The Hotel New World Collapse Commerce Essay

The Hotel New World Collapse Commerce Essay Public relation officers agencies are very important people to any organisation as they are the ones who in my opinion keep the ball rolling day in day out. Being a public relations officer, he or she must learn how to handle the media learn how to get clients to keep the business running and most importantly learn how to manage a crisis. There was crisis which took place in 1986, the Hotel New World collapse. 15 March 1986, at approximately 11.25 am The Hotel New World, which is also called the Lian Yak building, located at the junction of serangoon road and owen road, collapsed killing 33 people with 17 survivors. This collapse was a major factor why buildings in Singapore now are much more versatile and less likely to collapse. This was a major disaster which could also be classified as a crisis. And I believe there could have been more effective ways where they could have reacted better and save more lives. 2. Crisis management First and foremost what is crisis management? Crisis management, also known as firefighting, is where you know how to avoid the crisis if its possible and appropriately react to the crisis if it cannot be solved (Bernstein, 2011). During a crisis having a crisis team would be essential. Also the members of the team should be able to tell the higher officials in their organisation what to do during a crisis with no fear. The team members should consist of two spokesperson who are the mouth. One will be a backup. A leader who is the brain, someone who will make the important decisions and are accountable for those decisions, such as the CEO or owner of the organisation. And a lead in-house professional and the full PR agency team also known as the hands, for breadth of reach and redundancy reasons (Anthonissen, 2008). The spokespersons, also known as the mouth are representatives of an organisation. How many spokesperson an organisation needs depends on the size of the organisation as they might have many outlets in many countries. But the basics are two spokesperson. The first one would be the primary spokesperson. He or she would represent the company while handling the media. The second one would be a backup He or she will represent the company if the first spokesperson is not available or if is need to explain the crisis in another location. Also these spokesperson need to be media trained. They should know how to handle the media as its the organisations reputation which is at stake. Thus making a wrong move in front of the media would further add to the crisis hence the spokesperson need be a specialist but must be able to handle the media well. Next is the brain which is the crisis committee. This crisis committee is led by the leader who might be the CEO or owner of the company. The committee`s first job is to make a decision on how will they be operating during a crisis. A very simple way to operate is to make sure majority of the team agrees on the decisions made. But this might not be the best option as ex British Prime Minister, Margaret Thatcher said, Consensus is the negation of leadership. The team must co-operate with the leader to make it an effective committee. Also in the team one person has to be in-charge of all the communications taking place during the crisis This person has to be responsible for- getting the team together during the crisis Communicating the needs of the committee to the mouth Approving all communication messages before they go live Reporting the situation as it develops to the crisis committee Reporting the total crisis once it`s all over (Anthonissen, 2008). Usually the people who are in charge of communications point are the lead in-house communications professionals. During the crisis having a media contact team is also vital. As during the crisis calling up the media and updating would be time consuming thus this team would handle the information being given to the media. The team will need to inform he media about press conference etc. To have a good media contact team they must- Have good press contacts Have a clean and updated full media list at any given time Understand how journalists and editors from different news media work Be practised at media tools Have facilities to translate documents and provide simultaneous translations at a press conference or media interview, if required Have ability to move very quickly(Anthonissen, 2008). Therefore having these qualities would make the media contact team much more useful and essential to update the media about the crisis. Thus that would be one burden of the shoulders of the leader and therefore concentrate on how to resolve the crisis much more efficiently. A good public relations officer will not think that crisis would not happen in his or her organisation and would be well prepared for it. Therefore they must be well prepared for a crisis by looking into what could be the possible areas that might cause a crisis. Next they must come up with a crisis plan. A good public relations officer will plan out everything in detail on what to do when a crisis occurs. This crisis plan can include information such as what are the steps to take by the staffs, crisis management team members. Lastly they must implement the action plan. Planning for a crisis is one thing. But facing a real crisis will be very stressful and it will be a much tensed environment thus no matter how hard an organisation plans out a crisis plan it would be tougher when faced with a real crisis. Therefore it is important to select members of a crisis team for their ability to remain calm and in control while under pressure (Ali, 2011). Also during the crisis every member of the crisis management team should have a copy of what the crisis plan is. Also they should know what their roles are during a crisis. Therefore ensuring a smooth crisis management during a crisis. There are three types of crisis. They are creeping crisis, slow-burn crisis and sudden crisis. Creeping crisis is where a crisis is foreshadowed by a series of events that decision-makers dont view as part of pattern. An example of a Creeping crisis is when the steps take to save a persons life in an emergency situation is not clear. Slow burning crisis is where the signs or warning has been given about the situation but it has not caused any damage to the organisation yet. An example of slow burning crisis is when the organisation goes thru a lawsuit, discrimination complaints or when the organisations reputation is at stake. Sudden crisis is where the damage has been already inflicted and the crisis will get worst if the damage is not contained well. An example of sudden crisis is when a fire breaks out in the building or when the building collapses. The Hotel New World disaster is classified under the category of sudden crisis as it the building collapse was an unexpected event which took place too quickly for anyone to react in time. 3. Analysis The Hotel New World crash shocked everyone in Singapore. It killed a total of 33 people. The crisis is considered to be one of the worst in Singapore history. Before the collapse the building was also in the headlines as it left 35 hotel customers unconscious in August 1975 due to a carbon monoxide leak. The building came down within less than a minute. It was completely demolished. There were 17 people stuck in under rubbles still alive who were eventually the survivors. The building was occupied by an industrial and commercial bank and a night club. But major parts of the building were taken up by The Hotel New World. On 15 march 1986 at approximately 11.25 the lian Yak building came crashing down to rubbles. The building was brought sown within less than 60 seconds. The first call to the SCDF was made at 11.33 sending out their men to the area. First to arrive at the scene was station officer Abu Bakar. He was in charge of the first two fire engines which arrived at the scene with the thought of just nothing more then just a fire outbreak. Upon reaching at the location he then realise its way worst then what he had expected. There was not enough time for anyone inside the building to have escaped in time. Once the rescue team had arrived at that place they started planning on how to operate this mission as this building collapse was the first of its kind in Singapore thus the rescues team were not well trained for this situation and also the equipments were not the appropriate ones used for this type of rescue mission. By noon most of the ministers had arrived at the scene too and almost all the available rescue officers were deployed in order to help the survivors escape thru the rubbles. On first 2 days they tried removing the rubbles first then finding for people. After that on the second day the rescue officers consulted experts whom were at that time tunnelling for the MRT lines in Singapore. Then with their assist the rescue team had work intensively to find for survivors. On 19 march 1986, the rescue mission was called off. A total of 50 people were trapped under the rubbles of the building. 33 people died at the scene. There were only 17 survivors. Then president, Mr Wee Kim Wee had then set-up a group on 22 march to investigate why the building crashed without any warning. This team which was assembled consisted of Mr Justice L. P. Thean, Dr A Vijiaratnam, Professor S. L. Lee and Professor Bengt B. Broms. On 16 February 1987 the final report was submitted to the president. It gave the full details about the building the building owners and especially on why the building crashed was revealed. The main cause of the collapse was in the structural design. According and to the Report of the inquiry into the Collapse of Hotel New World, Analyses of the structural design showed that the dead weights of many structural elements were underestimated and that a large number of individual structural members were grossly under-designed. This is quoted directly from the report. This shows that the building is in fact a ticking time bomb. And the mistake was indeed made 15 years ago when the drawings of the building were made was the. Next w as the construction. The quality of the way the building was being constructed was unsatisfactory according to the report. Reinforcements were less than what was stated in the R.C drawings. Also there was no professional supervision in the construction site which was one of the many factors leading to the collapse. And finally three of the pillars in the building had cracked thus bringing the Lian Yak building down on 15 March 1986. It could stand its own weight because the building was like a time bomb waiting to collapse and when there were new installations placed in the roof the Lian Yak the building it could not hold any longer thus collapsing. The inquiry also brought to light that the managing director of Lian Yak Realty was the one who was the overall in-charge of the building. But unfortunately he had died in the collapse. It was revealed that he had actually used draughtsman to build the building. And the engineer did not calculate the weight of the building properly thus making the building collapse. Also after this incident, the Singapore government had made all their constructions of building rules much more tighter, did checks on existing buildings and find out which buildings were at risk and also they gave the power of authorising and inspection of the buildings to the Ministry of National Development. In my opinion this disaster could have been easily avoided. It was due to carelessness which caused 33 people lives. First and foremost I believe the managing director should not have overseen the construction of this building alone and they should have had group or a team which represents the Lian Yak realty company. Also I believe the communication process which went through the organisation was poor as in the end the managing director was at fault for hiring draughtsman to build the building. This shows that the organisation did not check what was the managing directors doing or who he was employing at the construction site. This is where a public relation officer would be vital. As they can come with a check list on what can be done when there is a crisis. What are the minor and major things to take note during a crisis. Also in my opinion I believe the government could have done their part by ensuring all the rules and regulations for construction were followed strictly. The recommendations that were given in the report could have been implemented earlier. They should have learnt from past disasters such as the collapse of Broadways Grandest Hotel which took place in the year 1973. Also they could have better prepared the Singapore Civil Defence Force (SCDF) in theses type of crisis. They could haves sent them for training overseas instead of taking the hotel new world collapse as a lesson. This crisis clearly shows that nobody was prepared and had the mentality that the building will never collapse thus in my opinion a contributing factor for so many deaths. 4. Evaluation There are ways that could prevent this kind of sudden crisis. There are a lot of measures to be taken to avoid such crisis would be vital in life and death situations. Thus one must be prepared to face all kinds of situation. The definition of being prepared here is having a plan ready to be executed when there is a crisis (Anthonissen, 2008). This firstly there must be a check list created on what to do when a crisis occurs. When creating the check list the public relation officer must think of all possible crisis and what are the steps to avoid the crisis or escape the crisis. Like I earlier mentioned one must not be too complacent and think to themselves that the crisis would not happen. As a public relation officer we must expect the unexpected. Thus creating a check list would be beneficiary to anyone who uses it during a crisis. Also like earlier mentioned having a crisis management team would be very vital. Successful managers are those who work with successful teams (Hunsaker, 2001). Not only that the team should consist of people from various departments thus they would be aware of what to do when a crisis situation occurs. Thus it would be easier for them to escape during a sudden crisis compared to only one person handling the whole situation. This causes more stress on that individual this sharing the workload would be the best thing to do therefore having a crisis management team is definitely a positive impact. There also ways where we can prepare the people by having drills to for a sudden crisis would be a good solution to better prepare them and make sure they know what to do when having a crisis. There are three types of crisis drills. They are Tabletop exercises, Drills and Full scale exercises (Bernstein, 2011). Firstly the tabletop exercises. These exercises are usually done with the people sitting around a table. Its a discussion where the key manager explains the roles of the people during a crisis (Bernstein, 2011). Next is the Drill. Drills are where a specific department might be put to test to see how they would react when in crisis. External officers might sometimes do the evaluation. Finally the Full-scale exercise. As the names says it full-scale exercise, the organisation, the people working in that building will be put to test when they re-enact a crisis situation and would then see how quickly they escape and checking if their crisis management has been successful The Hotel New World collapse could have been a crisis avoided but the collapse has now educated the people the relevant authorities on how to improve their crisis management skills. The SCDF got experience on how to manage a sudden crisis like The Hotel New World collapse. The Singapore government came down hard on the rules of buildings. From a PR point of view, in my opinion the Lian Yak Realty failed in handing this sudden crisis. Yes this was a lesson but I believe the Lian Yak Realty should have been better prepared and should have at least done their part in the aftermath of the collapse. I am sure this crisis should have been avoided if there was a proper organisational structure in Lian Yak realty. This was an incident which changed the future of Singapore in terms of how the buildings were constructed and how to handle a crisis.

Characterization in John Updike’s A&P Essay

John Updike’s short story, A&P, is recounted from the point of view of its nineteen year old narrator, Sammy. Sammy’s character is particularly significant in the story. While the work has received several different interpretations, the focus of the story is clearly the lesson that the narrator learns in the course of events. The use of narration and description are especially revealing for Sammy’s personality. The story is told in the Present Tense and the style is appropriate for oral rather than written presentation. The descriptions, which focus on the appearance and gestures of the three girls in bathing suits who walk into the supermarket, are also significant as they monitor Sammy’s reactions. Thus, through the raw style used for narration and description, the story reveals Sammy’s subjective perception of the events, his youthful, romantic infatuation with the three girls and his desperate, chivalric but useless act. Sammy, who works on the cash register of a supermarket, is dazed by the appearance of three young girls, dressed in bathing suits. This is immediately apparent in the opening line of the story: â€Å"In walks these three girls in nothing but bathing suits† (Updike 187). The beginning of narration already reveals the impact that the image of the three girls has on the young boy. Significantly, Updike preserves the ungrammaticalities that Sammy makes in his speech. This technique has the effect of characterizing the narrator as a young, unsophisticated, middle-class boy. The whole of the story is dedicated to Sammy’s careful, detailed observation and description of the three girls and to his own, chivalric act, which concludes the story. The description of the three girls is in itself revealing for Sammy’s character. The focus is on the narrator’s eye, as he follows the girls from his place at the register, as they appear and disappear behind the aisles of the supermarket. He is both surprised and delighted at their appearance and their beauty. His eye is first caught by the chubby girl, wearing a green two-piece bathing suit and then by the brunette girl. Ultimately however, his focus remains with the third girl, that he calls Queenie. As the name he gives her shows, she is his favorite of the three and, in his view, the most beautiful one. Thus, the description is made exclusively from the narrator’s subjective point of view and registers faithfully his own reactions and impressions. What is significant moreover is the way in which Sammy perceives the girls on the whole. If the other characters in the story are either judgmental of the girls’ impropriety or else sexually attracted to them, Sammy is fascinated with the girls. According to his idealized perception, they are mythological or exotic creatures that belong to another world. He is so struck by their nude appearance and their natural beauty that he feels they are unlike everything else he has seen before. The setting of the story is particularly important in this respect. As Sammy himself emphasizes, the supermarket affords only dull views, unremarkable or ugly people. In Sammy’s view, there is a striking contrast between these unwonted customers wearing only bathing suits and the regular clients of the supermarket. Thus, when the girls approach with their single purchase, they hesitate between Sammy and one of his colleagues on another register. Sammy’s description of the old couple that goes up to Stokesie is very significant: â€Å"†¦Stokesie with his usual luck draws an old party in baggy gray pants who stumbles up with four giant cans of pineapple juice (what do these bums do with all that pineapple juice’ I’ve often asked myself)†¦Ã¢â‚¬  (Updike 193). The couple is dressed in â€Å"baggy, gray pants†, contrasting deeply with the girls’ colorful bathing suits and their young bodies. Also, Sammy is puzzled by the old couple’s purchases and obviously perceives them as ridiculous. On the other hand, he is not struck by the girls’ attire in an unpleasant way. When he notices one of his coworkers looking at the three girls in an improper way, Sammy feels that this is unjust and he even feels sorry for them: â€Å"All that was left for us to see was old McMahon patting his mouth and looking after them sizing up their joints. Poor kids, I began to feel sorry for them, they couldn’t help it† (Updike 195). There are other examples in the description that emphasize Sammy’s own perception of the girls. For instance, he is absolutely struck by the way in which Queenie wears her suit, with the straps down: â€Å"She had on a kind of dirty-pink – – beige maybe, I don’t know — bathing suit with a little nubble all over it and, what got me, the straps were down† (Updike 188). The fact that the girl wears the straps of her bathing suit down is delightful for Sammy. Moreover, the fact that he is sometimes clumsy in his description, not knowing, for example, what the exact color of Queenie’s suit is, also speaks of Sammy’s character as a young boy who is not extremely pertinent in fashion matters. Also, when the manager reprimands Queenie and her companions, Sammy sees the pickled herring jar reflected in the blue eyes of the girl. Again, the way in which Sammy observes and describes the situation shows him to be a romantic character, who regards the girls as representatives of an exotic, mythological world. Furthermore, Sammy’s romanticism is obvious in the way in which he contrasts the girls with the other shoppers. For him, the others are blind to the beauty of the three siren girls: â€Å"You could see them, when Queenie’s white shoulders dawned on them, kind of jerk, or hop, or hiccup, but their eyes snapped back to their own baskets and on they pushed. I bet you could set off dynamite in an A & P and the people would by and large keep reaching and checking oatmeal off their lists†¦Ã¢â‚¬  (Updike 192). The others do not perceive the girls as Sammy does and are not struck by their aesthetic quality. Queenie’s white shoulders, bare and indicative of purity, are the symbol of the natural, uncensored by social rules world of the beach, whereas the consumers are symbols of the automatic drives of production and consumption of the capitalist society. Sammy sees the other shoppers for what they are – not individuals, but the components of a system, a mere herd, their personalities limited to the very automatic gestures and directions imposed by the shopping list. In his descriptions, Sammy sets the girls well apart from the ordinary, mechanical and artificial world of the supermarket. As critics have emphasized, the story’s symbolism clearly points to Sammy as a romantic hero who becomes lured by the beauty of the sirens: â€Å"Updike pokes gentle fun at Sammy because he succumbs to the girls who are cast in the roles of the legendary Sirens–the mythological temptresses who lured unwary males to their destruction† (Blodgett 103). Sammy portrays the girls as being in sharp contrast with the common world, which is represented by the materialist preoccupations in the supermarket. As he stands dazed by the appearance of the girls, he significantly makes a mistake on the register, ringing the same box of crackers twice. The mistake further emphasizes Sammy’s abstraction into the fairytale, mythological world the three girls belong to. His final gesture of quitting his job in order to defend the girls is also significant: he refuses any connection to the pragmatic, insensitive world of the supermarket, which remains careless in front of the girls’ beauty. Their exoticism is further underlined by the fact that the city is far from the ocean that the girls’ image represents so well: â€Å"It’s not as if we’re on the Cape; we’re north of Boston and there’s people in this town haven’t seen the ocean for twenty years† (Updike 189). For Sammy, the girls are sirens who conquer him with their beauty and who also prove to have a fatal influence over his destiny in the end. Thus, Sammy’s narrative and descriptive style points to his personality and his views on the events he participates in. He embodies the young, inexperienced youth who becomes infatuated with a beautiful, exotic girl. As Wells points out, Sammy is not aware of his sexual attraction to the girls and idealizes it, transforming it into a gesture of honor and chivalry: â€Å"A&P is told after the fact by a young man now much the wiser, presumably, for his frustrating infatuation with a beautiful but inaccessible girl whose allure excites him into confusing his sexual impulses for those of honor and chivalry† (Wells 129). In the end however, Sammy learns a hard lesson. His romantic view, resembling that of Don Quixote, makes him quit his job and adopt the role of the unacknowledged hero: â€Å"The girls, and who’d blame them, are in a hurry to get out, so I say ‘I quit’ to Lengel quick enough for them to hear, hoping they’ll stop and watch me, their unsuspected hero†(Updike 194). However, like Don Quixote, Sammy obviously mistakes the girls’ potential for sexual appeal for something more. Instead of the glory he expects as a hero, he is left with the uncertainty of a future without a job. The girls, like fairies, vanish into thin air and the supermarket world remains as grey as before, with its usual inhabitants: â€Å"I look around for my girls, but they’re gone, of course. There wasn’t anybody but some young married screaming with her children about some candy they didn’t get by the door of a powder-blue Falcon station wagon† (Updike 196). Sammy is therefore the embodiment of an idealist, inexperienced young man, who seems to believe that the three girls belong to another world. Through the use of narrative and description, Updike renders a vivid portrait of the narrator of A&P. Thus, the narrator speaks in his own language, using his own particular style. Moreover, his observation and description of the three girls and of the events is very significant, as it reveals him to be an idealist young man, with unreasonable expectations of what the surrounding reality should look like. Works Cited: Blodgett, Harriet. Imagery in the Works of John Updike. New York: Heldref, 2003. Updike, John. â€Å"A&P. † Pigeon Feathers and Other Stories. New York: Knopf, 1962. 187-96. Wells, Walter. â€Å"John Updike’s ‘A&P’: A Return Visit to Araby. † Studies in Short Fiction. 30. 2 (1993): 127-33.

Critical Review of the Literature of the role that Dietary Factors Play in Preventing Type 2 Diabetes Essay

Critical Review of the Literature of the role that Dietary Factors Play in Preventing Type 2 Diabetes’ Introduction Type 2 Diabetes (T2D) is a rapidly growing international public health issue. It has been reported that 285 million 20–79 year olds had the disease in 2010 worldwide and this is estimated to grow to 439 million by 2030. (19) T2D has been associated with a variety of other health problems such as cardiovascular disease, blindness and shortened life expectancy. (4,40) The prevalence of the disease is associated with obesity and overweight as well as a ‘Western’ dietary pattern and lack of exercise. (17) It has been reported that approximately 80% of people who develop T2D are obese or overweight prior to diagnosis.(8) Diabetes is a preventable disease, (19) with weight loss being identified as one of the most powerful interventions. (4) Diet and physical activity (PA) are effective interventions in attaining this (25) and have also been linked with reduction in risk independently. (40) The primary focus of this paper will look at diet and review the evidence on whether diet alone can help to prevent T2D. As a secondary theme it will also look at the evidence that diet can help to prevent the development of and help to control symptoms after T2D has been diagnosed. 8 papers will reviewed, (26-33) with a purpose of identifying some practical, evidence based dietary guidelines. Dietary guidelines are easier to follow when they indicate specific foods and patterns rather than nutrients and properties of foods and greater compliance can be achieved . (29,31) For this reason the studies reviewed focus on specific foods and diet styles rather than macronutrients and or micronutrients which do not translate into dietary guidelines as easily. Literature Search A literature review using the following databases was carried out; Pubmed, Web of Science, Embase, CINAHL, British Nursing Index and Medline. The following keywords were used in various combinations; Diet, prevention, food, T2D, interventions, dietary, fruit, vegetables, nutrition. Other resources such as ‘Google scholar’ and NHS Choices ‘behind the headlines’ were also utilised. Because T2D is an international issue, papers from around the world were considered. The criteria for inclusion was less than 10 years old, the intervention had to be a specific food group or diet style, measuring new incidents of T2D, or changes is symptoms associated with T2D and adults as the sample group. Diet as a tool to prevent T2D 6 Studies looked at whether diet can prevent T2D. Please refer to Table 1 for details of all the studies. Villegas et al (26) and Bazzano et al (27) looked at fruit, vegetable and fruit juices consumption and fruit and vegetable consumption respectively. Both of the studies used women only in their sample groups, limiting the generalizability of the findings to the wider population. (5) Dietary assessment was achieved through Food Frequency Questionnaires (FFQ) in both studies. Villegas et al (26) provided evidence of their FFQ having been validated, (21) however reported using it only 3 times within a 4.6 year timeframe, questioning the accuracy of their collected data. Bazzano et al (27) data collection was retrospective in that the FFQ was designed in 1984 and followed up at 4 year intervals. The concern with such a dated questionnaire is that it has not accounted for different trends that have occurred over time, affecting the accuracy of the results. Villegas et al (26) confirmed incidence of T2D through subjects meeting the criteria set out by the American Diabetic Association.(2) Bazzano et al (27) used criteria set out by National Diabetes Data Group for all participants up to and including 1997.(16) The Criteria for participants after 1998 was set out by the American Diabetic Association. The reason for this was due to new criteria being published at this time. (2) The main difference being the plasma glucose reading changing from 7.8mmol/l or more to 7.0mmol/l or more. (9) The Criteria Set out by the World Health Organisation in 1985, (24) could have been used to confirm incidence of T2D in the Bazzano et al (27) study . It was published 1 year after baseline data was taken and would have resulted in a higher percentage of participants being diagnosed with the same criteria, increasing consistency and reliability in the results. Villegas et al (26) reported that a higher consumption of vegetables was associated with a reduced risk of T2D. Participants who had a higher vegetable intake were also less likely to smoke and have higher levels of PA, both factors that can reduce the risk of T2D questioning the causality of the reduction in risk. (4) Participants with a higher fruit intake were also less likely to smoke and have higher levels of PA. There was no association made between fruit intake and risk of T2D therefore it is possible to consider that confounders like PA and smoking may not have effected the level of risk to T2D in this study. Bazzano et al (27) reported an inverse association between whole fruit and green leafy vegetable intake. Women who had a higher intake of fruit and vegetables were older, less likely to smoke and more likely to have higher levels of PA. Fruit Juice was positively associated with incidence of T2D which could be due to high sugar content.. (22) Also participants who had the highest fruit juice intake had the lowest levels of PA which is associated with increased risk of T2D. (20)Salas-Salvado et al (28) and Martinez-Gonzalez et al (29) both studied the risk of T2D and adherence to the Mediterranean diet (MedDiet). A MedDiet is characterised by high consumption of fruit, vegetables, whole grains, olive oil, nuts, pulses, fish and reduced consumption of red and processed meats, high fat dairy refined gains and foods high in sugar and starch. (11) Salas-Salvado et al (28) compared adherence to a MedDiet supplemented with either olive oil or nuts with a low fat diet (control group). The supplemented items in the MedDiets were given to participants. Participants in the control group were given non dietary gifts to encourage adherence. There are concerns about the ethics of using incentives and gifts in research. (6)Within this study the use of gifts appears innocuous, the concern lies with how adherence to the diet is reliably measured. When participants are given vital ingredients, this will influence their dietary intake, making it difficult generalize the results. (13) The sample population in this study were older and had at least 3 risk factors relating to cardiovascular disease again making it more difficult to generalise results. Participants were given 7 goals, including;  increasing vegetable and fruit consumption, reducing red and processed meat and increasing the consumption of either olive oils or nuts. The control group were asked to reduce all types of fat. Results showed that participants in the MedDiet groups had a greater reduced risk of T2D. Risk was reduced by 51% in the olive oil group and 52% in the nut group. These findings are backed up by other studies. (38-39) Diabetes incidence was lower in those who attained ≠¥ 4 of the 7 goals. PA levels and changes in weight did not differ through all 3 groups, although the participants in the both the MedDiet groups were associated with higher levels of PA. This study was carried out on Spanish participants, who traditionally follow a MedDiet. The control group may have had a strong adherence to a MedDiet naturally, which could impact on the reliability of the results. Martinez-Gonzalez et al (29) used participants who were nurses and university graduates. Prevalence in T2D is associated with lower socioeconomic status, (1) so by using the participants from a higher socioeconomic group may bias the findings. (13) Participants were not excluded if they had Diabetes at baseline. Data was collected via FFQ which consisted of 136 items with 9 responses ranging from never to more than 6 times a day. Points were allocated to determine a score indicating level of adherence. Questions covered areas such as cooking methods, supplements and fats and oils. This FFQ goes into a lot of detail to obtain the most information it can about participants diets, increasing the validity of the data. However reliability is compromised as participants are asked to recall food intake from the previous year decreasing the accuracy of data collected. (5) The results indicated a significant reduction in risk of developing T2D in those who with strong adherence to the MedDiet after adjustment for age and sex. Participants with a score of ≠¥ 6 had an 83% reduction. Although participants in this group had the highest levels of physical activity, which is a known factor in decreasing the risk of T2D, they also had a higher baseline prevalence for increased risk factors for Diabetes such as age higher BMI and higher blood pressure. This adds weight to the findings the MedDiet can reduce the risk of developing T2D. Fung et al (30) and VanDam et al (31) looked at more generalised dietary  patterns. VanDam et al (31) used a 131 item FFQ specifying specific foods, portion sizes and frequency of intake. Over a space of 12 years data on food intake was collected 3 times. In order to make these results more reliable data collection should have occurred more frequently. The participants were all male health professionals making the sample group quite specific reducing the ability to generalise the findings to the wider population. (13) Foods were classified into groups based on nutritional profiles. Factor analysis was then applied in order to identify food patterns. Two dietary patterns were identified ‘Prudent’ and ‘Western’. Prudent was characterised by high consumption of vegetables, fish and whole grains and Western by high consumption of red and processed meat, high-fat dairy and eggs. Men with higher Western patterns were younger, more likely to smoke and did less PA. Men with higher Prudent diet patterns were older less likely to smoke and engaged in more PA. The Prudent diet was associated with a modest reduction in risk in developing T2D with wholegrain foods having the highest inverse association. Fruit and vegetables were not considerably associated with reduced risk. The Western diet was associated with considerably higher risk of developing T2D. Processed meat, other processed foods and refined grains indicating the most significant association. This could indicate that cutting out specific foods could me more beneficial in reducing the risk of T2D than increasing intake of other foods. Fung et al (30) used participants from the Nurses Health Study which was established in 1976. This is the same study from which Bazzano et al (27) took their participants. The same FFQ was used in this study with baseline also being the 1984 FFQ as this was the expanded 116 item version. The information obtained was then used and classified in the same way as the VanDam et al (31) study producing the same Prudent and Western dietary patterns. The results from this study focus mainly on the Western diet pattern. Similarly to the men in the VanDam et al (31) study, women who scored high in the Western diet pattern were more likely to smoke. The results also mirrored that of the VanDam et al (31) study in that it reported an increased risk of developing T2D and a Western diet pattern. This study investigated the characteristics of the Western dietary pattern further and found positive associations between red and processed meats and  the development of T2D. This could also add weight to the previous comment that cutting out specific foods, such as red and processed meats could be more beneficial than adding other food groups in preventing T2D. A replica study using the same FFQ and Prudent and Western diet pattern and using a sample group that consisted of both men and women could add strength to the finds of both of these studies.(5) Diet as a tool in preventing the development of and giving greater control over the symptoms of T2D Elhayany et al (32) compared a low carbohydrate Mediterranean diet (LCM) a traditional Mediterranean diet (TM) and the 2003 American Diabetic Association diet (ADA) on health parameters. Glycemic control for people with T2D diagnosis was one of the outcome measures. Participants were randomly assigned to 1 of the 3 groups, given recommendations for daily intake on nutritional elements such as calories and protein and advised to engage in 30-45 minutes of PA a week. The LCM and TM diets included only low glycemic index carbohydrates, with LCM having a lower %. The TM and ADA diets had the same % of carbohydrates but the ADA also included mixed glycemic index carbohydrates. FFQ were used asking the participants to recall the last 24hour food intake. It is felt this data will be more accurate than those studies asking participants to recall food intake from the previous year, making results more reliable. Data was collected 3 times over a 12 month period. Results showed all groups had reduced weight and BMI with no significant difference. All 3 dietary interventions reduced factors that increase glycemic control such as HbA1c and triglyceride levels. The LCM diet was the most effective in increasing glycemic control. Esposito et al (33) compared a LCM and a low fat calorie restricted diet (LFD) on glycemic control and the delay on needing to commence antihyperglycemic medication in people newly diagnosed with T2D. The LCM diet was rich in fruit vegetables and whole grains and low in red meat. There was also a requirement that no more than 50% of calories was from  carbohydrates. Complex carbohydrates rather than low GI carbohydrates were stipulated. Some complex carbohydrates can have high GI levels, which are associated with increased risk of Diabetes. (10) The LFD was based on American Heart Association guidelines. (12) Participants were randomized into 1 of 2 groups asked to keep food diaries and given guidelines on increasing physical activity. Data was collected through reviews of the diary. Food diaries could provide more reliable information than FFQ if they are filled out daily. There is still a risk that they could be filled out inaccurately, and that participants may modifies their intake as a result of keeping a diary. The study reported that both groups lost weight, but reduction was greater in the LCM. Overall there was a significant difference in the need to commence antihyperglycemic medication between the LCM and the LFD; 44% and 70% respectively. Potentially this result could have shown more significance if low GI carbohydrates were stipulated instead of complex carbohydrates. Discussion The findings coming out of this review indicate that certain dietary interventions maybe helpful in reducing the risk of developing T2D and may also help with glycemic control after diagnosis.(26-33) Some food groups and dietary patterns provide more consistent evidence than others. The results regarding fruit intake and risk of T2D are inconsistent within this review with Villegas et al (26) reporting no association between fruit and risk reduction, where as Bazzano et al (27) did. High consumption of fruit and vegetables are a major component in the Mediterranean diet and the Prudent dietary pattern, both of which were associated with an inverse association. Vegetables are more consistently associated with a reduced risk, in this review and a recent meta-analysis, (3) particularly green leafy vegetables. (27) More research studying the effects of fruit and vegetables separately is needed. This inconsistency is reflected in other studies and systematic reviews. (7) High intake of fr uit and vegetables has often been associated with higher PA levels within this review, (26-29,31) which is a risk reducing factor in itself. Part of the problem could be that many studies that look at dietary interventions are prospective cohort studies and  although they can provide an association they can not prove whether the cause is due to the dietary item or another factor such as PA or weight loss. More experimental designed research is needed so that a direct cause between diet and the reduction of T2D can be established. (13) While it is unclear the exact role that fruit and vegetables play in reducing the risk of T2D there is an abundance of evidence that a diet rich in fruit and vegetables is beneficial in overall health (34-35) and weight reduction, (23) so including them as part of a healthy diet may indirectly help to reduce the risk of T2D. Red and processed meat has been more consistent in its positive association to developing T2D. Fung et al (28) and VanDam et al (29) found strong associations between consumption and increased risk of T2D. One of the characteristics of The Mediterranean diet is the absence or reduction of red and processed meats, and this diet has been associated with reduced risk. These findings were backed up in a recent meta-analysis paper (18) studying 3 cohorts who’s conclusion suggests that red meat consumption, particularly processed red meat is linked to higher risk of developing T2D. Meta-analysis produces level 1 evidence, providing increased confidence in the conclusions and good grounding for providing evidence based information such as dietary guidelines.(13) Diets high in red and processed meats are linked to high cholesterol (14) which is one of the leading causes of death in people with T2D (15) and other serious health conditions such as cancer and cardiovascular disease. (36) So while increasing fruit and vegetable intake may have a more beneficial and holistic effect on health, the same could be said for reducing the intake of red and processed. Salas-Salvado et al (28) produced higher level evidence being a randomised control trial giving more weight to their findings;(5) following a MedDiet can reduce the risk of T2D. One of the studies that looked at the effect of diet after diagnosis, (32) was also a randomised control trial providing the same level of evidence and weight to their findings that LCM can delay the need for hyperglycaemic medication therefore having a positive beneficial effect on T2D. Although these two studies looked at the effect of diet after diagnosis it could be reasonable to suggest that following the dietary  patterns associated with these findings, prior to diagnosis could help prevent T2D as they are similar dietary patterns to two of the other studies.(28-29) While the findings from this review indicate that making changes to ones diet may help to reduce the risk of Diabetes occurring, it also suggests that implementing the same kind of dietary changes may help with glucose control after Diabetes has been diagnosed, preventing the further development of the disease and the need for antihyperglycemic medication. (32-33) One study has implied that dietary changes in the form of energy restriction can actually reverse beta cell failure and insulin resistance, symptoms found in T2D. (37) It is a very small study and the dietary intervention is severe energy restriction making it difficult to generalise to the wider population, but it is a controlled study and could provide interesting findings that further research could be built upon, that dietary interventions may be able to reverse the symptoms of T2D. Collating this information together it seems reasonable to suggest that making positive changes to dietary habits could have benefits pre and post T2D diagnosis. Dietary Guidelines The findings from the 8 studies in this review can not all be discussed in detail due to word limitation. However recurring themes seem to be occurring, providing information on which to base a set of guidelines. Going by these findings the following guidelines are recommended: Reduce intake of red meat and processed meat (all colours) Substitute these with white meats and fish Reduce intake of other processed foods Reduce intake of refined grains Reduce intake of high sugar foods and drinks including fruit juices Carbohydrate intake should be based on items with a low GI score Increase intake of olive oil Increase nut intake Increase intake of pulses Increase wholegrain intake Increase vegetable intake especially green leafy vegetables Increase fruit intake A Mediterranean style diet is characterised by much of this advise and is therefore a recommended diet style to follow. Conclusion The prevalence of T2D is growing around the world. It has been associated with many other health problems and reduces quality of life and life expectancy. It is a preventable disease and diet is one of the ways in which this disease can be combated. Dietary guidelines have been recommended from the findings of this review, based on following a Mediterranean diet, reducing intake of red and processed meats and other processed foods and increasing intake of foods such as fruit and vegetables, wholegrains and olive oils and nuts. While it has been acknowledged that more research needs to be carried out to further examine the cause and effect between diet and T2D, it is reasonable to suggest that one may find these dietary changes beneficial in helping to reduce the risk of T2D and other areas of health, possibly helping to indirectly reduce risk of T2D. It is also reasonable to suggest that a change in diet may bring beneficial changes once diagnosis has been given. Table 1 Reference list 1. Agardh E, Allenbeck P, Hallqvist J, Moadi T and Sidorchuk A. Type 2 Diabetes and Socioeconomic Position: A Systematic Review and Meta-analysis. International Journal of Epidemiology. 2011: 40(3) 804-818 2. American Diabetic Association Report of the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Diabetes Care. 2000: 23(1s) 3. Carter P, Gray LJ, Troughton J, Khunti K, and Davies M. Fruit and vegetable intake and incidence of Type 2 Diabetes mellitus: A Systematic Review and Meta-analysis. British Medical Journal. 2010: 341:c4229 4. Davis MJ, Tringham JR, Troughton J, Kunit KK. Prevention of T2D mellitus. A review of the Evidence and its Application in a UK Setting. Diabetic Medicine. 2004: 21: 403-414 5. Gerrish K and Lacey A. The Research Process in Nursing. 2006 5th Edition. Oxford: Blackwell Publishing. 6. Grant RW and Sugarman J. Ethics in Human Subjects Research: Do Incentives Matter? Journal of Medicine and Philosophy. 2004: 29(6) 717-738 7. Hamer M, Chida Y. Intake of Fruit and Vegetables and Antioxidants and Risk of Type 2 Diabetes. A Systematic Review and Meta-analysis. Journal of Hypertension. 2007: 25:2361-2369 8. Hensrud DD. 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European Journal of Clinical Nutrition. 2004:58:17–23 22. Shulze MB, Manson JE, Ludwig DS, Colditz GA, Stampfer MD, Willet WC, and Hu FB. Sugar-Sweetened Beverages, Weight Gain, and Incidence of Type 2 Diabetes in Young and Middle-Aged Women. The Journal of the American Medical Association. 2004: 292(8):927-934 23. Tohill B, Seymour J, Serdula M, Kettle-Khan L, and Rolls BJ. What Epidemiological Studies Tell Us about the Relationship between Fruit and Vegetable Consumption and Body Weight. Nutrition Reviews. 2004: 365 -374 24. WHO Study Group on Diabetes Mellitus. Diabetes Mellitus: Report of a WHO Study Group. Geneva: World Health Organisation: 1985 25. NICE Public Health Guidance. Preventing Type 2 Diabetes: Population and Community Interventions. National Institute for Health and Clinical Excellence. 2011: Issue 35 26. Villagers R, Shu OX, Gao YT, Yang G, Elasy T, Li H and Zheng W. Vegetable but Not Fruit Consumption Reduces the Risk of Type 2 Diabetes in Chinese Women. 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Who Is Diagnosed With Schizophrenia - 1106 Words

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