Diabetes In The 21st Century: Fill & Download for Free

Life has gotten harder for centuries with every succeeding generation. It’s the way it is when a culture advances. I just love these answers that give off this virtuous “we had it hard and it was good for us” air. Please. I say the biggest reason is because the stuff considered necessary to make it in today’s world or that is available for purchase wasn’t stuff that was needed in 1950 or existed in 1950. Just like the stuff that 1950s people needed or desired to have wasn’t what was needed or available in 1900.We who live in the 21st century aren’t any better or worse than any other generation before us.A family in 1900 didn’t have to have much compared to a midcentury family. They made their own clothes, they raised their own food or traded with the neighbors and only went to the store for staples like bread (and they made that at home as well), flour, salt/spices, and other basic ingredients so they could cook—there was no such thing as ready made meals or any food off the shelf that could be purchased ready to eat, and nobody really went out regularly for meals. They made or grew/raised just about everything they ate, they did physical work on the farm to make money by selling what they grew or made, they didn’t own things like cars or appliances. They used horses or walked for transportation, they didn’t have washers or dryers or refrigerators. Their houses didn’t have electricity. They used outhouses and got water from a pump outside for bathing and cleaning/cooking instead of indoor plumbing. They also didn’t need child care because mother and father worked from the home and when they left to go somewhere a neighbor looked out for the kids or they took the kids with them—people knew their neighbors back then. They also didn’t have to send kids to college—a good factory job back in the day was all they needed to be able to support themselves, and you didn’t need college for that. Most jobs didn’t require any education higher than 12th grade, and folks that did complete the 12th grade were rockstars.If people needed a doctor in 1900, they weren’t expensive and they would come to the house. Unless people were really sick or injured nobody went for extended hospital stays. Giving birth, recovering from an illness or dying was done at home, and treatments for many diseases, severe injuries, or medical conditions were very elementary or didn’t exist at all. People who got diabetes died from it. People who had heart ailments or had a heart attack were SOL— stents or open heart surgery didn’t exist, you went toes up when your heart failed. Farm accidents killed a lot of people. Even surviving something like the flu was a crapshoot, you crossed your fingers that you would make it since there were no vaccines and flu killed a LOT of people in the early 1900s. And of course women’s odds of surviving childbirth weren’t great. Infant/child mortality was high as well—lots of children didn’t make it to adulthood. Medical care was cheaper in part because there wasn’t much doctors could do for people who were sickly, badly injured, or had a serious health issue—such people lived as long as their bodies held up then just died from whatever it was they had.A family in 1950 had it harder than their 1900 counterparts. People had to live in a city or at least a medium sized town if they wanted a good job, they needed to have at least one car so someone could go to work, they generally didn’t make their own clothes, they needed to have (or in the city, that was all there was available) a modern house with indoor plumbing and electricity as opposed to a cabin with an outhouse and a pump, they shopped for food instead of growing/raising it. Families may have owned at least a washing machine but not a dryer—people used to line dry their clothing. They owned a refrigerator and toaster, but not a dishwasher or a microwave. They had a phone, radio and TV-that was the extent of the available technology. Because the society was becoming more technical than the society of 1900, college became more of a necessity if one wanted to be middle class—unless a person was working as a tradesman or a union job, a post high school education, either a college education or completion of a vocational program became necessary.Going to the hospital when sick or when medical attention was required was more common than in 1900. Women didn’t really give birth at home like they did in 1900, and if people were sick with anything more serious than a cold, flu or some childhood disease like chickenpox, you spent time in the hospital. Costly treatments for conditions like heart disease or cancer that kept a person alive for years didn’t exist, which meant people with those conditions just died back in the day.Since mom stayed home, childcare costs were pretty much reduced to paying a neighborhood teen to babysit for a few hours if Mom and Dad wanted or needed to go somewhere.So families in the 1950’s spent more to live than the family in 1900, and people who grew up in 1900 probably had much to say about “modern families spending too much on luxuries like that durned indoor plumbing and ‘lectricity, and needing to go back to the old ways, when we had to get a light to go to the toilet out back in the middle of the night”.And now? In the 21st century, two cars are necessary because both spouses work. And they are working for: cable TV (it’s nearly impossible to rely on rabbit ears), internet service which in today’s world is essential, electricity bills because to power that huge TV with the surround sound and the security systems , household appliances like microwaves, washers and dryers, and refrigerators, cell phones (which you have to have now, good luck finding a payphone anymore), computers/laptops, and AC, will cost you. If you live in the city, there are more people living there now than there were in 1900 or 1950, so rents and home prices are very much higher, and most people who need to get a good job need to live in a city—living in a rural area in the 21st century is near impossible for working age people who need a job that pays a living wage. And of course, working parents need childcare-the neighborhood teen isn’t enough anymore.And medical care is now very different even from 1950—it costs more and people are getting treatments for diseases, injuries, and health conditions that would have killed them in 1900 and 1950. In exchange for cures and treatments that weren’t available earlier, we are paying more to live longer.So. I say, it’s not only because people are more wasteful or more materialistic now than in eras past. Every era had people who were materialistic and needed to have the latest and greatest, 21st century folk aren’t the first to want more luxuries and nice stuff. I’m sure there were people in 1900 who paid a lot of money for the latest whiz bang farm tool that promised to make their lives easier, or the most luxurious fabric for clothing, or specialty staples and exotic spices to make their food with if they could.And there were more than a few 1950’s folks that got the biggest home in the best neighborhood they could afford, bought the coolest car with the latest gadgets in it, and bought nice furnishings and clothing for themselves and their families as well. WE all know that not every person in the 1950s or the 1900s deprived themselves if better was available and they could afford it. Very few folks turned up their noses at indoor plumbing when it became available, for example—they ran to get those indoor toilets. They loved turning on a faucet as opposed to pumping water every time they needed it. When electricity became available, very few people said, “Nah, I’ll stick with candles, thanks”.Peruse any advertisement from the 1900s or the 1950s—people sold exotic, new, upscale, state of the art, and glamorous just as hard as they sell it today. To make it sound like those folks back then were some kind of superhuman saints because they went to the bathroom outside and we don’t is a ridiculous retelling of history and human nature. The people who lived in the 1900s went to the bathroom outside because they didn’t have a choice. Just like I used a payphone in the 1970s because that was all there was. But if someone told me I could have a cellphone as opposed to depending on public phones—come on now.It’s the price we pay for increasing advances in technology and for having a more comfortable, long life. Most people are not going to live like a person did in 1900. They don’t have to and they aren’t going to do it, even if they THINK it was “better”. We as a species developed all these high falutin’ things BECAUSE life sucked hard without them, we possessed enough brains to figure out how to make things better as opposed to living like the rest of the animal kingdom, and we invented them to make life suck less hard. Of course that naturally means you’ll pay more but most folks value comfort and convenience a LOT.If you want to talk about the advantages of living a simpler life, then you have to acknowledge the risks, dangers, and inconvenience that went along with that simpler life and acknowledge that the only reason many people didn’t have what we have today is because it wasn’t available for them to get. But don’t sit there and pretend you are ready to go back to 1950, you know you aren’t going to.

In the UK over 90% of healthcare interactions occur in primary care - primary care physicians comprise approximately a quarter of the medical workforce. Not only amazingly good value for money but an invitation to ask: 'What is there left for secondary care to do?'The migration of activity from secondary to primary care clearly must have limits, otherwise every community would house its own local hospital and cover all eventualities - that isn't going to happen. Primary care must remain a broadly generalist discipline and that dictates limits. Having two packs of specialists would be wasteful. A generalist also has the crucial advantage of knowing the full physical, psychological and social picture of the patient which does or should inform management - secondary care often needs its hand held with this aspect.Now that most diagnostic modalities are accessible from primary care only the truly puzzling need end up in out patients. Complex co-morbidities need multidisciplinary management which may not be available in primary care. Procedures that require very high value plant and support staff will remain in secondary care.Perhaps a list of the most frequently occuring primary care services in 21st century primary care would help:general medical services - making the initial response to whatever comes through the doorfamily planning - all modalitiesimmunisation - children, adults and touristsminor surgery - including joint and soft tissue injectionsphysiotherapycryotherapycounselling/CBTUVB - we did in my health centreminor injury managementante and post natal carehealth educationchronic disease management - BP, asthma, lipidaemia, diabetes etc.podiatrymedical assessments for employment etcinsurance medicals- and quite a few others.At the end of my career I was doing a much wider range of things than at the start. Most of the list above I introduced or contributed to the introduction of in the practices in which I worked.Primary care has moved from basic triage and onward referral to being the primary locus of healthcare.The taking of a history, full examination, lab tests and imaging and accurate placement into the secondary sector if required relieves the burden on hospitals at that end of the patient journey. When formal diagnosis and secondary sector treatment continues and finishes much monitoring occurs in primary care - again taking the burden from secondary care.Let me know if that prompts further questions.

Everybody has written about the Roads, Pokhran-II tests, etc. Though these are big achievements, I consider the silent laying of a strong foundation for a knowledge economy was the main one.Despite running a coalition, Mr. Vajpayee and the then HRD minister Dr. Murali Manohar Joshi had achieved much more in the knowledge front than many other governments before and after.The key knowledge things that were initiated and currently became a grand success are…Formation of NIT and merger of RECs with the NIT structure and creation of many new NITs — common entrance along with IITs. Now with over 20 NITs all over the country, along with IIT, are into world class education in Engineering and Technology.Formation of IIITs — in many states where there were no IITs.Clean-up of Rashtriya Sanskrit Sansthan and merger/ formation of many Sanskrit universities (campuses) with Rashtriya Sanskrit Sansthan. Samskrita Bharati was commissioned to teach the entry level courses such as “pathama-diksha", etc. — As a result, within a span of 2 years over 1 crore (10 million) people studied Sanskrit and wrote the exams. Thus started the renaissance of Sanskrit in 21st Century.Formation of AYUSH department (which has become a ministry now). Creating and cleaning up of many key research institutions, such as CCRAS for modernised Ayurvedic research.Formation of NMPB (National Medicinal Plants Board) as part of AYUSH department and major revival of Medicinal herb cultivation.Formation of TKDL (See below for more details on TKDL and also on and Bio-piracy and how IPO theft is being prevented because of TKDL)Formation of National Manuscript Mission (Now it is known as NaMAMI)ITK (Indigenous Technical Knowledge) research in Agriculture as part of ICAR — this has resulted in many cost effective and efficient traditional practices — natural/local/organic being brought to lime-light and also been put into practices by people. This also helped in the subsequent Organic farming movements across the country in 2009-2011 and further gained mind share during Anti- GMO agitations in 2010. This resulted in India regaining a huge market share for spices in the world with good YoY growth since due to Organic farming of spices.These were some of the phenomenal achievements of Vajpayee government in the knowledge front. There are few more, but are even more subtle than these.Many of these things didn't get proper publicity in the MSM (main stream media) and that has been the failure of Vajpayee government.The current government certainly need to learn from Mr Vajpayee's government wrt. to HRD.Mr. Vajpayee's touch on many things in governance is what we were missing, are missing and will be missing.--------------------Why TKDL?Many don't know that American pharma companies had unsuccessful attempts to patent Neem (nimba) and Turmeric (Haridra /Haldi) in WIPO. Indian government then fought and successfully prevented them from getting patented. However many Ayurvedic herbs' active ingredients and active molecules are already were taken and used in Western medicines for quite some time. To prevent this ancient knowledge being stolen was the main reason for the formation of TKDL.There is a very special Ayurvedic herb called “नित्यकल्याणि” (“nityakalyāṇi”) which has been used for both Diabetes Mellitus as well as Cancer since time immemorial in Ayurveda. From this Ayurvedic herb “nityakalyāṇi” (“Catharanthus roseus” - formerly known as “Vinca rosea” from which the Vinca Alkaloids where isolated) and from this the leading cancer drugs Vinblastine and Vincristine have been formulated. These drugs are patented, costly, etc. No credit what so ever is given to Ayurveda, on top of that the plant out of the only 2 regions in the world it grows — India and Madagascar. There is no mention of India and even the botanical name was changed.There are widespread efforts to discredit Ayurveda our ancient wisdom in healthcare and ancient Indian achievements on every field.In the current times of 100s new medicinal formulations in Western medicines being discovered everyday from ancient Ayurvedic herbs, through the reverse pharmacology methods — the role of protecting our Biological wealth becomes more important. Thus TKDL is doing great service to the nation and a billion people for their primary healthcare needs.