are equal among males and females and are more common in European people (Type 1 Diabetes Trial Net, n.d.). Mayo Clinic (2014) reports, that the people of Finland and Sardinia have 400 times higher chances of having IDDM than people of Venezuela. World Health Organization [WHO] (2014) reports that nearly 347 million of the worldwide population have diabetes mellitus and it is reported this may be the 7th main cause of death by 2030. IDDM accounts for approximately 10% of all the diabetic population (WHO, 2014). Family history, exposure to some viral infections such as mumps and coxsackie, asShow MoreRelatedSelf Monitoring Of Blood Glucose786 Words   |  4 Pages4. 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In 2011, millions of cases of diabetes had been reported across the world by the World Health Organization. Many complications in the body can come as a result ofRead MoreInformative Essay on Diabetes1506 Words   |  7 PagesAn Informative Essay On Diabetes Mellitus Diabetes is the seventh leading cause of death listed in the United States. Diabetes is the leading cause of blindness. In 1996 diabetes contributed to more than 162,000 deaths(Lewis 1367). Diabetes mellitus is not a single disease but a group of disorders with glucose intolerance in common (McCance 674). Diabetes mellitus is a metabolic disorder characterized by hyperglycemia (increased blood sugar) and results from defective insulin productionRead MoreEssay on Diabetes Mellitus1447 Words   |  6 PagesDiabetes Mellitus Diabetes is the seventh leading cause of death listed in the United States. 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This essay will discuss a family memberRead MoreDiabetes Mellitus : A Debilitating And Chronic Disease2025 Words   |  9 PagesDiabetes Mellitus is a debilitating and chronic disease in which life long care and rehabilitation is required. According to the World Health Organization, diabetes affects over 300 million people worldwide, and continues to rise each year. There are three main categories of diabetes; type 1, type 2 and gestational diabetes. The pathophysiology of diabetes mellitus is related to insulin, which is a hormone secreted by th e cells of the pancreas. (WHO) Insulin is responsible for maintaining an idealRead MorePractical Implementation Tips: Type 2 Diabetes (T2Dm).922 Words   |  4 PagesPractical Implementation Tips: Type 2 Diabetes (T2DM) 1. 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(WHO) Insulin is responsible for maintaining an idealRead MoreDiabetes Mellitus, Burden And Trends1250 Words   |  5 PagesDiabetes Mellitus, burden and trends in diabetes-related Complications Diabetes is a serious chronic disease, which occurs when the body becomes resistant to insulin or doesn t make enough insulin (T2DM, usually in adults) or the body can’t effectively use the insulin (T1DM) (WHO definition: http://www.who.int/diabetes/en/). WHO diagnostic criteria for DM is the FPG 7.0mmol/l. This diagnostic point affect the risk of micro-vascular complications such as retinopathy, neuropathy, renal failure andRead MoreThe Use of GLP 1 Analogues1608 Words   |  6 Pagessupporting use of GLP 1 analogues Patients with type 2 diabetes are at risk of macrovascular and microvascular complications. Evidence has shown that an improvement in blood glucose control, as shown by a reduction in HbA1c levels, is associated with a reduction in microvascular complications (2,3,4). Evidence from ACCORD (2), UKPDS(3) and ADVANCE(4) suggests that intensive blood glucose control reduced composite endpoints for microvascular outcomes, but the impact on patient oriented outcomes such

Sunday, December 15, 2019

The Secret Circle The Divide Chapter 12 Free Essays

Cassie slept late into the afternoon the next day, which was unlike her. Normally she was an early riser, whether she wanted to be or not. But she must have needed the rest, because she woke up feeling refreshed and with a clearer head than she had the night before. We will write a custom essay sample on The Secret Circle: The Divide Chapter 12 or any similar topic only for you Order Now Cassie’s argument with Adam had left her feeling confused and upset last night, but today was a new day. And it was beautiful and sunny, not a cloud in the sky. After getting dressed in her most comfortable jeans and favorite blue sweater, Cassie decided to head out for a walk. She wasn’t quite ready yet to talk to Adam, or anyone really, but hopefully while she walked, the words would start coming to her, and she’d return home knowing just what to say to make everything right again. What Cassie needed was to better understand her own feelings. She wasn’t a jealous person, and she didn’t want to be. But she also couldn’t ignore what was bothering her about Adam and Diana. She owed it to both of them, and to herself, to be honest. She knew they had a history together that she couldn’t compete with. Cassie tied her sneakers tightly and went out the back door. She trudged through the maze of her grandmother’s herb garden and across the surrounding acre of swaying green grass. She stepped over a few soggy piles of stray leaves and along the path of sand and dirt that led to the leaves and along the path of sand and dirt that led to the bluff. There she found Nick out by the water’s edge. He’d taken his leather jacket off and tossed it on the ground beside him. The wind off the water was blowing through his white T-shirt as if he were flying. It fanned his dark brown hair up from his sober face. Watching Nick when he didn’t have his defenses up was like overhearing a secret. It made Cassie feel special to witness it but also a little bit guilty. Cassie had wanted to be alone, but now she wanted nothing more than to be with Nick. Not in a romantic sense, of course. She loved Adam, but that didn’t mean she and Nick couldn’t be friends. So she went to him, preparing herself the whole way for his rejection of her company. But she felt she had to try at least. Nick may have been dark and brooding, he may have been unpredictable, and most days he could even be called rude – but there was a solid center beneath all that, and it was pure, like the crystal ine core to a rough rock. Cassie had seen it, and she was determined to break through his tough exterior to reach it again. She missed his friendship – even though she knew she was pushing him to be friends when their breakup was still so fresh. â€Å"Hi,† she called out to him from a few steps back, not wanting to startle him. He turned slowly, unsurprised to see her, almost like he was expecting her. â€Å"Hi,† he said, which was invitation enough for Cassie to join him. â€Å"How are you?† Cassie asked. â€Å"Okay. How are you?† â€Å"Good.† It was awkward, definitely, but as they persevered through it, they began to slowly settle into their old habits. Nick teased her, pretending to be cruel, and Cassie rolled with his punches, laughing too loud. She’d wanted this for so long, she didn’t want to mess it up, but there was one thing she couldn’t let go. â€Å"Can I ask you something?† she said, when there was a lull in their conversation. Nick nodded, his jaw strong. â€Å"You can ask me anything, but it doesn’t mean I’ll answer you.† Cassie grinned. â€Å"Did you come out here hoping to see me?† â€Å"Wow, you’re conceited.† Nick cracked up laughing. â€Å"Is that a yes?† Nick stopped laughing then and just smiled. He was so stingy with his full-toothed smile, Cassie had forgotten how beautiful and bright it was when it happened. Its scarcity only made it that much more valuable. â€Å"Maybe the thought of you coming out here vaguely crossed my mind,† Nick said. â€Å"I have missed this between us.† At last. This was the Nick she knew. â€Å"Me too,† Cassie said. â€Å"Now I get to ask you something.† Nick flashed his bad-boy grin. â€Å"Is Adam driving you crazy yet?† â€Å"Nick!† â€Å"Nick!† â€Å"He is. I know he is. Don’t even try to deny it.† â€Å"No comment,† Cassie said, laughing. But then she added, â€Å"I guess I’m still getting used to his – â€Å" â€Å"Smothering?† â€Å"His goodness,† Cassie scolded. â€Å"Now be nice.† Nick suddenly appeared lighter, happier. Maybe all he needed to feel better was to take a good shot at Adam. Cassie let her eyes go soft on the ocean. â€Å"I promise things will go back to normal,† she said. â€Å"For you and me. For all of us.† But the moment those words left her lips, dark clouds formed overhead, too fast to be natural. They were ominous clouds of the sort you’d see in movies about the apocalypse. Nick grabbed Cassie’s hand, and they took a few cautious steps back, away from the ocean. â€Å"What’s happening?† Cassie asked. â€Å"Is it a tornado? Do you even get those around here?† â€Å"I don’t know what this is.† Nick scanned the surrounding area for a safe shelter. â€Å"We have to get out of here. All these trees. We have to try to run to your house.† They started running, but they only made it a few steps when streaks of furious lightning began flashing all around them, seemingly right at them. â€Å"Keep running,† Nick screamed. â€Å"And cover your head.† Ice-cold rain poured down, pelting them like needle-pointed arrows. The sky was completely black except for the lightning, which, when it flashed, ill uminated the angry wind in the trees. The blustering sand and litter stirred up from the ground. Cassie strived to keep her eyes closed to the debris but also open enough to follow Nick’s course of escape. â€Å"We’ll never make it,† Cassie screamed breathlessly. â€Å"We should try a spell, to stop it.† â€Å"No!† Nick yelled. â€Å"No magic. Keep running.† One flash after the next, the lightning and thunder reminded Cassie of fireworks. â€Å"It’s them, isn’t it?† Cassie cried out. â€Å"The hunters.† Nick stopped running for a second, and Cassie also stopped, breathing heavily. Nick’s thick neck was pulsing; his chest was heaving. â€Å"I think so,† he said. â€Å"It could be a trick to get us to use our magic.† Then a lightning bolt struck a willing target – one of the many elm trees nearby. It cracked and sparked from the blow. Cassie shielded her eyes with her hand like a visor, watching the elm shiver and smoke. â€Å"Seems like they might already know we’re witches, don’t you think?† Then another tree right beside that one was hit, and then another, each one closer to Cassie and Nick than the one before. Finally, a fiery bolt crashed at the ground right next to Cassie’s feet. She screamed, and Nick pushed her out of the way, shielding her body with his own. Cassie and Nick were both on the ground now, she beneath him. His broad muscular body was heavy on hers. â€Å"Are you okay?† he asked. Rainwater dripped from his face onto hers. â€Å"Yes,† Cassie said. From beneath him she watched the trees that had been hit succumb to wild orange flames. It was the most furious fire Cassie had ever seen, with Bill owing black smoke rising up from it like a ghost. That could have been me, Cassie thought to herself. If Nick hadn’t thrown her out of the way, she would have been dead. It was a sight to see, those once great elms darken and wither to ash so fluidly. Their rugged brown bark melted at the will of the heat, like a chocolate bar left out in the sun. Whatever the hunters were trying to prove, they’d proven it. Clearly they were powerful, and they were willing to kill. They weren’t witches, but this kind of control over the elements looked like black magic to Cassie. What kind of witch hunters used the same tactics of evil witches? â€Å"They’re so close,† Cassie said. Nick let some of his weight off Cassie’s quivering body beneath him. â€Å"And they’re getting closer every minute.† It seemed to Cassie like there was no escape. She and Nick could get up and keep running, but the lightning and thunder would follow their every step until it finally hit its bull ‘s-eye, striking them down with a ball of fire that would burn and bend their bones like the brittle branches of an old elm tree. Or they could lie right there on the ground, unmoving, clutching each other and closing their eyes to it all. They could go with it easily, rather than try to fight it. Dying side by side with Nick was better than being shot down from the sky. And then as if it had all been a dream, the rain suddenly came to a halt, the lightning stopped, and the sky cleared the way for the sun. The day returned, eerily and beautifully, the way for the sun. The day returned, eerily and beautifully, to the perfect color photograph it had been before. If the trees at their side hadn’t still been steadily burning, clouding the air around them with bleak black smoke, Cassie would have believed she’d imagined the whole nightmarish scene. â€Å"I guess we passed the test,† Nick said, standing up and brushing off his jeans. He ran his fingers through his soaking-wet hair and then offered Cassie his broad hand to help her to her feet. â€Å"How is that?† Cassie asked, taking Nick’s hand. â€Å"By not dying?† â€Å"It’s a pretty good start.† Nick put his sturdy arm around Cassie’s drenched sweater. â€Å"Let’s get you home.† Cassie looked up into his mahogany eyes gratefully. She’d never forget the way he’d protected her. Without a moment’s hesitation, he was willing to die for her. â€Å"I’m only going home if you’re coming with me,† she said. â€Å"Well, I’m sure as heck not staying out here,† Nick said playfully, trying to make light of the situation. â€Å"Nick.† Cassie refused to take another step until he looked her in the eyes and acknowledged what had just passed between them. â€Å"What?† â€Å"Thank you,† she said. He shook his head and looked away again. â€Å"You don’t have to thank me.† â€Å"Yes, I do.† Nick started to laugh awkwardly, nervously. The kind of laugh that comes out when you’re trying not to cry. Then he laugh that comes out when you’re trying not to cry. Then he pulled Cassie in toward him and kissed her affectionately on the forehead, like a big brother might do. â€Å"No problem,† he said. How to cite The Secret Circle: The Divide Chapter 12, Essay examples

Saturday, December 7, 2019

Oil and Gas Vital Role in Todays Society

Question: Discuss about the term for Oil and Gas of Vital Role in Todays Society. Answer: Introduction Oil and gas play a very vital role in todays society. Oil and gas are most used sources of energy by human beings. Besides being an energy source, they also serve as the raw material for many consumer goods, thus playing a relevant in peoples life. With its positive side, the oil and gas industry has a negative side that it holds a major potential of affecting the environment hazardously. It may impact harmfully at various levels on air, water, soil and the whole clan of living beings. The most dangerous impact of oil and gas industry is pollution which is associated with basically all the stages of oil and gas production. It starts from exploration then it goes to production and in the end distribution. Gas emissions, solid waste, wastewaters, and aerosols generated during drilling, production, and distribution of all types of chemicals and other refined products of oil and gas industry. Other impacts include increase of green house effect, poorer water quality, groundwater contamination, acid rain, and much more. Strong measures need to be taken to control the pollution created by the oil and gas industry. As the most affected by this environmental pollution will be human beings and their coming generation. Issues related with the impacts of oil and gas exploration, production, and distribution Impacts There many impacts of the oil and gas industry on the environment, its impacts on the soil will be discussed here. The first step of oil and gas industry is to search the oil, and that process is known as an exploration of oil and gas. This step includes drilling, exploration of land, and seismic surveys. In short it is the small scale extraction process. In search of oil number of surveys is done on the land and that leave a negative impact on it. Exploration of land create soil pollution; it harms the surface of the earth with the movement of traffic, ground clearing and other crew activities that not only disturbs the earths surface but also the subsurface of the earth. In search of oil, they drill the earth surface hence harming ecological resources also like vegetation, wildlife, biota, and special status species which affect the fertility of soil therefore it leads to soil pollution. During the process of exploration continues, the crew appointed for working on various activities may generate waste like plastic, paper, containers, leaks/spills, paper, and human waste. Also, waste produced by exploratory drilling like mud, drilling fluid, used oil and filters, drill cuttings, scrap metal and garbage causes soil pollution (Fellet, Marder and Patzek, 2014). Once the step of exploration is completed and the company put up the plant to extract the oil and gas from the earths surface, and they are processed in a refinery or at the field plant itself to produce the final product for the consumer. The production of oil and gas leave the maximum negative effects on the environment and creates a lot of soil pollution. Wastes produced by the oil and gas industries, containing petroleum hydrocarbons, naturally occurring radioactive materials, metals, toxic chemicals, and salts, give hazardous effect as they can prevent the growth of vegetation and cause soil pollution. Water released from such industries contains contaminants and concentrated salts which are often disposed of in the ponds, rivers or stored in pits. This contaminated water can stop the growth of vegetation and sterilize the soil. Contaminants entering in soil may not only remain on the surface but seep into the ground water, which may, later on, pollute the other environmental sources too. (Fellet, Marder and Patzek, 2014). After production, oil and gas have to reach to its ultimate consumer. A distribution system is formed to transport the natural oil and gas from one place to another. Tankers and pipelines are generally used to carry oil and gas from one place to another. In the process of transferring oil and gas from one place to another leakage or, in other words, oil spill is the main issue that a distribution system faces which harm the environment. Any kind of leakage affects the vegetation if happened in an agricultural land and also waste the scares natural product which affect the fertility of soil causing soil pollution. If the oil spill or leakage is not cleaned properly, then its layer remains on the surface of the earth, which restricts any kind of growth of vegetation on the land. Even water also not able to seep in properly through the earths surface, which later affects the underground water level (Sykes, 2008). Issues This whole process of exploration, production, and distribution has lot of negative impacts on environment which give birth to many issues related to it. The main issue is the harmful effect of all these processes and due to them the amount of pollution is caused which affect the health of all living species. A number of chemicals are used and released in the process of refining which is later released from these industries either in the nearby water resources, or they are dumped in the pits. These chemicals later on get mixed with the natural resources and reach in the body of living beings. For example contaminated water used for irrigating fields which will not only harm the fertility of the soil creating soil pollution but also the vegetation will have effects of these chemicals which later on will be consumed by the human beings ultimately causing many health issues. These chemicals are making our soil toxic and harmful. It also sterilizes it making it worthless. Measures Measures that can be taken to reduce the impacts of the process o exploration, production, and distribution of oil and gas industry are like the recycling of waste and contaminate water can be done before releasing it as this can harm the environmental sources. Oil from wastewaters and sludge should be recovered to the maximum and clean water should only be released. Phenols, caustics, and solvent should be recovered and reused as they cause a lot of harm to the environmental sources specially soil and water. In a case of emergency, refinery should be prepared to reduce the hazardous effect to the minimum. Corrosion monitoring, control, and prevention of underground pipelines and tank bottoms should be practiced. Leak detention and repair programs should be established. Adopting environment-friendly technology will help in minimizing impacts of petroleum development on the environment. Steps to be taken by the government and oil companies towards environmental restoration. Environmen tal research and management institutions should be developed. Awareness programs to educate public about the environmental restoration should be run. If all these measures are taken into consideration, then not only soil pollution but other pollution level will also decrease. New technology Research and development department of government and oil and gas industries are working hard to come up with some new technologies that may help in reducing the impacts of oil and gas industry. Availability of energy sources to the ultimate consumer globally at nominal prices would be the next step for oil and gas industry. Development and promotion of renewable energy should be the priority to decrease pressure on oil and gas industry and to the scarce natural resources. Renewable energy will help in reducing the impact of oil and gas industry on the environmental sources. The efficiency of the existing fuels available for the consumption should be improved up to twice what at present. Alternative fuels like bioalcohols, biodiesel, green diesel, and biogas should be promoted and used. Developing biofuel to reduce the usage of the scare natural sources and using a waste material for developing such biofuels will definitely help oil and gas industry to remain the leader in the global energy market and also help in reducing its impact on the environment (Longlong and Yifei, 2012). There are many laws stated by the Government to regulate oil and gas industry. Environmental impact assessment is a law that assesses the environmental consequences of the proposed project. Air quality law handles the assessment of polluted released by the industry. Water quality law regulates the release of contaminated water into the water resources. The waste management law keeps a control on the waste storage, transportation, and disposal of all kinds of waste like municipal waste, or hazardous waste. The environmental cleanup law regulates the removal of contaminants and polluted waste into the environmental media. Forestry law controls the land under the forestry regulation. It regulates the burn practices and land acquisition by the industry. Wildlife law regulates the impact of industrial activity on the wildlife (Schmitt, 2007). Sustainability To minimize the harmful effects of the various process of exploration, production and distribution of oil and gas companies and government need to invest in better technology and talent as it will help the oil and gas industry to meet the challenge of sustainability socially, economically and environmentally. Heavy investment in research and development department for new technologies and alternative fuel type is also required. Other actions that the oil and gas industry can take include the implementation of energy-efficient processes and usage of renewable sources of energy will help in attaining sustainability. Introducing and promoting sustainable energy products in the new market. Flaring of gasses should be reduced during production of oil, and the captured gas should be used in other energy initiatives. Development of core competencies and investing in research and development. Public awareness about the availability of sustainable energy product should be an objective of the oil companies. To have a sustained development, it is necessary for oil and gas industry to find fuels that are responsible socially and environmentally. Oil and gas industry produce the maximum share of energy in the global energy market around the world. With the increasing population the standard of living also improve, it demands for more energy. The demand for an alternate energy source will also become bold in the coming future that too at a reasonable cost, thus it is necessary for the industry to be sustainable (Longlong and Yifei, 2012). Issues realated to the economic, social and environmental sustainability All the activities of an oil and gas industries engender high risks, they are working continuously to reduce their adverse impacts on the environment and people (Schneider, Vargo, Campbell 2011). Compensation has to be given to a land for using his land for exploration but many time if a company doesnt found a natural resource they pack their things and move without paying for using the land. This harm the social image of the company. Same way, the waste created by the crew members and the processes is not cleaned and recycled will harm the environment. The greenhouse gas emission and habitat destruction affect the environment badly. Oil spill is the major issue of oil and gas industry, if there is any kind of wastage of precious oil because of leakage then it effect the economy as that much barrels of oil has to be imported for the country. Recommendations To minimize the harmful effects of the various process of exploration, production and distribution of oil and gas companies and government need to invest in better technology and talent as it will help the oil and gas industry to meet the challenge of sustainability socially, economically and environmentally. Heavy investment in research and development department for new technologies and alternative fuel type is also required. Other actions that the oil and gas industry can take includes the implementation of energy efficient processes and usage of renewable sources of energy will help in attaining sustainability. Introducing and promoting sustainable energy products in the new market. Flaring of gasses should be reduced during production of oil, and the captured gas should be used in other energy initiatives. Development of core competencies and investing in research and development. Public awareness about the availability of sustainable energy product should be an objective of the oil companies (Schmitt, 2007). Conclusion Although, the activities of exploration, production and distribution of oil and gas cause alteration to the environment. Means they have significant negative effects on the environment, but some of the effects can be reduced or prevented by taking important steps. New technologies are being invented to reduce the dependence on petroleum products. Petroleum products are an integral part of the modern life because not only for transportation, petroleum products act as a raw material for many other things that are useful in our day to day life like pharmaceuticals, plastics, paints, pesticides, solvents, and cosmetics. With the increased population and advancing technology, the demand for all the products is also increasing many of which include petroleum products. With the increased usage of the petroleum products, the negative impacts will also increase with it. That means, not only all the attention should be paid to increase its efficiency but also how to reduce its hazardous effects. Oil companies should be monitored, for following the rules and regulations set up by the government and it can be done by establishing a monitoring agency for this purpose will help to restrict these oil companies (Sykes, 2008). References Fellet, M., Marder, M. and Patzek, T. (2014). Cement performance impacts integrity of oil and gas wells. MRS Bull., 39(12), pp.1048-1050. Longlong, C. and Yifei, L. (2012). Research on Main Constraints in Sustainable Development of China Oil-Gas Upstream Industry. Energy Procedia, 14, pp.325-330. Schmitt, H. (2007). Environmental politics and the oil and gas industry. Natural Gas, 13(1), pp.13-16. Sykes, R. (2008). Oil and Gas Industry Efforts on Behalf of Human Rights and Sustainable Development. The Way Ahead, 04(02), pp.12-13.a