Type 2 diabetes mellitus

Type 2 diabetes mellitusDiscuss the affirmable design of mental f wagerors end-to-end the course of an malady Type 2 Diabetes Mellituswellness psychology is a topical exploitation in the integration of biomedical and social sciences in wellness c ar. It addresses the role of mental factors in the ca call, progression, and outcome of wellness and distemper (Ogden, 2007). Psychological theories dissolve guide wellness development and promotion, and offer the wellness c are practitivirtuosor a integrated preliminary to dread and contact the wellness get hold ofs of health and social care redevelopment practice sessionrs (Morrison and Bennett, 2009). The liking of health psychology posers gutter assist practitioners in evaluating their contribution to service users understanding of health, behaviors relating to health and the practice of health care. Appraisal and evaluation modify health care workers to apply psychological warnings and theories when analysing aspects of health and conduct relevant to practice (Marks et al, 2005).The ethos of health psychology is that of tr take in the whole person, non just the tangible adaptations that transpire associated with disorder. This world power embrace behavior throw, urging passs in beliefs, and heading st outrankgies, and acquiescence with medical advice. As the whole self is alloted, the someone becomes to a certain extent responsible for their treatment. For case, an several(prenominal) whitethorn establish a certificate of indebtedness to take medication, and to variegate beliefs and behaviour. Therefore, the individual is no thirster seen as a victim. From this viewpoint, health and illness are on a continuum. sooner of being either healthy or ill, individuals may move on along a continuum from healthiness to illness and back again. Health psychology withal argues that the mind and body act together. It perceives psychological issues as non and potential effects o f illness, but as adding to totally the phases of health, from utmost healthiness to illness (Morrison and Bennett, 2009).Health psychology is concerned primarily with indispensable factors, especially individual perceptions of health- cogitate behaviour. Health behaviour, defined as behaviour related to health status, is becoming increasingly authorised. Public health policy has increase the emphasis on individual responsibility and picking and because of this there is a corresponding bespeak to improve understanding of individual motivations that affect those choices and health-related behaviours (Marks et al, 2005). The health behaviours examine by psychologists are varied, but the most leafy vegetablely studied health behaviours drive home immediate or long-term implications for individual health, and are partially within the experience of the individual (Ogden, 2007).Type 2 diabetes, at one era kn induce as non-insulin dependent diabetes mellitus, is a serious and progressive indisposition. It is chronic in nature and has no known cure. It is the stern most common cause of death in most developed countries (UK Prospective Diabetes acquaintance Group, 1998a). Although no exact figures are available, it has been suggested that by the year 2010 there would be 3.5 million muckle with diabetes in the United Kingdom (UK). However, approximately 750,000 of the estimated occur may be undiagnosed (Diabetes UK, 2008a). Diabetes UK campaigns to raise awareness of eccentric 2 diabetes because if left undiagnosed, the condition croup result in long-term complications much(prenominal)(prenominal) as retinopathy, nephropathy, neuropathy, and an change magnitude essay of myocardial infarction and stroke. The total count of peck with diabetes has change magnitude by 75% over the last sestet years and the incidence in the UK is escalating at a faster rate than in the United States (Gonzlez et al,2009).There is a higher incidence of part 2 diab etes in peck with due south Asian or African descent (Department of Health, 2007). One of the reasons for this is thought to be that these ethnic groups apply increased insulin resistance. Signs of image 2 diabetes are already present in UK children of South Asian and African-Caribbean origin at ten years of age, according to look into funded jointly by the British Heart Foundation and the Wellcome Trust (Whincup et al,2010).The preponderance of character 2 diabetes increases with age to as much as one in ten in those aged 65 years. The lifetime jeopardize of evolution the condition in the UK is greater than 10% (Leese, 1991). Diabetes-related complications can dupe a major effect on the individual and family members, and are pricey to the patient. A study undertaken by Bottomley (2001) examined the make ups of living of patients with diabetes complications, including taking time off work and transport costs for hospital appointments. The study showed that the cost of tre ating aboutone with type 2 diabetes with microvascular and macrovascular complications was 5,132 compared to 920 for someone who does non have diabetes-related complications (Bottomley 2001). This also has implications for the National Health Service (NHS) in terms of the financial interference of managing and treating the condition and the use of resources. It has been estimated that the cost of treating diabetes nationally adds up to approximately 9% of the NHS annual budget, although most of that is used to treat associated long-term complications, much(prenominal) as kidney failure, blindness, am set upations and organ transplantation, rather than the provision of medication (Bottomley, 2001).With study to type 2 diabetes, psychological theories and models have a long history of informing attempts to change behaviour and improve turned on(p) well-being. Over recent years, m whatsoever clinical guidelines in the UK by the National Institute for Health and Clinical excell ence (NICE) have included recommendations for psychological interventions for long-term conditions. Evidence-based recommendations have been made non only for the treatment of associated mental health problems much(prenominal)(prenominal) as notion and anxiety (NICE, 2009 NICE, 2004) but also for physical health conditions much(prenominal) as obesity (NICE, 2007) and changing behaviour related to public health issues such(prenominal) as smoking and lack of conserve (NICE 2007). The aim of this essay is to seek the psychological implications for a person suffering from type 2 diabetes and otherwises mixed in the experience of that illness.Type 2 diabetes, is caused as the result of rock-bottom secretion of insulin and to computer peripheral resistance to the execution of insulin that is, the insulin in the body does not have its usual biological effect. It can often be supportled by diet and operation when first diagnosed, but many patients require literal hypoglycaemic agents or insulin in order to maintain satisfactory glycaemic book and prevent the complications of diabetes (Diabetes UK, 2008a). To reduce the chance of long-term complications, both macrovascular and microvascular, people with type 2 diabetes need access to appropriate, individualised education, which informs them about the risks associated with the condition. Information relating to life manner changes such as healthy eating, increasing activity levels, and smoking effect are vital (Diabetes UK, 2008a). several(prenominal) people accept their diagnosing of diabetes and all that this nastys, and curb to adapt to their new lifestyle, but others find it difficult. Changes depart need to be made to the type of food they eat, the keep down they eat of point foods and perhaps to the time at which they eat their meals. As a issuance of the required changes to lifestyle, it is not surprising that many people need some professional psychological support (Diabetes UK, 2008a). Diabetes may have an impact on peoples careers, driving, and insurance policies (life, driving, and travel). Difficulties surrounding holidays, work or travel abroad may prove insurmountable without support. People with diabetes who are also caring for others, for face children or elderly relatives, may find it very difficult to put themselves first (Diabetes UK, 2008a).Some people who have been diagnosed as having diabetes note that they have been condemned to a life where everything has to be planned. There are, however, support ne dickensrks available. For example Diabetes UK, a charity that supports people with diabetes, their families and the health professionals who care for them, has local and regional branches where people can meet and discuss problems and learn from each other how they manage their day-to-day-life (Diabetes UK, 2008a).The majority of people with type 2 diabetes are insulin resistant. Obesity exacerbates insulin resistance. As many as 80% of people with ty pe 2 diabetes are obese at the time of diagnosing (Marks, 1996). Weight loss not only improves insulin resistance, but also lowers blood glucose, lipid levels, and blood pressure. cardiovascular disease is often present in people with type 2 diabetes. The presence of insulin resistance accelerates atherosclerosis, leading to macrovascular complications such as myocardial infarction, stroke, and peripheral vascular disease. The mechanisms responsible for this are thought to be hyperinsulinaemia, dyslipidaemia and hypertension (Garber, 1998). However, microvascular problems such as retinopathy, nephropathy, and neuropathy still occur. The mechanism responsible is thought to be hyperglycemia (Garber, 1998). Therefore, corking blood glucose authority is of crucial enormousness.Although the prognosis for people with type 2 diabetes mellitus is less than favourable, evidence has shown that making major lifestyle changes, such as having a healthy diet, smoking cessation, and increasing activity levels, can reduce the risk of long-term complications (UK Prospective Diabetes Study Group, 1998a). However, using the bane of long-term complications as a means of inducing lifestyle or behaviour changes has not proved to have any prolonged near effect (Polonsky, 1999). Continued support and appropriate education is required to indue individuals to take charge of their condition and make appropriate and timely remedial terminations. The healthcare professional and the individual must decide on the most appropriate treatment regimen to provide optimum care and the trounce medical outcome (Marks et al, 2005). NICE published a document in 2008 entitled CG66 Type 2 diabetes which recommended that all people with diabetes should be offered structured education, provided by a trained specialist group of healthcare professionals (NICE, 2008). The engagement of theoretical health psychology models can assist these specialist team practitioner in empowering individuals wi th type 2 diabetes to contemplate and instigate the changes in lifestyle behaviours such as smoking, lack of exercise and unhealthy eating habits that have adverse consequences on long-term health outcomes.With run into to health psychology, as previously mentioned, health psychology is concerned primarily with infixed factors, especially individual perceptions of health-related behaviour. Attributing health-related behaviours to infixed or external factors has been discussed in similitude to the concept of a health venue of control. Individuals differ as to whether they regard events as controllable by them (an upcountry locus of control) or intractable by them (an external locus of control) (Ogden, 2007). Accessing diabetes related health services for test or treatment could be viewed from either perspective. The healthcare professional is comprehend to be a powerful individual who can diagnose and treat diabetes (external) however, by accessing services the individual is taking responsibility for determining their own health status (internal). It is useful for the healthcare practitioner to accept that in attending diabetic health services the individual has made an sign bar in taking control of their own health needfully (Marks et al, 2005).Individuals with an internal locus of control are more(prenominal) likely to act in concordance with advice from a health professional than those with an external locus of control (Ogden, 2007). Knowing this can assist practitioners in their communication style with individuals who have type 2 diabetes. Identifying the specific needs of the individual, by understanding their locus of control, can cooperate the healthcare practitioner to tailor the mind (Marks et al, 2005). When an individual has a sense of responsibility for actions or behaviours that exposed them to a potential risk of diabetic complications, the practitioner can work on exploring the circumstances that surrounded those behaviours. The individual may already flavor cause to change these circumstances. In the case of a client who does not lie with that their own behaviour or actions were a contributory factor in posing a risk of behaviour related complications, the practitioner should prudence on developing the individuals level of awareness to shift their locus of control from the external to the internal. For example, the individual who perceives that taking responsibility for healthy eating use is always that of their partner (Ogden, 2007).Self-management for chronic illnesses such as type 2 diabetes requires tenderness to treatment regimens and behavioural change, as well as the acquisition of new deal strategies, because symptoms have a great effect on many areas of life (Glasgow, 1991 Kravitz et al,1993). For many individuals, optimum self-management is often difficult to achieve, as indicated by low rates of adherence to treatment, reduced quality of life, and short(p) psychological wellbeing, effe cts that are frequently encompassed in some(prenominal) chronic illnesses (Rubin and Peyrot, 1999). Self-management interventions aim to enable individuals to take control of their condition and be actively involved in management and treatment choices. In the 1980s, psychological theory was applied to develop theoretical models and their constructs have had a event effect on the development of self-management interventions.The Health Belief exercise (Becker 1974) defines two related approximation processes undertaken by the healthcare practitioner in league with an individual the aff indemnify of illness and the behavioural reaction to that threat. Threat appraisal involves consideration of the individuals perceived susceptibility to an illness and its anticipated severity. Behavioural response involves considering the costs and benefits of engaging in behaviours likely to reduce the threat of disease. It can be useful for the healthcare practitioner to establish the clients perception of risk and implications of their adverse health behaviours when discussing the reasons for healthy eating, increasing exercise, and smoking cessation. It is also important to discuss the likely impact of diabetes on the individuals lifestyle and behaviour (Marks et al, 2005).The Health Belief Model can be applied to evaluate the risk of lifestyle changes. The healthcare professional can initiate structured raillery with the individual to identify their educational needs, particularly around developing a realistic understanding of risk factors associated with diabetes and unhealthy eating habits, lack of exercise and smoking. It is important for the healthcare practitioner to discuss the efficacy of changes in the in a higher place in prevention of diabetic complications, while discussing other methods of behaviour modification in context (Marks et al, 2005). It is also important to establish that the individual feels surefooted in the practicalities of and behavioura l change. Therefore, the healthcare practitioner must support the diabetic in behaviour change by giving practical health education advice on the issues of healthy eating, the benefits of exercise and the immensity of giving up smoking (Marks et al, 2005).The Protection demand Theory (Rogers 1975, 1983) expands the Health Belief Model to include four personas that predict behavioural headings to improve health-related behaviour, or intention to veer behaviour. These include self-efficacy, responsive strongness, severity, and vulner big businessman. In social cognitive theory, behaviour is thought to be affected by expectations, with individuals confidence in their ability to perform a given behaviour (self-efficacy) particularly important (Bandura, 1992). Therefore, self-efficacy can be said to be the belief in ones ability to control personal actions (Bandura, 1992), and is comparable with the concept of internal locus of control. It is based on past experience and evokes beh aviour concordant with an individuals capabilities. Self-efficacy is distinct from unrealistic optimism and does not elicit unreasonable risk-taking (Ogden, 2007). Within the context of smoking and diabetes, an example of self-efficacy might be, I am confident that I can take responsibility for protecting myself from increasing the risk of further complications by giving up smoking. This concept has been used in self-management interventions through the teaching of skills, such as problem solving and goal setting, to increase self-efficacy. Again, in type 2 diabetes, this could mean the acquisition of knowledge relating to healthy eating principles and putting that knowledge into practice by repealing foods that would make the blood glucose rise quickly. The goal would be to incorporate this behaviour into daily life on a long-term basis (Marks et al, 2005).Behavioural intention can also be predicted by severity, for example Diabetes will have serious implications for my health and lifestyle, but conversely, uncorrupted blood glucose control will decrease the risk of diabetic complications. The fourth predictor of behavioural intention is vulnerability, which in the context of diabetes may be the likelihood of cardiovascular disease or diabetic retinopathy occurring. Rogers (1983) later suggested a fifth component of fear in response to education or discipline as a predictor of behavioural intention.The concepts of severity, vulnerability, and fear describe in Protection Motivation Theory relate to the concept of threat appraisal, as discussed in the context of the Health Belief Model. Self-efficacy and response military posture, on the other hand, relate to the individuals grapple response, which is the behaviour intention. If a person has self-efficacy and perceives benefits in taking control of their actions (response effectiveness), they are likely to have the intention to modify their behaviour to reduce health risks (Ogden, 2007). Information or ed ucation that influences an individuals emotional response can be environmental (external influence, such as advice from a health professional), or interpersonal (relating directly to past experience). Information and education contribute to an individuals self-efficacy. This in turn helps develop a robust internal locus of control and will inform and/or contribute to the individuals coping response (Marks et al, 2005). The coping response is considered to be adaptive (positive behavioural intention) or maladaptive (avoidance or denial). Assessment of the individuals capacity to understand and apply information and to have an adaptive response is a vital skill of the health professional. A maladaptive coping response, such as the denial of set risk factors, has potentially serious consequences for the health of the individual (Marks et al, 2005). Successful carrying out of the Protection Motivation Model can enable informed choice and empower the individual to take personal respons ibility and control of behaviours influencing their health (Morrison and Bennett, 2009). Skilled questioning and the use of checking skills by the healthcare professional sideline information-giving are important to evaluate the benefit, if any, to the individual with diabetes (Ogden, 2007).Readiness to change is a concept derived from Prochaska and DiClementes (1983) transtheoretical model. It refers to how prepared or ready individuals are to make changes to their behaviour. Interventions head by this theory focus on individuals motivation to change and the approach is adapted according to differences in participants motivation to change behaviour. Success is achieved only when the individual is ready to take on the actions needed to change behaviour. An individual may know that smoking and type 2 diabetes are not a beloved combination. However, unless the person is ready to quit smoking, no amount of discussion with a healthcare professional will change the persons decision to continue smoking. Establishing an internal motivator is a good first step to assessing an individuals readiness to change, however, an individual also needs to feel that the time is right and that they are prepared to change. Readiness to change can be assessed by asking individuals, as soon as the potential problem is set, whether they have ever attempted to change the behaviour before. Six stages of change were identified in Prochaska and DiClementes (1983) Transtheoretical model of behaviour change Pre-contemplation Contemplation Preparation bodily function Maintenance and Relapse.Most people (around 60%) will be at the pre-contemplation stage when they are identified by the healthcare practitioner and will generally react in a closed way to the idea of change (Prochaska and Goldstein, 1991). They may be rebellious to the idea, they may rationalise their occurrent behaviour or be resigned to it, or they may be indisposed to consider the possibility of change (Prochaska and G oldstein, 1991). In this situation, it is tempting to push people into making an attempt at behaviour change using their health as a motivator or by making them feel guilty. However, this is likely to prompt the individual to either lie about their behaviour or avoid the nurse completely. During the contemplation phase, it is suggested that individuals who are starting to consider change look for information about their current and protruded behaviours, and analyse the risks involved in changing or maintaining their current behaviour. The most appropriate action is to ask the individual to formalise the analytical process by projection a decisional balance exercise (Health Education Authority (HEA), 1996). In this exercise the person is asked to consider the positive and negative implications of maintaining or changing their behaviour. The individual then decides whether maintaining or changing the behaviour will give them increased positive outcomes, and if they are willing to at tempt the change. To be at the cooking stage, individuals need to believe that their behaviour is causing a problem, that their health or wellbeing will improve if they change the behaviour, and that they have a good chance of success (Prochaska and Goldstein, 1991). Once the healthcare practitioner establishes that the individual has an internal motivator and is ready to make an attempt at behaviour change, a supportive treatment plan is needed. Individuals who are in the process of behaviour change, or who have achieved and are maintaining the new behaviour, need help to avoid relapse (Prochaska and Goldstein, 1991). The most effective way to do this is to ask the individual to reflect on their experiences so far.Apart from taking into account the management behavioural change for those with type 2 diabetes, it is also of vital importance that there is a consideration the emotional impact of a diabetes diagnosis and living with the condition. How patients feel when presented with the diagnosis of a chronic illness such as diabetes can have an enormous impact on their lives, and on their ability to make emotional adjustments to the disease itself (Marks et al, 2005). Research has comprise that that the diagnosis of a chronic illness can have a good emotional impact on individuals, with reactions of grief, denial and depression. The emotional aspects of developing and coping with diabetes can affect overall control of the disease profoundly. Similarly, these feeling may form a barrier to effective listening and learning during the credit process and any future self-management strategies. Therefore, it is proposed that this should be taken into consideration when developing educational programmes and protocols for people with diabetes (Thoolen et al, 2008).Coping and adapting to a long-term chronic illness is a major theme in health psychology (Ogden, 2007). Leventhal Nerenz (1985) propose that individuals have their own common sense beliefs about their il lness. These include indistinguishability diagnosis (diabetes) and symptoms (elevated blood sugar levels, excessive hunger and excessive thirst). comprehend cause of illness distort, a virus, unhealthy lifestyle. Time line keen or chronic. Consequences physical (pain, mobility problems) and emotional (lack of social contact, anxiety). Cure and control for example by taking medication or getting plenty of rest. With regard to adapting to an illness such as diabetes, the stress coping model of Lazarus and Folkman (1984) Transactional model of stress is the concept that is most widely utilised.The model suggests that there are key factors in adaptation to chronic illness, disease-specific coping efforts, changes in illness representation over time, interaction between psychological reality of disease and affective response, procedures for coping with the disease and interaction with context. The stress coping model (Lazarus and Folkman, 1984) emphasises the value of coping strateg ies to deal with a particular condition. Self-management strategies based on this model attempt to improve the individuals coping strategies. In type 2 diabetes, people are faced with the prospect of long-term complications caused by the condition. If people are aware of these possibilities and also that no-hit treatment is, available it makes a diagnosis of such problems less daunting. However, there are demarcations to this model. It is debated that it is a strain of reference, not a theory that ignores specific features of the illness. The situation dimension seedy represented and it is not specific. The model also neglects interactions with context (e.g. social support, other life events) and offers no account of life goals on illness representation and coping (Ogden, 2007). It is of vital importance that stress is controlled and managed in an individual with type 2 diabetes. Research has shown a link between stress as a causal factor and that stress has been found to be a f actor in regulation of blood glucose regulation. Sepa et al (2005) found that family stress has a significant impact on the and development of diabetes among infants. With regard to stress and metabolic control, research has found that stressful life events predict poor glucose control. In a study by Surwit et al, (2002) the management of stress was found to improve glucose control.Therefore, it is posited that the impact of stress can affect diabetes adversely and any interventions to manage stress may be a worthwhile component of diabetes education programs.An additional influence on coping and adapting to living with diabetes and the development of self-management strategies has come from clinical psychology, particularly Cognitive Behavioural Therapies (CBT). Central to these therapies is the importance of attempting to change how people think about their illness and themselves, and how their thoughts affect their behaviour. low gear is one of the most common psychological prob lems among individuals with diabetes, and is associated with worse treatment adherence and clinical outcomes (Gonzalez et al, 2010). A randomised controlled trial (RCT) undertaken by Lustman et al, (2008) found that the function of patients achieving remission of depression was greater in the CBT group than in the control group. Although the research found that there was no difference in the mean glycosylated haemoglobin levels of the groups post-treatment, put through mean glycosylated haemoglobin levels were significantly better in the CBT group than in the control group. Therefore, it is debated that the combination of CBT and supportive diabetes education is an effective non-pharmacologic treatment for major depression in patients with type 2 diabetes. It may also be associated with improved glycaemic control. It is important to note however, that certain limitation apply to the above study that may have an effect on the findings.The generalizability of the findings is uncerta in. The study was limited to a relatively small number of patients. Similarly, the follow-up interval was limited to the 6 months immediately after treatment. Likewise, the researcher cannot exclude the possibility that CBT and diabetes education interacted in a way that potentiated antidepressant effectiveness analogous interactions may have occurred in many clinical trials. merely studies comparing CBT and diabetes education, individually and in combination, are needed to answer such questions and to see whether successful CBT alone is sufficient to produce glycaemic improvement. Correspondingly, it is worth noting that patients in the CBT group had education almost a full year longer than controls. The difference in education was not statistically significant, but the duplication educational experience may have contributed to improved outcome in the CBT group. Finally, treatment was administered by a single psychologist experienced in the use of CBT. Whether treatment would be as effective when administered by other therapists is uncertain.For any person with type 2 diabetes to engage in any self-management strategy, good mental health is necessary. However, studies have shown reduced self-worth and/or anxiety in more than 40% of people with diabetes (Anderson et al,2001). There are several possible reasons for this. Being diagnosed with diabetes immediately poses major concerns for the individual, including what the future holds in terms of health, finance, and family relationships. Although everyone deals with diagnosis differently, for some it can cause immediate stress, including feelings of shock or guilt. Some individuals may also be ashamed and want to keep the diagnosis a secret. Others may be relieved to know what is causing the symptoms they have been experiencing. An Audit Commission (2000) report acknowledged that people with diabetes are more likely to suffer from clinical depression than those in the general population. The report then went on to specify that therefore, diabetes services should make explicit provision for psychological support and should monitor the psychological outcomes of care.In conclusion, to be successful in changing behaviour to negate the complications of type 2 diabetes, individuals need to decide for themselves which behaviours are undesirable, that is, which behaviours could have negative health, financial, social or psychological implications. People with diabetes also need to feel that the negative impact of forged health behaviours will be reduced or altered if they change their behaviour. It is important that individuals have confidence in their ability to make and maintain behavioural changes. It is not the health practitioners role to make this judgement or impose his or her beliefs. To support behavioural change, healthcare professionals need to feel comfortable in discussing lifestyle behaviours. They also need to assess an individuals prep to make a change and identify the factor s that motivate them to change. The application of health psychology models, such as the Health Belief Model, the Protection Motivation Theory and the Transtheoretical model of behaviour change, to the management process can enable healthcare practitioners to assess contributory factors to health behaviours. Applying models can also help to identify motivators and barriers to health-improving and health-protecting behaviours, and identify strategies which assist the person in behavioural change. The role of the healthcare professional is to enable individuals to make an informed choice by working in partnership with them to decide when and if behaviour change is desirable. By understanding how an individual copes and adapts to living with a long-term condition such as diabetes can assist in empowering individuals to managed stress that appears to have a negative im

Importance Of Exercise And Diet Health And Social Care Essay

Importance Of Exercise And Diet Health And Social C atomic number 18 turn upExercise and diet is considered to be an important determinant of advantageouslyness and sickness. Historically, a fat child means a ample child, one who is loosen from infection. Today obesity or heavy(p) in children, very a lottimes related to degenerative diseases is mainly due to improper exercise and dietetical pattern. According to World Health Organization (2004), Body Mass list in the midst of 25 and 29.99 is considered as grievous.Over load is associated with the assault of major chronic diseases leading to complications and problems in children and adult. Childhood obesity/ all sound is very often a risk factor for obesity in adulthood, compared to adult onset obesity. Hence close monitoring of overweight and taking timely preventive measures volition be an effective approach in dealing with the problems. incidence of childhood overweight is on the rise since last few decades and is pacify continuing to rise. Since the 1970s, the prevalence of overweight children has to a greater extent than doubled for pre schoolers ages 2-5 years and adolescents antiquated 12-19 years and it has more than tripled for children 6-11 years. Nearly one third of children and adolescents of two sexes, gray 6-19 years (30%) are considered to be either at risk for overweight(The Center for Health and Healthcare in Schools 2005). The transition in nutrition, inactive life style, lack of exercise, ontogenesisd television watching, computer addiction, improper dietary pattern adopted by children today are the major causes for overweight seen in children. The World Health Organization has identified school as important settings for promotion of physical activity among children. Physical bringing up provided at school, is an ideal way to encourage activity and develop fitness among children. For this reason, the Centers for distemper Control and Prevention (CDC), the National Asso ciation for Sports and Physical Education (NASPE), and the American Heart Association all recommended comprehensive daily physical statement for children Kindergarten to 12th standard.The aim of this subscribe was to assess the experience on corpse weight and its maintenance among overweight children and to assess the say-so of self instructional booklet.The conceptual frame work used for this study was based on titler et al (2004) effectiveness model. A quasi experimental pre test put test require crowd design was used to assess the effectiveness of self-instructional booklet on body weight and its maintenance among over weight children.The study was conducted in a selected school with a sample of 60 overweight children studying in 7th to 12th standard samples were selected by purposive sampling method. First 30 samples were assigned to the control group and the next 30 samples were assigned to the experimental group.The tool for this study was a structured questionnaire. The questionnaire consisted of 2 parts.Part I was developed to assess the familiarity of over weight children in relation to body weight, diet and exercise. Each were consisted of 5 multiple response questions. Part II consisted of selected demographic variables such as age, educational qualification of father and mother, occupation of father and mother, family income, items at home, family fodder geek and items.FINDINGS OF THE STUDYDemographic characteristicsDemographic characteristics presents that to the highest degree in both the groups the children under the age group of 12-14 years, had family income above 10,000 and major facilities like television, cycle per second and cycle. And most of the fathers were private employees and mothers were nonworking. All the mothers are literate and majority20 23(66.7% 76.7 %) of children in both the groups had Body Mass Index value between 25 and 27.5.Body weight and its maintenanceOverweight children were grouped into two, experimen tal group and control group. It was noted that in both the groups the knowledge of children assessed were almost similar in forrader intervention. In after intervention children gained knowledge in experimental group and children remained same knowledge in control group.Significant FindingStatistically there was no significant differences in the knowledge score between experimental and control group before intervention and statistically there is a significant difference of knowledge in experimental group between before and after intervention. This increase in knowledge of the experimental group could be attributed to the self-instructional booklet.CONCLUSION nice health leads to a normal life. To promote the health of the child and quash the danger of over weight and obesity, it is important that children are encouraged to bring in near form of physical activity on a regular basis and good dietary pattern. These above facts highlight the select for self discipline in a child to live a healthy and active life. People are more lethargic when compared to their ancestors. foregoing children spent the majority of their free time playing outdoor games which meant that they were automatically getting more physical activity. Currently there are more organized sports activities but still fewer children participate in them. umteen prefer to play video games or watch television which is assisting in their weight gain. The remote control, video games, the automobile, television, and to some extent the computer are all part of the environment which discourage people from being physically active.Healthy eating and exercise habits should be thought as a pair, one cannot go without the other, for the childs best health.This can be developed only with education. There is lot of education available today with magazines, televison, posters internet etc. But these children dont show any interest in that. Perhaps material is readily available in hand children will read it and may follow it.LIMITATIONSExact response cannot be judge from the children. These self-reported data may not exactly reflect the reality of respondents.IMPLICATIONSThe study has its implication in nursing practice, nursing education, nursing administration, nursing research, well-disposed pediatrics and community.breast feeding PracticeNursing professionals can provide a better frame work for healthy life style and school based programs. Nurses understand the biologic, psychological, causative and social aspects of being an overweight and their relate on health. The nurse can render awareness by education of the parents and children at the school, hospital and community level.The nurse can also change the knowledge of parents, children and school teachers by conducting education awareness program and by pleader. A healthy life style is important for the proper emersion and development. Guidance and Counseling services should be arranged timely, provided with adequate kn owledge, verifying support to make the child as a healthy element of society in future.Nursing EducationFindings of the study have some implication for nursing education. The health care system pays more aid on the training of nursing students and school teachers. So that they will ask more knowledge and will be able to help oneself in knowing the importance of healthy lifestyle. Motivation to change and psychological counseling technique is the key to any lifestyle intervention. Teaching about healthy diet and the importance of maintaining moderate physical activity in two-year-old children is important as obesity is more easily prevented than treated. It is important to drive preventive efforts early in childhood.Nursing AdministrationNursing administrators should be necessarily involved in formulating policies for health education program in the school, hospital as well as community settings. All the heathland education and school based program should integrate education on healthy diet and regular physical activity in children.Nursing ResearchThere is a need for extensive research in this area. The findings of the study help to expand the scientific body of knowledge upon which notwithstanding research can be conducted.In the CommunityThe community health nurse has an important role as health educator, health plugger and health protector in the community. During home visits the nurse can break the vulnerable overweight children and observe different lifestyle adopted by the family and children. Nursing personnel working in the community should be stipulation in service education to update and improve their knowledge regarding overweight and life style practices. Within the healthcare community, the multidisciplinary team might allow in a primary physician, a diabetic educator, a nurse, a dietitian, a fitness counselor and a social worker as well as the patient and family. Educating and counseling the obese and over weight children and their pare nts through media is vital. Healthcare professionals should also become involved in setting up new community programs to promote healthy lifestyle.RECOMMENDATIONSBased on the findings of the study, the police detective proposed the following recommendations.A replication of present study can be done with large sample.Maximum publicity should be given through mass media for educating knowledge among children regarding body weight and its maintenance.A similar type of comparative study can be done between urban and rural settings.A present study can be conducted with considerable duration by assessing BMI andLifestyle practices before and after intervention.

Glaxosmithkline Business Strategy

Glaxosmithkline Business StrategyHowever, save in this study we whollyow get to k promptly the core elements of GSK, its let out drivers of change, incidentors for it success, grievous vexation strategies and the extent at which it has been able to align these with its resources and capabilities.2. secern DRIVERS FOR CHANGE AND CRITICAL SUCCESS FACTORS2.1 core elementsOver the eld the pharmaceutic labor has played an important role alongside other economic system sphere of influences1in contributing to the UK delivery. As the economy gets older the more(prenominal) grounded the fabrication becomes, by acquiring strategies of merging and acquisition to expand and form the main companies/competitors of the industry like Pfizer, GSK, Sanofi-Aventis, Novartis, Roche etc. The pharmaceutical industry is the leading sphere of influence in the UK, investing about 10 million daily on R D2(Euromonitor 2004),employing well-nigh 73,000 concourse and by being self-consistent i n the top three(leading in 2007) ranking of trade surplus(ABPI 2007). Furthermore, laying more emphasis on one of the main companies in the welkin (GSK) who feature 9.0% of the sectors market share after the largest share holder of the sector (Pfizer 9.3%)(ABPI 2007). In getting to know its level and intensity of market opposition, the Porters five forces testament be used in for the analysis. This frame pass water was designed by Prof. Michael E. Porter of Harvard business school to determine the degree of competition at bottom an industry (D. Campbell 2005). These five forces are bargaining designer of suppliers, bargaining power of buyers, threat of new entrance, threat of substitute products and competitory competitor. For the purpose of this cogitation we allow for be looking solely at competitive rivalry but considering the circumstance that the other four forces determine its strength. This is where industries in the sector convergek to maintain and gain more marke t share both by contrastiveiation, innovation etc.(D. Campbell 2005).GSK acquired Stiefel for 2.5 billion few months ago, Merck took over Schering Plough for a wide- neglect of 29.8 billion and, Pfizer s merger with Wyeth (guardian 2009), these activities shows that the giants of the sector are breed to maintain and if possible acquire more market share by acquiring smaller companies .2.2 key drivers of changeThese are some international factors that affect GSK either positively or negatively and to an extent helped to her incumbent position. This will be analysed with the used of PEST analysis frame work which are analysed belowPolitical concerning the normal of practice of medicines licensing, the government has had a vertical agreement with the industry (PICTF 2001) which will improve competitiveness within the European Union (EU). fit in to (PPRS 2009) the NHS must take hold access to medicines of reasonable price, whole tone brands in fix to promote competition i n the sector. The measure regulation has been a problem for the industry as it affects her UK based companies due to the purpose of addition in tax rate and taxing foreign profits (Buchanan, Barbara 2008) which has produced migration of companies like Shire pharmaceutical.Economic the hit of recession on the UK economy has chaired to summation in inflation rate which affected the pharmaceutical sector but not as much as other sectors (BBC 2009). With the fact that in that location is a shake in inflation rate, increase tax rate, wage drops. The average familys disposable income drop by more than cl a year (times online 2009) which has affected the passing power of the population.Socio -cultural- over the age in that location has been a change in peoples lifestyle whereby they go for seaworthiness and health clubs at the expense of taking fitness and health medication. in that location has been an increase of 23% in segmentship between 2004 and 2008 and recently there h as been 10% increase in the number of adult members despite the backwardness in the economic (Mintel 2009). However it has been discussed that there has been an increase in nonprescription(a) drugs due to the fact that peoples now practice self medication because of tyke illness (Bainbridge, Jane 2008) which has made the sector rise by 23% since 2003. The ripening population might be an opportunity for the sector since they are tends to have diseases like rheumatism and insomnia.Technological- over the old age the use of technology has yielded cypher but positive effect on industry. The UK government comports GSK, Welcome Trust, and EEDA to maturate a biotechnology science park in the UK in order to strengthen the industrys bioscience to compete against those in other countries (PBR 2009). Technology has helped to become blockbuster drugs in the past and the membrane technology used in biopharmaceutical discovery, development and commercial production worth of $740 million in 2004 has increase to $1.23 billion in 2009 (BBC research 2004) which is as a result of its increase in research and technology.However havent analysed the external factors affecting the pharmaceutical sector, it is transparent that although some factors have affected the company negatively but she take over maintained her market share and position in the economy because people keep spending on medication no matter the difficulties because benefit is essential.2.3 Critical success factorsThis simply point at the products features that are wanted by a collection of guests and therefore, where the organisation must excel to outputerform competition (Johnson 2005) which can be said to identification of customers needs and things exceptionally through for this purpose which gives them competitive advantage. For a clearer knowlight-emitting diodege, strategical groups in UK pharmaceutical will be briefly analysed.Strategic group- companies vary in different shipway which make some operate similarly that differentiate some from others. In the UK pharmaceutical industry there are two main groups generic and Proprietary group. The proprietary group adopts strategy of high price charges, patent of invention drugs because of high RD spending and stress which makes the prone to high risk (high loser rate in drug development) and returns. The generic group concentrate on low price, low RD spending and imitate drugs made by companies in proprietary after expiry of patent. (Hill Jones 2007) .GSK spend 300.000 on RD every arcminute and spends over $500million to develop a new drug that takes up to 12 years (Mintel, 2007), which obviously tells its membership of proprietary group.However havent identified GSKs strategic group in UK, its main rivals are the companies that belong to the kindred group and perform similar activities like Pfizer, Merck..who stand as threats to its profit because consumers see them as substitute for each other whereas patent can cause low substitute. Due to this it is hard for companies in generic group to blend into this group because of high RD spending and skills. Gaining the idea of GSKS business model, the critical things it does for it extract and to meet the needs of its customers and attract more will be mentioned bellow. advert and Marketing in 2001 GSK handed a 53 million government note to Mediacom to buy activities for its British customers (Marketing 2001) and support its media plan and to a fault spent 1million to support its sensodyne brand Television campaign(Chemist and Drug 2002). It also market 30 vaccinums all over the world (Datamonitor 2009)Merger and Acquisition the formation of GSK in 1998 resulted to increase in sales the following year, huge number of staffs, increase RD readiness and have more products to meet customers needs (Smithklines four promising drugs in final stage of production and Glaxo Wellcomes blockbuster drug Zantac) (Lazo 2001)RD and Innovation it is impo rtant for pharmaceutical company to come up with faster ways of repossess for diseases and always find a solution to new diseases. Due to this fact and business model GSK spend 300,000 on RD every hour (cio100 2009) in order to keep up with the trend of continues discovery which leads to several innovations. According to (Datamonitor 2009) GSK has 40 major products and as RD continues, more innovations are to come.3. KEY transaction STRATEGY3.1 mini introductions (past 5 years)Over the past five years GSK has engaged in adopting different strategies for the success of its business and meet customer needs (Emerald 2009) and the Porters generic strategy will be used to refer these strategies.3.2 porters generic strategyMichael Porters gave his view of business strategy as the different ways that companies take to achieve competitive advantage in the industry (Drypen 2009) which he classified as Cost leadership, Differentiation and Focus. He explained hail leadership as a strategy of low cost business operation to have an edge over rivals in the industry and specialism as a strategy of producing unique products valued by customers and might attract high price charges. He lastly describe focus as a strategy that targets a particular group or class of people whereby focusing for either reason of cost (cost focus) or differentiation (differentiation focus) which is usually low in volume.Taking note of the proprietary group and its characteristics, it is argued that GSK operate using the differentiation strategy which is be highlighted below.Non- immobilize RD strategy- GSK has always engaged in huge spending on RD as to develop its own drug and patent it as a member of proprietary and recently has led immediate rival Pfizer on a hidden RD partnership journey (Invivo 2009). Although their partnership was known to the public for sales of HIV drugs but here lies the secrete behind it.Sales merchandising strategy- with the help of Vodaphone , GSK was able to mar ket its Flixonase spray to cure hay pyrexia to its customers through mobile text messages and its sales team (mobile merchandising 2006) which makes it marketing standout from others.Outsourcing strategy- GSK and Galapagos Biotech formed an innovation alliance for the purpose of novel medicine osteoarthritis (A. Hoekema 2007) which GSK did with main intent of outsourcing for innovation because of expiry of patent. intricacy strategy- GSK formed a partnership with Dr. Reddys a generic drug maker in India and also bought 16% of Aspens stake, a generic drug maker in southwesterly Africa (mintel 2009). Its main objective was to have access to acclivitous market and generic drugs, sell many of it drugs (reduced rate) in Africa, Asia and Latin America.However it has been argued that GSK operates under differentiation strategy but we can see that as a result of patent expiry which led to direct completion with generic drugs, it changed strategies to do business with generic drug makers and use these avenue to penetrate emerging markets too boost it sales.4. RESOURCES AND CAPABILITIES4.1 introductions (past ten years)Over the past ten years GSK had developed some strategies as shown earlier in the report, we will be looking at its resources, capability and how it has been able to make these work in concert to actualise the strategies above to gain competitive advantage. These resources and capabilities can be wand which is the necessary ones needed for it to function and compete in market fleck unique resources and core capabilities are those different, distinctive, to imitate ones that make companies gain competitive advantage over others in the industry (G. Johnson et.al 2005)4.2 Companys resources and capabilitiesGSKs threshold, unique and core resources and capabilities will be reviewed below.Threshold resourcesStrong RD of new medicines- over half of GSks total sales come from blockbuster drugs which has made them rely on lodge out of the drugs over the yea r (A. Townsend 2004). This has made them to make effort of underdeveloped more drugs as patent of the former expires.Skilled and talented staffs- as at 2008, GSK UK employed 99,003 staffs which includes scientists, pharmacist, IT3, sales (Datamonitor 2009)Large number of employee Gsk employs 99,003 people in 2008 (Datamonitor 2009)Employee motivation- GSK motivates their staffs with making salaries and bonuses competitive and reward for their performance.Supplier, buyers and stakeholders- GSK is a leading supplier of drugs and vaccine to NHS, fund academic research.Merging to gain more brand awareness- GSK is presently partnering with Pfizer to make a mega sell of HIV drugs.Capital for RD- it has been known that GSK spend over $500 million to develop a new medicine and takes 12 years or more (Mintel 2007)Unique resourcesGood reputation- GSK happens to drop curtain amongst the first five of the worlds most admired pharmaceutical companies. (Mintel 2009)Threshold capabilities tyco on to reduce cost- GSK has been slashing prices since 2001 after the merger and moving of some of his pecuniary jobs to low cost countries like China and Poland. They have been able to cut cost by increasing money paid on its high selling drugs in order to reduce cost on it drugs face with generic competition (Guardian 2005)Partnering Partnership with other biopharmaceutical companies to develop drugs to fight ailments e. g it partnership with Nabi for monoclonal antibodies to stop smoking (Silico research 2009)Core capabilitiesThe spectacular merger- the merger between Glaxo Wellcome and Smithkline Beecham which made it acquire block drugs, second largest consumer goods shaper in tooth paste and energy drinks (Lazo 2001)Dynamic capabilitiesThe earlier stage of mergers where companies of the same view came together , which was known as the massive merger that led to consolidation in pharmaceutical industry and formation of gsk.Later there was acquisition of smaller firms like the biopharma, science and biotechnology firms. Gsk acquired lot of these companies around this time.The last stage can be described with what is happening now in the industry where companies outsource, restructure and expand. Gsk has engaged in series of outsourcing and expanding activities. deal merging with Galapakos biopharmaceutical in order to outsource and avenue to enter emerging market (A. Hoekema 2007)4.3 extent of alignment into business strategySWOT abridgment According to (G. Johnson et.al. 2005) swot help to give a look on how the key environmental issues and capabilities of a company will affect its strategic development. And (R. Lynch 2009 p302) sees it as analysis of strengths and weaknesses present internally and opportunities and threats approach organization externally.STRENGHTSStrong sales and marketingRobust sales forecast to lunch portfolioStrong brand nameDemonstrated ability to sway cost loftyly innovative RDAdvanced technologyProfitabilityExpansionStr ong rebranding imageFinancial abilityWEAKNESSESRestructuring requiredFailure of subscriber line to deliver initial commercial expectationOver dependent on leading productsLack of block buster drug launches after the great mergerOPPORTUNITYEmerging new markets for pharmaceutical companies in developing countriesPipelines to deliver strong growth for next few yearsHigh growth oncology marketContinued cost reductionSmaller biotech and biopharms affrightIncreasing cost of RDGeneric competition with high selling products policy/regulation5. CONCLUSION

Indicators of Country Development

Indicators of Country DevelopmentThis lesson deals with the mixer and other indicators of let outment. Increasingly, outgrowth economists deem become aware that growth of outfit or income by themselves are not adequate indicators of tuition, and that the reduction of beggary and the satisfaction of basic military man needs are goals that should show up in a measure of phylogenesis. on that point has been growing enkindle in designing better measures of knowledge, including modifications of GNP, affectionate indicators and associated systems..________________________________________________________________________________ObjectivesAfter going with and by means of this lesson, you should be able toDescribe the supplementary nature of socio- frugal factors.Describe the importance of kind indicators.________________________________________________________________________________________6.1 conversation colloquy is overlap of make outledge, education and get it on. It makes masses understand, persuade, convert or overlook one another. It is a two way swear out. Communication is an essential element of life. It begins with the birth of a man and ends with his death.It is an ongoing process and is everlastingly in motion. For the sake of convenience we may talk about discourse elements such as source, context and message as if they were static and trenchant elements alert apart from their role in the total act of intercourse. yet this is simply a method for explaining and illustrating the miscellaneous elements.Basic everyy, intercourse is a continuous, dynamic, circular, unrepeatable, irreversible and complex process. All the activities of not wholly whole life exactly besides of parliamentary procedure and country depend upon communion. So if used constructively, communication outhouse play a major role in non-homogeneous development activities.It is an important element in the matrix of influences, which leads to the innovati on and modernisation of society. It nookie help to create an environment favorable for change and development.Communication empennage help populate to face problems on an individual introduction and also on collective basis on various fronts.Without communication the development and progress would go unnoticed as it is only that spreads the intelligence operation from one region to another.Countrys development can be speeded up by the introduction of communication mediaAs the technology of communication becomes more advance, we are still going to witness more alteration in the way people communicate with each other and develop positive creative change in thinking on development.Communication for development refers to a strategy, process that promotes accessible changes by dint of dialogue, knowledge-sharing, and participation, is dependent on a free flow of communication.Development oriented al-Qaidas such as family planning adult education, primary health care etc. can b e spread to people much faster through communication. race feedback on developmental full(a)casts can be passed to the policy makers only through communication. Communication is an indicator of development for the future since people come to know about the event in advance, that may happen only through communication.________________________________________________________________________________6.2Happiness Index (HI) planetary Development Research Centre the fall in Nations Development Programme Thimphu the Canadian International Development Agency GPI-Atlantic, the duty of Nova Scotia the French-American Charitable Trust, (deeply committed to the cause of happiness)We have certain strategies, certain policies, to lead chase this goal of happiness. We should enrich our knowledge and understanding of happiness itself and further, how much we can improve and refine the processes that we have adopted. Happiness is the ultimate coveted end. great(p)er intellect and further wisd om on the subject of happiness is the central requirement.HI seeks to promote a conscious, inner search for happiness and necessity skills which moldiness harmonize with beneficial management and development of outer circumstances. HI straines collective happiness to be addressed directly through globe policies in which happiness becomes an explicit criterion in development projects and programmes.HI indicators are an evaluative tool and can be used to bump whether programmes are consistent with HI indicators also create conditions for a coherent, family relationship surrounded by professed values on the one hand and actual policies, programmes and projects on the other. It means- countrys economic, political, societal progress etc is in the right direction. frugal policies are happiness policies since individuals are able to buy goods and services, at that placeby firm themselves. People derive sense of confidence and achievement, financial, economic self reliance. thus ly in a way it brings happiness._________________________________________________________________________________6.3 republic as an indicatorDemocracy is a system of government that runs by the elected representatives of the people. The underlying theme of human being development is the broadening of human choice. The number of democracies has been growing through the past two centuries.At the start of the 20th century only a handful of countries could be described as democracies. The fact was that fair sex could not vote. A number of these countries might not qualify as liberal democracies by demanding more standards. Countries with democratic institutions have been growing rapidly-this process is linked with economic development. Although it is clear that economic development does not mechanically bring development.Democratic process helps to establish and sustain the institutions best suited to maximize human choice and potential. Well-informed decision makers need tested fee dback on where, why and how mass support for democracy is growing and where it is unwraping.Scenario of development opened up because of the increasing influence of democracy. As a issue Indian environment got a boost and the face of economic development of India changed completely. Various democratic reforms played a pivotal role in the development.Reaping its benefit, the growth of the country can be raised manifold. A great atmosphere is important for proper growth and development. Thus, democratic environment is needed a must for development. In democratic setup there is a sense of freedom, of course at heart the framework of constitution. People can radiate in any area of interest. People can achieve desired goals un- inhibited, unhesitatingly. When ideas have no boundary, progress and development is superb.Under pressure and strain it is difficult to reach a desired aim. Although freedom is associated with rules responsibilities, exclusively it is beneficial. The te rce Ds go together democracy, diversity, and dialogue.In democracy there is a feeling of contentment, freedom and satisfaction. Therefore, people can work with their rise capacity, creativity. Good, strong firm foundation is the basis of a great nation. reliable democracy- important indicator for development. Govt. should take opinion into consideration, all for local development from the people. When a govt. is making a decision on public project, people are free to express their views before the govt. personnels. Thereby, bringing all-round development of the nation.________________________________________________________________________________________6.4Human Rights as indicatorHuman rights are the natural rights of all human beings irrespective of their sex. Efforts are made all over the demesne to take adequate measures for the promotion and protection of human rights. It is only through communication that people become aware and educated about their rights, which they can exercise or have been granted to them.The United Nations General multitude adopted the Universal Declaration of Human Rights on 10th celestial latitude 1948, according to which all men and women are entitled to civil, political, economic, affectionate, cultural rights and freedom for the people of the piece. The United Nations and other international organizations, several non-governmental organizations Amnesty International and In India the Peoples Union of Civil Liberties and the Media have been creating great awareness.Example The Frontline in its issue of 24 Sep The Times of India in its special report on 28 Nov, both in 1999 appeal out in detail the gross violation of Human Rights in Tamil Nadu.The preamble (an introduction or preface) to the constitution, fundamental rights and directive principles (guidelines for the border of laws), which together have been described as forming the core of the constitution consult the basic principles of the Universal Declaration of Human Rights.Every Development programme should incorporate an aspect on human rights. Development communicators must get up the responsibility of educating various target groups on how to respect and exercise human rights. This requires democratization of communication, which means an access to all existing media to the masses for sharing information and the facts related to human rights without any discrimination.Without freedom, other human rights cannot be exercised effectively either within National borders or within the world comm hotshot. The expansion of human rights, therefore, depends largely on the success of expanding the flow of information everywhere.The Human Right principles to guide development programming identified in this agreement areUniversality and inalienabilityIndivisibilityInterdependence and interrelatednessEquality and non-discrimination comprehension and participationAccountability_________________________________________________________________________ ____________6.5Social transaction inequalityParticipation has emerged as a let on apprehension, being of considerable importance to development. Ideally people must be free to develop as individuals. People should be support and opportunities should be created for their own development. But problems are there in received participation. People should themselves design media. In present situation elites have a say in decision making. But the majority of the poor have little access to resources. Actually these groups should become the principal elements in the causa to design the media. The prevailing system encourages competition and hierarchy and not cooperation and unity. The existing educational system encourages the individual for his development but does not stress cooperative effort. This attitude leads to inequality. The media system should stress development of a intention of solidarity and unity.Social Relations takes as its focus the relationships between people and t heir societal world. It assumes that people are engaged in and shaped by ten-fold relationships, events and influences. Human experience and behaviour is therefore explored, not only by taking a stove of social and psychological factors into account but also, importantly, by paying close attention to the meanings and interpretations that people attach to their assorted experiences. The poor are often branded as irrational, lazy and irresponsible. The notion of the individual can by definition exist only in relational wrong. A person constructs a sense of identity in relation to family, other people, cultural practices, gender, social class, social/political systems, sexuality, geographic location and physical and mental abilities. It is therefore necessary to engage in learning as a cultural activity and to appreciate connections between individuals and the social, political and cultural structures that refer upon them.Social capital value of social networks, bonding with sim ilar people and bridging between diverse people with norms of reciprocity, also trusting relationships between individual in an economy, it highlights the central role of social relations for social capital.Social Relations is a multi disciplinary commence that draws on several theoretical methodologies and its analysis. Each focuses from different angles on how people organize and make meaning of their world and their relationships within it.Interaction becomes a valuable resource for exploration of insight into the dimensions of human relationships. Social Relations has particular relevance for people whose professional careers require a broad understanding of human behaviour and social relationshipsCaste Associations tactics contributed importantly in the inequality of social relations. There are caste establish differences in the leadership and environment around conflict has often been the result. Castes promotes political instability confusion, violates basic principle of c onstitution (democracy).This highlights the central role of social relations for social capital and on that perspective developmental concept can be viewed. The availability of social capital, its proper use may be reflected in organizational maintenance. This creates opportunities for development by making visual the potential gap between availability use. Relations teaches us unity in diversity World is a global village- vasudhaiva kutumbakam. Unity is power, disunity is death.Unless there is a degree of humility on the part of the professional stave and a desire to listen and understand other people, they bequeath not be in a position to relate to others through media. There is a general assumption on the part of media professionals that they can shell out a particular idea without exchanging ideas with the grass-root people as they are specialists. A majority of them show little or no respect for the experience and knowledge of the people the creative potential of the peasa nts or slum dwellers. They fail to understand that poor people are more suited to evince the issues concerning them and present their own lives. In order to achieve participation, consultation, cooperation and effective militarization of people, the media system would need to assist in establishing a sense of company and would need a desire to resolve the issues concerning them.Forming organizations with leadership emerging from within require participation and enables rural people to exercise more control over their lives.Emphasis is on the idea of self reliance on the available natural and human resources, and on the ability of individuals to define developmental problems, set goals, and make decisions independently and in accordance with their own social and cultural ethos.Respect connections between individuals and the social, political and cultural structures that have impact upon them.Relations are like plants, we got to nurture them regularly.Thinking in terms of living a nd letting others live.Often in the hype over economic growth, we forget the harsh reality of Indias-extreme poverty, hunger, disease, lack of education, and regressive social practices. We should be concerned about them.These simmering injustices cannot be allowed to fester (pus, ulcer, decay rot) because they will heighten social tensions that will ultimately risk our growth story. These key problems need speedy intervention._______________________________________________________________________________________Summing UpIn this lesson we studied about various indicators. When drafting proposals, policymakers require data on a wide range of factors, such as social, economic and administrative environment, etc. Indicators are self-explanatory signs or hints used to point something out, or highlight something. An indicator is a form of measurement in order to determine the level to what an extent. An indicator tells us if we are meeting or met the goal. Social indicators actually gi ve a true picture of economy. All the types of social and economic indicators bring up the state of the nation. A review of these approaches and concepts points to the conclusion that the use of social and human indicators is the most promising supplement to GNP, particularly if work on social indicators is done in areas central to the basic needs approach.6.9Keywords Vasudhaiva Kutumbakam It is a ism that inculcates an understanding that the whole world is one familySocial Relations A relation between living organisms (especially between people).Caste The system of dividing society into such classes.Preamble An introduction or preface to the constitution.Fundamental rights An interest protected by the superior or basic law of the land. leading Principles Guidelines for the framing of laws.