Risk Behaviours of Cardiovascular Diseases Study

Risk Behaviours of Cardiovascular Diseases Study Title of the Study To identify the prevalence of ineffective physical activity and unhealthy dietary pattern among MSc Nursing students; could lead to cardiovascular diseases. Significance of the Research Problem Global Burden of Cardio Vascular Diseases: There are many risk factors associated with coronary heart disease. Some risk factors such as age, ethnicity and family history, cannot be changed. Additional risk factors that can be treated or changed which include tobacco exposure, hypertension, high cholesterol, obesity, physical inactivity, diabetes, unhealthy diets, and harmful use of alcohol. In terms of attribute global deaths, the leading CVD risk factor is raised blood pressure 13%, tobacco use 9%, raised blood glucose 6%, physical inactivity 6 % and overweight and obesity 5% (World Health Organization, 2012). Low- and middle-income countries are disproportionally affected: over 80% of CVD deaths take place in low- and middle-income countries and occur almost equally in men and women (Mendis, Puska Norving, 2011). The number of people, who die from CVDs, mainly from heart disease and stroke, will increase to reach 23.3 million by 2030 (Mendis, Puska Norving, 2011). Most cardiovascular diseases can be prevented by addressing risk factors such as tobacco use, unhealthy diet and obesity, physical inactivity, high blood pressure, diabetes and raised lipids. Cardiovascular diseases and Ineffective physical activity: Insufficient physical activity is the fourth leading risk factor for mortality. People who are insufficiently physically active have a 20 to 30 percent increased risk of all-cause mortality compared to those who engage in at least 30 minutes of moderate intensity physical activity most days of the week. In 2008, 31.3% of adults aged 15 or older (28.2% men and 34.4%) were insufficiently physically active. Cardiovascular diseases and unhealthy dietary patterns: Approximately 16 million and 1.7 million of deaths worldwide are attributing to low fruit and vegetable consumption (Mendis, Puska Norving, 2011). Frequent consumption of high-energy foods, such as processed foods that are high in fat and sugar, promotes obesity compared to low-energy foods. Adequate consumption of fruit and vegetables reduces the risk of Cardio Vascular Disease. A healthy diet can contribute to a healthy body weight, a desirable lipid profile and a desirable blood pressure (Mendis, Puska Norving, 2011). Risk Behaviors The vulnerable populations of MSc Nursing students are at high risk of developing such risky behaviors that might endanger their own lives. Although, the above behaviors are modifiable but due to shortage of time and increase load of studies, students are seems careless of their diets and physical activity. Purpose The purpose of this study is to look for the two main risk behaviors of cardio vascular diseases among MSc Nursing students. These are: Ineffective physical exercise. Unhealthy diet. Research Questions What is the prevalence of ineffective physical activity among MSc Nursing students? What is the Prevalence of unhealthy dietary pattern among MSc Nursing students? Target Population The target population for this study would be the existing students of, Masters of Science in Nursing of the Aga Khan University, Karachi, Pakistan. Study Design This would be a descriptive cross sectional study design. Key Study Variables The key variables of the study would be ineffective physical activity and unhealthy diet. Operational Definitions of the Study Variables Ineffective Physical Activity Ineffective physical activity can be defined as ‘less than five times 30 minutes of moderate*activity per week, or less than three times 20 minutes of vigorous activity** per week, or equivalent(Mendis, Puska Norving, 2011). *Moderate activity level Your heart beats faster than normal; you can talk but not sing. Examples include fast walking, aerobics class, doing weights, or swimming gently. **Vigorous activity level Your heart beat increases a lot; you can’t talk or your talk is broken up by large breaths. Examples include jogging, running, basketball, or hiking up a steep hill (World Heart Federation Organization, 2014). Unhealthy Diet: High dietary intakes of saturated fat*, trans-fats** and salt, and low intake of fruits, vegetables and fish (white meat) are linked to cardiovascular risk (Mendis, Puska Norving, 2011). *Saturated fats found primarily in animal sources including red meat and whole milk dairy products. **Trans fats found in vegetable shortenings, some margarines, crackers, candies, cookies, snack foods, fried foods, baked goods, and other processed foods made with partially hydrogenated vegetable oils (World Heart Federation Organization, 2014). Hypothesis There is a prevalence of unhealthy diet among MScN students. There is a prevalence of ineffective physical activity among MScN students. Description of the Questionnaire A questionnaire is formulated to test the hypothesis under the light of the research question. The questionnaire comprises of the following three parts. Demographic information: The first part addresses the basic demographic information. The aim of acquiring the demographic information from the participants is to gather a baseline data about the key characteristics of the sample. Moreover demographic variables will be needed to assess the similarities and differences between the participants and characterize them accordingly. A total of 6 items are included in this section. The demographic characteristics included in the questionnaire comprises of name which is kept optional. The other components of this part include age, gender, ethnicity, family history related to (angina, stroke, diabetes, and kidney disorder), use of any medications, language, and family relationships. We make this form with the help of available literature and exclude other points like education level, because it is already known from sample. Physical Activity The second part consists of 12 items modified and derived from the Healthy heart questionnaire, which develops by Colorado Public Health Research. We modified it according to the developing country life style. We adopt the pattern of multiple choice and nominal scale for clarification of analysis (Colorado Public Health Research, 2010). For fulfilling the purpose we include the questions related to WHO definitions and for making user friendly, we have given the conceptual definition of the moderate, light and vigorous exercises in easy English words, and these definitions are also derived from American Heart Association guidelines. Dietary Pattern The third part of the questionnaire comprises questions related to dietary pattern. These questions are derived and modified from American Heart Association and American Nutrition guidelines. The scale includes; more than once a day, about once a day, 2-3 times a week, about once a week, 1-3 times a month, and less than once a month, for accuracy of the data of the nutritional status (Colorado Public Health Research 2010). Assumptions underlying the Statistical tests to be used The analysis of the data would be done through available valid statistical software like SPSS 19.0. For the purpose of analyzing the data three statistical tests would be applied in order to measure different levels of association between the key variables. The demographic information would be presented through descriptive statistical analysis (Beitz, 2008). This would include measures of central tendency like (mean, median and mode) to describe the overall demographic characteristics of the study population. Apart from the measures of central tendency, percent analysis (Beitz, 2008) would be used to determine the presence and overall prevalence of ineffective physical activity among study participants. Also percent analysis would be used to determine the unhealthy dietary pattern. In order to determine the association between various demographic variables like age, gender, height and weight of sample size individuals, univariate analysis would be used while determining that the obse rvations would be independent of each other. Population is normally distributed and assuming the homogeneity among the population variances (Bluman, 2011). Moreover, Pearson correlation analysis would be used to examine the strength and nature (positive, negative, inverse, none) of 2 variables of cardio vascular disease. With unhealthy dietary habit, keeping in mind the four assumptions of correlation i.e. the variables should be measured in interval and ratio scale, variables should have a linear relationship between the two, there, all significant outliers should be predicted and removed and the variables should be approximately normally distributed (Beitz, 2008). Effectiveness and Correctness of the Tool Pre –testing of the tool In order to test the effectiveness and correctness of the tool, the tool was pilot tested among three fellows from the MScN students from our class. The tool was distributed for filling the form. The feedback which was received from fellows is quite helpful .While testing the questionnaire; we identified a few components that needed to be modified. Firstly, they identified that in dietary pattern, if we add the instruction that tick the examples mention in bullets so it would be helpful to analyze that which type of ingredient is more common in our population. Secondly they suggest that the BMI should be added in the questionnaire with that feedback we respond that we asked in our questionnaire about weight and height which is equivalent to BMI therefore it was not added in the questionnaire. The feedback was taken as a positive critical reflection and first advice would be incorporated in the final questionnaire for the study purpose. Reflection Overall the questionnaire development was a stimulating and challenging task. The process of questionnaire development in itself is quite difficult as it requires researchers to critically analyze the hypothesis and research questions and formulate such questions that fulfill the overall inquiry of the subject understudy while excluding the unnecessary those details which are not suitable for developing country. In conclusion, the tool development task was a vigorous exercise that would help us to develop an effective tool for our thesis in particular. The pilot testing was an effective strategy to be kept in mind while developing the final tool. Acknowledgement We would like to thank Dr. Raisa Gul and Ms. Yasmin Parpio for their valuable support and guidance throughout the process of the questionnaire development. We would also like to acknowledge and thank all the three study participants who co-operated with us and provided us their valuable time and required data to test the questionnaire.

Network Design Proposal

Unlimited Security International is a diversified company composed of two segments (Security Solutions, and Fire Protection) that provides vital products and services to customers around the world. Security Solutions: Sell, designs, installs and maintains integrated systems to detect intrusion, control access and react to movement, fire, smoke, flooding, environmental conditions, industrial processes and other hazards. Fire Protection: Sell, designs, installs and maintains fire detection, fire sprinkler, fire suppression, emergency communications, and nurse call systems in both new and existing facilities.Our global reach allows us to anticipate changes across geographies and industries, and deploy the right solutions rapidly. In the most challenging and demanding environments, we help our customers achieve their safety, security and business goals. Unlimited Security International is a market leader in the $100 billion+ global fire protection and security solutions industries. Our 2 25,000 employees take great pride in knowing that they make a difference in the world: their work helps protect and safeguard people and property. Our products and solutions help protect:80% of the world’s top retailers More than 1,000,000 fire fighters around the world 300 international airports 100+ major stadiums around the world 200+ hospitals around the world Nearly 9 million commercial, government and residential customers Communications Methods used by Unlimited Security International1. Desktop computers – Used by management, sales, service, and administrative workers to conduct daily transactions, email, and training. 2. Plain old telephone service- Used to conduct routine conversations with customers, and field technicians. 3. VoIP – Used to conduct secure conversations within the organization. 4. Video teleconference, conference calls, and Web-Cast – Used for training, passing word, analyzing plans while saving money from travel expenses. 5. Lap top computers and VPN’s – Used by management, and mobile employees. 6. PDA’s – Used by remote employees to view, and update  plans and documents. 7. Smart phones – Used by mobile employees 8. Wireless network 9. Global Positioning System – Track vehicle location and usageProtocols802.1q (VLAN) 802.3an 802.11n 802.16 (WiMAX) Media Gateway Control Protocol (MGCP) Domain Name Service (DNS) Ipv4 Hypertext Transport Protocol (HTTP) Hypertext Transport Protocol Secure (HTTP) Trivial File Transfer Protocol (TFTP) Simple Network Management Protocol (SNMP) Internet Control Message Protocol (ICMP) Internet Protocol Security (IPSec) Session Description Protocol (SDP) Temporal Key Integrity Protocol (TKIP) Wi-Fi Protected Access 2 (WPA2)Management and MonitoringThe goal of our network fault management and monitoring is to detect, log, notify users of, and (to the extent possible) automatically fix network problems to keep the network running effective ly. Fault Management—Detect, isolate, notify, and correct faults encountered in the network. Configuration Management—Configuration aspects of network devices such as configuration file management, inventory management, and software management.Performance Management—Monitor and measure various aspects of performance so that overall performance can be maintained at an acceptable level. Security Management—Provide access to network devices and corporate  resources to authorized individuals. Accounting Management—Usage information of network resources. The management and monitoring platform will include:Network discovery Topology mapping of network elements Event handler Performance data collector and grapher Management data browserTrivial File Transfer Protocol (TFTP) and system log (syslog) servers are crucial components of this troubleshooting infrastructure. The TFTP server is used primarily for storing configuration files and software images fo r network devices. The routers and switches are capable of sending system log messages to a syslog server. The messages facilitate the troubleshooting function when problems are encountered.Security ManagementThe goal of our security management is to control access to network resources according to local guidelines so that the network cannot be sabotaged (intentionally or unintentionally). The security management subsystem can monitor users logging on to a network resource, refusing access to those who enter inappropriate access codes. Use the following methods of controlling access on the routers and switches: Access Control Lists (ACL)User IDs and passwords local to the device Terminal Access Controller Access Control System (TACACS)TACACS is an Internet Engineering Task Force (RFC 1492) standard security protocol that runs between client devices on a network and against a TACACS server. TACACS is an authentication mechanism that is used to authenticate the identity of a device se eking remote access to a privileged database. Variations of TACACS include TACACS+, the AAA architecture that separates authentication, authorization, and accounting functions. AuthenticationAuthentication is the way a user is identified prior to being allowed access to the router or switch. There is a fundamental relationship between authentication and authorization. The more authorization privileges a user receives, the stronger the authentication will be.AuthorizationAuthorization provides remote access control, including one-time authorization and authorization for each service that is requested by the user.Accounting Accounting allows for the collecting and sending of security information used for billing, auditing, and reporting, such as user identities, start and stop times, and executed commands. Network managers can track the services that users are accessing as well as the amount of network resources they are consuming.Unified Communications1. Unified Messaging (Voice, Ema il & Fax) 2. Mobility 3. Audio & Video Conferencing 4. Core UC (VoIP, IM, Group chat, webconferencing) 5. PBX Integration and/or Replacement 6. Contact Center 7. Communication enabled Business Process (CEBP)Protocols1. Session Initiation Protocol (SIP) 2. Real-Time Streaming Protocol (RTSP) 3. Real-Time Transport Protocol (RTP) 4. Real-Time Control Protocol (RTCP)

Application of Simulation Technique in Queuing Model for ATM Facility Essay

1.0 Issues/ Problem Statement: Most of the ATMs have the problem of long queue of customers to undergo simple transaction at the peak hours and remain idle due to the lack of customer entry at the off peak hours. 2.0 Objectives: 1. To develop a simulation model to reduce the waiting time of customers and the total operation cost related to ATM installation. 2. To determine whether only one machine is required to fulfill the need or two more machines are needed to be installed to give comfort to customers who are really of short period of time. 3. To develop an efficient procedure for ATM queuing problem 3.0 Literature Review: Apart from ATM problem, simulation with queuing model had been used for various applications too: According to Pieter Tjerk de Boer (1983), substantial focus has been dedicated to the estimation of overflow probabilities in queuing networks. A different adaptive method has applied to queuing problems than in the present work with few simple models been considered.The article of S. S. Lavenberg(1989) has discussed that simulation is feasible for statistically studying a complex queuing model. Moderate simulation durations are found to be sufficient to obtain precise confidence interval estimates. As current configuration at each step of savings or insertion procedures is possibly infeasible, thus the alternative configuration is one that yields the largest savings in some criterion functions with these procedures can be found in Clarke and Wright (1964) or in Solomon (1987). Christofides et al (1981) has discussed Lagrangean relaxation procedures for the queuing of customer in front of ATM. Interactive optimization is incorporated into the problem-solving process with adaptations of this approach to queuing are presented by Krolak et al (1970). Brame and SimchiLevi (1995) has illustrated simulation model is worked by initially introducing the location based heuristic for general queuing problem as a location problem which is solved subsequently and the solution is transformed into solution to the queuing problem. 4.0 Methodology: Simulation technique in queuing model is used for solving ATM waiting time problem since this problem cannot be solved with mathematical techniques and physical experimentation. Simulation technique helps identifying the pitfalls of existing 3 ATM services of 3 different banks at VIT (Vellore Institute of Technology). Initially, the simulation is being applied to see the rate of entry and exit, the waiting time of a customer with the ATM machine’s idle time after observation of the similar and continuous trend on weekdays and weekends separately. The next step i.e. utilize queuing model to examine the number of customers in the system to the customers wait before being served, thereby it proposes a new ATM service from any of these banks or other than the existing banks based upon the service required from the customers. A suitable simulation technique is also formulated to reduce idle time of servers and waiting time of customers for any bank having ATM facility. 5.0 Findings: The overall result shows the comparison between the three banks based on several characteristic, by applying mathematical formula, the simulation technique and queuing theory. From the simulation result, Indian Bank weekend has the lowest expected time customer spends in the system, 80; whereas Indian Bank weekdays free and Centurion bank have the highest in expected time customer spends in the system that is 120. Apart from that, the result also shows Indian Bank weekdays free and Centurion Bank has the 0 time for the customer expected to wait, whereas SBI weekend has the highest expected waiting time per customer, 12. From the queuing result, Centurion Bank has the lowest expected time customer spend in the system that is 189, whereas Indian Bank weekdays free, SBI weekdays free and SBI weekend has showed the highest, 250. For the expected waiting time per customer, Centurion Bank has showed the lowest 69, whereas SBI weekend with the highest result, 159. 6.0 Discussions: By taking one day as a standard, a heavy crowd is found in prime hours during the weekdays in Indian Bank and SBI ATMs, the equipment ATM is 100% utilized by the customers. Utilization factor for Indian Bank and SBI in the non-busy hours is 50% and 55% respectively. In weekend period, the utilization factor for Indian Bank and SBI is 62% and 64% respectively. The reason shows that the SBI has obtained the highest utilization factor among the other 2 banks is because of the customers do not face the â€Å"Out of Service Problem† which is frequently occurred in Indian Bank and Centurion Bank, with an average of two times in a week. However, it takes more time to reload the currency in the ATM machine than Indian Bank in SBI. Few customers have the ATM transaction with Centurion Bank because of the dissatisfaction on its customer service and the minimum number of branches throughout the India. In addition, from the tabulate results, SBI ATM has obtained the minimum Ws and Wq than the other two banks which imply that it has attained the customer satisfaction on its services. 7.0 Recommendations: Every aspect that has an effect on making the waiting time longer in the ATM should be taken into the consideration. The aspects like the people that are not well versed with ATM, customers who have stand in the queue and leave, the time the workers take to feed the ATM with currency, out of stock situation and holidays which mostly after exams the utility of ATM should be taken into account of the waiting problem. Another recommendation is the sample size should be extended into larger sample size and more days of observation to obtain more accurate results. In addition, the consideration of waiting cost and service cost can help developing an efficient procedure for ATM queuing problem and to find out the best ATM facility. 8.0 Conclusion: Queuing Model and Simulation Model(SM) are used to define the queuing problems in terms of decision making to reduce the customer’s waiting time. After comparing the customers’ behaviour on different TM service at VIT, a new ATM machine (SBI) should be installed in men’s hostel to facilitate more customers towards the service by reducing the customers cost and service cost for the long run’s benefit. 9.0 Personal Comment/ opinion: In the last ten years, simulation software and methodology has been developed and used in the bank services. The previous sections have shown that using the simulation technique can increase sustainability of a bank with better customer service and enhanced customer satisfaction. However, this simulation technique is not limited only in modeling the customer in a bank, but the same concept can also be applied in defining and analyzing the model of a system or problem in the banking areas. Other areas can be modeled in banking areas such as customer flows to evaluate alternative layout within a branch bank, cash flows between branches and the bank’s central office. Once these models developed, it can easily be used to examine the effect of different parameters on the variables in the model.

The Effects Of Early Childhood Education On The...

ston – Clear Lake Abstract The field of developmental psychology has provided a plethora of information on the impact of early childhood education on the development of necessary social and cognitive skills. The research literature has consistently maintained that children previously enrolled in early childhood education programs generally tend to be more advantaged when beginning formal schooling than children who receive traditional or non-traditional parental care. While many studies have discovered the positive effects of early childhood education interventions, there are many important issues to consider, namely children who are disadvantaged in some way. This review sought to examine recent research literature surrounding the topic of early childhood education, how the research addressed contentious issues such as the long-term effects of early childhood education programs, and the impact that these programs have on the social and cognitive development of children in lower socioeconomic status families. Additionally, this review compared two studies on the effectiveness of early childhood education programs. Future research directions and areas of exploration are also discussed. Introduction Childhood and the course of personal development from birth to late adolescence have been demonstrated throughout decades of research literature to be crucial in formation of the foundation of psychological health (Hall, 2008). 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