Information Technology Ethics Issues Article Summary Essay

Message With today’s advances in technology, software development and usage is paramount. Software connects computer’s hardware to users. Without software, computers would be useless. Unfortunately due to the complex nature and high demand for many software systems, the prices have sharply risen. A Seattle man, Rex Yang and a few friends decided they could capitalize on this high demand, high price market. To keep their overhead down and maximize on profits, the group chose a less than ethical route. According to an article in Forbes, Yang and the other participants in the software scam worked since 2009, obtaining and selling fraudulent product activation keys for Microsoft and other software programs through e-commerce websites. The participants traded product key codes over email and wired money to each other between different bank accounts. They allegedly operated a series of ecommerce sites, claiming to be selling the product activation keys legally, and received many â€Å"cease and desist† letters from Microsoft. It is thought the group may have made at least $30 million in profits over the years. That surge in profit from pirated software began to fall apart in 2013. In April 2013, Homeland Security Investigation Agents, received a tip that the owner of a company called â€Å"Software Slashers† was selling counterfeit computer software and DVDs, mostly from China. Through the investigation, Yang’s wrongdoing was uncovered. Although no criminal charges have been filed to date, the process of seizing property has begun. At the end of 2014, HSI Special Agents began seizing bank accounts and assets connected to the pirated software. Over $7 million in liquid assets (as shown in the table below) were taken; CASH BITCOIN LITECOIN 7,000,000 105 900 In addition, the following items were also seized; Vehicles, including a Porsche Gold and Silver Four Rolex watches (one studded with diamonds) A Diamond ring The seizure of property is often the first step in these investigations, eventually leading into criminal preceding. Software piracy is taken very seriously in the United States, and companies do not take kindly to others stealing their software and activation codes. This group of unethical individuals will most certainly face a legnthy prison term and possible the liability of restitution.

Erasmus, Praise of Folly Essay

1.) In Joe Sachs translation of, Aristotle’s on the soul and on Memory and Recollection, we are presented with the idea that our soul is broken up in to the contemplative and the practical forms of intellect. We use our contemplative and practical intellect to identify what is good for us, so that our desires reflect our needs. Although, they both work towards the same goal, both are separate and depend on ineffable forces for success. The contemplative intellect is fueled by our curiosity for knowledge. Aristotle was a major believer in contemplation because he believed that living a contemplative life is how humans should live. A contemplative life allows humans to lead a morally sound life. The more humans engage in contemplation, the closer they are to their gods and the happier they will be. The contemplative intellect is our capacity to determine the potentiality of the practical intellect. The practical intellect is our response to our contemplation. Contemplation can prolong political disasters and prevent us from using practicality. But, we have no choice but to contemplate because to understand we must contemplate and to act morally we must be able to understand. Being able to understand is being able to grasp the potentiality of something. Misunderstanding something’s potentiality is the reason leading a practical life is more difficult. It is human nature to contemplate. Distinguishing the two intellects is tricky because Aristotle stresses that we are one soul part of a larger one. However, if it is the same soul producing practical and contemplative intellect, how can life be divided into these two things? Our individuality controls our actions. So, our contemplative is what makes us what we are and our existence is the reason we act (practical). Practicality and contemplation are distinctions within our intellect. Contemplation is to be looked at as human nature, it helps us understand. Understanding gives way to the practical intellect. These two separate intellects not only involve different unknown forces, but they also utilize different types of motion. Practical is a physical motion, while contemplation is a motion in the sense that whenever we are thinking and contemplating, we/our minds are in motion. The soul seeks truth. Contemplation leads us towards the truth, while practicality is a truth. These intellects are virtues in different parts of the soul. To acquire happiness one must have moral virtue to choose correctly and practicality to choose ‘how.’ For example, one might attain the knowledge, facts, and actuality of how to ride a bike. But, knowing those facts does not determine your potential to ride the bike. Aristotle provides an affective example, â€Å"There is something that has knowledge in the way that we say any human being is a knower, because humanity is part of the class of what knows and has knowledge, but there is also a sense in which we mean by a knower the one who already has, say, grammatical skill; and each of these is in potency but not in the same way, but the former is because his kind and his material are of a certain sort, while the latter is because he is capable of contemplating when he wants to, if nothing outside him prevents it† (417a 23-30 Aristotle). Aristotle tells us the there are different types of potentiality and actuality here. This example demonstrates a ‘knower.’ A knower would be human, know grammar, and talking (exercising knowledge). This example is important in the distinction because it describes the process and the different roles of contemplation and practicality. The contemplative intellect, in this case, would be that the knower is human and has potential without actual knowledge. The knower, with grammatical knowledge, has this knowledge but is not thinking about it. The knower would be exercising knowledge through recognizing grammatical errors in conversation, readings, etc. In the two most previous instances the knower uses their practicality intellect because their actual knowledge of the grammar is their potentiality to think and perform actions. Contemplation allows us to do, think, and imagine anything we want within out minds/soul. â€Å"†¦The soul is a being-at-work-staying-itself in the way that knowledge is, for both sleep and waking are in what belongs to the soul, and waking is analogous to the act of contemplating but sleep to holding the capacity for contemplating while not putting it to work (practical).† (412b 26-30 Aristotle). Practicality can only utilize what is physical and in front of us. Aristotle The connection between these intellects demonstrates Aristotle’s belief that every body contains a soul and the soul is not separate matter. It is a capacity, it doesn’t have a capacity and is inseparable from the body. The soul has no identity. Aristotle believes we are all individual human beings, made up of different forms and matter. But, there is one soul that is in all of us, equally. No one persons soul is ‘better’ than another’s. This is important in the distinction because contemplation takes place in the soul and practicality is what we do with the connection between our soul and body. 2. ) In Erasmus’, Praise of Folly, the character Folly is used to express Erasmus’ philosophy. Folly states that the actions of different people are foolish and she is congratulating them, she calls wisdom foolish and the fools, wise. Throughout the book Folly, with sarcasm and satire, demonstrates the main forms of folly in order to show the importance of folly. Erasmus wanted to share three main forms of folly in his writing. The first form being, the fundamental form of folly, which is the force in our life that is indescribable. This form mainly refers to religion and faith, but also the folly in any belief of a higher/greater good. The second form is the human folly. In this form, Folly mocked those who deem or consider themselves wise or philosophers. She picked on mainly prominent people, anyone who thought they were better because they knew more about something. The third form is best described by egotistical, hypocritical, and greedy folly. This form depicts the folly of the self-centeredness of humans. Erasmus as Folly illustrates how the Christians appear foolish at first, yet actually possesses true wisdom. Folly quotes the Bible repeatedly to prove her point. She uses the passages to show how folly is good. Within these passages, Folly says that the bible, values fools more than the wise. For example, Adam and Everwere forbidden to eat from the Tree of Knowledge, but they disobeyed. Thus, knowledge destroyed their happiness. Folly describes the Christian fools as those who, â€Å"squander their possessions, ignore insults, submit to being cheated, make no distinction between friends and enemies, shun pleasure, sustain themselves on fasting, vigils, tears, toil, the humiliations, scorn life, and desire only death – in short, they seem to be dead to any normal feelings, as if their spirit dwelt elsewhere than in their body† (p. 128 Erasmus). Folly deems Christians slightly mad because of their view on life, and how they are so focused on the spiritual and eternal that they barely live. Erasmus contradicts Biblical truths when he is speaking as folly and expresses that life would be meaningless without folly. Our world, especially in the United States, relies on instant gratification, but the Bible clearly teaches that those kinds of things will pass away and are not important. Erasmus challenges Biblical truths when he praises ignorance, self-loveand flattery. This goes directly against the Bible, which speaks out against these kinds of things. He explains that the piousness of Christians is madness. In the second form, Folly takes the prominent professions of her time and shows their folly. She begins with merchants, who she describes as liars and thief’s yet they are still respectable citizens. Next she attacks a grammarian, â€Å"He supposes he’d be perfectly happy if he were allowed to live long enough to define precisely how the eight parts of speech should be distinguished, something in which no one writing in Greek or Latin has ever managed to be entirely successful. And then if anyone treats a conjunction as a word with the force of an adverb, it’s a thing to go to war about† (p. 80 Erasmus). Folly describes the schools as dirty and a waste of time. He believes the teachers teach useless information, but still feel important. He goes on to poets and rhetoricians and deems their professions purposeless. The narrator’s particular target is the church, â€Å"as they roll their rock of Sisyphus and string together six hundred laws in the same breath, no matter whether relevant or not†¦.However, their self-love keeps them happy, and three syllogisms arm them enough to go straight to battle on any subject and with any man† (p. 84 Erasmus). These foolish men explain the ‘mysteries’ of life and the Bible according to themselves. Even the monks exude folly. They take vows of poverty and claim to hate money, but still take part in other vices. This form of folly reminds us to not mask ourselves to make us look better. Just because a merchant is respectable profession, doesn’t make that specific merchant respectable. If a monk gives up his money, does that mean he has no other vices? â€Å"†¦why shouldn’t I rightly be recognized and named the ‘Alpha’ of all gods, when I dispense every benefit to all alike?† (p. 19 Erasmus). Folly allows life to continue because men must become silly fools to do it. Without her, she exclaims, couples would be married, and women would not repeat childbirth. Without the pleasure Folly gives to life, it would not be worth living. Folly accuses the stoics of attempting to keep all the pleasure for themselves while commanding others to avoid it. As an example, Folly uses childhood and old age. Everyone loves children because they are foolish and innocent. Age and life experiences only fade their beauty and charm. Thus, in old age Folly recognizes a second childhood, freeing us from the worries of life. With old age comes foolishness and senility, which allows them to be happy. These silly old people are much more fun to be around, then a wise old person. â€Å"’Folly is the one thing which can halt fleeting youth and ward off the relentless advance of old age’† (p. 25. Erasmus). Folly discovers that we use passion over reason, â€Å"he (Jupiter) confined reason to a cramped corner of the head and left all the rest of the body to the passions. Then he set up two raging tyrants in opposition to reason’s solitary power: anger, which holds sway in the breast and so controls the heart†¦Ã¢â‚¬  (p. 30 Erasmus). Folly is logical, when our human nature puts passion over reason. Folly concludes her praise of folly with a comparison to Plato’s, Allegory of the Cave. A man who lived in a cave by firelight his whole life, one day saw sunlight. But, the two men that remained in the cave, who would seem foolish, are equally as happy with what they believe is real. 3.) Aristotle makes a better case for his outlook on human life. It is important for humans to feel important and feel like they belong and have a purpose. Aristotle’s idea of the one soul, not only offers a sense of unity to the human race but also deepens the mystery of our existence. It is in contemplation that we find happiness, whether we contemplate our future, our past, or the present. Human happiness is rooted in human interaction and contemplation allows us to create commonality and it develops culture. Although the truth of folly is important in understanding human incentives, it is in our intellect that we can find harmony. Folly in itself is a folly. It pokes fun at the ignorance of human lives. Being foolish is innate in our nature. When do people have the best times? When they laugh and feel enjoyment from company. Our folly makes us human, it is necessary for our happiness. Erasmus presents folly as a much more bleak and pessimistic attribute. When Aristotle describes the soul it is much more pleasing. He stresses that sources/forces like God, are ineffable. These higher powers cannot be identified or described, but to believe in it reassures us that we are meant to be here. Without this mysterious force, who are we? Why are we here? It is our nature to feel wanted and have a purpose. We attempt to find this purpose through contemplation. This is a major aspect of human life. It forces us to look deeper and attempt to act morally. Humans are at their highest potential when they contemplate. Contemplation is a completely isolated process and helps us understand and perceive the world. This ability drives us and helps us advance. In personal experience, I find it is important to really think, ponder, and contemplate the things that make me happy. I can then decide if that is a practical thing to do or if I need to change what makes me happy. For example, drugs may make someone happy in their contemplation, but is that really what they want? Erasmus and Aristotle have contrasting outlooks on life. Erasmus is very realistic, sarcastic, and satirical. While Aristotle reaffirms that it is all right to contemplate the unknown. Aristotle brings us to higher level of thinking and helps us strive for a happier and morally active life.

Cardiovascular Diseases

Cardiovascular disease Introduction Heart disease is No. 1 killer disease worldwide. It causes 12 million deaths annually. Thanks to the rising health awareness and government programmes this number significantly reduce during last 30 years. Coronary heart disease and cardiovascular disease Cardiovascular diseases are diseases of the heart (cardiac muscle ) or blood vessels (vasculature).Cardiovascular disease (CVD) means all the diseases of the heart and circulation (blood vessels disease) including coronary heart disease (angina and heart attack) and stroke, as well as coronary and periphery blood vessels disease (problems with circulation). Diseases from this group are the biggest killer in Europe and USA, but developing and non-develop countries too. The final and most tragic consequence of different types of heart disease is heart attack with tragic consequences. Heart diseases are caused by atherosclerosis, a disease of arterial blood vessels resulted from atheroma i. . plaques accumulated (forming; sticking) on artery walls which makes the blood vessels nonelastic and narrowed and leads to decreased blood flow. For the atherosclerosis doctors very often use alternative name chronic cardiovascular disease. The opposite group acute heart disease made group of diseases which are dangerous for patients lives. Acute heart diseases include conditions or illnesses which usually have a rapid onset of symptoms and may resolve within days with or without treatment.A condition or illness that is sudden or severe. On the other hand a condition or illness that arises slowly over days or weeks and may or may not resolve with treatment made a group of chronic heart disease. Both of them are caused by atheroma and the most known are next: a) Acute heart disease Heart attack is caused by lack of O2 in heart muscle cells. Very often it is caused by rupture of â€Å"hard plaques† patches which result in blood clots and partially or completely block blood flow and ca use a heart attack.When a fiber cap becomes thin, these â€Å"hard plaques† can suddenly rupture, spilling their contents, resulting in blood clots that partially or completely block blood flow and cause a heart attack http://www. authorstream. com/Presentation/nitin-35423-heart-diseases-science-technology-ppt-powerpoint/ Cholesterol glossary. http://www. mybwmc. org/library/28/000225 Stroke Stroke is death of brain cells caused by obstructed blood flow to parts of the brain. Since the level of LDL cholesterol is main cause of narrowed of blood vessels, it is necessary control it. If not treated properly, high LDL cholesterol can cause a stroke.Cholesterol glossary. http://www. mybwmc. org/library/28/000225 b) Coronary heart disease Heart disease (coronary heart disease), When the plaque build up in th conorary arteries heart does not get sufficient blood, the condition is called coronary artery disease or coronary heart disease. Atherosclerosis is a disease of arterial blood vessels in which plaques form on artery walls. This is a consequence of different substances circulating in the bloodstream (inflammatory cells, proteins, cholesterol and calcium) sticking inside the vessel walls. Plaque patches influence on narrowing blood flow in the artery. ttp://www. bodybuilding. com/fun/gastelu5. htm Peripheral artery disease (reduced blood flow in the limbs, usually the legs Coronary plaque Coronary plaque is a term which use in practice as a synonym for atheroma or atherosclerosis. Patches of atheroma are formed from substances that circulate in the bloodstream. They consist of lipid, or fat, cores covered by collagen fiber caps which are sticking to the inside of the vessel walls. Over time plaque or patch of atheroma increases making an artery narrower and the blood flow through the artery is reducing.We can see the changes in blood vessels caused by plaque in the Figure 1. Figure 1 Artery with the patches of atheroma – plaque Preventing Cardiovasc ular Diseases. Patient. co. uk. emis < www. patient. co. uk/health/Preventing-Cardiovascular-Diseases. htm> (March 13, 2013) http://medicineworld. org/blogs/heart/blog/permalinks/Jan-2006/coronary-plaque-detection-by-molecular-imaging. html> (March 13, 2013) Mature plaques typically consist of two main components: soft, lipid-rich atheromatous â€Å"gruel† and hard, collagen-rich sclerotic tissue.Lipid-rich and soft plaques are more dangerous than collagen-rich and hard plaques because they are more unstable and rupture-prone and highly thrombogenic after disruption. Researchers have found that many people who have heart attacks do not have arteries narrowed by plaque. Many heart attacks are now known to be caused by soft or vulnerable plaques, located on an inflamed part of an artery. This plaque can burst, leading to the formation of a blood clot that can cause a heart attack. The 2009 issue of â€Å"The American Journal Pathology† edited explanation of those relatio ns discovered by Olga Ovchinnikova and er colleagues. They found that inflammation results in the formation of soft (vulnerable) plaque which is filled with different cell types that promote blood clotting. This leads to a reduction of mature collagen, resulting in thinner caps that are more likely to rupture, even in the cases when total level of plaque isn’t extremely high. The authors advocate different viewpoints about relations between the plaque level and structure, i. e. its influence on heart attack. The first group claims that described types of blockages cause only about 30 percent of heart attacks.On the other hand, some sources state that more than two-thirds of acute coronary events result from rupture of coronary plaques. However problems that plaque creates are extremely dangerous for people’s life and it is very important to prevent and monitor its appearance and changes. Graphs of vulnerable plaque and rupture of plaque which causes a heart attack is p resented below. Figure 2 Vulnerable atherosclerotic plaques. Vulnerable atherosclerotic plaques. A. Atherosclerosis in a chronic disease that leads to plaque rupture and vascular occlusion. B.Cross-section of a lethal coronary plaque rupture. Adapted from Heistad D. Unstable coronary-artery plaques. N Engl J Med. 2003. Atherosclerosis Modeling In-vitro. http://www. remedi. uzh. ch/research/disease. html Figure 3 Plaque Rupture and Heart attack http://hon. nucleusinc. com/generateexhibit. php? ID=30468&A=1027 Factors influencing plaque growth and stability Based on everything mentioned above and medical experience the conclusion about relations between heart attack and other cardiovascular disease and the level of plaque increasing are found.The higher the level of plaque the higher risk of heart disease will be. The level of plaque will increase as the result of high level of cholesterol, type LDL, so called â€Å"bad cholesterol† in blood. When the level of LDL is normal, bl ood can pass in and out of the blood vessels without problems, but if it significantly increase particles of the blood will accumulate and sooner or later provoke trigger (cause) heart attack. Other very important factors influencing plaque level increasing are high blood pressure and cigarette smoking.Both factors accelerate the plaque formation changing (damaging) artery walls and even more, helping cholesterol forming. Medical experience proved that plaque composition and vulnerability (hard or soft plaque) is more responsible for the conversion of a stable disease to a life-threatening condition than the plaque size. Except the plaque vulnerability the risk of plaque disruption is are consequence of rupture triggers (extrinsic forces). Soft plaque – lipid-rich one is more dangerous because of its instability and higher probability for rupture.Even (IAKO) Although â€Å"hard plaque† that one having higher level of calcium influence on the blood vessels walls and the ir â€Å"hardness† experience show that heart attacks are mostly caused by soft plaque disruption. Figure 4 Plaque rupture and its consequences in the form of heart diseases http://www. nature. com/nrg/journal/v7/n3/fig_tab/nrg1805_F2. html Risk factors of coronary heart disease Risk factors influencing cardiovascular disease we can group based on their stability into the three groups: a) Modifiable risk factorsIn this group hypertension is the most dangerous risk factor for heart attacks, but even more for stroke. It is forming as the result of abnormal blood lipid levels which means high total cholesterol, high levels of triglycerides and high levels of low-density lipoprotein or low levels of high-density lipoprotein (HDL). Smoking, physical inactivity, Type 2 diabetes, and a diet full with saturated fats are risk factors strongly influencing the heart disease. All of them are treatable and patients (individuals) belonging into the different types of risk customersâ€℠¢ groups should avoid practice them. b) Non-modifiable risk factorsThe factors from this group mostly are constant, like the case in gender or family history. Others are changing when time is passing, like age and lifestyle and personal habits. Older people have more chance to get heart attack and the man, especially those having â€Å"bad medical history†. Ration between man and woman are changing when women past the menopause. After that the level of risk is similar as the men’s one. As I’ve presented there is direct correlation between cardiovascular disease and condition and health of blood vessels, more precisely of developing atheroma, means level and structure of plaque in vessels.On the other development of plaque and its level is directly influenced by level of cholesterol and some other elements which are connected with individual person and his/her life and genetic predispositions. As with the other diseases everybody has some risk of developing ather oma, but some risk factors increase the risk level for several categories. Those risk factors include: fn 12 †¢Fixed risk factors – factors that person cannot change: oA strong family history which means close relatives who developed heart disease or a stroke before they were 55 (for males) or 65 (for female). Severe baldness in men at the top of the head. oAn early menopause in women. oAge. Older people have more risk to develop atheroma. oEthnic group. Medical data show that people from different ethnic group have different risk for heart diseases. †¢Treatable or partly treatable risk factors include different health problems caused basically by the same causes as the: oHypertension (high blood pressure). oHigh cholesterol blood level. oHigh triglyceride (fat) blood level. oDiabetes. oKidney diseases causing diminished kidney function. All factors from this group have to be controlled and monitor.Any kind of their complication probably will trigger more serious pr oblems such as heart attack or stroke. †¢Lifestyle risk factors that can be prevented or changed. Actually these factors PRETHODE precede to those belonging to the second group. Except the genetic factors way of life and daily habits are the more responsible for different kind of heart diseases. Those factors are: oSmoking (Smoking cigarette increase blood pressure, decrease HDL; damages arteries and blood cells and increases heart attacks. Passive smoking is also a risk factor for cardiovascular disease ) oLack of physical activity. Obesity (People who are overweight (10-30% more than their normal body weight) have 2 to 6 times the risk of developing heart disease. ) oAn unhealthy diet and eating too much salt. oExcess alcohol. Looking on those three groups one can easily conclude that people with â€Å"bad predisposition† having high fixed risk factors have to think about their lifestyle risk factors even more, in order to try to decrease the second group of factors (t reatable or partly treatable risk factors). On the other hand some of risks are more dangerous than the others; for example smoking increases risk for heart disease more than obesity.And of course combination of two or more risk factors increases significantly the level of risks; older man (or woman) who smokes, without physical activity and with bad eating habits has more chance to get some of previously explained disease than the one who have â€Å"just one of bad habits†. The more risk factors someone has the greater is the likelihood that he/she will develop cardiovascular disease, unless taking action to modify his/her risk factors and working to prevent them compromising his/her heart health.That doesn’t mean that people with â€Å"good genes† can be irresponsible and ZANEMARITI risk factors from other groups. With or without genetic predisposition modern life significantly increases a risk of heart disease for everybody. Hormones impact on lipids and othe r risk factors Different numbers of man and women died from heart attack initiated a lot of research about hormones' influence on the risk factor and heart disease development. Number of men died from the heart attack outnumbered the number of women in pre-menopause period, but in the post-menopause data show completely opposite situation.A percentage of women in post-menopause having heart disease and dying from heart attack increase dramatically and now outnumbered the men. The main reasons for those changes are connected to the level of hormones and their influence on level and structure of cholesterol and consequently on risk factors and heart disease. As mentioned before total cholesterol actually is made of two different types of cholesterol: LDL – low density lipoprotein (LDL), so called bad cholesterol and high density lipoprotein (HDL).High levels of LDL cholesterol lead to atherosclerosis increasing the risk of heart attack and ischemic stroke. HDL cholesterol redu ces the risk of cardiovascular disease as it carries cholesterol away from the blood stream. http://www. walgreens. com/marketing/library/careguides/careguide. jsp? docid=000225=28=High%20Cholesterol Estrogen, a female hormone, raises HDL cholesterol levels, partially explaining the lower risk of cardiovascular disease seen in premenopausal women.But after menopause (natural or surgical) when a level of estrogen significantly decreases total cholesterol rises, low density lipoprotein (LDL) cholesterol rises, and high density lipoprotein (HDL) cholesterol does not change or decreases slightly. This is the reason why negative hormones’ effect after menopause increasing more than proportionally. Some authors argue that even influence of estrogen on LDL and HDL level is proved it is yet unclear whether increase in risk is caused, at least partially, by increased level of androgen (the other of hormones belong to steroid as estrogen too), which is characteristics of menopause too. This sexual dimorphism means a lower incidence in atherosclerotic diseases in premenopausal women, which subsequently rises in postmenopausal women to eventually equal that of men. These observations point towards estrogen and progesterone playing a lifetime protective role against CAD in women. As exogenous estrogen and estrogen plus progesterone preparations produce significant reductions in low-density lipoprotein (LDL) cholesterol levels and significant increases in high-density lipoprotein (HDL) cholesterol, this should in theory lower the risk of CAD.UKLOPITI U ONO GORE Among estrogen's positive effects on the heart are: †¢Reducing the LDL (â€Å"bad†) cholesterol in the blood. †¢Increasing the HDL (â€Å"good†) cholesterol in the blood. †¢Helping to keep blood vessels open. †¢Lowering blood pressure at night. †¢Reducing blood viscosity (how sticky the blood is), a property that may cause blood clots which could result in a heart attack o r stroke. Estrogen's effects on clotting are complicated, however, since there also is an increased risk for thromboembolism (a blood clot that blocks a vessel) in women taking estrogen. Possibly enhancing fibrinolysis, which is the body's natural process for breaking down blood clots. Read more: http://ehealthmd. com/content/what-are-benefits-hrt#ixzz2NbWR3MxY http://ehealthmd. com/content/what-are-benefits-hrt#axzz2NbW1GJJN Nutrition guidelines As presented before three different groups of risk factor exist. Some of them people can change but the other are fixed, non-changeable because they caused by genetic heritage ( ) influences. Controllable factors are connected to the lifestyle of person.Lifestyle changes can prevent or slow the development of coronary plaque and heart disease. In order to prevent a disease development one have to keep track of his/her blood pressure and cholesterol levels. Choosing a heart-healthy diet is vital in controlling weight, which helps keep blood pressure and cholesterol levels down. Foods high in cholesterol and saturated fat should be avoided, and quitting smoking is imperative. Regular exercise and an increased overall activity level contribute to heart health and help reduce stress.The risk of cardiovascular disease is possible to reduce following recommendation for lifestyle changing: Cessation of smoking and avoidance of second-hand smoke. Nutrition should ensure a healthy diet wiht total diet no more than 8% of saturated + trans fatty acids of total energy intake. All people, especially ones with high risk factors should lower alcohol consumption As the prevention physical activities are recommended – at least 30 minutes of moderate intensity physical activity per day or three days week (i. e. 150 mins/week minimum). Currently practiced measures to prevent cardiovascular disease include: †¢A low-fat, high-fiber diet including whole grains and plenty of fresh fruit and vegetables (at least five portions a d ay)[29][30] †¢Tobacco cessation and avoidance of second-hand smoke;[29] †¢Limit alcohol consumption to the recommended daily limits;[29] consumption of 1-2 standard alcoholic drinks per day may reduce risk by 30%[31][32] However excessive alcohol intake increases the risk of cardiovascular disease. [33] †¢Lower blood pressures, if elevated, through the use of antihypertensive medications[citation needed]; †¢Decrease body fat (BMI) if overweight or obese;[34] Increase daily activity to 30 minutes of vigorous exercise per day at least five times per week;[29] †¢Decrease psychosocial stress. [35] Stress however plays a relatively minor role in hypertension. [36] Specific relaxation therapies are not supported by the evidence. [37] Routine counselling of adults to advise them to improve their diet and increase their physical activity has not been found to significantly alter behaviour, and thus is not recommended. [38] http://www. news-medical. net/health/What-i s-Cardiovascular-Disease. aspx http://www. barnesandnoble. om/w/prevent-halt-and-reverse-heart-disease-joseph-piscatella/1100260037 Primary and secondary prevention of heart disease It is necessary start with prevention from heart disease as early as possible. Changes in the number of people killed by heart attack in developed countries show that prevention and awareness about this group of disease help to http://circ. ahajournals. org/content/123/20/2274/F2. expansion. html health plans must continue to drive cardiovascular care further along the continuum toward primary prevention of cardiovascular disease (CVD).CVD risk factors should be managed not only after a coronary event has occurred, but also before the onset of such and event. Ideally, health lifestyles should be promoted with all patients so that risk factors for CVD never develop. In this way, CVD care can be moved from the inpatient setting to the outpatient setting. Sidney C. Smith Jr, MD. Focus on Cardiovascular Dise ase; A Word About the Quality of Care in Cardiovascular Disease. Director, Center for Cardiovascular Science and Medicine University of North Carolina at Chapel Hill. http://www. qualityprofiles. rg/leadership_series/cardiovascular_disease/cardiovascular_introduction. asp Key priorities for implementation Primary prevention of CVD †¢For the primary prevention of CVD in primary care, a systematic strategy should be used to identify people aged 40–74 who are likely to be at high risk †¢People should be prioritised on the basis of an estimate of their CVD risk before a full formal risk assessment. Their CVD risk should be estimated using CVD risk factors already recorded in primary care electronic medical records †¢Risk equations should be used to assess CVD risk People should be offered information about their absolute risk of CVD and about the absolute benefits and harms of an intervention over a 10-year period. This information should be in a form that: opresen ts individualised risk and benefit scenarios opresents the absolute risk of events numerically ouses appropriate diagrams and text (See www. npci. org. uk) †¢Before offering lipid modification therapy for primary prevention, all other modifiable CVD risk factors should be considered and their management optimised if possible.Baseline blood tests and clinical assessment should be performed, and comorbidities and secondary causes of dyslipidaemia should be treated. Assessment should include: osmoking status oalcohol consumption oblood pressure (see ‘Hypertension’, NICE clinical guideline 34) obody mass index or other measure of obesity (see ‘Obesity’, NICE clinical guideline 43) ofasting total cholesterol, LDL cholesterol, HDL cholesterol and triglycerides (if fasting levels are not already available) ofasting blood glucose orenal function oliver function (transaminases) thyroid-stimulating hormone (TSH) if dyslipidaemia is present †¢Statin therapy is recommended as part of the management strategy for the primary prevention of CVD for adults who have a 20% or greater 10-year risk of developing CVD. This level of risk should be estimated using an appropriate risk calculator, or by clinical assessment for people for whom an appropriate risk calculator is not available or appropriate (for example, older people, people with diabetes or people in high-risk ethnic groups) †¢Treatment for the primary prevention of CVD should be initiated with simvastatin 40 mg.If there are potential drug interactions, or simvastatin 40 mg is contraindicated, a lower dose or alternative preparation such as pravastatin may be chosen. Secondary prevention of CVD †¢For secondary prevention, lipid modification therapy should be offered and should not be delayed by management of modifiable risk factors. Blood tests and clinical assessment should be performed, and comorbidities and secondary causes of dyslipidaemia should be treated.Assessment sho uld include: osmoking status oalcohol consumption oblood pressure (see ‘Hypertension’, NICE clinical guideline 34) obody mass index or other measure of obesity (see ‘Obesity’, NICE clinical guideline 43) ofasting total cholesterol, LDL cholesterol, HDL cholesterol and triglycerides (if fasting levels are not already available) ofasting blood glucose orenal function oliver function (transaminases) othyroid-stimulating hormone (TSH) if dyslipidaemia is present. Statin therapy is recommended for adults with clinical evidence of CVD †¢People with acute coronary syndrome should be treated with a higher intensity statin. Any decision to offer a higher intensity statin should take into account the patient’s informed preference, comorbidities, multiple drug therapy, and the benefits and risks of treatment †¢Treatment for the secondary prevention of CVD should be initiated with simvastatin 40 mg. If there are potential drug interactions, or simvasta tin 40 mg is contraindicated, a lower dose or alternative preparation such as pravastatin ay be chosen †¢In people taking statins for secondary prevention, consider increasing to simvastatin 80 mg or a drug of similar efficacy and acquisition cost if a total cholesterol of less than 4 mmol/litre or an LDL cholesterol of less than 2 mmol/litre is not attained. Any decision to offer a higher intensity statin should take into account informed preference, comorbidities, multiple drug therapy, and the benefit and risks of treatment http://www. eguidelines. co. uk/eguidelinesmain/guidelines/summaries/cardiovascular/nice_lipid_modification. phpHow to lower the risk of cardiovascular disease The risk of cardiovascular disease is possible to reduce following recommendation for lifestyle changing: Cessation of smoking and avoidance of second-hand smoke. Nutrition should ensure a healthy diet wiht total diet no more than 8% of saturated + trans fatty acids of total energy intake. All peop le, especially ones with high risk factors should lower alcohol consumption As the prevention physical activities are recommended – at least 30 minutes of moderate intensity physical activity per day or three days week (i. . 150 mins/week minimum). Cessation of smoking The aim of this measure is complete cessation of smoking and avoidance of second-hand smoke. Patient and their families need to stop smoking. Those who are unable to quit may need professional help in form of counselling, behavioral therapy and even pharmacological therapy. Nicotine replacement therapy (NRT) is the first line choice of medication. Nutrition The aim of this measure is to ensure a healthy diet. Total diet should have no more than 8% (of total energy intake) of saturated + trans fatty acids.All patients are advised to take approximately 1g Eicosapentaenoic acid (EPA) and Docosahexaenoic acid (DHA) and more than 2g Alpha Linolenic Acid (ALA) daily. Diet should have vegetables, fruits and legumes, g rain-based foods, moderate amounts of lean meats, poultry, fish and reduced fat dairy products. EPA and DHA can be obtained from oily fish and marine n-3 (fish oil) capsule supplements. Alcohol consumption All patients should be advised to lower alcohol consumption. Men should drink no more than 2 standard drinks per day and women no more than 1 standard drink per day. Physical activityThe aim of this measure is to raise physical activity and exercise to the recommended goal of at least 30 minutes of moderate intensity physical activity on most, if not all, days of the week (i. e. 150 mins/week minimum). Maintaining a healthy body weight The aim should be to achieve a waist measure of less than or equal to 94 cm in men and less than or equal to 80 cm in women. The body mass index (BMI) should be maintained at 18. 5–24. 9 kg/m2 Lowering blood cholesterol The aim of therapy should be to maintain blood cholesterol at: †¢Low density lipoprotein (LDL) at – less than 2. mmol/L †¢HDL – more than 1. 0 mmol/L †¢Triglyceride (TG) less than 1. 5 mmol/L The blood cholesterol can be maintained with the use of pharmacotherapy. Statins are commonly used lipid lowering drugs. Those with diabetes and atherosclerosis need stringent blood cholesterol control as well. Other lipid lowering drugs include fibrates like gemfibrosil, clofibrates etc, Ezetimiber and niacin. Lowering blood pressure High blood pressure is one of the important risk factors for cardiovascular disease. Those with coronary heart disease, diabetes, kidney disease or stroke need tight blood pressure control.The aim should be a blood pressure of less than 130/80 mm of Hg. Diabetes and blood sugar control Those diagnosed with diabetes need stringent blood sugar control to prevent cardiovascular damage. HbA1c levels should be maintained at less than 7%. Other drugs to lower risk of cardiovascular disease Other drugs used to lower risk of cardiovascular diseases include: †¢ Antiplatelet agents – this includes Aspirin and Clopidogrel. These drugs when given to patients with risk of heart attacks may prevent such attacks and events. †¢ACE inhibitors like Enalapril, Captopril, Lsinopril and Cardiovascular Diseases Cardiovascular disease Introduction Heart disease is No. 1 killer disease worldwide. It causes 12 million deaths annually. Thanks to the rising health awareness and government programmes this number significantly reduce during last 30 years. Coronary heart disease and cardiovascular disease Cardiovascular diseases are diseases of the heart (cardiac muscle ) or blood vessels (vasculature).Cardiovascular disease (CVD) means all the diseases of the heart and circulation (blood vessels disease) including coronary heart disease (angina and heart attack) and stroke, as well as coronary and periphery blood vessels disease (problems with circulation). Diseases from this group are the biggest killer in Europe and USA, but developing and non-develop countries too. The final and most tragic consequence of different types of heart disease is heart attack with tragic consequences. Heart diseases are caused by atherosclerosis, a disease of arterial blood vessels resulted from atheroma i. . plaques accumulated (forming; sticking) on artery walls which makes the blood vessels nonelastic and narrowed and leads to decreased blood flow. For the atherosclerosis doctors very often use alternative name chronic cardiovascular disease. The opposite group acute heart disease made group of diseases which are dangerous for patients lives. Acute heart diseases include conditions or illnesses which usually have a rapid onset of symptoms and may resolve within days with or without treatment.A condition or illness that is sudden or severe. On the other hand a condition or illness that arises slowly over days or weeks and may or may not resolve with treatment made a group of chronic heart disease. Both of them are caused by atheroma and the most known are next: a) Acute heart disease Heart attack is caused by lack of O2 in heart muscle cells. Very often it is caused by rupture of â€Å"hard plaques† patches which result in blood clots and partially or completely block blood flow and ca use a heart attack.When a fiber cap becomes thin, these â€Å"hard plaques† can suddenly rupture, spilling their contents, resulting in blood clots that partially or completely block blood flow and cause a heart attack http://www. authorstream. com/Presentation/nitin-35423-heart-diseases-science-technology-ppt-powerpoint/ Cholesterol glossary. http://www. mybwmc. org/library/28/000225 Stroke Stroke is death of brain cells caused by obstructed blood flow to parts of the brain. Since the level of LDL cholesterol is main cause of narrowed of blood vessels, it is necessary control it. If not treated properly, high LDL cholesterol can cause a stroke.Cholesterol glossary. http://www. mybwmc. org/library/28/000225 b) Coronary heart disease Heart disease (coronary heart disease), When the plaque build up in th conorary arteries heart does not get sufficient blood, the condition is called coronary artery disease or coronary heart disease. Atherosclerosis is a disease of arterial blood vessels in which plaques form on artery walls. This is a consequence of different substances circulating in the bloodstream (inflammatory cells, proteins, cholesterol and calcium) sticking inside the vessel walls. Plaque patches influence on narrowing blood flow in the artery. ttp://www. bodybuilding. com/fun/gastelu5. htm Peripheral artery disease (reduced blood flow in the limbs, usually the legs Coronary plaque Coronary plaque is a term which use in practice as a synonym for atheroma or atherosclerosis. Patches of atheroma are formed from substances that circulate in the bloodstream. They consist of lipid, or fat, cores covered by collagen fiber caps which are sticking to the inside of the vessel walls. Over time plaque or patch of atheroma increases making an artery narrower and the blood flow through the artery is reducing.We can see the changes in blood vessels caused by plaque in the Figure 1. Figure 1 Artery with the patches of atheroma – plaque Preventing Cardiovasc ular Diseases. Patient. co. uk. emis < www. patient. co. uk/health/Preventing-Cardiovascular-Diseases. htm> (March 13, 2013) http://medicineworld. org/blogs/heart/blog/permalinks/Jan-2006/coronary-plaque-detection-by-molecular-imaging. html> (March 13, 2013) Mature plaques typically consist of two main components: soft, lipid-rich atheromatous â€Å"gruel† and hard, collagen-rich sclerotic tissue.Lipid-rich and soft plaques are more dangerous than collagen-rich and hard plaques because they are more unstable and rupture-prone and highly thrombogenic after disruption. Researchers have found that many people who have heart attacks do not have arteries narrowed by plaque. Many heart attacks are now known to be caused by soft or vulnerable plaques, located on an inflamed part of an artery. This plaque can burst, leading to the formation of a blood clot that can cause a heart attack. The 2009 issue of â€Å"The American Journal Pathology† edited explanation of those relatio ns discovered by Olga Ovchinnikova and er colleagues. They found that inflammation results in the formation of soft (vulnerable) plaque which is filled with different cell types that promote blood clotting. This leads to a reduction of mature collagen, resulting in thinner caps that are more likely to rupture, even in the cases when total level of plaque isn’t extremely high. The authors advocate different viewpoints about relations between the plaque level and structure, i. e. its influence on heart attack. The first group claims that described types of blockages cause only about 30 percent of heart attacks.On the other hand, some sources state that more than two-thirds of acute coronary events result from rupture of coronary plaques. However problems that plaque creates are extremely dangerous for people’s life and it is very important to prevent and monitor its appearance and changes. Graphs of vulnerable plaque and rupture of plaque which causes a heart attack is p resented below. Figure 2 Vulnerable atherosclerotic plaques. Vulnerable atherosclerotic plaques. A. Atherosclerosis in a chronic disease that leads to plaque rupture and vascular occlusion. B.Cross-section of a lethal coronary plaque rupture. Adapted from Heistad D. Unstable coronary-artery plaques. N Engl J Med. 2003. Atherosclerosis Modeling In-vitro. http://www. remedi. uzh. ch/research/disease. html Figure 3 Plaque Rupture and Heart attack http://hon. nucleusinc. com/generateexhibit. php? ID=30468&A=1027 Factors influencing plaque growth and stability Based on everything mentioned above and medical experience the conclusion about relations between heart attack and other cardiovascular disease and the level of plaque increasing are found.The higher the level of plaque the higher risk of heart disease will be. The level of plaque will increase as the result of high level of cholesterol, type LDL, so called â€Å"bad cholesterol† in blood. When the level of LDL is normal, bl ood can pass in and out of the blood vessels without problems, but if it significantly increase particles of the blood will accumulate and sooner or later provoke trigger (cause) heart attack. Other very important factors influencing plaque level increasing are high blood pressure and cigarette smoking.Both factors accelerate the plaque formation changing (damaging) artery walls and even more, helping cholesterol forming. Medical experience proved that plaque composition and vulnerability (hard or soft plaque) is more responsible for the conversion of a stable disease to a life-threatening condition than the plaque size. Except the plaque vulnerability the risk of plaque disruption is are consequence of rupture triggers (extrinsic forces). Soft plaque – lipid-rich one is more dangerous because of its instability and higher probability for rupture.Even (IAKO) Although â€Å"hard plaque† that one having higher level of calcium influence on the blood vessels walls and the ir â€Å"hardness† experience show that heart attacks are mostly caused by soft plaque disruption. Figure 4 Plaque rupture and its consequences in the form of heart diseases http://www. nature. com/nrg/journal/v7/n3/fig_tab/nrg1805_F2. html Risk factors of coronary heart disease Risk factors influencing cardiovascular disease we can group based on their stability into the three groups: a) Modifiable risk factorsIn this group hypertension is the most dangerous risk factor for heart attacks, but even more for stroke. It is forming as the result of abnormal blood lipid levels which means high total cholesterol, high levels of triglycerides and high levels of low-density lipoprotein or low levels of high-density lipoprotein (HDL). Smoking, physical inactivity, Type 2 diabetes, and a diet full with saturated fats are risk factors strongly influencing the heart disease. All of them are treatable and patients (individuals) belonging into the different types of risk customersâ€℠¢ groups should avoid practice them. b) Non-modifiable risk factorsThe factors from this group mostly are constant, like the case in gender or family history. Others are changing when time is passing, like age and lifestyle and personal habits. Older people have more chance to get heart attack and the man, especially those having â€Å"bad medical history†. Ration between man and woman are changing when women past the menopause. After that the level of risk is similar as the men’s one. As I’ve presented there is direct correlation between cardiovascular disease and condition and health of blood vessels, more precisely of developing atheroma, means level and structure of plaque in vessels.On the other development of plaque and its level is directly influenced by level of cholesterol and some other elements which are connected with individual person and his/her life and genetic predispositions. As with the other diseases everybody has some risk of developing ather oma, but some risk factors increase the risk level for several categories. Those risk factors include: fn 12 †¢Fixed risk factors – factors that person cannot change: oA strong family history which means close relatives who developed heart disease or a stroke before they were 55 (for males) or 65 (for female). Severe baldness in men at the top of the head. oAn early menopause in women. oAge. Older people have more risk to develop atheroma. oEthnic group. Medical data show that people from different ethnic group have different risk for heart diseases. †¢Treatable or partly treatable risk factors include different health problems caused basically by the same causes as the: oHypertension (high blood pressure). oHigh cholesterol blood level. oHigh triglyceride (fat) blood level. oDiabetes. oKidney diseases causing diminished kidney function. All factors from this group have to be controlled and monitor.Any kind of their complication probably will trigger more serious pr oblems such as heart attack or stroke. †¢Lifestyle risk factors that can be prevented or changed. Actually these factors PRETHODE precede to those belonging to the second group. Except the genetic factors way of life and daily habits are the more responsible for different kind of heart diseases. Those factors are: oSmoking (Smoking cigarette increase blood pressure, decrease HDL; damages arteries and blood cells and increases heart attacks. Passive smoking is also a risk factor for cardiovascular disease ) oLack of physical activity. Obesity (People who are overweight (10-30% more than their normal body weight) have 2 to 6 times the risk of developing heart disease. ) oAn unhealthy diet and eating too much salt. oExcess alcohol. Looking on those three groups one can easily conclude that people with â€Å"bad predisposition† having high fixed risk factors have to think about their lifestyle risk factors even more, in order to try to decrease the second group of factors (t reatable or partly treatable risk factors). On the other hand some of risks are more dangerous than the others; for example smoking increases risk for heart disease more than obesity.And of course combination of two or more risk factors increases significantly the level of risks; older man (or woman) who smokes, without physical activity and with bad eating habits has more chance to get some of previously explained disease than the one who have â€Å"just one of bad habits†. The more risk factors someone has the greater is the likelihood that he/she will develop cardiovascular disease, unless taking action to modify his/her risk factors and working to prevent them compromising his/her heart health.That doesn’t mean that people with â€Å"good genes† can be irresponsible and ZANEMARITI risk factors from other groups. With or without genetic predisposition modern life significantly increases a risk of heart disease for everybody. Hormones impact on lipids and othe r risk factors Different numbers of man and women died from heart attack initiated a lot of research about hormones' influence on the risk factor and heart disease development. Number of men died from the heart attack outnumbered the number of women in pre-menopause period, but in the post-menopause data show completely opposite situation.A percentage of women in post-menopause having heart disease and dying from heart attack increase dramatically and now outnumbered the men. The main reasons for those changes are connected to the level of hormones and their influence on level and structure of cholesterol and consequently on risk factors and heart disease. As mentioned before total cholesterol actually is made of two different types of cholesterol: LDL – low density lipoprotein (LDL), so called bad cholesterol and high density lipoprotein (HDL).High levels of LDL cholesterol lead to atherosclerosis increasing the risk of heart attack and ischemic stroke. HDL cholesterol redu ces the risk of cardiovascular disease as it carries cholesterol away from the blood stream. http://www. walgreens. com/marketing/library/careguides/careguide. jsp? docid=000225=28=High%20Cholesterol Estrogen, a female hormone, raises HDL cholesterol levels, partially explaining the lower risk of cardiovascular disease seen in premenopausal women.But after menopause (natural or surgical) when a level of estrogen significantly decreases total cholesterol rises, low density lipoprotein (LDL) cholesterol rises, and high density lipoprotein (HDL) cholesterol does not change or decreases slightly. This is the reason why negative hormones’ effect after menopause increasing more than proportionally. Some authors argue that even influence of estrogen on LDL and HDL level is proved it is yet unclear whether increase in risk is caused, at least partially, by increased level of androgen (the other of hormones belong to steroid as estrogen too), which is characteristics of menopause too. This sexual dimorphism means a lower incidence in atherosclerotic diseases in premenopausal women, which subsequently rises in postmenopausal women to eventually equal that of men. These observations point towards estrogen and progesterone playing a lifetime protective role against CAD in women. As exogenous estrogen and estrogen plus progesterone preparations produce significant reductions in low-density lipoprotein (LDL) cholesterol levels and significant increases in high-density lipoprotein (HDL) cholesterol, this should in theory lower the risk of CAD.UKLOPITI U ONO GORE Among estrogen's positive effects on the heart are: †¢Reducing the LDL (â€Å"bad†) cholesterol in the blood. †¢Increasing the HDL (â€Å"good†) cholesterol in the blood. †¢Helping to keep blood vessels open. †¢Lowering blood pressure at night. †¢Reducing blood viscosity (how sticky the blood is), a property that may cause blood clots which could result in a heart attack o r stroke. Estrogen's effects on clotting are complicated, however, since there also is an increased risk for thromboembolism (a blood clot that blocks a vessel) in women taking estrogen. Possibly enhancing fibrinolysis, which is the body's natural process for breaking down blood clots. Read more: http://ehealthmd. com/content/what-are-benefits-hrt#ixzz2NbWR3MxY http://ehealthmd. com/content/what-are-benefits-hrt#axzz2NbW1GJJN Nutrition guidelines As presented before three different groups of risk factor exist. Some of them people can change but the other are fixed, non-changeable because they caused by genetic heritage ( ) influences. Controllable factors are connected to the lifestyle of person.Lifestyle changes can prevent or slow the development of coronary plaque and heart disease. In order to prevent a disease development one have to keep track of his/her blood pressure and cholesterol levels. Choosing a heart-healthy diet is vital in controlling weight, which helps keep blood pressure and cholesterol levels down. Foods high in cholesterol and saturated fat should be avoided, and quitting smoking is imperative. Regular exercise and an increased overall activity level contribute to heart health and help reduce stress.The risk of cardiovascular disease is possible to reduce following recommendation for lifestyle changing: Cessation of smoking and avoidance of second-hand smoke. Nutrition should ensure a healthy diet wiht total diet no more than 8% of saturated + trans fatty acids of total energy intake. All people, especially ones with high risk factors should lower alcohol consumption As the prevention physical activities are recommended – at least 30 minutes of moderate intensity physical activity per day or three days week (i. e. 150 mins/week minimum). Currently practiced measures to prevent cardiovascular disease include: †¢A low-fat, high-fiber diet including whole grains and plenty of fresh fruit and vegetables (at least five portions a d ay)[29][30] †¢Tobacco cessation and avoidance of second-hand smoke;[29] †¢Limit alcohol consumption to the recommended daily limits;[29] consumption of 1-2 standard alcoholic drinks per day may reduce risk by 30%[31][32] However excessive alcohol intake increases the risk of cardiovascular disease. [33] †¢Lower blood pressures, if elevated, through the use of antihypertensive medications[citation needed]; †¢Decrease body fat (BMI) if overweight or obese;[34] Increase daily activity to 30 minutes of vigorous exercise per day at least five times per week;[29] †¢Decrease psychosocial stress. [35] Stress however plays a relatively minor role in hypertension. [36] Specific relaxation therapies are not supported by the evidence. [37] Routine counselling of adults to advise them to improve their diet and increase their physical activity has not been found to significantly alter behaviour, and thus is not recommended. [38] http://www. news-medical. net/health/What-i s-Cardiovascular-Disease. aspx http://www. barnesandnoble. om/w/prevent-halt-and-reverse-heart-disease-joseph-piscatella/1100260037 Primary and secondary prevention of heart disease It is necessary start with prevention from heart disease as early as possible. Changes in the number of people killed by heart attack in developed countries show that prevention and awareness about this group of disease help to http://circ. ahajournals. org/content/123/20/2274/F2. expansion. html health plans must continue to drive cardiovascular care further along the continuum toward primary prevention of cardiovascular disease (CVD).CVD risk factors should be managed not only after a coronary event has occurred, but also before the onset of such and event. Ideally, health lifestyles should be promoted with all patients so that risk factors for CVD never develop. In this way, CVD care can be moved from the inpatient setting to the outpatient setting. Sidney C. Smith Jr, MD. Focus on Cardiovascular Dise ase; A Word About the Quality of Care in Cardiovascular Disease. Director, Center for Cardiovascular Science and Medicine University of North Carolina at Chapel Hill. http://www. qualityprofiles. rg/leadership_series/cardiovascular_disease/cardiovascular_introduction. asp Key priorities for implementation Primary prevention of CVD †¢For the primary prevention of CVD in primary care, a systematic strategy should be used to identify people aged 40–74 who are likely to be at high risk †¢People should be prioritised on the basis of an estimate of their CVD risk before a full formal risk assessment. Their CVD risk should be estimated using CVD risk factors already recorded in primary care electronic medical records †¢Risk equations should be used to assess CVD risk People should be offered information about their absolute risk of CVD and about the absolute benefits and harms of an intervention over a 10-year period. This information should be in a form that: opresen ts individualised risk and benefit scenarios opresents the absolute risk of events numerically ouses appropriate diagrams and text (See www. npci. org. uk) †¢Before offering lipid modification therapy for primary prevention, all other modifiable CVD risk factors should be considered and their management optimised if possible.Baseline blood tests and clinical assessment should be performed, and comorbidities and secondary causes of dyslipidaemia should be treated. Assessment should include: osmoking status oalcohol consumption oblood pressure (see ‘Hypertension’, NICE clinical guideline 34) obody mass index or other measure of obesity (see ‘Obesity’, NICE clinical guideline 43) ofasting total cholesterol, LDL cholesterol, HDL cholesterol and triglycerides (if fasting levels are not already available) ofasting blood glucose orenal function oliver function (transaminases) thyroid-stimulating hormone (TSH) if dyslipidaemia is present †¢Statin therapy is recommended as part of the management strategy for the primary prevention of CVD for adults who have a 20% or greater 10-year risk of developing CVD. This level of risk should be estimated using an appropriate risk calculator, or by clinical assessment for people for whom an appropriate risk calculator is not available or appropriate (for example, older people, people with diabetes or people in high-risk ethnic groups) †¢Treatment for the primary prevention of CVD should be initiated with simvastatin 40 mg.If there are potential drug interactions, or simvastatin 40 mg is contraindicated, a lower dose or alternative preparation such as pravastatin may be chosen. Secondary prevention of CVD †¢For secondary prevention, lipid modification therapy should be offered and should not be delayed by management of modifiable risk factors. Blood tests and clinical assessment should be performed, and comorbidities and secondary causes of dyslipidaemia should be treated.Assessment sho uld include: osmoking status oalcohol consumption oblood pressure (see ‘Hypertension’, NICE clinical guideline 34) obody mass index or other measure of obesity (see ‘Obesity’, NICE clinical guideline 43) ofasting total cholesterol, LDL cholesterol, HDL cholesterol and triglycerides (if fasting levels are not already available) ofasting blood glucose orenal function oliver function (transaminases) othyroid-stimulating hormone (TSH) if dyslipidaemia is present. Statin therapy is recommended for adults with clinical evidence of CVD †¢People with acute coronary syndrome should be treated with a higher intensity statin. Any decision to offer a higher intensity statin should take into account the patient’s informed preference, comorbidities, multiple drug therapy, and the benefits and risks of treatment †¢Treatment for the secondary prevention of CVD should be initiated with simvastatin 40 mg. If there are potential drug interactions, or simvasta tin 40 mg is contraindicated, a lower dose or alternative preparation such as pravastatin ay be chosen †¢In people taking statins for secondary prevention, consider increasing to simvastatin 80 mg or a drug of similar efficacy and acquisition cost if a total cholesterol of less than 4 mmol/litre or an LDL cholesterol of less than 2 mmol/litre is not attained. Any decision to offer a higher intensity statin should take into account informed preference, comorbidities, multiple drug therapy, and the benefit and risks of treatment http://www. eguidelines. co. uk/eguidelinesmain/guidelines/summaries/cardiovascular/nice_lipid_modification. phpHow to lower the risk of cardiovascular disease The risk of cardiovascular disease is possible to reduce following recommendation for lifestyle changing: Cessation of smoking and avoidance of second-hand smoke. Nutrition should ensure a healthy diet wiht total diet no more than 8% of saturated + trans fatty acids of total energy intake. All peop le, especially ones with high risk factors should lower alcohol consumption As the prevention physical activities are recommended – at least 30 minutes of moderate intensity physical activity per day or three days week (i. . 150 mins/week minimum). Cessation of smoking The aim of this measure is complete cessation of smoking and avoidance of second-hand smoke. Patient and their families need to stop smoking. Those who are unable to quit may need professional help in form of counselling, behavioral therapy and even pharmacological therapy. Nicotine replacement therapy (NRT) is the first line choice of medication. Nutrition The aim of this measure is to ensure a healthy diet. Total diet should have no more than 8% (of total energy intake) of saturated + trans fatty acids.All patients are advised to take approximately 1g Eicosapentaenoic acid (EPA) and Docosahexaenoic acid (DHA) and more than 2g Alpha Linolenic Acid (ALA) daily. Diet should have vegetables, fruits and legumes, g rain-based foods, moderate amounts of lean meats, poultry, fish and reduced fat dairy products. EPA and DHA can be obtained from oily fish and marine n-3 (fish oil) capsule supplements. Alcohol consumption All patients should be advised to lower alcohol consumption. Men should drink no more than 2 standard drinks per day and women no more than 1 standard drink per day. Physical activityThe aim of this measure is to raise physical activity and exercise to the recommended goal of at least 30 minutes of moderate intensity physical activity on most, if not all, days of the week (i. e. 150 mins/week minimum). Maintaining a healthy body weight The aim should be to achieve a waist measure of less than or equal to 94 cm in men and less than or equal to 80 cm in women. The body mass index (BMI) should be maintained at 18. 5–24. 9 kg/m2 Lowering blood cholesterol The aim of therapy should be to maintain blood cholesterol at: †¢Low density lipoprotein (LDL) at – less than 2. mmol/L †¢HDL – more than 1. 0 mmol/L †¢Triglyceride (TG) less than 1. 5 mmol/L The blood cholesterol can be maintained with the use of pharmacotherapy. Statins are commonly used lipid lowering drugs. Those with diabetes and atherosclerosis need stringent blood cholesterol control as well. Other lipid lowering drugs include fibrates like gemfibrosil, clofibrates etc, Ezetimiber and niacin. Lowering blood pressure High blood pressure is one of the important risk factors for cardiovascular disease. Those with coronary heart disease, diabetes, kidney disease or stroke need tight blood pressure control.The aim should be a blood pressure of less than 130/80 mm of Hg. Diabetes and blood sugar control Those diagnosed with diabetes need stringent blood sugar control to prevent cardiovascular damage. HbA1c levels should be maintained at less than 7%. Other drugs to lower risk of cardiovascular disease Other drugs used to lower risk of cardiovascular diseases include: †¢ Antiplatelet agents – this includes Aspirin and Clopidogrel. These drugs when given to patients with risk of heart attacks may prevent such attacks and events. †¢ACE inhibitors like Enalapril, Captopril, Lsinopril and

DIABETES LITERATURE REVIEW Essay Example | Topics and Well Written Essays - 1000 words

DIABETES LITERATURE REVIEW - Essay Example The research was conducted by the National Institute of Health. The method for this particular research was kept very simple where three year cross sectional sample of patients’ electronic health records were accessed and analysed. The research analysed the health records of 21,816 Asians above the age of 35 years. Diabetes was analysed and classified through ICD-9 Codes, laboratory tests, and use of anti-diabetic medication (McNeely, Boyko, 2004). Afterwards, the prevalence of diabetes was analysed in a scientific manner. In terms of the result, it was found that age related prevalence ranged from 5-18% in women and the odds of diabetes in South Asian women were quite high. It was further found that the chances of diabetes were quite high in Asians compared to other populations (Ye, et al, 2009). The prevalence of diabetes was quite high in Asian women mainly because of their diet and lifestyle. Based on the results, it was concluded that the prevalence of diabetes is quite h igh among Asian women compared to other populations (Ye, et al, 2009). Though, obesity was not a major factor leading to diabetes but erratic lifestyle and diet was the major reason behind the prevalence of diabetes among Asian Women. ... an and Pacific Islander Populations: A View from California The overall population of Asian Americans has been increasing at a rapid pace in the United States. Asian Americans include people from India, South East Asia, and Far East and comprise around 4.7% of the total US population. As per the National Health Survey, participants from Asian subgroups were asked questions on their understanding of diabetes in them and around 14% of Asian Indians reported to be having diabetes (Kanaya, et al, 2008).The method for the survey was kept simple based on the analysis of genetic, behavioral, and socio-cultural factors. It was found that in terms of the genetics, various participants suffer from diabetes because of the involvement of genes while many suffer from the insulin secretory defects. In terms of the behavioural factors, it was found that obesity is one of the major factors in diabetes and majority of participants were suffering from the obesity issues. Asian Indians and Filipinos we re found to have more obesity issues. In terms of socio-cultural factors, it was found that low economic status was one of the major reasons behind the prevalence of diabetes (Kanaya, et al, 2008). In terms of the results, it was found that, demographic, socio-cultural, behavioral, and psychological factors play an important and major role in deciding the prevalence of diabetes among Asians. The chances of diabetes were supposed to be higher in South Asian women mainly because of their diet and obesity issues. Moreover, cultural issues like lack of physical movement outside the home and little awareness on the issue of diabetes were factors behind the rise of diabetes in Asians especially in South Asian women. Based on the results, it was concluded that the goals for diabetes prevention and

Housing Finance Essay Example | Topics and Well Written Essays - 1750 words

Housing Finance - Essay Example The housing financial sectors can play very essential and important roles in this process. As a policy officer I had great chances to work with governmental homes, communities, agencies and council of members of that particular locality. With respect to my vast experience in this field I have some views regarding housing and regeneration, which I want to share with the people of Chesterfield Derbyshire. The proposal for housing and regeneration is on account of the great demand of people who cannot forward their housing demands to the open market. The local council members have got the authoritative power of local housing. They are responsible for conducting researches and analysis regarding housing matters and trends. They organize funding for special housing schemes according to social environments. Moreover the environmental factors are very much related to housing and health policies. The awareness regarding these matters will enable to manage the housing and regeneration policies so perfectly. The center for planning and housing research often conduct seminars to verify the currently prevailing situation of housing and housing finance. This enables the housing and planning authorities to adopt methods and schemes to be implemented for the uplifting of the project. These types of seminars are too much worth since they can provide certain views regarding housing schemes and mortgage market. Sometimes these seminars are helpful for designing houses at affordable prices according to market trend. The main disadvantage of this process is the instability of the global economic condition. If the economic instability is prevailing for a prolonged period that will effect the housing and housing financial sector so inversely. In such situations the central and local ministry can do something positive to countercheck the falling trend in housing sector. The authorities of housing, financing, planning and regeneration can do a great deal if the governmental agencies are ready to supp ort them. This associated event will enable them to find out fresh alternatives to deal such unfavorable situations so successfully in both social and private housing sectors. The very common alternative at this juncture is to develop plans to construct houses at affordable costs irrespective of the economic down fall taking place globally. While undertaking this task the government must simultaneously launch measures to reduce the price hike and cost of living among common men, so that the government can succeed in bringing the poverty under control. All these miraculous measures are capable to make the ordinary people feel anything unfavorable with respect to economic recession taking place globally. Role of housing and planning research centers Housing and planning research centers can be commissioned by governmental authorities and community personnel. This is a very suitable suggestion to estimate the improved housing schemes. These innovative housing schemes can be made popularized among people of any concerned locality by providing them suitable awareness and advice. This is very essential to eradicate any existing misunderstanding among the people regarding housing and regeneration process. The advices and awareness class are capable to familiarize people about affordable schemes such as low and medium housing projects. The community planning division can

Feminist theories Why you think women commit crime Personal Statement

Feminist theories Why you think women commit crime - Personal Statement Example According to Einstadter (2006), the rise in the rate of female crimes in the early 1960s and 1970s was due to the fact that most women were adopting male roles thus, masculinising their behaviour and attitudes. On the same note, other scholars argue that immense participation of women in the workforce exposes them to crimes. Consequently, most women in prison are accused of abusing drugs, robbery, shoplifting, motoring, burglary, and fraud. What is clear is that women commit particular crimes at a different level from that of their male counterparts. Therefore, there is a large gap between men and women who commit a crime as it is unlikely to hear women being incarcerated for serious crimes such as murder. Freda Adler who was a theorist related the rise in female crimes to the success of the women’s liberation movement. According to him, the social movements increased women’s prospects and the need to commit crime to meet their societal needs. On the same note, Sigmund Freud argued that although women commit fewer crimes as compared to men, women who are involved in antisocial behaviour do it in revenge due to the fact that they do not have a penis; hence, they assume masculine traits (Cote, 2002). Based on this, it is sound to argue that most women commit crimes because they show masculine biological and psychological orientations. Consequently, they have a desire to be recognized in the society; hence, resort in illegal activities. Burgess-Proctor, A. (2006). Intersections of race, class, gender, and crime: future directions for feminist criminology. Retrieved from

Unit 5 speer review Essay Example | Topics and Well Written Essays - 250 words

Unit 5 speer review - Essay Example Par 5, line 2 and 3: â€Å"This irony here is that the product was at first quite a disaster†. The sentence is unclear or rather ambiguous. Despite its weak construction, the irony being referred to is nonexistent. Par 5, line 3: â€Å"Sven Mattisson, the man behind the technology stated:..† The extra information â€Å"the man behind the technology† should have been enclosed with commas. Moreover, instead of the colon efore the direct quotation, a simple comma should have been used. So the sentence should look like: â€Å"Sven Mattisson, the man behind the technology, stated, â€Å"†¦Ã¢â‚¬ . The content is quite appealing. The introduction is organized and guides the reader throughout the essay by providing an ostensible road map. While the content is profound, little has been done on the development of the Bluetooth technology. The inclusion of the stepwise development of the technology would have bolstered the quality of the essay and the argument being

Obamas budget plan Essay Example | Topics and Well Written Essays - 500 words

Obamas budget plan - Essay Example Obama’s budget indicates that the country’s deficit will increase this year to its highest post-World War II level, and then gradually decrease over the decade. The article indicates, however, that it will remain at ‘troublesome levels’. Obama argues that his budget will save over $1 trillion by ending the previous administration’s tax cuts and by enacting a three year spending freeze. (the spending freeze won’t include spending on health programs, national security, and veteran’s programs) However, the article indicates that the savings are only, â€Å"one-fifth of the size of the debt that will pile up from now to 2020.† Major areas of change will occur in tax cuts. Large budget spending on military equipment will be supplanted by spending on education and civilian research. Taxes among oil companies and affluent citizens will rise. Small businesses, however, will see large amounts of tax reductions over the next decade. Spending will continue on the proposed health care system and energy infrastructure.. Food and drug research and biomedical technology will also receive increased funding. While NASA’s budget will be further reduced, spending on science will rise as the National Science Foundation will receive, â€Å"$7.4 billion, a nearly 8 percent increase from the budget last year.† While Republicans criticize Obama for the rising levels of debt, he argues that his administration will still maintain its goal of reducing the deficit in half before the end of his term in office. The article indicates that spending will necessarily rise as towards the end of the decade with large amounts of retiring baby boomers. Increasing health costs are greatly centered around the Department of Health and Human Services, and the National Institute of Health, both of which are receiving multi-billion dollar increases in funding. The article contends that a number of Obama’s proposed spending cuts may be difficult to enact in

Jukushop Essay Example | Topics and Well Written Essays - 1000 words

Jukushop - Essay Example To ensure effective communication and coordination, Jukushop has an organizational structure which interrelates groups of the organization. Jukushop has adopted divisional structure. Divisional structure is formed when an organization is split up into a number of self contained business units, each of which operates as a profit centre. The division occurs on the basis of the products or market or a combination of the two with each unit tending to operate along functional or product lines, but with certain key functions such as personnel, finance and corporate planning. (Burns and Stalker, 1961) Jukushop has invested heavily on marketing especially in sale promotion. Sales promotion is one of the four promotion mix. The other three are advertising, personal selling, and publicity or public relations. Sales promotions are non-personal promotional efforts that are designed to have an immediate impact on sales. It is usually a media and non-media marketing communication employed for a pre-determined and limited time to increase consumer demand and also to stimulate market demand or improve product availability. Examples of sales promotions aspects include: discounts and sales, free samples, gifts and incentives, coupons and rebates. In their sales promotion, Jukushop has been targeting both consumers and retailers/wholesalers hence they applied consumer sales promotion and trade sales promotion. (Mitchell, 2005) International Involvement Companies that are international involved have a major market to deal with hence they have to be aware of all the required regulations in the international market. They have to be aware of the requirements with various countries and even join a number of international trading bodies. II. INTERNSHIP GOALS A formalized internship program gives a hands-on experience in ones preferred field so that one can truly determine if it is the right industry for him. It is very important for one to participate in an internship program as one receives the exposure to his chosen industry. The beauty of an internship is that it helps one determine what he is looking for in a career before graduation such that one can make adjustments to his curriculum if needed. Internship helps one to apply the skills learnt in college and allows one to identify opportunities for improvement. Recognizing where improvement is needed is essential for one to have proper skill and become competitive in the job market by the time one graduate. For this case, in my internship, I have received a lot of exposure in the marketing field and more so I have applied what I learn in class. III. TASKS ASSIGNED Jukushop being a house of style of pets that are marketed internationally, I was assigned a number of marketing duties in the organization. I was assigned the duty of formulating marketing strategies for the firm. Marketing strategies serve as the fundamental underpinning of marketing plans designed to reach marketing objectives. A marketing plan contains a list of specific actions required to successfully implement a