Exploring the Substance Abuse Treatment Programs

Abstract This research paper establishes that the problem of substance abuse in the female sex is increasing in most parts of the world. The trend is worrying. Some of the policy changes discussed include the use of specialized care providers, provision of care in the society, and the establishment of more women-specific rehabilitation centers. Issues concerning the course and nature of substance abuse, addiction, recovery, and relapse among this population of female substance abusers have also been discussed.Advertising We will write a custom research paper sample on Exploring the Substance Abuse Treatment Programs specifically for you for only $16.05 $11/page Learn More Various evidence-based approaches to treating substance abuse and addiction in various settings in the selected target population will be tackled in the research paper. The context of a changing health care environment for women substance abusers will also be highlighted. Important ther apies such as the nontraditional approaches of motivational therapy, solution-focused brief, and group therapies will take the center stage. SFGT emerges a futuristic treatment modality for women with substance abuse problems. Introduction Women are a special population of drug abusers. They provide a challenge to any group or individuals who are working towards their treatment. Like many states in the US, the state of Florida is one of the most affected with the problem of drug abuse among women. The impacts of substance abuse are relatively similar to those in the male population. However, this group of substance abusers also faces special challenges. Therefore, it is important to examine the impact of substance abuse on this population and its recovery at an individual (micro) and systems (macro) level. This research paper looks at substance abuse in women, evidence-based approaches to the provision of treatment services for them, and any historical and current policy issues that may have prevented or supported treatment-service delivery to this client group. Relevant Policy Issues Policies addressing the treatment of substance abuse in women with substance abuse problem have been developed from many research findings. The treatment of the special client group is mostly similar to the male colleagues, although there are few variations in the policies. Zarkin, Dunlap, and Homsi (2004) looked at some of the substance abuse services cost analysis programs (SASCAP) and some of the major policies in the management of substance abuse. Some of the policy changes include the allocation of scarce drug abuse treatment dollars (Zarkin, Dunlap, Homsi, 2004). A major policy is the establishment of the Center for Substance Abuse Treatment (CSAT), which is responsible for the treatment of drug abusers. Grella and Greenwell (2004) and Cowan, Deering, Crowe, Sellman, Futterman-Collier, and Adamson (2003) report a considerable increase in the number of women abusing drugs i n the United States.Advertising Looking for research paper on health medicine? Let's see if we can help you! Get your first paper with 15% OFF Learn More Grella and Greenwell (2004) noted that non-specialized and mixed gender individuals mostly managed the treatment programs that were in place. However, they were less likely to address the problems of this group of clients. Most of the women who abuse drugs are also treated as outpatients, hence corresponding to treatment for other groups of drug abusers. Some of the challenges include the existence of few facilities that are dedicated to the treatment of substance dependence in women only. As Grella and Greenwell (2004) state, the women-only providers were more concentrated in the residential facilities. Even though these facilities provide advanced care to the women who are known to be drug abusers, they make up only a small proportion of the treatment system. However, over the past few years, there has been growing attention to the treatment programs for the women drug abusers globally, especially in the US. Some of the policies that have positively affected funding of programs for treatment of women with the problem include the federal block grant, initiation of projects that are federally funded, and the â€Å"women’s set-aside† (Grella, Greenwell, 2004, p. 378). The state of Florida has a treatment program for drug abusers. However, the number of women-specific facilities is still small. The program in place in this region is the Substance Abuse and Mental Health (SAMH) program, which operates within the Florida Department of Children and Families (DCF). It is the single-state authority on substance abuse and mental health (Substance Abuse, 2014). The region also has a treatment and referral system for drug abusers in accordance with the national policy on drug abuse. The US Department of Health and Human Services, specifically the Substance Abuse and Mental Health Services Administration’s (SAMHSA), has a national drug and alcohol treatment referral service, which provides Spanish and English treatment programs for the residents for free and with assurance of confidentiality (Substance Abuse, 2014). Nature of Substance Abuse, Addiction, Recovery, and Relapse Substance abuse in women is a common problem as stated above, with millions being affected by the problem. The cause of the substance abuse is dependent on the individual factors and drug characteristics that the individual is abusing (Doweiko, 2008). Harmful drug abuse rarely occurs before teenage, with most of the abusers being over 15 years (McCollum, Trepper, Smock, 2003). The disorder or habit begins to increase with the increasing age, with a described peak being witnessed in the early 20s (Berg, Miller, 1992). In one of the population studies in the US, the prevalence of alcohol dependence was reported at 2% in people aged 12 to 17 years. The incidence was higher in 18- to 20â€⠀œyear-olds, standing at 12% (Grant, Stinson, Dawson, 2004a). The prevalence of dependence and abuse for the other groups that are older than 20 years is relatively smaller. It decreases with increased age.Advertising We will write a custom research paper sample on Exploring the Substance Abuse Treatment Programs specifically for you for only $16.05 $11/page Learn More Addiction and substance dependence among women substance abusers takes a course that is similar to other groups of dependence. Large proportions of women that are dependent in their 20s will remit later in their life, with some remaining addicted into their later ages (Thoits, 2010). Most of the women who remain dependent and addicted to the substances will develop a more chronic course (Cowan et al., 2003). They are likely to experience physical and psychological conditions that are associated with the condition. Women with limited social support and stability including being unemployed , without family, and housing are more likely to remain addicted for longer, with their recovery being dependent on these factors (Weiss, Griffin, Mirin, 1992). Stressful life experiences are a contributor to the problem of drug abuse among women since it influences the treatment course (Taylor, Biswas, Vaughn, 2012; Minkoff, 2013). Recovery among the population of women who are drug abusers is better in relation to their male counterparts since most of the drug abusers that seek help are the women group (Berg, Miller, 1992). The cases of relapse with treatment are common, especially in people who have abused the substance for long. One third of the treated cases of drug abuse are the women who are known to relapse in a 10-year period. A few of them continue to have the drug abuse problem for life (Russell, Gockel, 2005). Therefore, the treatment of drug abuse for the women group is dependent on the social support among other factors. Moreover, the recovery of women drug abusers is a function of factors such as social support, pre-morbid personality, and the environment in which they are located (Ruger, Abdalla, Luekens, Cottler, 2012). Women have a better recovery from drug abuse compared to their male counterparts. The understanding of this situation is due to the wider support they have and the ease of seeking help. The average period of recovery according to Berg and Miller (1992) is 3 years. However, this period varies among individuals. Relapse is common in women drug abusers. One third of those who undergo treatment are known to relapse. The treatment of patients without elimination of the predisposing conditions causes them to relapse to their previous state. The chances of treatment after relapse are considered to reduce. Women drug abusers who experience relapse mostly end up abusing drugs for life (Berg, Miller, 1992). The treatment of women drug abusers who relapse is different from first-time patients. Evidence-Based Treatment Approaches Evi dence-based substance abuse treatment approaches for the women population have undergone a change over the last few decades. Many studies have been conducted on the most effective methods of treatment, with their findings informing the approaches (Emmelkamp, Vedel, 2006).Advertising Looking for research paper on health medicine? Let's see if we can help you! Get your first paper with 15% OFF Learn More Straussner (2012) is one of the researchers who looked at the evidence-based treatment modalities for substance abuse and the changes that this plan has undergone in history. The researcher states that one useful tool in the diagnosis and management of substance abuse is the Diagnostic and Statistical Manual of Mental Disorders (DSMIV-TR), which has been useful in the management of all genders of substance abusers (Straussner, 2012). Treatment of substance abuse is mainly approached as an outpatient and inpatient approach. Rehabilitation is a major trend presently and in the past. Detoxification has largely been used, with substitution therapies being applied to treat the drug substance abusers (Straussner, 2012). Pharmacotherapy has been applied in most of the treatment modalities. In the treatment for alcohol dependence, some of the medications used include disulfuram and naltrexone (Straussner, 2012). Acamprosate is also a medication that has been tried with varying degrees of ef ficiency in reducing alcohol abuse in the general population and in women. Behavioral therapies constitute the other evidence-based method of treating substance abuse in women. They have been used successfully in most of the patients in combination with other therapies (Straussner, 2012). According to Straussner (2012, p. 129), â€Å"Behavioral therapies help people engage in the treatment and recovery process, provide incentives to remain abstinent, modify their attitudes and behaviors related to substance abuse, and increase skills to handle stress and environmental cues that may trigger craving for AOD.† Cognitive behavior therapy is another method that is widely used in the management of substance use disorders in women. The technique teaches the affected persons on how to control their thoughts and modify the maladaptive beliefs and cognitive distortions that may be pushing them to the drug abuse (Straussner, 2012). Motivational enhancement therapy and the Twelve Step Fa cilitation Therapy (TSF) are widely applied therapies that form the basis of Alcoholic Anonymous and their treatment of substance abuse (Straussner, 2012). Harm reduction is another of the models that have been used in the management of substance abuse. It originated in Europe with the adoption in the US in the late 80s to prevent the transmission of HIV among substance abusers (Straussner, 2012). Family-focused treatments have also been found to be important in the management of substance abusers. Current Substance Abuse Treatment System Traditionally, the treatment of substance abuse in the female population of patients was similar to that of male patients. Evidence provided in this essay, especially in the reviewed literature, suggests that the treatment of this special group of clients is mainly effective if they are treated in their own specialized facility (Knight, Logan, Simpson, 2001). The researchers state, â€Å"clients who receive services targeted toward their specific needs are more likely to complete treatment and that they have better outcomes at follow-up† (Knight, Logan, Simpson, 2001, p. 11). Specialized facilities for the provision of treatment for women that are known drug abusers have increased, with an on-going training for more specialists who will cater for the individual needs of this class of patients in this changing environment. The current management of substance abuse is more focused on the institution of care at the community level, with patients being managed at their homes and in the society. The measures are more effective in the current management of substance abuse in women, as it incorporates some of the social stressors that may be contributing to their substance abuse (Berg, Miller, 1992; Mott Gysin, 2003). In the changing environment of care for groups with special needs, women with substance abuse problems are more affected by changes in the health context. The current substance abuse treatment system is also focused on influencing the psychiatric and social effects of the substance abuse, with a wide use of group therapies as discussed below. Group Therapies Heather (2005) explored addictions in the context of being disorders in motivation. He suggested that motivational therapy is an effective measure in management. According to Heather (2005), the use of motivational interviewing presents a good way of dealing with addiction. The previous trials and use of the same have proved to be effective. Motivational therapy is done to patients to encourage and motivate them to relinquish their substance abuse habits. They are first motivated to have a change in attitude. Motivational enhancement therapy has been used in the management of alcohol abuse disorder with considerable success in combination with other therapies. The treatment modalities that are combined with motivational therapy require the patient to be motivated to proceed with any treatment, and thus the increased efficiency and efficacy (Berg, Miller, 1992). Smock, Trepper, Wetchler, McCollum, Ray, and Pierce (2008) looked at the efficacy of the solution-focused group therapy in the management of substance use disorders. The efficacy of the SFGT was remarkable in the study. Treatment of the drug abusers was successful in most of the instances in the study (Smock et al., 2008). However, the research was focused on the treatment of substance abuse in level-1 substance abusers. Patients who received either SFGT or the traditional treatment approach were reported to improve on either treatment (Smock et al., 2008). Nonetheless, significant improvement was noted in patients who were treated using the SFGT. The researchers concluded that the treatment of substance abuse in patients who are known substance abusers has to take that approach (Smock et al., 2008). The approach of using SFGT, which is a resiliency-based approach, is gaining popularity among clinicians treating substance abuse in health facilities. T he approach provides a feasible method of treatment of the same in any women-specific treatment programs. The popularity in the use also means that clinicians have faith in the method and that they have documented improved outcomes with treatment. The modalities will likely enhance treatment in the current health care environment, with more patients receiving direct care. Group therapies are more concerned with the treatment of individuals with similar conditions. They are tailor-made to the needs of the unique groups. Very few group therapies deal with the treatment of women who are diagnosed with substance abuse disorders. There should be more attempts to increase the number of women receiving this specialized care (Berg, Miller, 1992). The above-discussed modalities in the treatment of substance abuse in women might enhance the current health care environment. The insurance coverage for women drug abusers is a significant part of the changing health environment. Many organizatio ns offer insurance coverage for such patients. This accessibility reduces the cost of treatment for women drug abusers. Patients that are not already insured should be put in the insurance programs to reduce their treatment costs. It is important to note that most organizations involved in the treatment of women drug abusers charge for these services. This observation is one of the factors that cause those affected not to seek treatment. In the state of Florida, the number of women drug abusers is significantly dropping. This finding can be attributed to the rise of many organizations offering women-specific rehabilitation services. Conclusion and Recommendations In conclusion, the course and nature of substance abuse, addiction, recovery, and relapse among this population of women substance abusers has also been discussed. Various evidence-based approaches to treating substance abuse and addiction in various settings in the selected target population have also been discussed. Recom mendations in the management of substance abuse disorder in women are possible from the above research. The future management of the problem needs to be taken in the social setting of patients to ensure that the problems causing them to engage in substance abuse are tackled. The research establishes that poor social support for the patients often ends up complicating their management, with most of patients with poor support structures ending up with relapse. The management also needs to take a more specialized approach where structures are set to ensure that the facilities taking care of women with substance abuse disorders are treated by a specialized team of practitioners. The client group has established special needs that may be overlooked by the general practitioners who handle other needs in the society. The other recommendation is that there needs to be education that is more consistent to the public on the effects of substance abuse, with special focus on the specific effect s that the client group may experience. The education needs to be in the form of campaigns where the bodies established to deal with the problem of drug abuse constantly engage in the reduction of the main predisposing factors to the problem. The other recommendation is that treatment modalities discussed in the paper such as SFGT should be widely applied in the management of women who are drug abusers. The use of these modalities will lead to increased success in the management of patients since they present a better success rate. There is also need to carry out more research on the best methods of intervention for this group since there are more knowledge gaps, with the issue continuing to dominate in many parts of the world. Reference List Berg, K., Miller, S. (1992). Working with the Problem Drinker: A Solution-Focused Approach. New York, NY: W. W. Norton. Cowan, L., Deering, D., Crowe, M., Sellman, D., Futterman-Collier, A., Adamson, S. (2003). Alcohol and drug treatment for women: Clinicians’ beliefs and practice. International Journal of Mental Health Nursing, 12(1), 48-55. Doweiko, E. (2008). Concepts of Chemical Dependency. London: Cengage Learning. Emmelkamp, M., Vedel, E. (2006). Evidence-based treatment for alcohol and drug abuse: A practitioner’s guide to theory, methods, and practice. New York, NY: Routledge. Grant, F., Stinson, S., Dawson, A. (2004a). Prevalence and co-occurrence of substance use disorders and independent mood and anxiety disorders: results from the National Epidemiologic Survey on Alcohol and Related Conditions. Archives of General Psychiatry, 61(1), 807–816. Grella, C., Greenwell, L. (2004). Substance Abuse Treatment for Women: Changes in the Settings Where Women Received Treatment and Types of Services, Journal of Behavioral Health Services Research, 31(4), 367-383. Heather, N. (2005). Motivational interviewing: Is it all our clients need? Addiction Research and Theory, 13(1), 1-18. Knight, D., Logan , S., Simpson, D. (2001). Predictors of program completion for women in residential substance abuse treatment. Am. J. Drug Alcohol Abuse, 27(1), 1-18. McCollum, E., Trepper, T., Smock, S. (2003). Solution-Focused Group Therapy for Substance Abuse: Extending Competency-Based Models. Journal of Family Psychotherapy, 14(4), 27-42. Minkoff, K. (2013, April 19). Treating Comorbid Psychiatric Substance Use Disorder. Psychiatric Times, pp. 1-10. Mott, S., Gysin, T. (2003). Post-Modern Ideas in Substance Abuse Treatment. Journal of Social Work Practice in the Addictions, 3(3), 3-19. Ruger, J., Abdalla, A., Luekens, J., Cottler, L. (2012). Cost-Effectiveness of Peer-Delivered Interventions for Cocaine and Alcohol Abuse among Women: A Randomized Controlled Trial. PLoS One, 7(3), 1-12. Russell, M., Gockel, A. (2005). Recovery Processes in a Treatment Program for Women. Journal of Social Work Practice in the Addictions, 5(4), 27-45. Smock, S., Trepper, T., Wetchler, J., McCollum, E., Ray, R., Pierce, K. (2008). Solution-Focused Group Therapy for Level 1 Substance Abusers. Journal of marital and family therapy, 34(1), 107-120. Straussner, A. (2012). Clinical Treatment of Substance Abusers: Past, Present and Future. Clin Soc Work J, 40(1), 127-133. Taylor, D., Biswas, B., Vaughn, M. 2012). Incremental Validity of Stressful Life Experiences in Predicting Psychiatric Comorbidity Among Women in Substance Abuse Treatment Rebecca. Journal of Social Service Research, 38(1), 382–391. Thoits, A. (2010). Stress and health. Journal of Health and Social Behavior, 51(1), S41–S53. Weiss, D., Griffin, L., Mirin, M. (1992). Drug abuse as self-medication for depression: An empirical study. The American Journal of Drug and Alcohol Abuse, 18(2), 121–129. Zarkin, A., Dunlap, J., Homsi, G. (2004). The substance abuse services cost analysis program (SASCAP): a new method for estimating drug treatment services costs. Evaluation and Program Planning, 27(1), 35– 43. This research paper on Exploring the Substance Abuse Treatment Programs was written and submitted by user Braxton House to help you with your own studies. You are free to use it for research and reference purposes in order to write your own paper; however, you must cite it accordingly. You can donate your paper here.

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Finally, the Current Ratio (Current Assets/Current Liabilities) went from 0.57 to 0.50 when evaluate to the previous year. (EMIS) Due to surrounded reasonableness and various consumption, customers find it hard to make head-to head cost-benefits comparisons and thus build the products appear to be to some extent non-homogenous a not completely substitutable for one another. These firms are also opposing and differentiating all the way through demand stimulus (shifting the demand curve) by organizing SMS contests, sponsoring shows like Malaysian Idol which support SMS voting, etc. where the SMS charges are priced much advanced than usual SMS charges in order to drive higher non-voice revenue and productivity as illustrated in figure by Maxis, Celcom and DiGis 2010 announcements below. (http://www.slideshare.net/amiwaleed99/maxis-economonics-assignment) TASK TWO An economic cycle is also known as a trade cycle or a business cycle which refers to the usual fluctuations in a market as a total. As Keynes describe, an economic phase is collected of cycle of excellent deal with increasing prices and high employment percentages, followed by periods of terrible trade with diminishing prices and high unemployment proportion. (Vengedasalam, 2007) Business cycle is discontinuous rises and declines in stage of trade and industry. A downturn is a stage of decline in whole production, profits and employment. This recession, which lasts 6 months or further, is marked by the well-known reduction of production activity in numerous sectors of the economy. A recession is more often than not followed by a recovery and development, a period in which real GDP, income, and employment grow as shown in figure 1.1(refer to appendix). (Campbell R., 2010) When we talk about increasing or constricting, we envision changes in the objective measure of goods and services produced. But the objective quantity of production is almost impractical to measure. So we measure the volume of production by its market price, not by its corporeal volume. Because prices differ from one year to another, GDP yardsticks must be adjusted intended for inflation. Assume that from one year to the next all prices doubled. So unadjusted quantify of nominal GDP would give us a false analysis, we may think production was speeding forward when in actual fact it was positioned still. (Schiller, 2009) In outlook toward the Malaysian economy, these are the impact of the business cycle for the past three years 2009, 2010, 2011 and the consequences faced by the government. In the year 2009, Bank Negara Malaysia has maintained a preventative advance to monetary policy. Previously in 2008, price increases was ascending because of the quick and considerable raise in provisions and power prices. The OPR, though, was left unaffected. The measurement of the Bank was that the food and energy price increases were hugely supply determined. Increasing interest rates beneath these circumstances would have a partial collision in containing inflation. This was the major deliberation within the assessment to keep up interest rates even though assertions that the Bank should have strictest monetary policy. Whereas household demand circumstances be fairly sound, the rigorous subside in exports, and the dejected economic viewpoint for quite a few of Malaysias main trade associates destined that major strategy maintain would be required to avoid the economy from inflowing a deep and extended downturn. With inflation decelerating, Bank Negara Malaysia frontloaded the interest rate cuts to reduce the market from a fast declining international economy. Overnight Policy Rate (OPR) its concentrated by the Bank by a total of 150 basis points beginning from November 2008 to February 2009 to 2% as shown in chart 1.1(refer to appendix). During a dilemma position, interest rate deduct with themselves are not satisfactory. Some corresponding procedures were also brought in to achieve particular sectors of the financial system. Therefore, as well as reducing rates of interest, the Bank besides introduced a amount of under attack procedures toward make sure sustained contact to financing, provisional expansion of security net, protection the cost of prosperity and actual profits of depositors and lessening extremely defenseless borrowers commencing the complete collision of the calamity. The decline in rate of borrowing in addition to procedures undertaken to make sure undisrupted credit flows to the economy were doing well in supporting financing action. Even though financing development measured in the beginning element of the year, credit flows had sustained although existing downturn circumstances in the household with exterior part of the economy. (Annual Report, 2009) Chart 1.2(refer to appendix) By the start year 2010, monetary indicators are signaling to facilitate the international downturn was retreating. International development was being lead through a recover within industrialized also an expansion in the stock cycle. Symbols of development are apparent from trade sales, customer self-assurance, and the accommodation markets. Global trade was as well starting to rise up. The amend in point of view was mirrored by the considerable growing reconsideration toward 2010 international development estimate by the IMF during January 2010 keep posted of the World Economic Outlook (WEO) as shown in chart 1.3(refer to appendix). In the meantime, price rises was predicted to ascend progressively but stay low all the way through the year. Procedures of interior rise and demand indicators recommended the possible materialization of demand through inflation later in the year, aligned with the upturn in require circumstances. Demand linked pressures on inflation, though, be predicted toward stay moderately self-effacing as shown in chart 1.3 and 1.4(refer to appendix). The work of financial implements becomes more diversify in 2010. Even though uncollateralized borrowings remain the major implement used (for 62.7% of incomparable economic policy implements), there be a substantial raise to securities base fiscal procedure instruments (2010: 37.3%, 2009: 20.2%). Bank Negara Malaysia Monetary Notes (BNMN for usual and BNMN-i for Islamic money markets) be ever more use in 2010 when there have be tough appeal for these securities by shareholder, mostly non-resident shareholder. These new organization would demand to a huge base of shareholder set the tighter conformity through Shariah supplies of diverse jurisdictions. In order by the visualization of Malaysia being an Islamic Financial Centre, the Bank will maintain toward grow original and supple Islamic monetary implement that are broadly suitable between international investors.(Annual Report, 2010) In the year 2011, financial display recommended that the upturn of the international economy was ongoing, even though the development presentation varies obviously across area. GDP development was predicted to stay vigorous at 5-6% as shown in chart 1.5(refer to appendix) for 2011. Inflation was estimated to rise in 2011 compared to 2010. Supply factors would be the most important source of inflation throughout the year. In December 2010 the amendments to the manage value of fuel goods would certainly increase heading price rises. Increasing worldwide force and provisions prices were likely to use rising force on firms expenses of production. Figures released in February in chart 1.5(refer to appendix) showed GDP development was constant at 4.8% in the fourth sector of 2010. Highly developed indicator and dealings of customer response keen to a sustained optimistic outlook designed for personal use. Comment beginning the Banks industrial actions recommended continuous development of service and income, which would be more sustain by the firm service value in the opening partially of the year. All the way through the year, the household money market and liquidity in the stock scheme be affecting by growth in the worldwide economic markets and unpredictable collection course. In general circumstances in the household money market, on the other hand, remained flexible to the worldwide financial confusion. Interbank markets sustained to function below a excess liquidity situation, among the entire contributor left behind as net lenders all through the year. As at end-2010 total excess liquidity increase starting from RM299.2 billion to as high as RM397.5 billion at June 2011 as shown chart 1.6(refer to appendix), before past it in the second half of the year. Quite a few raise schemes were apply in 2011 to raise the prepared effectiveness of monetary procedure and improve the diversity of capital market implement. The Range Maturity Auction (RMA) was completely operational throughout the year and develop into part of normal monetary process. (Annual Report, 2011) TASK THREE The telecommunications industry in Malaysia and the district is predicted to confront test in 2011 as of a growing voice market, fibre roll-out, and original technologies together with LTE as well as greater than ever consumer outlook. These are the few strategies used by these two companies Maxis and DiGi. The macro-economic environment in 2010 improves over 2009, a year during which performance of global financial markets exaggerated Asian economies. In opposition to the negative 1.7% recorded formerly, the Malaysian economy grew powerfully in 2010, registering a growth rate of 7.2%. Growth was fuelled by high confidential expenditure and continuous public division spending. On the other hand, the Malaysian telecommunications industry concerned many new entrants in the year beneath assessment, together with in the broadband sector. This, coupled with powerful competition in the midst of accessible players, reflected the gradually more challenging working environment. Customers continued to demonstrate a tough desire for mobile phone internet services and substance in addition to Smartphone and tablets. The varying scene has proposition for their company form with improved demands on margins. Their strategy for 2011 is divided into three parts, to get the most out of their voice company, to protected statistics admission management and access, and to distribute goods and services ahead of telecommunication sector. In accomplish this plan; we stay aggravated to deliver investor cost throughout presentation improvement, savings to protect continuous outlook profits flow and cautious economic organization. (Maxis Annual Report, 2009) (Maxis Annual Report, 2010) DiGi and the telecommunications sector in Malaysia in 2011 will certainly be an exciting year. Their industry will have a main part to play in building a first-class ICT infrastructure that will not only stimulate this development story but also build a more connected Malaysia in the course of a mature mobile internet and mobile broadband ecosystem. DiGi will maintain to aggressively attend to the growing demand for excellence statistics services in Malaysia. They continue dedicated to advance scheduled growing their complex marks that will also supply for superior rate capability, consistency and value of service. The group target to keep their tough development energy this year. They are aiming to obtain a reasonable distribute of the development in the mobile phone internet and portable broadband sector and further market sector. Being operationally capable will stay behind a main priority. (DiGi Annual Report, 2010) There are few responsibilities that DiGi wanted to do; control and expand existing accounts, accomplish effective account treatment during preparation of sales calls, handling enquiries from customers, gather round competitors information from consumers and providing market feedback, in charge for uncovering opportunities, advertising benefits of the full services of DiGi business and advertising adjacent to the competition, to do outbound calls from the given list/record of existing and potential customers, produce demand for DiGi business and direct in the selling process, and organize, price, negotiate and reference sales solutions as well as control daily forecast and opportunities.

A Diagnosis for Mr. Fix-it Essay -- Medical Research

Mr. Fix-it is a 59 year old man with a history of alcohol abuse and diabetic hypertension. Mr. Fix-it has been currently experiencing symptoms such as: rambling speech, poor short-term memory, weakness on the left side of his body, neglects both visual and auditory stimuli to his left side, difficulty with rapid visual scanning, difficulty with complex visual, perceptual and constructional tasks, unable to recall nonverbal materials, and mild articulatory problems. The diagnosis for Mr. Fix-it’s problem is most likely a right-hemisphere stroke. A right-hemisphere stroke is occurs when a blood clot blocks a vessel in the brain, or when there is a torn vessel bleeding into the brain. â€Å"A right-hemisphere stroke is common in adults who have diabetes and who are over the age of 55†, similar to Mr. Fix-it (Kluwer, 2012). In addition, Mr. Fix-it has a history of alcohol abuse in which it could have also increased his chances of experiencing a right-hemisphere stroke. The symptoms of a right-hemisphere stroke are very much similar like the symptoms Mr. Fix-it is experiencing. For example, both suggest that functions on the left side of the body are completely neglected; therefore, the left visual section of the body does not respond effectively to stimuli due to the neglect. Damage to the right occipital lobe is very likely. The patient may have experienced some damage to areas 18 and 19 of the occipital lobe. â€Å"Damage to these association areas resulted in the patient’s failure to recognize items even when they have been seen before†, such as Mr. Fix-it’s deficiency to recognize geometric shapes (Carlson, 2010). Moreover, the patient could have also experience damage in the frontal lobe, specifically on area 8, in which it could have r... ...lood pressure medication in order to keep his blood pressure in the normal state of 120/80. Other than taking medications, there is another alternative such as surgery, such as â€Å"ventriculosmy, craniotomy, and carotid endarterectomy† (Kluwer, 2012). The patient also has the option of going to a rehabilitation center where the patient may be able to receive speech therapy, occupational therapy, and physical therapy. In addition, the rehabilitation center may also include â€Å"functional electrical stimulation† (Kluwer, 2012). Works Cited Carlson, N. R. (2010). Physiology of behavior. (10 ed., pp. 69-101). Boston, MA: Pearson. Hemiparesis. (2011). Retrieved February 9, 2012, from http://www.stroke.org/site/PageServer?pagename=hemiparesis Kluwer, W. (2012).Right hemispheric stroke. Retrieved February 6, 2012, from http://www.drugs.com/cg/right-hemispheric-stroke.html

Diabetes and Nutrition

Diabetes mellitus is a continual disorder of carbohydrate and lipid metabolism in which blood levels of glucose and lipids are elevated. This abnormal metabolism results from a relative lack of insulin, either too little insulin is secreted or the insulin that is secreted is not effective. In addition, diabetes is associated with chronic systemic complications, which, over time, can affect the retina, kidneys, nerves, and cardiovascular system. The most common classifications of diabetes mellitus include type I, or insulin-dependent, diabetes mellitus (IDDM); type II, non-insulin-dependent diabetes mellitus (NIDDM); and gestational diabetes (GD).How it is DevelopedThe problems of diabetes originate in an organ located behind the stomach about the length of a human hand called the pancreas. The pancreas is necessary for both digesting food and regulating energy. It is the regulation of energy for the body that is important in the development of diabetes. The pancreas produces hormones that metabolize food. These hormones regulate the use of glucose, a simple sugar, which is used for most of the activities in our bodies. The pancreas regulates energy in a variety of behaviors in which humans engage such as exercise and movement, responding to trauma and stress, and infections.The pancreas emits three different types of hormones. Insulin is the first hormone that is produced when glucose rises in the blood. Insulin usually rises after eating a meal, and excess glucose that is not used is stimulated by insulin to be stored in muscles and fat cells so that energy can be used later. The liver also stores excess glucose in the form of a carbohydrate called glycogen. The second type of pancreatic hormone is glucagon. Glucagon breaks down glycogen stored in the liver so that it can be used as energy when blood glucose supplies are down. The third type of pancreatic hormone is called somatostatin, thought to be important in regulating both insulin and glucagon.When diabe tes develops, this balanced control system does not operate properly. The glucose in the bloodstream increases, and the cells are not able to utilize it. The individual develops hyperglycemia (excess glucose in the blood). This can be detected by measuring the glucose in the blood from a blood sample, or if the glucose is elevated enough, it can be detected in the urine as spillover. This sort of situation occurs when there is not enough insulin to permit the cells to utilize the glucose, or there is resistance most likely at the cellular level to the presence of insulin. Both cases produce diabetes.Symptoms of DiabetesSome of the symptoms of Diabetes Mellitus are increased thirst, increased urination, weight loss even though the individual is eating more, fatigue, nausea, and vomiting, skin infections, vaginitis, blurred vision, bladder infections, and impotence in men and cessation of menses in women.One severe symptom of diabetes is diabetic ketoacidosis. This symptom sometimes p roduces slightly sweet-smelling breath that is caused by acetone, a metabolic byproduct, when the body is forced to burn fatty acids rather than glucose. This process becomes more and more toxic to the body as it continues; the individual may develop diabetic coma and die. Ketoacidosis occurs when individuals are either not getting enough insulin or the insulin is not adequate to allow cells of the body to utilize the glucose.Effects of DiabetesDiabetes has two types of long-term effects. One type is associated with blood vessel involvement. Damage to the large vessels puts the diabetic at greater risk of stroke, heart attack, and gangrene of the feet. When small blood vessels are damaged, eyes, kidneys, and nerves become damaged. The other long-term effect is nerve damage usually in the feet, but also occasionally in the hands. This nerve damage is called diabetic neuropathy. This damage may cause a painful burning sensation with loss of sensation over time, making the body part mo re subject to injury and infection. Foot ulcers and gangrene can develop, with further damage in the extremities. In men, diabetic neuropathy may cause erectile impotence.Nutrition for DiabetesConsultation with a dietitian familiar with children and with type 2 diabetes is important for all patients. The dietitian should assess the nutritional status and practices of the patient and then counsel them to provide a meal plan which, at least initially, does not deviate in a major way from their usual eating practices. Changes made gradually, through subsequent appointments and interviews, frequently achieve compliance more successfully than does radical and rapid change.Individuals providing counseling must be clear about the differences in the management of patients with type 1 and type 2 diabetes. Because obesity is a typical finding in type 2 diabetes and caloric restriction results in improved glycemic control and insulin sensitivity, modest caloric restriction and weight loss or m aintenance are important goals: so is correction of the dyslipidemia, which frequently accompanies the metabolic syndrome or IRS.In general, calories from dietary fat should not exceed 30% of energy intake, and calories from saturated fat should not exceed 10%. An effort is also made to limit cholesterol in the diet to