Monday, January 27, 2020

Accuracy of Home Glucose Monitoring Devices

Accuracy of Home Glucose Monitoring Devices The Accuracy of Home Glucose Monitoring Devices during Hypo and Hyperglycaemia Self – monitoring of blood glucose at home is useful for the management of diabetes as it helps to monitor symptoms of hyper and hypoglycaemia (Diabetes UK). Testing of blood glucose also helps patients to adjust dosages of medication such as insulin and sulphonylureas, monitor the effects of exercise on blood glucose levels, and plan meals (Diabetes UK and Nipro Diagnostics, 2011). The FDA (US- Food and Drug Administration) (2014) refers to a trial in 1993 for control and complications of diabetes which stated â€Å"that good glucose control using home monitors led to fewer disease complications†. For these reasons blood glucose meters that aid self- monitoring most be accurate. Nipro Diagnostics (2011) in the â€Å"Accuracy Study of Blood Glucose Monitoring Systems† states that the â€Å"use of blood glucose meters and test strips are effective in controlling blood glucose values†. There are currently different brands of meters on the market ranging from expensive to less expensive. The accuracy of meters has been questioned by patients and consumer blog groups such as the† American Association of Retired Persons† and therefore the FDA and MHRA (UK-Medicines Healthcare Products and Regulatory Agency) monitor medical devices to ensure they work safely and provide accurate results. At a worldwide level the ISO (International Organization for Standardization) provide standards and regulations which manufactures must meet when producing self-monitoring glucose meters. All brands of glucose meters are subject to the ISO standards (Nipro Diagnostics, 2011) Incorrect blood glucose readings may occur with blood glucose meters due to software issues but may also occur due to operator errors, effects of oxidized uric acid and abnormal haematocrit levels (ADDE, 2013, Bode, 2007, and FDA, 2014). Inaccuracies due to operator error or short cuts, maybe due to poor technique, use of expired test strips, the use of un – calibrated meters, or meters calibrated with expired control solutions, unwashed hands before testing, applying too much or too little blood to the test strip, testing from sites damp with alcohol and from meters and testing strips not stored and handled according to manufacturer’s instructions (ADDE, 2013 Bode, 2007, and FDA, 2014). Oxidised uric acid may lead to falsely low glucose levels by the home glucose meter (Bode, 2007). Dehydration causes haematocrit levels to be elevated resulting in low glucose reading, whereas, high levels caused by anemia, for example, cause low levels of haematocrit resulting in high glucose readings (Bode, 2007). In 2013 the ISO updated the ISO 15197:2003 standards for the â€Å"self – testing glucose monitoring Systems† (ISO 15197:2013). The improved standards will enhance even greater accuracy for glucose meters for patient use (ISO, 2013). In 2013 a meeting of the Diabetes Technology Society researchers, presented evidence from studies done in the USA and Germany concerning accuracy of blood glucose meters using the ISO 15197:2003 standards (ADDE, 2013). The evidence presented showed that many meters did not meet the ISO standard that requires 95% of results to be within range of +/- 20% of the true value (ADDE, 2013). The new international standards ISO 15197:2013 require meters have increased accuracy especially with glucose reading over 4.2mmol/l, and 99% of all results to be within  ±15% of true value (ISO, 2013). The FDA (2010) report as cited on Diabetesnet.com says that a potential inaccuracy with glucose meters between 1992 to 2009 were associated with 100 deaths and 12,672 injuries from 2004 to 2008. American Diabetes Association reported that up to 50% of home glucose meters did not meet the  ±20% of the true values (Alto et al, 2002). The MHRA in April 2013 issued a Medical Device Alert (MDA/2013/022) about â€Å"Home Use Blood Glucose Meters†. These meters were recalled due to a software fault. At very high glucose concentration patients were given a â€Å"falsely low reading with One Touch Verio Pro and no results were recorded with One Touch Verio IQ†. A recent alert (MDA/2014/009) was issued from the MHRA March 2014 about â€Å"FreeStyle Mini ® and FreeStyle ® blood glucose meters†. The meters were recalled because they may be â€Å"reporting incorrect low blood glucose reading† (MHRA). Alto et al (2002) in a study of 111 patients using 21 different brands of meters found that 84% were within the  ±20% of the true value even though patients took short cuts. The study highlighted that patients were not always calibrating meters due to the price of strips and the use of expired control solutions (Alto et al, 2002). Overall, the blood glucose values obtained in this study were clinically useful (Alto et al, 2002). On the other hand, another study â€Å"The accuracy of home glucose meters in hypoglycemia† concluded that some meters were inaccurate in reporting hypoglycaemia (Aydoqdu et al, 2010). There is evidence that home glucose meters are associated with inaccuracies. These inaccuracies maybe due to software problems associated with the meters or due to the operator. The operator plays a very important role in the accuracy of home glucose monitoring. The operator should follow the manufacturer advice about use, technique, storage and calibration of meters to achieve optimum results. Diabetes UK (2014) and the FDA (2014) encourage patients to check accuracy of home glucose meters by comparing to results of blood processed in a laboratory (Collazo – Clavell, 2012). ISO has tightened requirements in 2013 for home glucose meters to ensure higher accuracy for all new meters. References Diabetes UK (2014)– â€Å"Blood Glucose Meter Guide† [Online]. Available at: http://www.diabetes.org.uk/ (Accessed 23 March 2014) FDA (2014) US Food and Drug Administration, ‘Medical Devices’, Blood Glucose Monitoring Devices’. [Online]. Available at: http://www.fda.gov/ (Accessed 23 March 2014) Nipro Diagnostics (2011) â€Å"Accuracy Study of Blood Glucose Monitoring Systems† http://www.niprodiagnostics.com/ (Accessed 23 March 2014) Bode, B.W, (2007) â€Å"The Accuracy and Interferences in Self-monitoring of Blood Glucose†, Blood Glucose monitoring, US Endocrine Disease, pp. 46 -48. [Online]. Available at: http://www.touchendocrinology.com/ (Accessed 30 March 2014) MHRA (2013) ‘Medical Devices Alert’ Home use blood glucose meters: Lifescan OneTouch Verio Pro; Lifescan OneTouch Verio IQ (MDA/2013/022 [online]. Available at: http://www.mhra.gov.uk/ (Accessed 23 March 2014) MHRA(2014) ‘Medical Device Alert’ FreeStyle Mini ® and FreeStyle ® blood glucose monitoring systems manufactured by Abbott Diabetes Care (MDA/2014/009)[Online].Available at: http://www.mhra.gov.uk/ (Accessed 24 March 2014) ISO (2013) â€Å"More accurate self-testing results for diabetes patients with new ISO standard† [Online]. Available at: http://www.iso.org/ (Accessed 23 March 2014) AADE (2013) ‘American Association of Diabetes Educators’ Practice Advisory Blood Glucose Meter Accuracy [Online. Available at: http://www.diabeteseducator.org/ (Accessed 24 March 2014) Alto, W.A., Bryson, P, Kindig, J, Meyer, D, and Schneid. J (2002) ‘Assuring the Accuracy of Home Glucose Monitoring’, Journal of the American Board of Family Medicine 15(1). [Online]. Available at: http://www.medscape.com/ (Accessed 30 March 2014) Aydoqdu, A, Erbil, M.K, Kilic, S, Kutlin, M, Serdar, M, Sonmez, A, Tapan, S, Taslipinar, A, Uckaya, S, Yazici, M, Yilmaz, M.I, and Yilmaz, Z (2010) ‘The accuracy of home glucose meters in hypoglycemia’ Diabetes Technol Ther 12(8), pp. 619-26. PubMed. [Online]. Available at: http://www.ncbi.nlm.nih.gov/ (Accessed 30 March 2014) Collazo – Clavell, M (2012) ‘Diseases and Conditions’, Sometimes my blood glucose monitor seems to give incorrect readings. What can I do to make sure the measurement is accurate? Mayo Clinic [Online]. Available at: http://www.mayoclinic.org/ (Accessed 30 March 2014)

Sunday, January 19, 2020

Russell Scott Sanders: a Feminist Past

A feminist is a theory of the political, economic, and social equality of the sexes. Russell Scott Sanders, â€Å"The Men We Carry in Our Minds,† discusses his personal observation of the conflict of gender equality that grew in his mind after seeing the harsh lives of his surrounding class of people. It deals with the problems that exist between sex and social class issues. He reveals that the men in this class had no choice over their own destiny in life. Their only ways of making money to barely survive were as factory workers or soldiers. He had envied women for what he thought they had a pleasant lifestyle, spent time in the home looking after the children, compared to the difficult lives of the men having to work at the factories and go to war in the foreign land. This essay demonstrates troubles that lie between rich and poor, males and females. Sander's was born into a poor, low-class family that had only known hard labor. During his childhood he witnessed many men go to the same job day in and day out to do back breaking labor so as to support their families. From his yard he had a view of the prison and watched black prisoner's slave away against the land. Watching them were guards dressed in white that didn't raise an arm or bend their backs to do their job. Sanders claimed that, â€Å"As a boy, [he] also knewof another sort of [man], who did not sweat and break down like mules† (Sanders). He saw soldiers, who didn't work in the factories or the fields, as far as he could tell they didn't work at all. He watched these soldiers from his house on a military base in Ohio. He knew the life of the soldier conceived of little excitement except for in the time of war. Either way, he knew that he neither wanted to inherit his father's life, though after time he prospered, or join the military. As a youngster, he also saw the difference in men and women in the workplace. His ideas of women were ladies who sat around the house reading, tidying up and running errands. To him this was a life of a luxury. In his childhood, he imagined his own destiny as eventually becoming one of these two cruel identities. Due to his early opinions of gender roles in his class, he was â€Å"slow to understand the deep grievances of women† (Sander). In his lifestyle the options of each gender were bleak. He idolized them, though they suffered as men suffered when money was tight, it wasn't their fault or responsibility. As Sanders say's, ‘†¦they were not the ones who failed† (Sanders). In the past, slaves of either sex or women of any race held property in their own labor. The labor of slaves, male and female, belonged to their owners. Free women of every race were conceived as wives and mothers; their labor belonged to husbands and families (as Sanders views). Both engaged in life as well as wage labor without acquiring what more privileged men understood as â€Å"rights to work. This issue of unfairness against women comes far beyond the class differences into our individual life, developed from our past, and in effect turning into an important part of the modern life. For example, free labor was built on a concept of independence in which skill at craft work was associated with a manliness that would preserve dignity while workers earned wages and that promised in the end to release them from wage labor. Men practically symbolized labor to show their manliness by operating industrial machines in which the past women were not allowed to operate. Men [he] knew labored with their bodies. They were marginal farmers just scraping by, or welder’s steelworkers, carpenters; they swept floors, dug ditches, mined coal, or drove trucks, their forearms ropy with muscle; they trained horses, stoked furnaces, built tires, stood on assembly lines wrestling parts onto cars and refrigerators†¦. The nails of their hands were black and split, the hands with tattooed scars† (Sanders). The idea also explicitly excluded women, even wives and daughters, from wage work. Women were usually the ones who catered the men with food or any housekeeping material and taking care of their children. This idea took a transition when he went to college. Sander's was very fortunate to attend college. He himself was very surprised, for among people of his social class, it was a rare opportunity. His views of the world were put into logical perspective. His socialization with the women opened his eyes to the hardships they had to undertake, to get out of the shadow of being a female and be respected for their intellect and hard work. As he felt helpless before for being poor, they in relation felt the same for being of a different gender. He thought he'd made an alliance because of the alienable circumstances that they'd been through. To his disappointment, the females at college did not take him in as a friend, but recognize him as the enemy. Even after he had grown up, escaped his harsh surroundings, and attended college, he often had to deal with the concept of unfairness. For in their lives growing up, being daughters of rich families, they knew from birth that men would become the ones with degrees and would be successful. Sanders proclaimed, â€Å"It was not my fate to become a woman, so it was easier for me to see the graces† (Sanders). This was an example of shift for Sanders; everything he thought he knew about women was turned upside down. Sander’s jealousy over women affects his views in college which creates contradicting elements of dignity towards the women he meets in college. Although the women he meets in college distinguish him as an enemy due to him being a feminist, he still respects their point of views. All Sander want for women to understand is equality. Since the women he meets in college come from a wealthy family and have no idea the way he was raised viewing life from a low class perspective; he tries to prove to them that this world is based on social perceptions rather than human perceptions. Not having a family that works in business and attire he only viewed men as toil workers and women as wives that provide house maintenance for the family. In conclusion, Sanders should be accepted as a feminist all to the women he meets in college. Sanders realized that the women he met wanted to share in the dignity of wealthy jobs worthy of degrees and intelligence. He also realized, â€Å"The difference between [him] and these women was that they saw [him], because of [his] sex, as destined from birth to become like their fathers, and therefore as an enemy to their desires† (Sanders). Sanders main point was that it is easier to overcome gender than class. By Sanders being accepted as a feminist in college he can engage those who are clueless and let them view his perspective. He can show his sympathy that he once faced in his childhood; the envies he had towards women.

Saturday, January 11, 2020

Managing Human Resources in H&SC Essay

Rules and regulations: Plagiarism is presenting somebody else’s work as your own. It includes: copying information directly from the Web or books without referencing the material; submitting joint coursework as an individual effort; copying another student’s coursework; stealing coursework from another student and submitting it as your own work. Suspected plagiarism will be investigated and if found to have occurred will be dealt with according to the procedures set down by the College. Please see your student handbook for further details of what is / isn’t plagiarism. Coursework Regulations 1 You are required to submit your coursework on-line through online e-learning system http://stponline.org.uk. Detailed information about this  is available in the student handbook submission 2 Details of submission procedures and penalty fees can be obtained from Academic Administration or the general student handbook. 3 Late coursework will be accepted by Academic Admin Office and marked according to the guidelines given in your Student Handbook for this year. 4 If you need an extension (even for one day) for a valid reason, you must request one, using a coursework extension request form available from the Academic Admin Office. Do not ask the lecturers responsible for the course – they are not authorised to award an extension. The completed form must be accompanied by evidence such as a medical certificate in the event of you being sick. 5 General guidelines for submission of coursework: a All work must be word-processed and must be of â€Å"good† standard. b Document margins shall not be more than 2.5cm or less than 1.5cm c Font size in the range of 11 to 14 points distributed to including headings and body text. Preferred typeface to be of a common standard such as Arial or Times New Roman for the main text. d Any computer files generated such as program code (software), graphic files that form part of the course work must be submitted either online with the documentation. e The copy of the course work submitted may not be returned to you after marking and you are advised to have your personal copy for your reference. f All work completed, including any software constructed may not be used for any purpose other than the purpose of intended study without prior written permission from St Patrick’s International College. Outcomes and assessment requirements Outcomes Assessment criteria for pass To achieve each outcome a learner must demonstrate the ability to: LO1 Understand processes for recruiting individuals to work in health and social care 1.1 Explain the factors to be considered when planning the recruitment of individuals to work in health and social care 1.2 Explain how relevant legislative and policy frameworks of the home country influence the selection, recruitment and employment of individuals 1.3 Evaluate different approaches that may be used to ensure the selection of the best individuals for work in health and social care LO2 Understand strategies for building effective teams for working in health and social care 2.1 Explain theories of how individuals interact in groups in relation to the types of teams that work in health and social care 2.2 Evaluate approaches that may be used to develop effective team working in health and social care LO3 Understand systems for monitoring and promoting the development of individuals working in health and social care 3.1 Explain ways in which the performance of individuals working in health and social care can be monitored 3.2 Assess how individual training and development needs can be identified 3.3 Analyse different strategies for promoting the continuing development of individuals in the health and social care workplace LO4 Understand approaches for managing people working in health and social care. 4.1 Explain theories of leadership that apply to the health and social care workplace 4.2 Analyse how working relationships may be managed 4.3 Evaluate how own development has been influenced by management approaches encountered in own experience. Case Scenario – St – Patrick’s Nursing Home You have recently been appointed as a trainee Human Resources Officer at  St-Patrick’s Nursing Home located in central London. During the first formal meeting with the Board of Directors you were told about the recent expansion of the nursing home by your HR Director. You were also informed about the various problems that St Patrick’s Nursing Home have been experiencing, such as the high rate of employee turnover(caused by low pay, poor working conditions, long hours, not enough benefits or a negative atmosphere from management, fixed/inflexible contracts; inadequate salaries; recruitment based on favoritismetc.). Alsocomplaints from residents and families about the quality of care, and staff errors due toInsufficient knowledge or application of clinical-care standards and protocols; lack ofguidelines; inadequate supervisionthat compromised the safety and efficiency of care. The HR Director is under pressure to increase staff retention in order to reduce future traini ng and recruitment costs. She believes that the current recruitment and selection policies of St-Patrick’s Nursing Home are partly responsible for the turnover problem. The HR Director also suggested that care workers’ performance, satisfaction and commitment to the organisation depend on collaborative team-working. She mentioned that staff members were often blamed for not communicating important messages to one another whilst on shift, not handing over effectively at the end of their shift, and coming to work â€Å"just to do their shift and go home†. As part of your job, you are required to ensure that the recruitment planning and selection approaches are used effectively and that the relevant legislative and policy framework of the home country are implemented during this process; andprepare a comprehensive and appropriate Performance Evaluation Plan for all of the employees working in your organisation; also you should to make some recommendations on the types of training nursing staff will require considering their current level of competence and future development requirements. At the end of the training, the employees will acquire the knowledge and skills to enable them apply the core standards set by the Care Quality Commission. You have been asked by your boss to arrange a training session for the care staff in order to enlighten them about the techniques and leadership skills that you have used and applied over the period of time in managing and leading people at the workplace, and which they can apply to their roles. You r training session also needs to educate them about the relevance and application of different  leadership theories in leading people and managing relationships with peers and subordinates. Finally, make them aware how you have been continuously updating your knowledge and developing yourself throughout, and what the benefits of ‘investing in yourself’ were. A grand party would be organizedby your HR director praising all your hard work and achievements you would have accomplished in a short span of time working at St-Patrick’s Nursing Home. More information can be accessed from the following websites: www.CQC.org.uk., www.legislation.gov.uk, www.acas.org.uk, www.cipd.co.uk Assignment: Based on the scenario above you are required to complete an ESSAY of 3,000 words (this is an indicative word limit).You should refer to the assessment criteria and the relevant unit content, when preparing your evidence of assessment. The essay is formed of the following four sections below which relate to the learning outcomes. Learning Outcome 1 (1.1, 1.2, 1.3) 1.1 Explain the factors that need to be considered when planning the recruitment of individuals to work at St-Patrick’s Nursing Home. (M1) 1.2 Explain how relevant legislative and policy frameworks of the home country influence the selection, recruitment and employment of individuals to work in St-Patrick’s Nursing Home(M1 and D1) 1.3 Evaluate the different approaches that may be used to ensure the selection of the best individuals, and make recommendations for St-Patrick’s Nursing Home (M1 and D1) Learning Outcome 2 (2.1, 2.2) 2.1 Explain the theories of how individuals interact in groups in relation to the types of teams that work in health and social care (M2 and D2) 2.2 Evaluate the approaches that may be used by staff at different levels to develop and promote effective team working at St-Patrick’s Nursing Home (M2 and D2) Learning Outcome 3 (3.1, 3.2, 3.3,) 3.1 Explain the ways in which the performance of individuals working in health and social care can be appraised(M3 and D3) 3.2 Assess of how individual training and development needs can be identified at St-Patrick’s Nursing Home (M3 and D3) 3.3 Analyse the different strategies for promoting the continuing development of individuals in the health and social care workplace (M3 and D3) Learning Outcome 4 (4.1, 4.2, 4.3,) 4.1 Explain theories of leadership that apply to the health and social care workplace (M2 and D2) 4.2 Analyse how working relationships may be managed at St-Patrick’s Nursing Home (M3) 4.3Evaluate how your own development has been influenced by management approaches that you encountered in your own experience (M3 and D3) Formative Submission How and why will formative assessment take place? Formative assessment will take place to advise you on your progress within the term (during 4th and 8th week) and the ways in which you could improve before the final (summative) submission. The feedback is for your benefit and is not part of your final grade for the unit. Formative feedback may however not be as detailed as the final feedback you receive, and may be in verbal and/or written form (at the teacher’s discretion). You will be asked to submit your work for formative feedbackin electronic form to your teacher or as hard copy, to which you will receive verbal and/or written feedback. Final (Summative) Submission You need to submit all of the documents relating to your final assignment covering all learning outcomes i.e. LO1, LO2, LO3 and LO4 via stponline.co.uk on or before 12TH April 2014 latest by 23:55. Merit Descriptors Indicative characteristics Contextualised Indicative characteristics (All the characteristics need to be achieved) M1 Identify and apply strategies to find appropriate solutions Complex problems with more than one variable have beenexplored. Has demonstrated an understanding of therelevant legislation and policies framework of the home country andknowledge of the different approachesthat may be used to ensure the selection of the best individuals to work in health and social careLO 1.1 1.2,1.3 M2 Select/design and apply appropriate methods/techniques The application of relevant theories, techniques and methods, and also justifying all sources of information. Has shown the understanding of the Leadership and team theories and applied them by developing the effective team and workingrelations.LO2.1,2.2,LO4.1 M3 Present and communicate appropriate findings The appropriate structure and approach has been used Has identified the appropriate method of performance appraisal and evaluated the correct staff training and development needsLO3.1, 3.2 Distinction Descriptors Indicative characteristics Contextualised Indicative characteristics (All the characteristics need to be achieved) D1 Use critical reflection to evaluate own work and justify valid conclusions Conclusions have been arrived at through synthesis of ideas and have been justified Has critically evaluated their work and drawn conclusions with justification on how the conclusions were arrived at in relation to the different approaches used to ensure the selection of the best individuals for work in health and social careLO 1.3 D2 Take responsibility of managing and organising activities Independent thinking has been demonstrated and all activities have been managed. Has applied the different leadership and team theories for team management and workingrelationships.LO4.1 4.2 D3 Demonstrate convergent/lateral/creative thinking Self-evaluation has taken place. Has critically evaluatedhow their own development has been influenced by management approaches. LO4.3

Friday, January 3, 2020

Cyber Politics And The Campaign Election - 1192 Words

Cyber Politics in The Recent 2016 Campaign Elections Following the Guidelines of Cyber-Democracy Course 273 Section 90-91 Stacie Beattie California State University of Monterey Bay Since the 2000’s, the Presidential campaign process and candidates have progressively increased with the power of Internet for political purposes like, interacting with the public, fundraising, gathering supporters, gathering data on voters, and reaching adolescence. The evolution of social media in the 2000’s created a locomotion, causing the candidates to connect with the voters via the Internet. The 2000 Presidential campaign decisively vested in the internet as a large part of news and information. The candidates used the internet as a fundraising tool, creating a positive thing for the non traditional candidate that could get financial support from supporters of their party. The American people sat at about 43%; within this percentage they used resources online for news having to do with the election. This percentage of people also stated that the online information influenced their voting preference (Kohut and Rainie). This proves that the progression of internet had large importance because of the adverse affect it had on voter’s decisions with the election. In the 2004 elections, there was a large boom in social media, and sites that were created within the early 2000’s. LinkedIn, MySpace, Google Blogger Tech were created in 2003. The launch of Facebook and YoutubeShow MoreRelatedHow The French Presidential Elections Will Affect The Entire World1593 Words   |  7 PagesHow the French Presidential Elections will Affect the Entire World After rejecting the two major political parties in the first round, the French voters will choose their new president. What will the election result mean for the world? After the Brexit results in the UK and Trump’s election in the US, France is next to face the challenge of elections on May the 7th for their second round. 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