Elderly Demographics Research Study

Elderly Demographics Research Study Topic Background Health seeking behaviour is becoming more popular in the field of research study at present time. The use of this, somehow, became the window of opportunity to policymakers in delivering a better health system especially in developing countries1. (Shaik, 2015). This is true among the elderly population since a shift in the pattern of morbidity and mortality was observed in recent years. Non-communicable diseases have become the top leading cause of morbidity. Furthermore, the emergence of lifestyle diseases in urban areas also adds up to the list of morbidity causes. This change contributes to the reluctance of elderly in seeking wellness therefore an obstacle to achieving good health. Health seeking behaviour plays a major role in the effect of their health status and not solely attributed to advancing age 2 (Sangmee Ahn Jo, 2007). A review literature 3(Grundy, 2010) indicated contributing factors that affect decisions of elderly on health. An identified hindrance is the preference of alternative or traditional therapies over formal health care which reportedly delay consultations, and in effect, cause delay of treatment accordingly 4-14. Grundy (2010) further emphasized that despite the variation in health seeking behaviour across regions, continuing studies of this aspect in health care is essential to provide a better picture of the disease process outcome. In this study health-seeking behaviour is defined as the following: the use of alternative or traditional therapies, reported delays in consultation and compliance of prescribed medicine among elderly population. Review of Related Literature Even though the growing population in the Philippines was dominated by the young we cannot ignore the needs of the increasing population of the elderly. The elderly were not given as much attention in the government health programs but the incidence of health problems play a part to the economic burden of households15. (Cecilia Santos-Acuin, 2013). In the 2010 national census it was stated that there were about 92.34 million Filipinos and approximately 5.8M (6.8%) of these belongs to the elderly population. Philippine population projected to increase to 142 million by 2045 and a span of 35 years around 50million people will be added16. (PSA:Population Projection Statistics, 2014)World Health Organization defined elderly according to the three main categories namely chronology, change in social role and change in capabilities .To standardized UN agreed a cutoff of 60 years old and above17. (World Health Organization:Health Statistics and information system, 2015). Health-seeking behaviour among elderly patients varies from each country. In the event of non-consultation or delay consultation among elderly it is obvious that the outcome was associated with adverse medical consequences. In one of the study conducted about managing nutrition among the elderly they pointed out the importance of prevention and early intervention because of the difficulty in treating an individual once the disease was already established4. (Damian Flanagan, 2012). This was also supported by cross-sectional study done in Namibia which the outcome resulted in higher treatment delays. In the study they determined the cause and categorized delay in the treatment as longer delay based on older age, urban residence, and longer walking distance to the nearest public facility, and doing a chest x-ray while having HIV seropositive and formal education determined the shorter delays5. (Kingsley Ukwaja, 2013). One significant Malaysian study focusing among elderly which utilized CAM for natural and safer use found out that non-consultation would contribute to the increasing undiagnosed cases of chronic diseases6.(Shahid Mitha, 2013). Further studies for different ways of treatment were done to substitute for complementary and alternative medicine especially common amongst Asians with elderly multiple co morbidities6 (Shahid Mitha, 2013).A study on DM conducted in Uganda showed that the unavailability of medicines prompted the people to use CAM for treatment and consulted a faith healer especially to those failures to manage DM causing an increase in DM related complications7. (Katarina Hjelm, 2011). Moreover, the elderly in the Philippines use medicinal plants before consulting to health professionals because of its availability, cheaper price than Western drugs, and usefulness in the treatment of various illnesses and to alleviate milder form of illnesses8. People who had chronic multiple morbidity took their medicines in a daily basis to survive, to work normally and to fulfil social work or obligations in the family. Taking multiple tablets in a day is a burden to them9. (Anne Townsend, 2003). One of the study conducted in Malaysia showed that the presence of a particular symptom will only start the usage of prescribed medicine. However, once these symptoms are resolve, medication would also be terminated giving them reason not to take drugs religiously. This will just worsen the disease process and later will lead to multiple admittance. Other studies also pointed out that noncompliance of medicine are due to the fear of drug dependency, multiple side effects and interaction with other drugs.(10). Thus, being more cautious and elaborative in giving instructions to patients who are taking multiple drug regimens should be practiced by health practitioners11. (Isacson D, 2002). A house-hold survey done among elderly Nigerian revealed that regardless of age and sex, family consultation is their first choice of treatment for their illnesses. This somehow increases the morbidity among the elderly population since family members know little about the safety and appropriate treatment for them12. (Abdulraheem, 2007) A cohort study in South Korea using AGE found out that the increase level of awareness and concern about the health of elderly women increases health-care consultation thus, resulted to increased risk of morbidity.2 (Sangmee AhnJo, 2007). In Myanmar, a study conducted to elderly women concluded that low-level of education and income play great role in skipping treatment and self-care13. (Soe Moe, 2012). Similarly, in Bangladesh, younger adult and elderly age group were compared in terms of health seeking behaviour (self-care/self-treatment). It showed no significant difference in health-seeking pattern. Both age group opted self-care/self-treatment as the first line of prevention due to poverty which would explain the increase in morbidity pattern of both.14(Syed Masad Ahmed, 2005). The growing trend of non-communicable diseases is the common cause of morbidity in today’s modern world. This lifestyle related disease can be altered in the future by determining the source of it. Also, health seeking behaviour plays a major role in determining the outcome of health status of an individual. No study on health seeking behaviour and factors that influence the behaviour of our elderly in our locality so a research study would be beneficial in gathering new information. Added to that, our elderly may have different factors towards health seeking behaviour and different morbidity pattern than the others. Research Question This study aims to determine what are the demographic and clinical characteristics of elderly patient 60 years old and above of the Davao Regional Hospital FAMED outpatient department that are associated with their health seeking behaviour? Significance of the study Since health care programs to the elderly is not yet well established in Davao Regional Hospital, the outcome of this study will be the basis of the future recommendation of programs for the elderly in the DRH outpatient department. With this study we will be able to deliver better health services to our elderly patients such as: a. Creating a geriatrics club that would exclusively cater the needs of the elderly patient so that they don’t need to line-up with other patients. This would somehow help lessen their delay in consultation at the same time will increase the need to seek consult to a physician as their first choice of health care giver. b. By incorporating a primary giver as a potential treatment partner for the elderly patients that would monitor and check the elderly patients’ compliance to medicine and assure treatment success. C.Enrolling those elderly patient’s ages 70 years and above residing within 5 km of the hospital premises to a family oriented program .This would benefit those elderly patient’s that cannot visit the hospital due to old age, too sick to move and avoiding too much crowd. A home visit from the assign physician will help lessen their delay in consultation, correct the use of alternative medicine and affect their first choice of care giver. Objective of the study This study general objective is to identify the demographic and clinical characteristics of elderly patient 60 years old and above of the Davao Regional Hospital FAMED outpatient department that are associated with their health seeking behaviour. Specific Objectives To determine respondents socio-demographic and clinical profile. To determine the health seeking behaviour among elderly patients in terms of: Delay in consultation of chief complaint Use of alternative and traditional therapies Compliance of prescribed medicine First choice of health care provider To identify the socio-demographic and clinical characteristics of patient that would determine their health seeking behaviour. II. Methodology A. Research Design A cross-sectional study will be conducted among elderly patient of Davao Regional Hospital outpatient department. B. Setting This will be done at Davao Regional Hospital outpatient department of Family Medicine sometime in September 1, 2015 to October 31, 2015. The triaging system of Davao Regional Hospital outpatient department starts with a priority number to all with special considerations to the elderly population. All elderly on the senior citizen lane will be distributed to the different departments based on their chief complaint. In this study all respondents triage to the Family Medicine department will be invited to participate. C. Participants The respondents of this study include elderly patients ages 60 years and above willing to participate in this study. All those who are critically ill will be excluded from the study. D. Sampling Procedure A convenience sampling will be done. E. Interventions and Comparisons: Not applicable F. Randomization: Not applicable G. Data Gathering Approval of the CERC board will be obtained first prior to the collection of data. Data will be collected using a three-part standard questionnaire which will be administered through a one on one interview by the FAMED residents rotating at the outpatient department. Independent Variables Part 1 will consist of information about socio-demographic profile like age, sex, highest educational attainment, place of origin and source of funds. Part 2 will consist of the clinical profile of the respondents which includes presence of concomitant chronic diseases and current chief complaint. Dependent Variables Part 3 will be the information about the respondents’ health seeking behaviour and the outcome to be measured. In this study the following health seeking behaviours are explored. First health seeking behaviour is according to delay in consultation which in this study refer as the time from onset of chief complaint to first consult in Davao Regional Hospital FAMED outpatient department. For this study, a delay of 14 days or more from the time of onset of chief complaint to the time that the patient goes to the hospital will be considered as â€Å"longer delay† and a delay of 7 days to 14 days from the time of onset of chief complaint to the time that the patient goes to the hospital will be considered as â€Å"shorter delay† 18-19(Fact sheet Diarrhoel disease, 2013) (Blanca Ochoa, 2002). The second health seeking behaviour is the use of alternative or traditional therapies which are define in this study as the use of herbal medicines, over the counter drugs, acupu ncture, reflexology, hilot and others not part of the conventional medicine before the initial consult referable to the chief complaint. Another health seeking behaviour is the compliance of prescribed medicine which in this study defines as the correct usage of drugs as to dosage, frequency, duration, and timing as prescribed by licensed physician of Davao Regional Hospital in relation to its chief complaint. Last health seeking behaviour is according to the first choice of health care providers. For this study, the first choice of health care providers in relation to its chief complaint. H. Sample size computation Sample size of this study was computed using the software StatCalc from EpiInfo 7. Calculations were based on the following assumptions: [1] 40% of patients aged 70 years (exposure) consult 2 weeks after onset of their chief complaint (outcome); and, [3] there are as many patients aged >70 years as there are patients aged 60-70 years. In a computation of odds ratios of getting the outcome, carried out at a 5% level of significance, a total sample of 194 patients will have 80% power of rejecting null hypothesis (no significant increase or decrease in odds ratio) if the alternative holds. An interim analysis will be done halfway through the recruitment (97%) in order to recompute the ideal sample size. I.Data handling and analysis Data for the study will be encoded in the Microsoft Excel and analyzed using EpiInfo 7. Categorical data will be summarized as frequencies and percentages, and compared. Continuous data will be summarized as means and standard deviations, and compared. Odds ratios of having particular health seeking behaviours will be computed. Level of significance will be set at 5%. Ethical Consideration Prior to participating in the study, the consent of the participant must be obtained. Ethics Review The proponent of the study will secure an approval from the Cluster Ethics Research Committee of Southern Philippines Medical Center prior to doing the research. Informed Consent: Form A written consent is obtained from the potential participants prior to conducting the study. Informed Consent: Signatory The signature of the participant should appear in the consent form. Informed Consent: Witness No witness will be required in order for the informed consent to be binding. Informed Consent: Proxy Consent There will be no proxy consent aside from that of the participant will be allowed. Informed Consent: Process Prior to signing the consent form, the potential participants are informed about the study rationale and objectives. Informed Consent: Timing and Venue The informed consent will be taken prior to the administration of the questionnaire. It will be done in the assigned area of the participant within DRH premises during office or duty hours. Disclosure of Study Objectives, Risks, Benefits and Procedures The participants will be informed of the study objectives, its purpose, its benefits and what is expected of them. They will also be told that there are no risks involved in the study. Remuneration, Reimbursement and Other Benefits No remuneration or reimbursement will be given to the participants. Privacy and Confidentiality The researchers will not disclose the identities of the participants at any time. Only the main proponent of the study has the personal information of the participants. The researchers will not contact the participants after this one time interview. Investigator’s Responsibility It is the investigator’s responsibility to ensure the confidentiality of any information obtained during the research. Specimen Handling N/A Voluntariness and Alternative Options The respondent’s participation in the study will be entirely voluntary. In case the participants wish to withdraw from this study the researchers will respect that decision and there will be no effect in the present and succeeding consultations. Information on Study Results The participants will have access to their data. After the data has been analysed, the overall results will also be made known to the participants. Extent of Use of Study Data At present there are no intended plans to use the data aside from the objectives stated in the protocol. Authorship and Contributorship Jacqueline N. Nuenay, M.D. is the principal investigator and the main author of the study. Dr. Chrysteler Clet is the co-author. Conflicts of Interest The principal investigator and the co-author declare no conflict of interest. Publication The research may be submitted for national and/or international presentation or publication. Funding The main proponent of the study is using personal funds to conduct the study. Duplicate Copy of the Informed Consent Form A duplicate copy of the informed consent form will be provided to the participants of the study. Additional copies can be made on request. Questions and Concerns Regarding the Study The participants will be encouraged by the principal investigator to voice out concerns about their participation in the study. Contact Details The participants of the study will be provided with the cell phone number of the principal investigator. The principal investigator is also available for questions, comments and concerns about the study.

Asthma :: essays research papers

  Ã‚  Ã‚  Ã‚  Ã‚  Asthma is a chronic illness that affects many people. Asthma affects approximately 155 million people around the world. The pharmaceutical industry approximates $5.5 billion in sales for asthma medication per year for a condition that is incurable.   Ã‚  Ã‚  Ã‚  Ã‚  Asthma is an inflammatory disease of the airways. The narrowing of airways occurs due to inflammation and excessive mucous secretion. The constriction of the airway gives rise to common asthmatic symptoms of wheezing, coughing, tightness in the chest, and shortness of breath. The usual form of control for asthma is bronchiodilators and corticosteriods.   Ã‚  Ã‚  Ã‚  Ã‚  Although, bronchiodilators are used in asthma therapy they have no effect on the inflammatory process. Bronchiodilators are a class of drug that relaxes airway smooth muscle by increasing cAMP and opening potassium channels. Corticosteriods on the other hand are now considered the first line of treatment for patients with severe and chronic asthma. Corticosteriods bind to a receptor in the cytosol, which translocates to the nucleus and binds DNA to activate genes. The main action of corticosteriods is to suppress multiple inflammatory genes, such as cytokines, inflammatory enzymes and adhesion molecules. The effectiveness of the corticosteriod is in most part due to the inhibition of transcription factors, such as AP-1 (activation protein 1), Nuclear factor-b (NF-b), and nuclear factor of activated T-cells (NF-AT), which are required for inflammatory response.   Ã‚  Ã‚  Ã‚  Ã‚  The FcRI is the receptor for the IgE antibody. The FcRI is composed of a  chain that binds the Fc portion of the IgE, the  chain and the  chain together form a tetrameric structure. Due to the fact that release of mediators from mast cells in asthma is IgE-E dependent one approach would be to block the activation of IgE using blocking antibodies that do not result in mast cells. A humanized murine monoclonal antibody directed to the FcRI-binding domain of human IgE (rhuMAb-E25) reduces allergen specific IgE after intravenous administration. RhuMAb reduces early and late responses to inhaled allergen and eosinophils counts from induced sputum.

A View From the Bridge - Arthur Miller - Catherines diary :: English Literature

A view from the bridge- Arthur miller Catherine's diary September 18th 1937 Y' know I was sitting down today and Eddie comes in from work, looked really tired. I had just dressed in my new dress that I bought for my new job and I had done my hair in a different style, it looked really good. I asked him what he thought of it, and do you know what he said? He said the skirt was too short and the heels were too attention drawing. He even told me I'm walking wavy and that he doesn't like the way I have been attracting looks from the people in the shops, I told him they look at every girl that way but this only seemed to infuriate him more. What's up with him these days, he doesn't let me do anything. When's he going to realize that I'm not a little kid anymore? I just want him to approve of me and it makes me so upset when he doesn't, why cant he be like my friends' fathers and let me have more freedom? I'm not saying I don't appreciate him and how hard he's worked and that he took me in and all but sometimes he's just makes me so annoyed. Anyway, he told me that Beatrice's cousins should be arriving today, I'm so excited, and I can't wait. I wonder what they're going to be like. Marco and Rodolfo are their names but that's all I know about them apart from that Marco has kids. You'll never guess what Eddie and Beatrice were arguing about today just after Eddie told Beatrice about her cousins. They argued about where the Beatrice's cousins were going to sleep. I mean can't B just stop moaning at Eddie, he's a good man and she just doesn't appreciate him but they settled it and they made up. I told Eddie about the job, he was so not pleased. He wants me to finish the stenography class. I want to work, I'll be getting paid $50 per week, think of what I could do with that money. It's such a privilege to be chosen out of the whole class, they said I was the best that they saw there so I could still get my certificate at the end of the year, plus there's nothing better than putting what I've learnt into practice. I want Eddie to be happy for me, can't he see that it's impossible to turn the job down, I just can't, for goodness sakes . It's not like I'm going to be working in a bad company, it's

Essay --

Ben Franklin himself said, "They that can give up essential liberty to obtain a little temporary safety deserve neither liberty nor safety." There are two subjects essential to this warning, the oppressive overbearing authority and the people who are willing to sacrifice their liberty for security. There are for possible outcomes with these two subjects: 1. The people of the nation have an attitude that does not allow a domineering government, thus out of fear no domineering government arises. 2. The people of the nation have an attitude that does not allow a domineering government, nevertheless a domineering government arises under radar. 3. The people of the nation have an attitude that allows themselves to be dominated, thus a domineering government arises. 4. The people of the nation have an attitude that allows themselves to be dominated, a domineering government however does not arise. Opportunity is a time or set of circumstances that allows for a possible action to occur. Given the opportunity, a domineering government will arise History will repeat itself, it has time and time again. Utopia is virtually impossible by its very definition as applied to the philosophy of today. The inevitable outcome of all organized systems is thus the enslavement of the human majority and the eventual revolution of a new system. Thus outcomes number two and three are most likely to happen eventually. The question remaining is thus, how can a nation prevent a domineering government for the longest time? This is outcome number one comes into play; a democratic system is by its very design meant to prevent a domineering government from arising. Outcome number four is the most unlikely to happen becau... ...ew act and lead it down a path it was never meant to go. The people of the United States are now more than ever willing to sacrifice their liberty for security. Dependency on government leads to a loss of personal liberty. The government should seek to make the people more independent and less reliant on social welfare programs. The fact that we see more dependent people now than ever before is a sure sign that U.S. citizens are sacrificing their liberties for security and comfort. We are not necessarily meant to live a comfortable lifestyle. Such a life would chock the freedom's that make hero's out of men. We need to separate the definition of peace and the definition of comfort as it applies to a people's own independence. The attitudes of the people who will allow themselves to be dominated is by far worse than a domineering government. Essay -- Ben Franklin himself said, "They that can give up essential liberty to obtain a little temporary safety deserve neither liberty nor safety." There are two subjects essential to this warning, the oppressive overbearing authority and the people who are willing to sacrifice their liberty for security. There are for possible outcomes with these two subjects: 1. The people of the nation have an attitude that does not allow a domineering government, thus out of fear no domineering government arises. 2. The people of the nation have an attitude that does not allow a domineering government, nevertheless a domineering government arises under radar. 3. The people of the nation have an attitude that allows themselves to be dominated, thus a domineering government arises. 4. The people of the nation have an attitude that allows themselves to be dominated, a domineering government however does not arise. Opportunity is a time or set of circumstances that allows for a possible action to occur. Given the opportunity, a domineering government will arise History will repeat itself, it has time and time again. Utopia is virtually impossible by its very definition as applied to the philosophy of today. The inevitable outcome of all organized systems is thus the enslavement of the human majority and the eventual revolution of a new system. Thus outcomes number two and three are most likely to happen eventually. The question remaining is thus, how can a nation prevent a domineering government for the longest time? This is outcome number one comes into play; a democratic system is by its very design meant to prevent a domineering government from arising. Outcome number four is the most unlikely to happen becau... ...ew act and lead it down a path it was never meant to go. The people of the United States are now more than ever willing to sacrifice their liberty for security. Dependency on government leads to a loss of personal liberty. The government should seek to make the people more independent and less reliant on social welfare programs. The fact that we see more dependent people now than ever before is a sure sign that U.S. citizens are sacrificing their liberties for security and comfort. We are not necessarily meant to live a comfortable lifestyle. Such a life would chock the freedom's that make hero's out of men. We need to separate the definition of peace and the definition of comfort as it applies to a people's own independence. The attitudes of the people who will allow themselves to be dominated is by far worse than a domineering government.

‘God’ is nothing but the Supreme Truth Essay

Differing from world’s other great religions Buddhism, is not based on any conception of a Supreme Being or Godhead (Myss, 2006). Buddhism relies on human effort to relieve suffering, â€Å"These wise ones, meditative, persevering, always using strong effort attain Nirvana – the supreme peace and happiness† (Buddha, 5th Century B. C). The Buddha, the founder of Buddhism, is a human being who achieved great enlightenment or ‘Nirvana’; but, even the Buddha is not ‘God’. The acceptance of a Supreme Truth is the closest to the concept of ‘God’ in Buddhism. This Truth is to be realized by every individual, by following â€Å"Dharma†; one â€Å"who with clear understanding perceives the four noble truths: namely suffering, the origin of suffering, the cessation of suffering, and the eightfold holy way that leads to the cessation of suffering†¦Ã¢â‚¬  (Buddha, 5th Century B. C). By being righteous and practicing ‘ahimsa’ or non-violence, the misery-filled human life can be transcended to a state of Nirvana or ‘Self-Realization’. In this enlightened state, there is neither happiness nor misery; when questioned by a disciple about the state of ‘Nirvana’, Buddha is said to have answered â€Å"I am the State of Pure Consciousness, that is reflected in all beings† (as cited by Swami Sukhabhodanda, 1997). Buddhism initially evolved as a repudiation of Hindu God and God-heads. Hence, even the so-called god-heads have to attain perfection. Supreme State of Enlightenment is achieved only by the individual’s efforts and thus the soul undergoes the cycle birth-death-and re-birth according to its â€Å"Karma†- or its doings in adherence to the path of Dharma, until it reaches ‘Nirvana’. While accepting the Karmic cycle of Hinduism, the eight-fold path of Buddhism are very similar to the Biblical sayings; for example Buddha’s Dharma of Right Action is very similar to â€Å"Faith by itself, if it is not accompanied by action, is dead† (James 2:17). But differs from Christianity in that, 1) there is no ‘God’, 2) there is no Judgment Day, and 3) the acceptance of the concept of re-birth. ‘That Thou Art’ The Vedas or the Holy Scriptures are the basic foundation on which Hinduism stands. And in the Upanishads, which are a part of the Vedas, one finds a numbers of instances in which the concept of the Supreme Being or ‘God’ is analyzed. The Atharva Veda says â€Å"Verily He is One/ Single, Indivisible, Supreme Reality† (Atharva Veda 13/4/20). In fact, the Rg Veda, the oldest of the existing Vedas, elaborates the concept of ‘God’ thus: â€Å"He is One Brahma/ The Creator of the cosmos/ Who pervades and protects/ And enlightens aft beings/ He is One Supreme Entity/ Whom sages call by various names/ Such as Indra, the glorious/ Mitra, the benign friend/ Varuna, the greatest, the noblest/ Agni, the resplendent, the bright/ Yama, the dispenser of justice/ Matarishwa, the almighty† (Rig Veda 1/164/46). ‘God’ is neither male, nor female, the Supreme Sovereign of all creation, animate and inanimate, Mother and Father. It is important to note, that ‘God’is all this but not limited to this. Therefore, it is not possible to merely say ‘God’ is ‘He’ or ‘She’, or ‘It’. Nameless and formless, infinite and incomprehensible, pervading all things yet not confined to anything. The various names by which ‘It’ is addressed denote the names by which human beings identify ‘It’, the name â€Å"Brhaman† including. The Kenopanishad (2/1/3), puts the concept as difficult to comprehend for the limited human mind, â€Å"He who thinks that he knows (Him) really, does not understand anything and proves himself ignorant. He who realizes that he cannot know (Him) has best understood†. The same concept is further explained in the Bhagavad Gita (2/25) too, â€Å"This Atman (the ParaBrhman) is beyond the comprehension of the five senses; Unconceivable by the mind; Unchanging. Hence, O Arjuna, perceive the Atman truly as such, since it does not become you to grieve†.

Reasons Why People Use the Internet

What is the Internet, and how does it work? The Internet, including the World Wide Web, is perhaps the single most important invention to impact on elementary, secondary, and higher education in today's world. If parents are to understand how their children use technologies for learning, they must understand some things about the Internet and the Web. This section of the San Diego Public Library site offers information for parents on various aspects of this invention. What is the Internet? The Internet, in simplest terms, is the large group of millions of computers around the world that are all connected to one another. These computers are connected by phone lines, fiber optic lines, coaxial cable, satellites, and wireless connections. When you log on to the Internet you are given access to many of the other computers that are connected around the world. Internet A global network connecting millions of computers. More than 100 countries are linked into exchanges of data, news and opinions. Unlike online services, which are centrally controlled, the Internet is decentralized by design. Each Internet computer, called a host, is independent. Its operators can choose which Internet services to use and which local services to make available to the global Internet community. Remarkably, this anarchy by design works exceedingly well. There are a variety of ways to access the Internet. Most online services, such as America Online, offer access to some Internet services. It is also possible to gain access through a commercial Internet Service Provider (ISP). The Internet is a global system of interconnected computer networks that use the standard Internet protocol suite (TCP/IP) to serve billions of users worldwide. It is a network of networks that consists of millions of private, public, academic, business, and government networks, of local to global scope, that are linked by a broad array of electronic, wireless and optical networking technologies. The Internet carries a vast range of information resources and services, such as the inter-linked hypertext documents of the World Wide Web (WWW) and the infrastructure to support email. Top 10 Reasons People Use the Internet 1. Information – The Internet is arguably one of the most successful and useful tools mankind has ever created. It is, in fact, the largest library ever created, and is growing daily. Although you need to always be careful of your sources, the Internet is THE modern source of information, delivered in multiple media: written word, visual graphics and images, video, and audio have changed the way that we humans look for and find information. 2. Communication – People use the Internet to communicate with one another. Software has made it possible to stream voice and video across the world with minimal delay, and email has become the main means of communicating for many a modern person. Without the Internet, it would be both more expensive and slower to maintain personal and professional relationships. 3. Entertainment – Many people use the Internet to enjoy themselves and to engage in personal interests. In recent years, multiple player games and virtual worlds have engaged the time and money of many. Plus, video and music are easy to find, stream and download†¦plus, the medium encourages feedback! Indeed, Internet use can go too far. But how can you know if you’re addicted to the Internet? We list the criteria and signs of Internet addiction in the link above. 4. Work – The Internet provides an alternative to 9-5 workdays, as more and more people can work from home, or â€Å"telecommute†. Plus, a growing number of people are making a living from the Internet itself, wither becoming experts in how people search the Internet, providing IT or web development services, or specializing in Internet marketing. 5. School – More and more elementary, high school and university curricula require use of the Internet for school work. 6. Relationships – People use the Internet to find, maintain, or end relationships. But people can get addicted to social networks, too. More on how to know if you’re a Facebook addict here. 7. Market – People use the Internet to research, find and buy services and products. Or to target and sell to the ultimate consumer. In effect, the Internet has become THE best way to buy and sell merchandise, as online â€Å"stores† are open 24 hours a day, 7 days a week. 8. Sexuality – Although it may surprise you, it’s no secret that a real majority of search is centered around porn. So, people [men] use the Internet to view pornography and to engage their sexual instinct. 9. Self expression – People not only consume information on the Internet, they CREATE it. And in doing so, people are able to express themselves politically, artistically, vocally, socially, etc. and give voice to what is important to them. The Internet is the ultimate forum on which you can discuss or monologue as you like. 10. Ask for help – The protocol for Internet use is one of private consumption without need for naming yourself. By virtue of the privacy and anonymity factor of cyber space, Some people use the Internet to ask for help. People ask for help in the form of emotional support, medical advice, or even simply listening. If you think that you may be an Internet addict, there is help out there for you. If you want to explore the deeper emotional and psychological issues for compulsive use of the Internet, first start by asking for help from your family doctor. S/He may refer you to a mental health specialist or center for technology addictions in your area. Or, if there are no specialists that live in your area, you might even consider videoconferencing, a form of distance psycho therapy that is starting to help people, no matter where you are. Whatever the case, you may need help to uncover the real reasons behind your reliance on the Internet, and to learn how to cut back and monitor Internet use for a healthy mind.

Help Seeking Behavior Health And Social Care Essay

Two reported eruptions of rubeolas in extremely immunized hilly countries were investigated under two bomber centres, viz. , Sailli and Sarah. In Sailli, the entire figure of instances were 51 with overall attack rate-6 % ; ( Sex Specific AR-male 12 % while female 7 % ) 4 ; and in Sarah there were 18 instances in all with overall onslaught rate as 4.2 % ; ( Sex specific AR-male 6.94 % and the female 7.2 % ) 5. All the instance patients belonged to 5 old ages plus age group ( Range being 5 old ages to 17 old ages ) during the period from September to November, 2006. The last reported eruption of rubeolas in the block was 8-9 old ages ago. During the same period no such eruptions were reported from any other blocks within the territory. Hence, a survey was undertaken with the aims ; ( 1 ) To depict the aid seeking behaviour of female parents of kids with and without rubeolas and the factors associated with it and ( 2 ) To urge appropriate remedial steps to forestall and command farther eruptions.MATERIALS AND METHODS:For this survey an in-depth reappraisal of the literature on the aid seeking behaviour of female parents and subsequent factors associated with rubeolas eruptions enabled choice of specific issues/factors. Many factors are reported to be associated with rubeolas such as geographically hard hilly countries, hapless socio-economic strata with unemployment ; marginalized subdivisions like scheduled castes/tribes ; illiteracy, overcrowding, beneficiary related issues like aid seeking behaviour of female parents ; community/mothers ‘ beliefs and barriers of people seeking health/help from the local chelllas/quacks/village elders/relatives/ neighbours/ /friends6. ( A ) Study design: A comparative survey. ( B ) Study period: 14th Nov. , to 14th Feb. , 2008. ( C ) Study country: Sub centres Sailli and Sarah, Shahpur block ( Measles outbreak Exposed ) and sub centres Mallan and Samloti of Nagrota Bagwan ( Measles not exposed ) block of territory Kangra which are more or less likewise placed. ( D ) Study population: Community members for Focus Group Discussions and female parents of kids ( from 5 old ages to 17 old ages ) with and without rubeolas of bomber centres Sailli and Sarah, Shahpur block ( Exposed ) and sub Centres Mallan and Samloti of Nagrota Bagwan comparative ( Non exposed ) block of territory Kangra. ( Tocopherol ) Sample size: Community members for 4 Focus Group Discussions ( FGD ) with ( two FGDs-one male and 2nd female ) for instances. One FGD consists of 20 males and likewise, 2nd one with 20 females individually under Shahpur block and equal Numberss of FGDs for comparing under Nagrota Bagwan block ; and all female parents of entire 69 instance patients of two eruptions in the Shahpur block with exposure to rubeolas ( 5 old ages to 17 old ages with average 9 old ages ) in survey country with equal number-age and sex matched in comparative Nagrota Bagwan block were taken while the population features were the same. ( F ) Operational definitions of Measless: WHO definition: We defined a instance as the happening of febrility with roseola with or without cough ; rhinitis and pinkeye in a occupant of the small towns under bomber Centres Sailli and Sarah of Shahpur block ( Kangra ) between 1st September to 30th November 2006.( G ) Data aggregation technique and tools: Study squad:Beneficiary related issues: We carried out an appraisal of aid seeking behaviour of female parents of instances and female parents of age and sex matched controls in comparative block utilizing Focus Group Discussions ( FGDs ) and in-depth interviews of all female parents of entire 69 instance patients with exposure to rubeolas in survey and comparative blocks. For this exercising, we constituted two squads of wellness workers. In each squad, there were six wellness workers ; three males and three females and they were supervised by two male wellness supervisors. The whole squad was trained and supervised by two senior med ical officers. This procedure was carried out by interviews utilizing check list of inquiries and interview agenda utilizing qualitative standardised questionnaire. We besides compared the responses for four FGDs and in-depth qualitative interviews of all female parents of entire 69 instance patients of two eruptions in survey Shahpur and comparative Nagrota Bagwan blocks. We sought and obtained clearance from ethical commission from National Institute of Epidemiology, Chennai. We analyzed the informations by MS-excel sheet, Stat calc and utilizing Epi info version 3.3.2.Consequence:Brief description of both countries: Topographically and demographically, both blocks are more or less likewise placed. Both the survey blocks are hilly situated at the height of 2600 pess to 2900 pess above the sea degree. Population features of both blocks are more or less same. 25-30 % of SC/ST and 4-5 % of ST with 30 % of OBC classs and remainder others constitute the caste constellation. In instance block, we have 36 bomber centres, 5 primary wellness centres, one community wellness Centre with 90 % of the adult male power in place while in comparative block, 38 bomber Centres, 5 primary wellness Centres and two community wellness Centres with 95 % of human resource in place.Beneficiaries related issues:Distribution of baseline features in the survey group: Age: The average age of the instance and comparative groups kids was 9 old ages while mean was 9.6 and the manner was 6 ( scope being 5-17years ) , as the survey was matched for age and sex merely. So, out of 69 instances, 35 ( 51 % ) instance group and comparative group were ?9 old ages and 34 ( 49 % ) kids were & A ; gt ; 9years of age. Sexual activity: The proportion of the males in instances and controls were high 43 ( 62.3 % ) while those of the females were 26 ( 37.7 % ) . Religion: All instance and comparative groups were belonging to Hindu faith. Type of household: Merely 45 instances ( 65.2 % ) and 49 ( 71.0 % ) were holding the atomic households. The cultural epidemiology and aid seeking behaviour of female parents of kids in Shahpur and Nagrota Bagwan blocks were assessed with ( I ) Focus Group Discussions and ( two ) for in-depth qualitative interviews, we recruited all 69 female parents for entire instance patients and equal Numberss in 1st comparative group from Shahpur block and 2nd one from non rubeolas Nagrota Bagwan block. They were exposed to the selected variables for cognizing socio-economic position ; the community every bit good as the personal beliefs/barriers of the female parents of the affected and non affected countries coupled with cognition, attitude and pattern ; clip and distance from wellness attention installation ; attitude towards the heath system variables etc. In the Shahpur/Nagrota Bagwan blocks, 20 females and 20 males from the different nearby small towns participated in each block. The educational degrees of the females participants in Shahpur/Nagrota Bagwan blocks varied from nonreaders ( 24/8 in figure ) ; 5th criterion ( 10/6 ) ; Middle criterion ( 4/10 ) Matric criterion ( 2/16 ) while those of the males participants fluctuated from nonreaders ( 14/6 in figure ) ; 5th criterion ( 16/12 ) ; Middle criterion ( 2/10 ) ; Matric criterion ( 6/10 ) to Graduate ( 2/2 ) . In Shahpur block, the two groups of the participants had a sum of 43 ( 40 three ) kids, out of which 15 have suffered from rubeolas. All the kids were immunized against rubeolas. In Nagrota Bagwan block, the two groups of the participants had a sum of 36 ( 30 six ) kids, out of which six have suffered from rubeolas. All the kids were immunized against rubeolas. From the above noted four FGDs ( 40 males and 40 females ) and in-depth qualitative interviews, ( 69 female pare nts of instance block and 69 female parents of comparative block ) , we concluded the undermentioned critical points from all the respondents of both blocks. In Shahpur and Nagrota Bagwan blocks, rubeolas is locally known as Dharrssali largely, ( 80 % ) followed by less known as Chhotti mata ( 15 % ) and the least as Bodri ( 5 % ) . For bodily experience of rubeolas, 95 % respondents in Shahpur block have the personal experience in over 5 old ages of age but 25 % respondents in Nagrota Bagwan block do non hold the bodily experience of rubeolas outbreak in the country. All rubeolas related information has been largely heard or got from other beginnings. On aetiologic standing, 68 % respondents under Shahpur block property rubeolas to the expletive of goddess-Mata Ka vardaan hei and hence no flight path while the 55 % respondents in Nagrota Bagwan block grade contagion-chhoot is the causative factor. For wellness ( aid ) seeking behaviour of female parents, bulk ( 68 % ) of the respondents under Shahpur block spell by the established community belief and barrier that the free traditional intervention by faith therapists who recites mantras and Vannan shrubs motion on the organic structure and face of the instance patient for three to five yearss ; followed by 12 % by small town elders/neighbors/friends/relatives and in conclusion, if needed, confer withing physicians in the nearby wellness attention installations. 85 % of the people of the instance country go for the traditional therapists. The cost of intervention scopes from nil to Rs.350/- for Shahpur block whereas that of Nagrota Bagwan block, it is Rs. 200/- to Rs. 1200/- merely. 59 % of the respondents in Nagrota Bagwan block prefer modern system of intervention. For the inoculation of the kids, they have to go as long hilly distance as over 6-10 kilometers on pes devouring 3/4th hr to 2 and ? hr for nearest available wellness attention installation with long waiting clip in uncertainness. For the first aid when their kid falls badly, as per their community/mothers ‘ beliefs, Shahpur block chiefly goes for faith therapists but the minority educated females ( 18 % ) from immature coevals insist for allopathic intervention while Nagrota Bagwan block respondents ( 65 % ) opts for authorities wellness attention installations but the minority older coevals ( 14 % ) still advocates for religion healing. Nutritional attention to the Dharrssali ( Measles ) afflicted kid is given in the signifier of restricted diet, Saunfi Banaksha, illaychi, decoction made of Gur ( Local autochthonal intervention expression ) . Seul ( Heat emancipating comestible ) should be given in copiousness and smoke Sarson ( Mustard seeds ) is blown under the fingerstall of the patient and the fried points be avoided. As a follow up patterns in the station recovery stage from unwellness, 58 % respondents from Shahpur block invoke the approvals of the goddess Sheetla. 69 % respondents acknowledge the visit of the local wellness worker one time in a month while in Nagrota Bagwan block, 74 % female parents confirms the frequence of visit of worker as twice in a month. For immunisation, 85 % respondents in instance block and 90 % in 2nd block go for inoculation in their several bomber Centres at the age of nine months to one twelvemonth. It is 100 % female parents all the manner who take kids to the Centre for inoculation. Protective value of vitamin A supplementation has been emphasized by 45 % respondents from Nagrota Bagwan block. 94 % of the respondents for instance block have indicated their pick Centre for immunisation and wellness seeking patterns for the common complaints in the center of small town which should be easy accessible with regular handiness of the worker at bomber Centre Sailli.Discussion:Our survey consequences need to be interpreted in context of the major factor, viz. donees ‘ related issues. The consequences of FGDs in two countries suggest difference in two countries with regard to knowledge sing cause of rubeolas, aid seeking behaviour, intervention and follow-up patterns. Illiteracy and cognition are complimentary. Added with beliefs and barriers in the present survey, many important factors like geographically hard hilly countries, nonreader female parents, marginalized subdivisions like scheduled castes/tribes ; poorness etc are more inclined towards traditional unscientific lines in footings of cause and consequence. Measles is locally known as Dharrssali. Shahpur block hypothesize the generation of rubeolas as expletive of goddess despite high immunisation coverage in the countries. Mahapatro M et Al observed that bhattara tribal adult females believe that rubeolas ( gundi ) and varicella ( maa ) occur due to the wrath of the Goddess ( thakurani ) on the patient, they visit the ‘desari ‘ instead than a medical practitioner7. More crowded instances of rubeolas are at that place d ue to their individual roomed adjustment and poorness in instance block. For the first aid when their kid falls badly, as per their community /mothers beliefs, Shahpur block chiefly goes for free of cost religion therapists. A good ball of female parents of the instance country go for the traditional intervention merely because of poorness and illiteracy in the country coupled with stiff personal and community beliefs The other grounds may be ill-mannered behaviour of wellness suppliers with hard handiness and handiness of the wellness suppliers with long waiting clip in uncertainness. The cost of intervention is non easy low-cost for Shahpur block. Jagrati V et Al observed that besides economic barriers, the other 1s are hapless agencies of transit and long distances8. Nutritional attention to the Dharrssali afflicted kid is given in the signifier of restricted diet, Saunfi Banaksha, illaychi, decoction made of Gur. Seul ( Heat emancipating comestible ) should be given in copiousne ss and smoke Sarson ( Mustard seeds ) is blown under the fingerstall of the patient which eases rubeolas roseola to break out shortly. Avoid the fried points. Restricted nutrient with Seul rich diet during rubeolas was more operable in instance block. Belief barriers like nutrient and fruit turning away farther enhances vitamin A lack. The badness and continuance of unwellness were less in Shahpur instance block with vitamin A supplementation. Vitamin A supplementation has the protective function in cut downing the morbidity and mortality during the rubeolas outbreaks9. Mayfong Mayxay et Al recorded that the proportion of parents who practiced nutrient turning away behaviour was higher in the group with measles10 which agree with our survey consequences. The community ailment beliefs are more powerful in instance block like bulks of respondents in Shahpur block believe that rubeolas has to look one time in life clip owing to the approvals of Sheetla mata-the culprit of the unwellnes s. As a follow up patterns in the station recovery stage from unwellness, so they invoke the approvals of the goddess Sheetla. On the other manus, population in Nagrota Bagwan block were cognizant of rubeolas as a disease caused by close contact with septic individual, resorted to intervention and followup by qualified physicians at healthcare installation. Mothers in comparative block country had better entree to healthcare installations as compared to instance country. From in deepness interviews it was apparent that though socio-cultural and economic factors were more favourable among comparative group female parents as compared to instance respondents. The surveies by Ratho RK11 et Al, VK Desai et al12, Murray M and Rasmussen Z13, Jagvir Singh et al14, R. F. Grais et al15 and Munesh SK et al16 support our observations.Restrictions:Recall prejudice could hold occurred with regard to remembrance of immunisation of the kids of the both survey countries. However, the prejudice could use to both survey countries. So the prejudice would be non derived function.Decision:-Majorities of the female parents with or without rubeolas in the hills seek traditional first aid ( such as intervention seeking and follow-up patterns of female parents ) during unwellness to quacks/chelas/faith therapists on history of hapless socio-cultural, economic factors ; myths and misconceptions ; malformed beliefs and barriers. -Distant and hard entree to healthcare installation in geographically tough countries is besides one of precipitating factors.Recommendations:Aggressive Information, Education and Communication ( IEC ) activities should be addressed towards modifying the aid seeking behaviour of female parents in the territory, particularly in the rubeolas affected countries. It has to be targeted and boosted for economic and societal behavioural alteration instead than informing the community. The duty has to be shared both by wellness suppliers, wellness searchers and community. Access to wellness attention installation needs to be improved through proviso of nomadic services on a regular basis in the distant countries.