intensive lifestyle modification for cad reversal successfully reduces circulating levels of metabolic hormones insulin and leptin

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I need some assistance with these assignment. intensive lifestyle modification for cad reversal successfully reduces circulating levels of metabolic hormones insulin and leptin Thank you in advance for the help! Introduction The incidence of cardiovascular risk factors in the form of diabetes, obesity, dyslipidaemia and hypertension are often considered as the metabolic syndrome. It is reported that almost 29 percent of global deaths occurring is from the Cardio vascular diseases with majority of causalities being reported from the low and middle income countries (WHO, ). It is also predicted that the heart ailments and stroke would be the major causes of death and disability that would result in more than 24 million fatalities in an year by 2030 (WHO, 2004). The proportion of the deaths reported from United States due to Coronary vascular disease is also 30 and this is reported maximum for the age groups above 65 (United States, 2006)

Among various pathogenic factors, insulin resistance and visceral obesity are considered most significant. (Duvnjak and Duvnjak, 19- 24) . The observed metabolic abnormalities are due to insulin resistance in muscles and surrounding adipose tissue along with the adverse impact on tissue by compensatory hyperinsulinaemia, which is insulin sensitive (Duvnjak and Duvnjak, 19- 24). In addition, abdominal adiposity is also considered a high risk for cardio vascular diseases (CVD). Also, the increasing obesity is found to decrease adiponectin that has important cardiometabolic actions (Bray et al, 30-40). Significant breakthroughs have also been achieved in understanding the key initiators for coronary artery disease. The initiation and progression of atherosclerosis has been found to be associated with leptin. Studies have also shown that plasma leptin concentration has direct relation to the incidence of coronory artery disease and thus could be used as a risk indicator for the development of the disease (Dubey et al, 124 – 128).

. It is clear that the role played by obesity in the cardiometabolic risk is very vital for the development of treatment strategies for the patients with a high risk for cardio vascular diseases (CVD).A critical role played by adipocytokines between insulin resistance and cardiovascular disease has been established. It is also anticipated that effective interventions to improve the functions of endothelial or adipose tissues could significantly reduce the occurrence of cardiovascular events in the obese individuals with metabolic syndrome (Hamdy, 231 – 241). One of the effective ways to treat the people with high cardiovascular risk is through the various lifestyle modifications like restricted calorie intake and increased physical activity (Hamdy, 231-241). The impact of exercise on the controlling the risk factors for the cardiovascular diseases have been reported. it has been shown that the low density lipoprotein , cortinsol and leptin levels can be significantly lowered following rigorous exercise sessions. (Karacabey, 1472-1478). Also add a sentence or two on drugs that can be used to lower leptin and insulin levels.

Modifications to the lifestyle are often proposed as necessary criteria for the reduction in the probability of incidence of cardiovascular diseases. But these approaches have not been accepted well by the scientific community due to the absence of adequate information on the long-term effects of the metabolic hormones. The study proposed here investigates the impact of intensive risk factor modification program on insulin and leptin serum level based on the measurements taken at baseline, 12 weeks and 1 year. Thus the specific objective is to assess the changes in physiological risk factors for CAD based on a one year healthy lifestyle intervention. In addition, the relative effect of the changes in insulin / leptin level and corresponding improvement in vascular health is also investigated. Finally, the benefits of cardiovascular risk reduction programs are also evaluated.

References

Bray, G. A., et al. “Overweight and obesity: the pathogenesis of cardiometabolic risk.” Clin.Cornerstone. 9.4 (2009): 30-40.

Dubey, L., et al. “Potential role of adipocytokine leptin in acute coronary syndrome.” Asian Cardiovasc.Thorac.Ann. 16.2 (2008): 124-28.

Duvnjak, L. and M. Duvnjak. “The metabolic syndrome – an ongoing story.” J.Physiol Pharmacol. 60 Suppl 7 (2009): 19-24.

Gnacinska, M., et al. “The serum profile of adipokines in overweight patients with metabolic syndrome.” Endokrynol.Pol. 61.1 (2010): 36-41.

Gnacinska, M., et al. “Role of adipokines in complications related to obesity: a review.” Adv.Med.Sci. 54.2 (2009): 150-57.

Hamdy, O. “Lifestyle modification and endothelial function in obese subjects.” Expert.Rev.Cardiovasc.Ther. 3.2 (2005): 231-41.

Hoefle, G., et al. “Leptin, leptin soluble receptor and coronary atherosclerosis.” Eur.J.Clin.Invest 37.8 (2007): 629-36.

Karacabey, K. “The effect of exercise on leptin, insulin, cortisol and lipid profiles in obese children.” J.Int.Med.Res. 37.5 (2009): 1472-78.

Klimcakova, E., et al. “Adipokines and dietary interventions in human obesity.” Obes.Rev. (2010).

Lindahl, B., et al. “A randomized lifestyle intervention with 5-year follow-up in subjects with impaired glucose tolerance: pronounced short-term impact but long-term adherence problems.” Scand.J.Public Health 37.4 (2009): 434-42.

Qasim, A., et al. “Adipokines, insulin resistance, and coronary artery calcification.” J.Am.Coll.Cardiol. 52.3 (2008): 231-36.

Reinehr, T., et al. “Leptin concentrations are a predictor of overweight reduction in a lifestyle intervention.” Int.J.Pediatr.Obes. 4.4 (2009): 215-23.

Reis, J. P., et al. “The relation of leptin and insulin with obesity-related cardiovascular risk factors in US adults.” Atherosclerosis 200.1 (2008): 150-60.

Rosin, B. L. “The progression of cardiovascular risk to cardiovascular disease.” Rev.Cardiovasc.Med. 8 Suppl 4 (2007): S3-S8.

Singh, P., et al. “Leptin upregulates the expression of plasminogen activator inhibitor-1 in human vascular endothelial cells.” Biochem.Biophys.Res.Commun. 392.1 (2010): 47-52.

Taneli, F., et al. “Increased serum leptin concentrations in patients with chronic stable angina pectoris and ST-elevated myocardial infarction.” Angiology 57.3 (2006): 267-72.

Thakker, G. D., et al. “Effects of diet-induced obesity on inflammation and remodeling after myocardial infarction.” Am.J.Physiol Heart Circ.Physiol 291.5 (2006): H2504-H2514.

Wannamethee, S. G., et al. “Plasma leptin: associations with metabolic, inflammatory and haemostatic risk factors for cardiovascular disease.” Atherosclerosis 191.2 (2007): 418-26.

Psychology (5)

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PSY 215 Module Five Milestone TemplateComplete this template by replacing the bracketed text with the relevant information.For this milestone, you will use the Four D’s diagnostic indicators to analyze one behavior that might impair a person’s adaptive daily functioning. You will determine if that behavior could potentially represent a clinical disorder. Use your template to address the rubric criteria listed below with a minimum of 3 to 5 sentences per bullet. Support your answers with a credible source when necessary.From the list in the Module Five Milestone Guidelines and Rubric, select one behavior that might impair a person’s adaptive daily functioning, then address the following:·  Distress: Describe the extent to which the selected behavior causes distress as characterized by mental or emotional imbalance.[Insert text]·  Dysfunction: Describe the extent to which the selected behavior causes dysfunction by interfering with adaptive daily functioning.[Insert text]·  Danger: Describe the extent to which the selected behavior presents as a danger to self or others.[Insert text]·  Deviance: Describe the extent to which the selected behavior deviates from normality.[Insert text]

Learning Goal: I’m working on a research & summaries multi-part question and nee

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Learning Goal: I’m working on a research & summaries multi-part question and need an explanation and answer to help me learn.Research ArticleDon’t Let the Flu Catch You: Agency Assignment in Printed Educational Materials About the H1N1 Influenza VirusQuestions 1) What was the purpose of this research study? State in your OWN words.2) Pick one hypothesis tested in the study and write it out in ONE, SINGLE, COMPLETE sentence. Specify IV and DV in the hypothesis:H1:a) Identify dependent variable:b) Identify independent variable:3) What theory or theories provided the foundation for this study ?4) What type of research design did the researchers use? If an experiment, specify the type of theexperiment used.5) What were the experimental manipulation(s) in this study? Briefly explain in your own words.6) Did the researchers use manipulation checks? If so, what were they ?7) How did the researchers operationalize the dependent variable you listed in Q2 in this study ?8) How did the researcher (s) establish internal reliability and internal validity? Specify the typeof internal validity used and information for evaluating internal reliability.a)Internal validity evaluation: Type of validity:b)Internal reliability evaluation: Information used to make the evaluation:9) Does this study have strong external validity? Briefly explain why/why not.YES / NO:Why:10) Which statistical tests were used in this study to test for the proposed hypotheses?11) Briefly explain TWO findings/conclusions from this study using your OWN words. In your explanation, state whether these findings have “social significance” and why/why not (5 pts).Finding 1:Social significance:Finding 2:Social significance:12) Briefly explain the TWO limitations of the study using your OWN words (5 pts).Limitation 1:Limitation 2:

Discuss how rifle technology changed the civil war

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Write a 1 page paper on how rifle technology changed the civil war. Technological advancements have affected the American civil war. Rifle technology was the most important one that changed the civil war. The use of rifle-musket changed the way war was conducted during the mid 19 century. Before the coming of rifle-muskets, the Napoleonic tactics of frontal attack was the source of success. The rifle used in the civil war had an effective range of over 500 yards (Moorehead).

It was Dr Richard J. Gatling, who invented the gun in 1861. He got patent for it also. It could fire 150 rounds in a minute. Since it could fire continuously, many regards it as the first machine gun. During the civil war, union forces used Gatling’s weapons on a limited basis (Shane Mountjoy).

Its increased lethality and range undermined Napoleonic tactics. An infantryman with a rifled musket was a greater threat to artillerymen and cavalrymen (Moorehead). During the civil war, an infantryman with a rifle was able to target an artilleryman before they were within the range of canister fire. With rifles, the infantry was able to attack the cavalry soldiers from a greater distance. So, the long-range firepower of the rifle reduced the importance of artillery and cavalry.

When some men advanced, other men gave them protection. It was clear during the battle of Wilderness at Brock Road on 6 May 1864 and Laurel Hill on 8 May 1864, that defensive positions repelled attacks. So, for victory, it became necessary to attack the opponent before he establishes a defence.