Models of Health for Obesity Intervention

Models of Health for Obesity Intervention Introduction Public health has been a topic of government debates. It is an increasing issue that is provoking a lot of publicity. Strategies are being implemented as well as policies in order to tackle the ever increasing problem of obesity which is clearly a public health issue. A case study from the Nuffield Council on Bioethics (2007) showed that the United Kingdom has the highest prevalence of obesity in Europe. Due to the NMC confidentiality clause in accordance with The Nursing and Midwifery Council (2008) Code of Conduct, nurses must respect peoples right to confidentiality. Therefore for the purpose of this essay the patient’s name has been changed and any personal or identifiable information has also been altered so as to protect his privacy and dignity.This essay aims to discuss and explore policies, biopsychosocial model and contribution of therapies to health and wellbeing with reference to Troy (see appendix 1) Public health Public health refers to the methods of preventing disease, prolonging life and promoting health through organised efforts and informed choices of society, organisations, public and private, communities and individuals (WHO, 2013). It is concerned with threats to health based on population health analysis. The population in question can be as small as a handful of people, or as large as all the inhabitants of the United Kingdom. The dimensions of health can encompass a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity (WHO, 2013). Sim McKee (2011) suggest that Public health incorporates the interdisciplinary approaches of epidemiology, biostatistics and health services. The focus of public health intervention is to improve health and quality of life through prevention and treatment of disease and other physical and mental health conditions. This is done through surveillance of cases and health indicators, and through promotion of healthy behaviors. The range of public health interventions in order to reduce food related ill health is potentially considerable and this includes; presenting on an individual basis, health education and promotion, composition regulation in food, accurate food information labels and product traceability just to name a few. From 2004, the United Kingdom has put together a number of initiatives that are aimed at tacking obesity with recognition of the need for policy change as well as individual behavior change and personal attitude towards food. Policy Due to the alarming statistics on obesity in the United Kingdom, the government has a policy to try and tackle the rising problem. According to the Policy, figures show that 61.9% of adults and 28% of children aged between 2 and 15 are overweight or obese. People who are overweight have a higher risk of getting type 2 diabetes, heart disease and certain cancers (Department Of Health, 2013). Excess weight can also make it more difficult for people to find and keep work, and it can affect self-esteem and mental health. This being the case of Troy as he suffers from type 2 diabetes due to his weight, has mental health and has never found work. It is costing the Government 5million pounds to obesity related illnesses. The policy has an action plan to reduce these statistics by 2020. The government want people to eat and drink more healthily while being more active. It is giving people advice on a healthy diet and physical activity through the change4Life programme. The programme promotes healthy life styles. The moto is ‘Eat Well, Move More and Live Longer’. Change4Life is a society-wide movement that aims to prevent people from becoming overweight by encouraging them to eat better and move more. It is the marketing component of the Governments response to the rise in obesity (Nhs, 2013). Improving labelling on food and drink will help people make healthy choices. The policy states that a system for labelling on the packages that makes it clear what is in food and drink, is important. The consistent system combines red, amber, green colour-coding and nutritional information to show how much fat, saturated fat, salt and sugar, and calories are in food products. Also encouraging businesses on the high street to include calorie information on their menus so that people can make healthy choices. By giving people guidance on how much physical activity they should be doing, the policy seeks to help individuals as well as professional to understand how to reduce the risk of ill health associated with inactivity and sedentary behaviors. As much as it is an individual’s choice on when and what they eat, the government want businesses to take responsibilities of the products that they are selling by making it easier for everyone make healthier choices for both staff and customers. The ‘Responsibility Deal has 4 networks’ include; alcohol, food, health at work and physical activity which all have collective pledges that businesses are encouraged to sign up to. The actions to help people eat more healthily include; reducing ingredients like salt, sugar and fat that can be harmful if people eat too much of them. Also encourage people to eat more fruit and vegetable to help reach their ‘5 A DAY’. Lastly putting calorie information on menus and helping people to eat fewer calories by changing the portion size or the recipe of a product (Department Of Health, 2013). The policy asks the local councils to get involved in combating obesity and encourage healthier lives by making sure that the r ight services are in place. An example of this is recreational areas in the neighborhoods have outdoor gym facilities. Biopsychosocial model Biopsychosocial model, traditionally considered appropriate with regards to obesity, as all elements of the model are relevant. This model shows disease arising from the overlap of components. In applying this model to obesity research, biologic systems are viewed in isolation, not taking into account their interaction with the environment and behaviours until one is obese. There are several factors that could lead one to be overweight or obese and the biopsychosocial model can be used to understand these factors. One of them is biological factors which include genetic susceptibility, increased number of adipose cells formed during childhood, hormonal imbalance such thyroxine produced be the thyroid gland, and several more (Marieb Hoehn, 2010).Although strides have been made exploring the pathophysiology of obesity, treatment and prevention have focused mainly on two components, the psychological and the social. The psychological aspects include eating behaviours, activity habits an d health awareness or knowledge. Troy suffers from depression this could be a factor to consider as a reason why he is obese. Taylor (2012) recognises that people that eat while depressed or stressed are more likely to consume sweet and high-fat foods. Troy has accustomed himself to bad eating behaviour. Most take away food have high volumes of sugar, fat and salt, which are triggers of weight gain. He may not be aware of the implications of his weight increase. As a student nurse, I feel talking to Troy and making him aware of his weight problems may be ideal. Giving him healthier options when he asks me order him a take away and advising him to eat more of the reduced sugar, fat and salt food. Troy has a high craving for sweet fizzy drinks, telling him of the alternative drinks such as sugar free or sweeteners would be ideal thus empowering him to make a choice. The social aspect of the model include socioeconomic, neighbourhood, schools and food policy. When it comes to obesity there are a great variety of social variables that contribute to one being overweight and obese. For instant today we are bombarded with advertisements for fast food restaurants and high calorie pre-packaged foods or microwave food. The media plays a big role in changing our attitude and behaviour toward food by using persuasive messages and images. A study by Taylor (2012) shows that socioeconomic factors contribute to one’s attitude towards food. The study revealed that that people of low socioeconomic status tend to be more overweight than people with high socioeconomic status. An explanation for this could be the fact that food that contain high-fat and processed foods are cheaper than nutritious and fresh foods such as vegetables and fish. Troy lives in poor estate and relies on the benefit system for his income. This in not much so he tend to buy the che aper and faster foods. Also social and family interaction could affect one to become obese as eating habits can be influence by others around the house. Other social factors could be educational level, employment and cultural influences. Advising Troy tocook his own meals when his at home and educating him on the difference between fresh cooked meals that contain low fat, sugar and salt versus Fast food would be in his best interest. He lives alone so giving himself more time outdoors and engaging in activities, like going out for walks or even light exercise as a starting point. Understanding the reasons for obesity is important but more important is to find ways to stop and prevent it. Health promotion is any effort that encourages people to engage in healthy behaviour’s such having a healthy diet and maintaining a healthy weight (Schneider, Gruman Coutts, 2005). Behavioral treatment Behavioral treatment is an approach used to help individuals develop a set of skills to achieve a healthier weight. This treatment is used in people who suffer from eating disorders and those who are overweight or obese. It does more than helping people to decide what to change but also helps them identify how to change. The behavior change process is facilitated through the use of self-monitoring, goal setting, and problem solving. Studies suggest that behavioral treatment produces weight loss of 8–10% during the first 6 months of treatment. Structured approaches such as meal replacements and food provision have been shown to increase the magnitude of weight loss (Foster, 2002). Stuart (1967) suggests that behavioral treatment of obesity developed from the belief that obesity is the result of maladaptive eating and exercise habits, which could be corrected by the application of learning principles. Behavioral treatment is based primarily on principles of classical conditioning, which suggest that eating is often prompted by antecedent events, for example cues, that become strongly linked to food intake. According to Brownell (2000) Behavioral treatment helps patients identify cues that trigger inappropriate eating behaviors and help them learn new responses to these cues. Treatment also seeks to reinforce the adoption of positive eating behaviors. This treatment also incorporates cognitive therapy due to the fact that, in cognitive therapy ones thoughts or cognitions directly affect feelings and behaviors (Beck, 1976). Negative thoughts are predominantly associated with negative outcomes. When one over indulges in food and they are dieting, they tend to think they have messed up their dieting schedule therefore proceed to eat even more secondary to feelings of failure and hopelessness. Beck (1976) in his book on Cognitive Behavior therapy mentions that cognitive therapy patient s learn to set realistic goals for weight and behavior change, enabling them to realistically evaluate their progress in modifying eating and activity habits, and to correct negative thoughts that occur when they do not meet their goals. Fairburn, C.G, Wilson G.T. (1993) agree with Beck (1967) that Cognitive interventions for weight management are based on those developed for the treatments of depression, anxiety, and bulimia nervosa. Programmes such as Weight Watchers can be incorporated in Behavioral Therapy as Weight Watchers meetings promotes goal setting and advices on low calorie food intake. Conclusion Arguably, although the policy set by Department of Health on obesity seeks to promote programmes like change4 life which supports eating five vegetable or fruit a day, it does not completely tackle the issue of affordability. Fresh vegetable, fruit and fish is expense meaning those who have low income cannot afford these foods. It then means it comes back to the fact of them not affording the healthier food so they opt for cheaper processed food. A lot of literature that has been written on the subject matter, obesity, is from the United States of America because they are a nation who are also trying to tackle obesity. They have much a bigger issue of obesity and I believe as a nation we can learn a lot from them. In the case of Troy, Behavioral therapy would be ideal as it involves cognitive therapy, so he can talk about his problem and set realistic goals for himself helping and improving his quality of life. The best interventions have been in the fields of dietary management and behavioural change. APA Reference Allen, N. B., Lewinsohn, P., and Seeley J.R. (1998). Prenatal and perinatal influences on risk for psychopathology in childhood and adolescence. Developmental Psychopathology. New York, United States of America: Guilford Press Beck, A.T. (1976). Cognitive therapy and the emotional disorders. New York, United States of America: International Universities Press. Brownell, K.D. (2000). The LEARN program for weight management 2000. Dallas, United States of America: American Health Publishers Co. Department of Health. (2013). Policies. Retrieved from https://www.gov.uk/government/policies/reducing-obesity-and-improving-diet Dilts, S. L. (2012). Models of mind: A framework for Biopsychosocial Psychiatry. East Sussex, United Kingdom: Routledge. Donatelle, R.J. (2008).Access to health(10the.d.).San Francisco,Canada: Pearson Benjamin Cummings. Fairburn, C.G, Wilson G.T. (1993). Binge eating: nature, assessment and treatment. New York, United States of America: Guilford Press. Foster, G.D. (2002). Goals and strategies to improve behavior-change effectiveness. Philadelphia, United States Of America: Hanley Belfus. Health Promotion Strategic Framework. (2014). Health promotion. Retrieved from http://www.healthpromotion.ie/hp-files/docs/HPSF_HSE.pdf Heim, C., Newporr, J., Heit, S., Graham, Y. P., Wucox, M., Bonsall, R., Miller, A. H., and Nemeroff, C. B. (2000). Pituitary-adrenal and autonomic responses to stress in women after sexual and physical abuse in childhood. Journal of American Medical Association, 284, 592-97 Marieb, E.N. Hoehn K. (2010).Human anatomy physiology(8th e.d.).San Francisco,America: Pearson Benjamin Cummings. Nhs. (2013). Change for life. Retrieved from http://www.nhs.uk/change4life/Pages/change-for- life.aspx Nuffield council on Bioethics. (2007). Public Health, Ethical Issues. Retrieved from http://www.nuffieldbioethics.org/public-health Schneider, F. W., Gruman, J. A., Coutts, L. M. (Eds.). (2005).Applied social psychology: Understanding and addressing social and practical problems.Thousand Oaks,Canada:Sage Publications Stuart, R.B. (1967). Behavioral control of overeating. Basel, Switazland: Reinhardt Druck. Taylor, S.E. (2012).Health Psychology(8th ed.).New York,United States of America: McGraw-Hill World Health Organisation. (2013). Obesity. Retrieved from http://www.who.int/trade/glossary/story076/en/ Appendix 1 During one of my placements in a hospital situated in the North of England, a young Troy man aged 24 was admitted to Psychiatric Intensive Care Unit (PICU) presenting with Psychotic episode and hallucinations. He lives alone in a one bed council flat, has never worked and receives Benefits. He has a long history of drug and alcohol misuse, although he has been drug free for over 6 months. Troy weighs 26 stone and has been known to the service for self-harming and depression from the age of 14. As his treatment has progressed, it has become clear to me that he has other issues like bad eating habits. His mother from a very young age, feed Troy with a lot of fast food as she herself suffered from Clinical depression. They lived in a poor estate up the age of 8 when he was put into care because his mother was unable to cope and neglected him and his siblings. He has very little contact with his family except his grandparents who regularly visit him. Now at his later stage in life, Troy likes to eat take away and drinks a lot of sugary fizzy drinks. His weight has become an issue on the ward as he has found the single beds too small and he complained of the blankets being too small. The consultant had been concerned about his weight and suggested that some of the psychotic medication he is taking may be contributing to his weight gain as they tend to trigger a lot of cravings. He has diagnosed with type 2 diabetes while admitted on the ward. http://psychrights.org/research/Digest/NLPs/Seroquel/SeroquelMedicalStudies/Gen.%20Cause%20Resp.%20Ex%2010.pdf

What should Betty do?

Betty needs to evaluate the ethical and legal aspect of the situation. Did Betty lied for the Senior Management position? The question Is about what Is right and what is ethical and, what Is the right thing for Betty to do? The current proposed action for Betty Is, whether the action Is legal? According to Bagley and Savage (2009), It Is vital to address the legal Issue first In order to establish the perception that legal compliance is the starting point for any standard.Also the authors stated that â€Å"when you try to keep to the letter of the law while undermining the spirit, you are likely to violate the letter in the end† (p. 26). This implies that it is better to adhere to the law because law helps to shape the competitive environment which affects each of the five forces that determine the attractiveness of an industry. In this regard being part of senior management, it is important for Betty to choose the legal path. Does answering yes to the legal issue, maximize sh areholders value? There are two answers to the question, yes or no. If Betty answers yes, the next question Is, Is It ethical?The Issues of ethical are to prove o the customers, employees, community, environment, and suppliers than satisfying the shareholders. If the proposed Issue maximizes shareholders value and It Is ethical, then Betty has to disclose to the human resource department. Similarly, If her answer in maximizing shareholders value is no, then Betty requires to evaluate the effects and cost on shareholders with regards to other stakeholders. The question is would it be ethical not to take action? If the answer to this question is no, then Betty has to disclose her actions to shareholders.How should Human Resources handle his situation? Since human resources have requested Betty's personal and educational information to update her records, the human resources department needs to give her a deadline as to when the Information is due and also give her the option to set a meeting If she Is unable to come up with the Information at the stipulated time. Until human resources receives the Information or hears from Betty, they should give her the benefit of the doubt without making any Judgment or assumption. In the event where Betty is unable to prove that she has an MBA, and decided to come clean,Human resources should offer her a step down with the option to complete her MBA, voluntary resignation and firing her should be the last resort considering her outstanding performance during her ten years tenure at Colossal. As Senior Vice President, the position requires legally astute managers and leaders are expected to adhere to the laws and ethical standards. As managers, they have to set the ethical tone of the company and employees. Go ethical behavior from leaders is considered good for a business and the authors stated that â€Å"patterns of unethical behavior tend o result In Illegal behavior over time† (p. 3). Reference Bagley, E. & Savage, D. (2009). DUMB 610 course pack: Managers and the legal environment. Coinage Learning: Mason, OH. Is Shaker's behavior ethical? Sharked behavior on one hand is unethical because he was someone â€Å"in the know', he gathers information through colonization from coworkers and shares the same information with other coworkers who may use the information to their advantage. This portrays Sharked as an unethical person that lacks integrity, fairness and honesty. On the other hand, Sharked has the right as an employee to ask questions bout the relationship between his boss and Sheila Sharpe.Sharked should review the company's code of conduct if available for guidance or call the company's ethic hotlist to report his suspicion. According to Bagley and Savage (2009), it may be worthwhile to inform other employees about unethical situation. If other employees did not show interest, through evaluation of his beliefs, Sharked can follow what he feels deem to proceed on the issue. Does it make a difference if the allegation of the affair between his boss and Sheila Sharpe is true or false? It does difference if the allegation of the affair between Sharked boss and Sheila Sharpe is true.If the affair is false this can lead to destroy the personal character of Sheila Sharpe. As a manager, he should set the stage for better ethical environment. As the manager, he the responsibility to enact code of conduct, training employees and arrange a method of reporting misconduct. Sam Cipher finds out that Sharked has been gossiping about him and Sheila Sharpe. Assume the gossip about Sam and Sheila is not true, and Sam wants to fire Sharked. Should the Human Resources Office support his decision? This is a conflicting situation the Sam Cipher should must decide as what is the right thing to do in this situation.According to Barrack â€Å"when trying to resolve problems that raise questions of personal integrity and moral, managers should ask, who am l? † This will reveal Sam Cipher feelings in terms of the conflict at hand and determine if the conflict may affect the company. The Human resource should ask, who are we as an organization? The human resource department should determine the interpretations of the ethical implication on the company. The human resource department should insider the position of the organization in terms of relationship with the stakeholders.

California Space Heaters

New line of invented, convection, kerosene space heaters Due to high energy prices In the ass, the units were expected to do well The target market was aimed at low Income consumers who had electric heating systems – especially In the east Also would be used by those consumers who had their heat shut off 1) Is this heater a socially useful product? Should it be produced at all? Yes, based on the incremental benefits of existing heating mechanisms, the space heater is a socially useful product.More cost efficient, enabled heat to be focused where needed eliminating unnecessary waste In rooms where heat wasn't needed, and could enable certain demographics to have heat where they otherwise wouldn't (due to high energy prices). 2) under what legal standards will consumer In]rules be dealt with? Liability lawsuits were probable should there be injuries or adverse health consequences. Strict liability in tort would in all likelihood be the applicable liability standard, so the compa ny could be held liable even if an injury were due to reasonable misuse by a consumer.Total costs would include the cost of liability insurance, legal and court costs, and the time of management required by the cases. Insurance costs could be reduced by adding safety features. 3) What framework should the company use to make decisions about which product safety features to add? Given that framework, which particular product safety features should they add? The company should weigh the costs of the bare bones option of the space heater.From here determine the costs and benefits of adding subsequent safety features while incorporating the likelihood of harmful effects based on the data that they have. Electric spark ignition should clearly be incorporated given that it reduced the likelihood of death by an estimated 50%. 4) Should the company offer a line of products with various safety features/price combinations from which customers can choose? How should the product be priced? Ther e should be one consistent, standard safety level that the company should strive o achieve.By implementing different safety levels, the company runs a large risk of legal risk of future penalties and the final price should have an optimal balance between cost of parts and labor vs. future liability. 1) What were the underlying cases of the spill? 2) Evaluate the political and economic logic of the $20 billion fund from both President Obama and BSP point of view. 3) Should the U. S. Government change the way that it regulates this industry? Implement policies that minimize risk California Space Heaters There is a fine line between how much safety a corporation should provide to the consumer regarding its products vs. how much responsibility of safety should fall on the average consumer. Take, for instance, the all too familiar McDonald’s coffee episode. Does McDonald’s have a responsibility to its customers to ensure the coffee isn’t hot enough to scald if spilled upon one’s lap? Or should the customer be held responsible for their own safety in regards to common sense judgment? This is what California Space Heaters, Inc. CSH) must consider when deciding exactly which products to launch. Kerosene heaters are often times used in shops and garages as well as inside homes. They are quite a bit heavier than standard electric space heaters, which tip over easily. Because of their weight (and low center of gravity with fuel), kerosene heaters are typically very sturdy. Tipping over a kerosene heater takes some doing. Additionally, because there is fuel involve d, people are probably more cautious than they might be with an electric heater. Users have the responsibility to use extreme caution when operating any fuel-based component, especially any type of heating device. Due to the stability of these types of heaters, a corporation should not be held liable for recklessness that results in a kerosene heater tip-over. Using these arguments, I would recommend that CSH does not incorporate an automatic cut-off when tipped over on any of its units. Instead, one of the most important features that should be implemented is an electric spark ignition. The first danger of no electric start option is simply the repetitive lighting of a match. While it is the users’ responsibility handling matches safely in their own home, a combustible fuel is also involved, which increases danger significantly. According to CSH engineers, adding an electric start option would decrease the probability of death by 50%. Even though the cost of the feature is relatively high at $19. 50, the risk of death is simply too high to ignore. A corporation that has been given such estimates from its engineering department has a responsibility to implement a safety device. Electric start is the single most important ption that should be incorporated on all models for safety reasons. The profile of users in a shop or garage setting differs greatly from users in a home. Users in a shop or garage are more likely to be mechanically inclined. Additionally, safety features are arguably more important in a home than in a shop or garage. In a home, the heater is typically closer to combustibles, including furniture, curtains, and carpet. Due to these v ariables, CSH should market an indoor/outdoor heater and an outdoor only heater. The only necessary option on the outdoor heater is the electric start, as previously discussed. A shop or garage user will likely be more mechanically inclined and able to adjust the wick accurately. A thermostat shouldn’t be needed because the unit will less likely be near combustibles. Overheating due to flare-ups will not be as big of an issue either because of the surroundings, not to mention the user is more likely to notice flare-ups because the unit will only be operating when he or she is in the garage or shop, in most cases. A removable tank would also not be necessary since fill-up is easier outdoors. On the other hand, the indoor/outdoor heater should have three options incorporated on the base model. The first is the electric start option, as mentioned previously. The second most important option is the wick stop. This option keeps users from lowering the wick too much, which causes inefficiency and increased emissions. The average home user is probably less likely to know how to operate the wick for ideal combustion. And because the unit is operating indoors, emission control is much more important than it is in a garage or shop where there is more ventilation. The third and last option absolutely necessary for the indoor heater is a removable tank. Refueling a tank indoors is dirty, aromatic, and more dangerous than refueling outdoors. A removable tank also eliminates the need for a siphoning system. A tank level gauge is just a â€Å"bell and whistle† not needed for a base model. An electric wick adjustment is an option that could be implemented on higher-end models, but is not a big safety concern, so does not justify the high cost. For both indoor and outdoor heaters, it would be very important to apply warning labels in clear view on the kerosene heater in regards to asphyxiation, proper wick adjustment methods, re-fueling methods, and other pertinent safety information. The cost of the basic heater without any safety options is $44. To add the electric ignition for the outdoor model, the cost would be $63. 50. Adding the wick stop and removable tank to the indoor model, the cost would be $76. With an average of a 95% markup for retail, the outdoor unit would sell for about $124. The indoor unit would sell for about $144. 50. The safety features implemented for these base models do three things. First of all, they address basic safety concerns that are considered (at least in part by the engineers) to be relatively dangerous to the average user. Secondly, by keeping the safety features to a minimum and including only the options deemed pertinent to safety, it keeps the price as low as possible, while maintaining corporate responsibility. And lastly, by implementing these features (though few), insurance premiums per unit should drop from the estimated $55 per unit. In conclusion, corporations have a responsibility to provide reasonably safe products, but consumers must also use common sense judgment and take responsibility for their own actions. By introducing these base model products as suggested, sales shouldn’t lag far behind the estimated 2,000,000 units annually; and on top of that, the units can be something CSH can proudly produce knowing that safety precautions have been provided to customers. Oh, and my view on the McDonald’s coffee case? Whether the coffee was 100 or 200 degrees, the customer who spilled the coffee was solely to blame.

Prometheus - Profile of the Greek Titan