Regular physical exercise in patients with type II diabetes mellitus

It is widely accepted that regular physical exercise helps diabetic patients control blood glucose, reduce cardiovascular risk factors, and prevent other related complications. In spite of the undoubted benefits of regular physical exercise, diabetic patients with chronic complications should be aware of potential hazards of practicing exercise. To avoid some harmful consequences of acute exercise, it is necessary to adopt a vigilant attitude with these risk patients and to carefully adjust type and intensity of exercise to the individual situation. This article intends to summarize and analyze the current literature concerning the preventive and therapeutic effects of regular exercise in diabetic patients, pointing out its physiological influence on blood glucose regulation, and to analyze the potential risks of acute physical exercise and the precautions given to patients with a variety of complications.     

The legal consequences for children born of chemically dependent mothers

The justice system has witnessed the negative consequences of chemical abuse. Infants are especially vulnerable to harm as a result of maternal drug use. This article uses a legal perspective to examine the conflict between maternal and fetal rights and reviews selected decisions and laws designed to protect children from maternal drug use. It advocates a policy of state intervention in order to protect children from the damage which can accompany maternal chemical use.     

The continuum of dependent family care: a theoretical explanation and model

ABSTRACT

Caring for dependents with disabilities and how this type of care differs from the care of typically developing dependents has largely remained unaddressed in the work–family literature, partly because of a lack of theoretical development on the concept of dependent family care. Studies examining dependent family care often apply a life course perspective, missing key disability factors influencing dependent family care demands and need for resources. This article develops a theoretical framework of dependent family care that accounts for both typical care, which follows the life course trajectory, and exceptional care, which follows a disability trajectory. We position dependent family care as based on a continuum, achieved by adapting life course theory, family adjustment to chronic illness, ecological systems theory, stigma theory and the social model of disability into a model. We explain how dependent family care occurs and what contributes to whether one is engaging in typical or exceptional care. We draw broad constructs representing predictors of different types of dependent family care. We provide specific examples to illustrate how one might test theoretical propositions, an agenda for further research and discuss implications for family–work–community research and practice.     

The relationship between vitamin D level and erectile dysfunction in patients with type 2 diabetes mellitus

Recent studies have suggested that a relationship could exist between 25-hydroxyvitamin D [25(OH)D] deficiency and erectile dysfunction (ED). The present study evaluated the relationship between 25(OH)D levels and ED in male patients with type 2 diabetes mellitus (DM). The study included 98 patients with type 2?DM aged between 18–80 years. The International Index of Erectile Function (IIEF-5) Questionnaire was administered. The patients were divided into three groups according to IIEF-5 scoring: IIEF-5 score between 5–10, severe ED; IIEF-5 score between 11–20, moderate ED; IIEF-5 score between 21–25, no ED. Biochemical parameters, 25(OH)D and hormonal analysis tests were obtained in all patients. All parameters were compared between these three groups. Of 98 patients included in the study, 32 had severe ED, 45 had moderate ED and 21 had no ED. The mean age was 55.12?±?9.39 years and the mean 25(OH)D level was 13.69?±?8.15?ng/ml. When the three groups were compared, 25(OH)D levels were significantly lower in patients with the IIEF-5 score between 5–10 (p?=?0.020). There was a moderate positive relationship between IIEF-5 score and 25(OH)D level (r?=?0.21, p?=?0.038). The patients with severe ED have considerably lower 25(OH)D levels.     

The impact of income on reunification among families with children in out-of-home care

Income appears to be associated with faster time to family reunification. The observed connection between income and reunification, however, may be causal in nature or the relationship may be an issue of selection, in that other underlying factors explain both income and family safety and stability. We examine the causal role that the source of income plays in reunification. We use administrative data on primary caregivers of children placed in out-of-home care in Washington State from 2000 through 2007 (N = 15,159) matched with public economic support and employment data linked by the Washington State Department of Social and Health Services (DSHS) Integrated Client Database (ICDB). Using instrumental variable analysis, we estimated the effect of the amount of earnings and the amount of cash benefits on reunification. We used county unemployment rates and county food stamp participation rates as instruments. We find modest and inconsistent results that suggest higher earnings are associated with lower likelihood of reunification. We find no consistent evidence linking cash assistance to reunification.     

Social policy and intervention with chemically dependent women and their children

The increase in drug dependency among infants has significant implications for social service providers and must be addressed on the policy level. The policy debates and legislation which have surfaced to date need to be examined more closely and considered in the context of social service needs. This article considers policy options from the framework of social needs and individual needs in relation to the problem of maternal and infant chemical dependency.     

Prevalence of the metabolic syndrome and its relationship with diabetes mellitus by aging

Abstract

Introduction.?It is important to make a prompt diagnosis of metabolic syndrome (MetS) in order to prevent the development of cardio-/cerebro- vascular diseases and diabetes mellitus (DM). The authors estimated the risk of development of DM by the presence/absence of MetS and age groups.

Methods.?A cross-sectional study of subjects undergoing intensive health examination was conducted (3149 men aged 30–69 years). Diagnosis of MetS was based on the criteria of the National Cholesterol Education Program Expert Panel (NCEP).

Results.?The prevalence of DM occurring in association with MetS increased with age; it was 11.9% in subjects with MetS in their 30s, it was 19.8% in subjects with MetS in their 60s. The prevalence of DM among subjects who had one or two components of MetS also increased with age. There was a significant progressive increase of the odds ratio in subjects in their 30s, 40s, 50s and 60s who were judged as having MetS; significant increase of the odds ratio was seen in subjects in their 60s, even in those who were not judged as having MetS.

Conclusions.?Subjects with MetS show a high prevalence of DM, and the prevalence increased with age in the subjects.     

The economics of adoption of children from foster care

Federal initiatives since 1996 have intensified the efforts of states to achieve adoption for children in foster care. For many waiting children, the path to adoption is long. The authors offer an economic analysis of adoption from foster care, with an emphasis on the reasons why achieving the goal of adoption for all waiting children may be so difficult. The authors then estimate the determinants of adoptions from foster care across the states using data for fiscal years 1996 and 1997. Adoption assistance subsidy rates stand out as the most important determinant of adoptions from foster care, followed by use of alternatives (e.g., intercountry adoption). Adoptive matching on the basis of race does not appear to prevent adoptions from foster care in the aggregate, leaving flaws in the matching process, such as a lack of information and difficulty using the Interstate Compact on the Placement of Children (ICPC), as a primary reason why children wait.     

The need for policy direction in the provision of care to the mentally ill: an interdisciplinary view

This paper argues that mental health care is underprovided, and that the role of nonprofit providers should be expanded for three major reasons. First, a positive externality exists since society, as a whole, benefits when those in need of mental health care consume care. External benefits include lower crime rates, lower unemployment, and less homelessness. Second, consumers of mental health care are mentally ill and often do not believe that they need care, underestimate their need, or believe that care is not worth the time or expense. Third, common law, to a large extent, is based on individual liberty, largely ignoring the benefits individuals receive from treatment. It is argued that government policy is needed to increase the supply of mental health care, through nonprofit agencies.     

The abuse of children in out of home care

SUMMARY: One of the major paradoxes in child protective services in the United States is that children removed from their homes on protective orders and placed in foster and group care face continued abuse. These children are reported at two to three times the rates of children living with their families. Investigations are performed by the very system that marks placements. In the US, some recommend resolving these problems by withdrawing from the active protection of children in care. Others hold that because children are in the care and custody of the state, and demand a higher standard of care, specialised prevention, identification. reporting and investigation initiatives are necessary to ensure their safety. This has important implications for other countries, especially the United Kingdom with its recent spate of inquiries into abuse in residential care.     

The use of institutional care for children across europe

This article describes the use and prevalence of institutional or residential care of children in Europe. It looks at systems in Western European countries and in countries of Central and Eastern Europe and discusses some of the difficulties in making comparisons across and within Europe. The author takes a wide view of the available literature, government and non-governmental statistics and case studies across the continent of Europe. Taking account of regional and national variations, he describes two broadly different approaches for children and their families and identifies trends in institutional and non-institutional care in the continent of Europe.

In Western Europe there has been a marked reduction in the use of residential care, accompanied by the development of non-institutional family based care and support services. Whilst there are good child-centred reasons for this shift in provision, some countries have gone too far in reducing residential care and are facing a shortfall in suitable foster carers. The financial costs of both residential and family based services remain high at a time of resource restraints. In the countries of Central and Eastern Europe some family based alternatives to institutional care are emerging, usually within the international non-governmental sector. However, children in out-of-home placements throughout the region continue to enter, and remain in, the same kinds of large, isolated and impersonal institutions that existed before the economic and political changes of the late 1980s.

The writer uses his teaching experience in Romania over the past four years to illustrate the development of small-scale social work initiatives in that country and calls for further developments in legislation and policy to support the practice of the emerging profession of social work.     

Association between sarcopenia and erectile dysfunction in males with type II diabetes mellitus

Background: The prevalence rates for both sarcopenia and erectile dysfunction (ED) gradually increase in middle-aged and elderly diabetic male population and they impair physical functioning, sexual functioning, and quality of life. The aim of the present study was to evaluate the sarcopenia in patients with diabetic ED.

Methods: The study included 98 male patients with type II diabetes mellitus (DM) aged 18–80?years. Blood chemistry and hormone levels were obtained. The International Index of Erectile Function (IIEF-5) questionnaire was administered to the patients. The patients were divided into three groups according to the IIEF-5 score; a score of 5–10 points indicated severe ED, a score of 11–20 indicated moderate ED, and a score of 21–25 points indicated no ED. The muscle mass, handgrip strength, timed up and go test, upper mid-arm circumference, calf circumference, and body mass index were obtained. The statistical analysis was performed using MedCalc Statistical Software version 12.7.7. All parameters were compared between the three groups.

Results: Of 98 patients included in the study, 84 patients had severe sarcopenia, 13 had moderate sarcopenia, while only one patient had normal muscle mass. The mean age was 56.59?±?11.46?years. When patients were divided into three groups according to IIEF-5 score, 38 had severe ED, 39 had moderate ED, and 21 had no ED. There was a significant difference between the three groups in terms of handgrip strength, timed up and go test scores, upper mid-arm circumference, and calf circumference (p?Conclusions: Although muscle mass remains unchanged, muscle strength and physical performance decrease in diabetic ED patients. Diabetic patients with severe and moderate ED have lower muscle strength and physical performance.     

The role of ethics in interdisciplinary technology assessment

Technology Assessment (TA) is a problem oriented endeavour dealing with political, societal, ecological, etc. problems. Only in rare cases is one individual scientific discipline sufficient to assess these problems. Usually the perspectives of different scientific disciplines have to be combined in order to develop interdisciplinary based recommendations to act. In this paper a quality controlled interdisciplinary discussion process is described which encourages an expert group to generate argumentation chains cross-cutting the disciplinary boundaries. The role of ethical reflection in this procedure depends on the problem situation. Whenever a technical application is on the agenda which cannot be allocated to a so-called “business-as-usual” case, one would ask for ethical reflection. This contribution argues that this ethical reflection has to take place together with the interdisciplinary discussion due to two reasons. Firstly, the technical, economical, legal and social aspects are deeply cross-correlated with the ethical reflection. And secondly, participating in such interdisciplinary discussions enables an ethical reflection which keeps in touch with the real world. Two case studies dealing with robotics applications in health care are mentioned as examples for problem settings, in which interdisciplinary TA succeed in developing discipline-crossing argumentation chains.     

The benefits of prisoner participation in interdisciplinary learning

Abstract

This paper considers the provision of an inter-disciplinary workshop day held for Social Work, Police and Nursing students at a UK university. The focus of the day was to give the students an insight into the reality of being a mother in prison, and the impact that having a mother in prison has upon children. A key feature of the day was the involvement of a group of imprisoned mothers from an open prison, who shared their experiences and engaged with students in small groups. The workshop allowed the stereotypes that the prisoners and student professionals held in relation to one another to be challenged. The planning, aims, process and outcomes of the day are considered along with feedback from those taking part. Students reported increased awareness of the stigma faced by this often overlooked vulnerable group of service users, an increased recognition of the needs of children with mothers in prison and an appreciation of the power of interdisciplinary working to deliver a good service. The imprisoned mothers welcomed the chance to educate the students about the issues faced by themselves and their children, and they found the experience of participating to be positive and empowering.     

The heterogeneity of children and their experiences in kinship care

Increasingly, children in need of out-of-home care are being placed in kinship care, yet few studies have followed their placement histories longitudinally to determine if these children constitute a homogeneous group or heterogeneous subgroups. This study of 484 children in kinship care in San Diego County, California, indicates that children in kinship care have markedly different sociodemographic and maltreatment histories, as well as heterogeneous placement experiences.     

Foster care: The protection and training of carers' children

One of the risk factors in foster placement breakdown is the presence of the carers' own children. A project is described through which carers' children express their feelings and conflicts and present a demand for a review of foster care, to be seen as care by families, not only parents. Many children in care have a powerful psychological impact on their carers, and the impact on other children in the household is underestimated and poorly understood. There is a confusion of role between carers' children and children who are fostered—on the one hand, the former are peers, and on the other, considerable demands of patience and understanding are made on them. This understanding, and perhaps also fear of allegations, may make them prematurely adult and distort aspects of their own development. The need for further research into the direct experience of foster care is highlighted and a training model of preparation for carers and their children is described, based on direct work with adolescents.     

The need for educational assessment of children entering foster care

Comprehensive medical and mental health evaluations of children in foster care are recommended within 30 days of entering care. What constitutes a comprehensive evaluation has yet to be established. This study examines the need to include educational assessment as a component of the comprehensive evaluation. Rates of achievement and language problems for Arkansas school-age children are compared with rates of medical and psychiatric disorders to assess the relative need for including educational assessment.     

Partnership with parents in planning the care of their children

Working in partnership with parents is a guiding principle of the Children Act. This principle is made more concrete through specific requirements of the Act, such as those relating to care plans and reviews for children looked after by the local authority. This article examines the extent to which working in partnership with parents has been translated into practice, using some of the findings from a major research evaluation of child care planning under the Children Act.