The Incidence And Severity Of Diabetic Nephropathy

Genetic susceptibility — Genetic susceptibility may be an important determinant of both the incidence and severity of diabetic nephropathy. The likelihood of developing diabetic nephropathy is markedly increased in patients with a diabetic sibling or parent who has diabetic nephropathy. Age — For type 1 diabetes, the risk of developing ESRD is very low for patients diagnosed prior to age 5; at older ages, the relationship of age to progression to ESRD is uncertain Blood pressure — Higher blood pressures have been noted to be associated with diabetic nephropathy. Obesity — A high body mass index (BMI) in patients with diabetes has been associated with an increased risk of chronic kidney disease. In addition, diet and weight loss may†¦show more content†¦Metabolic memory applies in nephropathy. In nephropathy, significant persistent benefits were noted in those who had received intensive therapy compared with those who received conventional therapy during the DCCT. After eight years of follow-up in EDIC, patients originally assigned to intensive glycemic control were significantly less likely to develop new microalbuminuria (7 versus 16 percent), new clinical albuminuria, also called macroalbuminuria, (1.4 versus 9 percent), and hypertension (30 versus 40 percent). After 16 years of follow-up in EDIC (22 years since in the start of the DCCT trial), patients originally assigned to intensive glycemic control were significantly less likely to develop impaired renal function, defined as an estimated glomerular filtration rate less than 60 mL/min per 1.73 m2 (3.9 versus 7.6 percent). Hyperlipidemia is common in diabetic patients, a tendency that is increased by the development of renal insufficiency. Aggressive lipid lowering is an important part of the medical management of all diabetic patients since diabetes is considered a coronary heart disease equivalent. An elevation in lipid levels also may contribute to the development of glomerulosclerosis in chronic kidney disease. A prospective study in patients with type 1 diabetes mellitus found that a plasma cholesterol concentration above 220 mg/dL (5.7 mmol/L) was an important risk factor for progressive renal disease,

Dress code Free Essays

Have you ever found yourself walking through the halls of a school and stretched out far beyond the sight of your eyes, you notice nothing but masses of students conformed into a single color or uniform? School dress codes have long since been a subject of debate amongst both students and faculty alike. In one school district after another, school uniforms are proposed as the solution. The real question is whether or not they actually serve a functional purpose, and the cost/extent of having those rules in place. We will write a custom essay sample on Dress code or any similar topic only for you Order Now School dress codes impose on freedom of expression, is time consuming, can be very costly and serve no functional purpose outside of school. Having a dress code (such as a uniform) is expensive and has no use outside of school. Poor families may not have the money to pay uniforms and having that as a dress code may be more of a hassle for them. They may depend on hand me downs or may buy clothes from second hand stores that do not provide uniforms. Buying clothes that follow a dress code may also be more expensive because children may still want clothes that they can wear outside of school. Uniforms have no use out of school. It is not a casual outfit for going to the mall or park. It is not a business suit that could be used for interviews and other occasions. Having a dress code causes the school to misuse its time. Dress codes are not enforced very well. Some teachers enforce following the dress code and others do not which presents miscommunication with students. Some students can get away with not following the dress code and others do not. When the dress code is enforced it wastes class time. It takes time away from the teacher and instructing the class. It takes away from the child’s learning experience and the rest of the child peer’s learning experience. Dress codes have not been proving to help students academically, behaviorally, or socially which means there is no valid reason to have one. Having a dress code infringes on an individual’s personal right. The first amendment states that â€Å"Congress shall make no law respecting an establishment of religion, or prohibiting the free exercise thereof; or abridging the freedom of speech, or of the press; or the right of the people peaceably to assemble, and to petition the Government for a redress of grievances. Implementing a dress code on someone violates their right of the first amendment. Clothing is a way of expressing yourself. It allows people to experiment with their identities and a way to discover your inner self. Self expression is very important to a child’s development emotionally. In an effort to allow students their rights of expression, avoid costly and wasteful time spending the use of school dress codes should be avoided. Dress codes are simply a way to give schools more power over students and to infringe on their creativity and freedom of expression. How to cite Dress code, Essay examples Dress Code Free Essays I believe that it would be beneficial for our scho ols to adopt dress codes. Although some may argue that this action would rest rict the individual student’s freedom of expression, I do not agree. Our right to express ourselves is important, but in our society none of us has unrestricted free dom to do as we like at all times. We will write a custom essay sample on Dress Code or any similar topic only for you Order Now We must all learn discipline, respect the feelings of others, and learn how to operate in the real world in order to be successful. Dress codes would not only create a better learning environment, but would also help prepare students for their futures. Perhaps the most important benefit of adopting dre ss codes would be creating a better learning environment. Inappropriate clothi ng can be distracting to fellow students who are trying to concentrate. Short skirt s, skimpy tops, and low pants are fine for after school, but not for the classroom. T -shirts with risky images or profanity may be offensive to certain groups. Stude nts should espress themselves through art or creative writing, not clothing. With fewer distractions, students can  concentrate on getting a good education which can help them later on. Another benefit of having a dress code is that it will prepare students to dress properly for different places. When you go to a party you do not wear the same clothes you wear to church. Likewise, when you dress for work you do not wear the same clothes you wear at the beach. Many profession s even require uniforms. Having a dress code in high school will help students adjust to the real world. Lastly, with all the peer pressure in school, many  students worry about fitting in. If a dress code (or even uniforms) were require d, there would be less emphasis on how you look, and more emphasis on learning. In conclusion, there are many important reasons our schools should adopt dress codes. Getting an education is hard enough without being distracted by inappropriate t-shirts or tight pants. Learning to dress for particular occasions prepares us for the real world. And teens have enough pressure already without having to worry about what they are wearing. How to cite Dress Code, Papers

Refining the Hr Policy Framework to Support the Vision free essay sample

We seek to lead through research, to educate for excellence and to connect ND contribute through engagement. Substantial progress has been made towards achievement of our vision to be one of the worlds finest UN verities and we will need to continue to adapt and improve in pursuit of this vision. The Universitys strategy document Growing Esteem 201 0, states: For the university to realize the ambitions of a refined Growing Esteem strategy it needs people who share the vision and can achieve the actions required. Over the coming years we need to ensure that our research and teaching reputation remain among the best in the world in the face of increasing intention; to adapt our approach, to both teaching and our general interactions with students to support a greater proportion of graduate students; and to diversify our sources of revenue to support our endeavourer. It is in this context that we seek to articulate our HRS strategies and refine our HRS Policy Framework so that we can support and develop our staff to achieve the excellence in performance that provides individual satisfaction and collectively will maintain and grow Melbourne standing. We will write a custom essay sample on Refining the Hr Policy Framework to Support the Vision or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page This paper identifies the major strategic and policy issues which need to be dressed to position us for the future through a refinement of the current HRS management framework over the next three years. This paper provides a blueprint for action to guide HRS policy development over the next three years. From this framework, detailed policies and procedures will be specified, and there will be opportunity for staff and other stakeholders to provide further input to these as they are progressively developed.These policies will be implemented at the local level within the university and therefore the support that will be provided to our supervisors and managers ho are responsible for the day to day interactions with our staff will be vital to their success in bringing about the required changes. Background 1 The environment we will be working in The environment we will operate in over the next 5-10 years will change significantly and both external factors and the internal decisions made in our plans Will impact on the staff profile we will need to prosper in the new environment and the HRS policies and procedures that we need to support our staff. External factors Changes in the external environment provide us with challenges and opportunities. Increased globalization of the higher education sector will lead to stronger competition for the best students and staff. This competition for staff will include professional staff, particularly specialists, who will also be sought after in the wider economy. Strategies will need to be implemented to attract, develop and retain the best academic and professional staff who can plan, deliver and support an excellent learning experience for students, and also demonstrate innovation and a capacity to thrive in a changing environment.Tech nological change will also open new avenues for both education and search and the way in which work is performed in general and aids networking. The increasing pace of knowledge acquisition will require review of the range of information taught in courses and in the way it is delivered. On the research side, funding models and the interest of governments in finding solutions to major societal problems drives greater collaboration both in the development of cross functional teams within the Sensitivity and also in increased engagement with other universities, other research bodies and industry.The national higher education policy environment is placing more emphasis n nation-building through growth in graduate Outputs, job readiness Of graduates, social inclusion, funding for performance, and international standardization of award nomenclature and content. There is also greater emphasis on engagement of universities with their broader communities. All of these factors and the funding regimes which support the national policy decisions are focused on growth, which is at odds with our chosen direction to limit growth in student numbers.The local policy framework is also influenced by continuing fluctuation in the global financial environment. The international educat ion company DIP Education is now predicting a considerable decline in international student numbers coming to Australia in the medium term which will impact on the University capacity to replace lost local revenue from this source. The ageing academic and professional staff profile across the sector and within the University more specifically means that we will have to attract, develop and retain high quality staff to replace staff lost through natural attrition. Internal decisions and factors Melbourne has taken the decision to limit growth and to eventually reduce dent numbers to a more stable and manageable size in order to provide the highest quality education to our students. Consequently we will need to build other revenue streams and to find ways of doing things more efficiently. We will need to be both flexible and entrepreneurial and be able to engage well with the external community. Over this time we will also significantly change our student profile, from the current ratio of 70:30 undergraduate to postgraduate students to achieve a 50:50 balance.It will be challenging to attract high quality postgraduate students in these numbers. This more mature student population will be more demanding and will have high expectations of teaching and support and of their interactions with our administrative staff. Their assessment of the quality of the teaching they receive, their overall satisfaction with their experience and their capacity t o get good jobs will impact on our rankings both nationally and internationally against our competitors. The HRS policy imperatives This likely future environment highlights the need to consider how together we can increase the focus on performance and productivity and ensure that ACH staff member achieves their goals and contributes to the University in the way best suited to their strengths and expertise. This will require a strong alignment between individual goals and performance and the University objectives and a different approach to developing and managing performance. These changes must be introduced in ways which protect and preserve the fundamental values of the institution, such as meritocracy, collegiality and academic freedom. Where we are now 1 Our current staffing profile Melbourne permanent staff number in excess of seven thousand, divided almost evenly between academic and professional staff and is supported by over two and a half thousand additional casual staff. Our academic and professional staff include many talented, committed and long-serving people. It is our s taff, their interactions with each other, with students and with local, national and international communities that establish and define our reputation and position in the global higher education sector.Staff are employed in positions classified according to the current academic and professional staff classification structures, specified in the Universitys Collective Agreement. In addition to our paid staff, a large number of honorary and visiting academic staff contribute to the life and scholarship of the University. Our current staffing profile has the following characteristics: ; We have a large number of early career academics, with approximately of the university academic staff employed at Levels A and B; ; These early career academics are predominantly employed on fixed term contracts.This position changes with seniority, with the majority of academic staff at Level C and above employed on a continuing basis; ; In contrast, most professional staff re employed on a continuing basis, with 55% of professional staff employed at HEW Levels 5 to 7; Figure 1 : Current distribution of Academic Staff by Classification (headcount, excluding casuals) I ICP] Fixed term : Distribution of Fixed term and Continuing Professional Staff by I Classification (headcount) Level B.I Level D. Level E. | 96. 2 Staff I Figure 2 171. 8 42. 6 125. 3 127. 9 ; The growth in the Universitys staff numbers from 2005 to 2008 has largely been the result of an increase in casual staff numbers. ; Over 1 0 % Of the university academic work was performed by casual staff in 2009. Casual tutors are responsible for a significant portion of teaching into new generation degrees. The ratio of professional to academic staff has remained relatively steady since 2007 and is below the average for Australian universities and the Group of Eight. This is largely because of the way the university classifies Level A and B research support staff as academic rather than professional staff unlike many other universities. Approximately a third of both professional staff and academic staff are over 50 years of age; Figure 3: Age distribution of academic and professional staff Academic Staff by level pick Professional Staff by level ; Approximately 55% of Melbourne academics are male; ; Women make up the majority of academic staff at Level A, but by senior levels the position is reversed. Although Melbourne performs better than the sector average in terms of the percentage of women at Levels D and E and at HEW, women remain underrepresented at PVC and DVD levels as well as amongst membership of the Senior Executive more generally.The appropriate consideration of performance relative to opportunity for staff with significant external responsibilities, non-traditional career paths, or less Han full-time working hours remains an ongoin g challenge; ; A higher proportion of our female staff is employed on a part-time basis than the ; In 2008 and 2009 over half of all professional staff sector average; positions have also been filled internally while 56% of self-initiated departures from the University in 2009 from this group were from staff with less than 3 years service.The corresponding percentage for academic staff for self- initiated early departure is 51 This suggests a turnover of newer staff to the University and is a concern if these staff are of high quality and being attracted by better offers from other employers. Level A academic staff and professional staff at HEW levels 3-5 are over-represented in these departure statistics suggesting a need to provide better opportunities and support for good early career academics and professional staff; and ; Staffing costs per FEET are increasing at a faster rate than student load.Until recently this has been compensated for by revenue growth but as the environmen tal scan above shows, this may not be possible in the future. 2 Current performance Melbourne is well ranked In international rankings and we improved our session in the most recent round of the Shanghai Jiao Tong and Times Higher Education Rankings. In the Jiao Tong rankings Melbourne was ranked 62nd in the world, the second Australian institution after ANN. at 59th. This ranking system uses weighted scores associated with alumni, awards, citations, and publications.Melbourne scores better than ANN. in the alumni and awards categories but has lower scores in each of the research categories. In the Times Higher Education rankings Melbourne is ranked first of the Australian institutions, at 36th in the world listing. A new methodology was seed in 2010 for this ranking based on teaching (the learning environment), international mix (staff and student ratios), industry income, research volume, income and reputation, and citation impact.The quality of teaching within the University is vital to our students educational outcomes. While the Times Higher Education teaching scores for Melbourne are higher than our national competitors we have some way to go to reach the level of our international benchmarking partners. The CEQ good teaching scale also indicates room for improvement. While these rankings vary and are not absolute indicators of teaching performance, it is clear that caching performance has a significant impact on the level of satisfaction of our students.Improvement in our overall teaching performance will contribute to a more positive learning environment for our students. Nationally in 2008 and 2009 Melbourne was ranked first in the country for research income and publications however, if these measures were viewed per capita (across the total number of research and teaching and research staff), then our leading position would not be maintained. We also performed well in nearly all discipline categories in the first trial ERA outcomes gaining cores Of 4 or 5 in nearly all discipline categories.Our research performance has a significant impact on our rankings and on our ability to attract research income and quality staff and students. While we should be justifiably proud of that performance it will be more difficult to maintain this position in the future due to likely improvements in the performance of our competitors. We could raise our position in the international rankings and maintain our premier position nationally if there was improved average performance in winning grants and publishing across a broader spectrum of the academic staff complement.The future 1 The goals of Growing Esteem 2010 Melbourne has articulated the outcomes we wish to achieve by 201 5 in Growing Esteem 2010, including that: ; Melbourne will have an academic workforce sustainable in number and quality and outstanding in its achievement; ; Melbour ne will be top ranked in all key national indicators of research excellence and impact; ; Melbourne will be top ranked in relation to research higher degree recruitment and outcomes; ; Through key partnerships we will have maximized the global impact of our research; ; Melbourne will be ranked in the top five against all national learning and each ins and student satisfaction indicators; ; Melbourne will be providing the best graduate experience in the country according to appropriate national indicators; ; Staff will feel able to contribute broadly to our vision of interaction with wider society through knowledge partnership, advancement and international activities; and ; Melbourne will have talented, diverse staff who share a common vision and whose skills and knowledge equip them to achieve the University goal of being one of the best international universities in the world. As has been shown Melbourne is currently well placed in relation to some of hose measures of performance, but given the increasingly competitive and global higher education environment, to maintain or improve this position will require improvements in leadership and management and to performance management and development, recognition of the diversity of professional and academic roles, greater recognition of the efforts of our staff and innovative approaches to retaining, and nurturing the best teachers and researchers and flexible and innovative professional staff.Specifically, amongst other things, we need to: ; Emphasis research excellence not just research activity and improve the verbal consistency of research performance and the number of high citation researchers who count among the worlds top 250 in their fields; Understand, reward and promote research excellence and creativity, provide career development opportunities and mentoring and develop a research recruitment and retention strategy; ; Improve the consistency of the quality of teaching and the student experience across the University while allowing for increased specialization of academic staff in this area; and, ; Promote engagement activities as an equal partner to research and learning and teach ins. Supporting this vision through a refined HRS Strategy To flourish in this environment and achieve these ambitious outcomes we will need to more actively manage our staff profile over the next five years through a refined HRS Strategy. Our HRS strategy must enable us to achieve the level of performance necessary if we are to be one of the worlds finest universities.We will need to: ; Develop our existing staff; ; Commit resources to attract and retain staff of the highest quality; ; Put in place appropriate succession planning; ; Provide classification structures which recognize diverse career paths and low specialization by both academic and professional staff; ; Nurture early career academic and professional staff and provide them with clear career paths in the university; ; Address the issues relating to the salutation of our staff complement and the increasing proportion of fixed term staff, while retaining flexible working arrangements; ; Recognize and develop the partnership be tween academic and professional staff and build the ability of staff to work seamlessly with colleagues from other disciplines and institutions; ; Develop and recruit change-adept and flexible academic ND professional staff; ; Enhance the support provided for the core activities of the University by improving performance of the central enabling divisions through professional development and performance review; Develop and improve systems which reward and recognize excellent performance in learning and teaching, research, engagement and leadership and in professionals disciplines; and ; Continue to encourage diversity and address issues relating to the participation of women, particularly at higher levels of the University.