Goals: Problem Solving and Population Reference Bureau

Abstract â€Å"To prepare for solving a problem, we must first acknowledge that the problem exists. Then, we must accept it, and clearly define or identify it. Finally, we must commit to solving the problem. Without some degree of personal commitment, the problems that we acknowledge, accept, and identify might never be resolved. 1. using a current local or international newspaper, identify an important local, national, or international concern that needs to be solved.Use the Library and Information Resources Network (LIRN) link by clicking here to locate two or more credible articles that provide background information and an analysis of the problem. You can also access LIRN in your online course by clicking on Course Home tab, then the Online Resources link. Contact your Campus for your LIRN password. 3. Using the articles you found as a resource, explain the concern using the five â€Å"Problem Solving Methods† found on page 104 of your textbook. Use Microsoft Word to resp ond to your problem.Your response should consist of 1-2 pages. Cite your articles using APA guidelines. Visit the APA Guide for assistance with APA formatting. † Week Two Individual Work (1) Introduction Using the articles I found as a resource, I am going to explain the concern using the five â€Å"Problem Solving Methods†. This is a big issue and I think we should all be actively trying to solve this issue. Environmental Problems I am going to be discussing environmental problems. I will use the problem solving methods as they are outlined in our text.â€Å"Problem- Solving Method (Advanced) Step 1: What is the problem? a. What do I know about the situation? b. What results am I aiming for in this situation? c. How can I define the problem? Step 2: What are the alternatives? a. What are the boundaries of the problem situation? b. What alternatives are possible within these boundaries? Step 3: What are the advantages and/ or disadvantages of each alternative? a. What are the advantages of each alternative? b. What are the disadvantages of each alternative? c.What additional information do I need to evaluate each alternative? Step 4: What is the solution? a. Which alternative(s) will I pursue? b. What steps can I take to act on the alternative(s) chosen? Step 5: How well is the solution working? a. What is my evaluation? b. What adjustments are necessary? †(Chafee) The problem is environmental problems, such as we have been polluting our planet’s air, water, and land; depleting its resources; and accumulating a lot of waste for which we need to find places to store.I know this situation needs to be suppressed on some level; because if we continue at this rate, then our environment will not be fit to live in. We have 6. 8 billion people on Earth today (Population Reference Bureau, 2009) and all of these people need food, water, clothing, and shelter. In addition to these minimal needs to survive, millions of people in developed nation s have cars, large homes, air conditioning, heated houses, washers, dryers, heated water for bathing, refrigerators, stoves, and so on.Hence, having nearly 7 billion people on Earth, compared to 5.2 billion people just 20 years ago (Population Reference Bureau, 1990), and having many people with a high standard of living, means that we humans will pollute a lot, deplete a lot, and build up huge amounts of waste that need to be stored. A second major reason why we have a big problem of polluting, depleting, and storing of waste is that during the past 200 years, we have gone from an agricultural way of life to an industrial way of life. Instead of â€Å"living off the land,† â€Å"growing grain to eat, and tending to farm animals, we built  factories and machines and created a new status called the factory worker to produce all kinds of products to consume—as a stroll through a typical shopping mall will show.To create these products, we have used a lot of resources and polluted the air and rivers. One of the most dangerous consequences of our polluting the environment is that we add huge amounts of carbon dioxide to the atmosphere as the result of burning fossil fuels, such as oil and gas, by industries and automobiles.†The result is the warming of our planet and the possible change of Earth’s climate, which could wreak havoc for the growing seasons. What can we do about this? More and more people are coming to the realization that we must consider the long term, what is good for the global community, and what is good for future generations if we want to survive as a species. This will require us to think, plan, sacrifice, and change our ways of living. Many people in our country, and throughout the world, do not realize the seriousness of our environmental problem.Hence, part of the solution is to make Americans more aware of the problem and to educate them about the problem. We must find ways to give these Americans incentives s o that they want to address the environmental problem or at least accept the notion that we must address this problem, regardless of their vested interests. The environmental problem will not go away by denying its existence or by denying that it is becoming a bigger and bigger problem. The oceans and the air are common property that we all share.If air and water pollution stayed only in the country that produced it, the nation producing this pollution could take the initiative and responsibility to clean up the pollution it produced. But air and water pollution does not stop at state boundaries; rather it spreads throughout the world. We as citizens of this world, not just citizens of a nation, will need to work together to clean up our oceans and air. Probably, we will eventually need to agree on some worldwide goals for the planet. We have been moving in this direction by attempting to decrease carbon dioxide and chlorofluorocarbon emissions.We will probably need to make saving o ur environment one of the main goals of our world community. Within this goal, we will need to agree on more specific goals such as decreasing carbon dioxide, sulfur dioxide, and chlorofluorocarbons; increasing the amount of rainforest; finding new, better, and safer ways of storing hazardous waste; and producing more energy without polluting more, depleting more, and creating more waste. Conclusion This is an issue we must all face together. We must realize that there is a problem and work on long term goals to correct this problem.Eventually, we may be able to turn this around. However, we must think long term, not only think about the here and now. Probably, a key factor, if not the key factor, in solving our environmental problem is time. Can we, as a world community, act soon enough to head off environmental trends that could be difficult, if not impossible, to reverse—for example, rising carbon dioxide emissions leading to rising temperatures, melting glaciers, rising s ea levels, and changing cli- mate patterns throughout the world? We must face this with a sense of urgency.

Cultural Differences Between France and Middle-East (Maghreb)

Western European culture (France) Over the past 500 years, France has been a major power with strong cultural, economic, military and political influence in Europe and in the world. During the 19th and early 20th centuries, France built the second largest empire of the time, including large portions of North, West and Central Africa, Southeast Asia. After the storming of the Bastille on 14 July 1789, the absolute monarchy was abolished and France became a constitutional monarchy. Through the Declaration of the Rights of Man and of the Citizen, France established fundamental rights for French citizens and all men without exception. The Declaration affirms â€Å"the natural and imprescriptible rights of man† to â€Å"liberty, property, security and resistance to oppression†. Freedom of speech and press were declared, and arbitrary arrests outlawed. Government The French Republic is a unitary semi-presidential republic with strong democratic traditions. Demographics With an estimated population of 65. 8  million people (as of 1 Jan. 2011), France is the 20th most populous country in the world. In 2004, a total of 140,033 people immigrated to France. Of them, 90,250 were from Africa and 13,710 from Europe. In 2008, France granted citizenship to 137,000 persons, mostly to people from Morocco, Algeria and Turkey. It is illegal for the French state to collect data on ethnicity and race, a law with its origins in the 1789 revolution and reaffirmed in the constitution of 1958.. While official data on the size of the country's ethnic minorities is not available, it has been estimated that between three million and six million people are of North African ancestry while an estimated 2.   million people are of Black African ancestry. It is currently estimated that 40% of the French population is descended at least partially from the different waves of immigration the country has received. Between 1921 and 1935 about 1. 1  million net immigrants came to France. Religion Roman Catholicism has been the predominant religion in France for more than a millennium, though it is not as actively practiced today as it once was. According to a Ja nuary 2007 poll by the Catholic World News – 51% identified s being Catholics, 31% identified as being agnostics or atheists 10% identified as being from other religions or being without opinion, 4% identified as Muslim, 3% identified as Protestant, 1% identified as Buddhist, 1% identified as Jewish. So we could see that France is one of the most multinational and multicultural countries in Europe. The main motivation for the law seems to be Sarkozy’s desire to do something to improve his dismal approval ratings. By appearing tough on Muslims he, perhaps, can counter the growing appeal of the right. His military adventures in Libya also seem calculated to that end. Obviously enough, this reason hardly justifies the law. Middle Eastern culture (Maghreb from Arabic – ‘West’) Actually in our case we will talk mostly about the region of Northwest Africa called Maghreb (also Maghrib). It includes five countries: Morocco, Algeria, Tunisia, Libya, and Mauritania and the disputed territory of Western Sahara. Because of Sahara desert contact between the Maghreb and sub-Saharan Africa is limited. That’s why the biggest influence was coming from Middle Eastern cultures. The Arabs reached Maghreb in 7th century and brought their own religion Islam and Arabic language. After the 19th century, areas of the Maghreb were colonized by France, Spain and later Italy. In 1950th and beginning of 1960th all five countries became independent with their own government and low which is similar to French system board. Today more than two and a half million Maghrebi immigrants live in France, especially from Algeria and Morocco. In addition, there are 3 million French of Maghrebi origin (in 1999) (with at least one grand-parent from Algeria, Morocco or Tunisia) Family is extremely important in Asian cultures with much importance being placed on the elderly members of the family. The elderly are much revered in Asian society and it needs to be said that we don't show the same respect to the elderly in Western culture. Approximately 5 -10% of the adult population in North Africa is illiterate. In the majority of Asian countries the social infrastructure is set in a class system and it really is the poor versus the wealthy with little opportunity to rise above poverty line certain Asian countries the name given to you at birth depicts where you are placed as a person in the scheme of things. Money tends to bypass he general populace in regards to support systems, such as improving hospitals, availability of fresh water, and implementing crisis agencies or whatever is required to enable people to seek shelter in times of need. All these things are high on the list of priorities and available in most Western cultures. We also take advantage of the fact that due to the rate of cheap labor in Asian countries it is more economical for Western businesses to manufactu re goods offshore, so their profit margins are increased. Algeria, Egypt, and Tunisia are all republican democracies, meaning they are governed by elected legislative bodies. Both Algeria and Egypt have bicameral legislatures while Tunisia is unicameral. Libya is a unique government in the region for two reasons. First, in theory, it is a socialist democracy in which people govern themselves through local political councils. Second, though these councils do exist and function, in reality the nation is governed by a military dictatorship which hasn’t changed since it took over in 1969 when cornel Muammar Quadhafi took power in a military coup. Morocco is a constitutional monarchy with bicameral parlament.

Business and society Research Paper Example | Topics and Well Written Essays - 750 words

Business and society - Research Paper Example e draft Norms mainly when these norms are imposed on corporations directly under international law and the duties of human rights that are provided by the state. On the other hand, the article contains a detailed conceptual empirical review of current international standard imposed on the business environment regarding the relation of businesses and society. The article reviews legal international norms that govern corporations globally as well as the voluntary initiative of businesses to its communities (Ruggie, 2007, p. 7). In conclusion, the article identifies strategies for establishing a framework to reduce gaps in administration and adherence to human rights by businesses. In attempt to minimize bias between globalization and transnational corporations, the Draft Norms incorporated ‘other business enterprises’ which are also affected by the draft. On the other hand, the draft exempted nationally operating businesses that have no connection with transnational corporations. Increasing in corporation network lead to establishment of parents and subsidiary corporation which have separate legal entities. Subsidiary companies are liable to laws distinct enacted in that particular country. However, the transnational corporation’s network is not directly governed by international laws. To this effect, a move to develop global legal standards for transnational corporations poses a major challenge. Transnational Corporation has greater influence on realization of rights than the state. The main objective of international laws is to provide a direct and uniform corporate responsibility to all corporations that are not enacted into domestic laws. In this perspective, the Draft Norm enumerated rights that the states have not recognized and some are still debatable at global level. On the other hand, the Draft Norms provides that not all rights pertain to businesses, but it provides no principled basis for making that determination. These rights are included and

Ethical Theory Paper Essay Example | Topics and Well Written Essays - 1000 words

Ethical Theory Paper - Essay Example Business is driven my profit motive. It meant that business owners put up their enterprises with the purpose of making money. Business therefore when left on its will do whatever it takes to make profit. It can only be mitigated by introducing ethics in business to temper its profit motive and have a sense of responsibility. Business ethics in fact, which business are now required to practice is in fact an oxymoron. One of the common practices of business to profit at whatever means possible is the case narrated by Gina Firenzi where deception is used in a warehouse sale. The â€Å"see through† pants were misrepresented by a marketing acrobatics to make it more appealing to customer by putting a tags saying â€Å"things dont always go as planned, this garment has fit, function, or visual imperfections† but did not say that it is in fact see through and that they are sold at final sale. Of course the company will refund those who complaint but those who will not, they already a made a money out of it. These pants were implied to be the recalled pants of Lululemon which is was already a reject but sold at a warehouse sale and made saleable by marketing acrobatics. They are prepared to do refund to those who will complaint, but will make money to those who will not. These pants were recalls anyway and it may not have cost them to buy it because they were supposed to be disposed. Business unethical practices however are not only confined to misrepresentation as cited by Gina Firenzi. The unethical practice can go back from the point of manufacture such as the recent case of the building of Cambodian factory that collapsed due to substandard working conditions. The collapsed exposed the unethical practice of major textile companies such as Swedish fast-fashion retailer  Hennes & Mauritz to subcontract sweat shop with hazardous working condition just to save on cost. And as expected Hennes & Mauritz denied

Sustainable Competitive Advantage Essay Example | Topics and Well Written Essays - 3000 words

Sustainable Competitive Advantage - Essay Example As the paper discusses  the concept of competitive advantage was first brought to the lime light by Porter. He mentioned in his book that competitive advantage can be attained by creating a unique differentiation and by achieving low cost of production. However, this theory has been revised by him and the concept of ‘Sustainable Competitive Advantage’ was introduced. He further mentioned that companies should follow either cost leadership or differentiation, and should not follow the middle path.  This essay stresses that  the resource availability is directly proportional to the organizational success, as high amount of resource can lead higher production volume. As a result, a company with higher amount of resources can easily meet the growing demands of the customers, compared to its rival thereby giving it a competitive advantage.  The resource heterogeneity or resource uniqueness is a major factor that gives firm a unique edge over its rivals. Thus if all th e existing firms possess the same resources, even in abundance, will not create competitive advantage for one firm. Thus competitive advantage cannot be same for all firms.  The uniqueness of a firm’s skills and resources is the primary factor responsible for development of the competitive advantage.  Organizational resources are valuable only when it has high demand in the industry, it is scarce and it is appropriate for the firms’ operational process.

Satelite Distribuidora de Petroleo Case Study Example | Topics and Well Written Essays - 1000 words

Satelite Distribuidora de Petroleo - Case Study Example From the high-interest rate expenses, SAT may face liquidity problems and risks. This risk will make SAT lack sufficient funds to facilitate its ongoing operations The main drive towards investing is the desire to create value. Therefore, some of the financial issues that Darby would be concerned about are the future returns that this investment will earn it. In addition, it will be concerned about the initial investment cost and the shareholding. Besides, Darby will study the past financial performance of SAT through both trend and ratio analysis in order to make an informed decision. The legal issues to be considered revolve about the nature of the relationship being created with regard to the Brazilian Company Law. This will involve issues to do with the minimum shareholding and control, rights and duties of each party. Closely to this are the governance issues that Darby will have to consider. I order to ensure that its interests were taken care of, it could be concerned that it is represented by demanding key executive positions and board seats (Applegate and Minardi). Darby is likely to reap immensely big by investing in SAT. This will arise from the already proven track record, and milestone SAT has taken to be among the most reputable firms in this industry (Applegate and Minardi). This gives rise to goodwill, which further assures it of continued market expansion and customer loyalty. Its team of able and strategic-minded executives has been screening the market for new opportunities and has diversified SAT’s single commodity to a line of them. In itself, this presents, SAT as a unique investment opportunity. The continued growth and expansion will make the SAT’s stock to increase in price thereby maximizing Darby’s value in it. However, there are also costs and losses related to this investment. The major losses that Darby stands to face when it invests in SAT are associated with the financial risks. These

English 251 (World Literature) Essay Example | Topics and Well Written Essays - 1500 words

English 251 (World Literature) - Essay Example The Bible itself is an exemplary of mixed culture as we have the Hebrew Bible, Christian Bible. The Gilgamesh is not a discourse on religion but it there are theological elements in the book. It is really difficult to trace the real origin of all the religious dictums. The three books are similar in certain spheres and differs in a many a grounds with the basic similarity of punishment. Early Muslims perceived that the Quran and the forerunner biblical texts and figures. Intertextuality is evident of the fact that each culture owes something to the other. The cross cultural influence is definitely responsible for these similarities. The cross cultural studies are a branch of literary or cultural studies dealing with the writings and the scriptures by the authors associated with more than one culture. The Great Flood in the three books brings out the issue of cross cultural influence. The Great Flood is mentioned in the religious books of the Bible, the Quran and the Gilgamesh. The basic ground of all theologies is the Almighty and is related to sin, retribution and redemption. The books also bear the message that God’s warnings should not be ignored and the judgment of the God should be done in the form of destruction to purge the world of sins. In other words, the books depict to show that the wages of sins are punishment, death and destruction. In Bible the story of the flood appears in Genesis (6:9-8:22).There are three motifs shown for this flood. It aims to show God as the judge of the whole world. He is the entity who has the supreme authority to distinguish between right and wrong. The second motif intends to say that God has made provisions for the recipients of His grace. To be explicit to receive the grace of God one must follow the path of righteousness. The third is significant for Israel. Through the flood the God judged the wicked Egyptians and brought them to the Red Sea to lie in humble

Logistics Transportation Cost Analysis Outline Example | Topics and Well Written Essays - 1250 words

Logistics Transportation Cost Analysis - Outline Example The successful completion of the proposed study is expected to come with several significant advantages. Whereas some of these benefit the field of logistics literature, others will be useful for professional logistics practice. As far as literature is concerned, it is expected that the study will fill most gaps that exist in the academia about logistics transportation cost analysis. By so doing, ongoing and future researchers would have very strong conceptual basis on which they will establish their own research. Very often, conducting research with limited resources for conceptual framework makes the research lack credibility because the researchers have to rely on personal intuition and reasoning instead of fact backed evidence. But where there are gaps in literature, researchers have very limited options than choosing such unproductive means. By concluding this study therefore, most gaps relating to the relationship between transportation cost and transportation tools, as well as the importance of scientific design transport network shall be put in context. From a more practical context, this study shall be conducted through the use of primary data collection, which means that there will be realistic interventions about how existing issues of logistics cost can be addressed within organisations. Waters (2003) lamented of the high degree of cost associated with logistics transportation, which makes companies fail on realising the real advantages that should come with SCM.

Psychiatry and control of human behavior Essay Example for Free

Psychiatry and control of human behavior Essay I. In order to create such a resolution and usually to resolve an ethical dilemma nurses use four fundamental ethical principles of nursing care and practice, which are considered by many experts as a cornerstone of ethical guidelines. Autonomy The first one is autonomy. This principle means that individuals have a right to self-determination, that is, to make decisions about their lives without interference from others (Silva, M. Ludwick, R., 1999b, p. 4). It is also possible to define empirically that autonomy consists of two elements: data acquired or proposed as a presupposition and reaching the decision as the action. Beneficence The second is beneficence. This principle is thought to be a basis of day-to-day nursing care and practice. The principle of beneficence and utilitarianism direct health care professionals to make an ethical decision to provide the maximum benefit and to minimize harm to the greatest number of people involved (Silva, M. Ludwick, R., 1999b, p. 4). Beauchamp and Childress (1994, p. 192) state that Each of three forms of beneficence requires taking action by helping preventing harm, removing harm and promoting good. (cited by Silva, M. and Ludwick, R., 1999b, p. 4). This ethical principle may cause some ethical questions when a dilemma regarding performing of a mentally ill patients wishes appears. Nonmaleficence The third fundamental ethical principle is nonmaleficence or do no harm, which is easily connected with the obligation of a nurse to defend safe keeping of the mentally ill patient. Born out of the Hippocratic Oath, this principle dictates that we do not cause injury to our mentally ill patients (Silva, M. Ludwick, R., 1999b, p. 6). Justice The fourth basic ethical principle is justice. This principle implies giving each person or group what he/she or they are due (Silva, M. Ludwick, R., 1999b, p. 7). This principle applies to parity, integrity or another point that may be fundamental for the justice decision. In nursing care and practice the principle of justice usually centered on rightful admission to nursing care and on rightful allocation of scarce resource. Rightful admission to the care means that nurses are easy of access to provide nursing care and a mentally ill patient as well as any member of a society realizes that nursing care is completely accessible. The principle of justice †¦ guides health care professionals to treat every client with fairness and equity regardless the prognosis of illness, social and economic status of clients, the social and financial consequences impose on others (Wilcockson, M., 1999, p. 21). Though it is necessary to remember what actually has the priority if we will compare it with nurses good, a nurse sometimes mixes up with what the nurse considers to be a mentally ill patients good. It is questionable what composes good for a mentally ill patient without violating his or her autonomy or allowing the mentally ill patient to suffer bitterly. And can it be ethical to abolish the choice of the mentally ill patients. For example Beauchamp and Childress (1994, pp. 277-278) maintain that paternalism can obtain two forms a weak and a strong one. They assert that weak form paternalism implies is that a nurse defends the mentally ill patients good when he or she is incapable to resolve some questions as a consequence of problems like depression or the effect of medicaments. But a strong form of paternalism, they say involves interactions intended to benefit a person despite the fact that the persons risky choices and actions are informed, voluntary, and autonomous (cited by Silva, M. and Ludwick, R., 1999b, p.5). II. In the proposed case study the old lady didnt write DNR order, thus, the nurse behaved just adequately. She remembered about her duty to a mentally ill patient to preserve her autonomy but it was no possibility for her and for her mentally ill patient to identifying and addressing problems in the decision-making process as the lady was too depressed. Her quality of life was decreasing ad she couldnt live independently but it was still questionable were these reasons adequate enough to make end-of-life decision. On this ground it is necessary to investigate the notion of quality of life. This obscure notion implied the situations when decisions concerning the question of withdrawing nursing care are formed and †¦based on the likely low levels of self-awareness, reasoning, communication and activity that the mentally ill patient will have and the low probability of improvement (Thompson, E., Melia, K. M. and Boyd, K. M., 2001, p. 44). Usually it is not up to mentally ill patient to make quality-of-life decisions as they are often reached by doctors or relatives. In other words quality of life should be determined by mentally ill patients themselves being able to evaluate it adequately. The unproved understanding of notion is often used in statements like: After all, we shouldnt waste any more money on this person because their quality of life will be so low, anyway (Hunt, G., 1994, p. 125) Considering the case study we may that the quality of life of the old lady was not so low as to bring to end-of-life solution. However it was up to the mentally ill patient to decide that problem independently as it was her right to create DNR order but she didnt do it, besides her depressed state and, thus, low self-determination was among the main reasons for reasonable nurses acts. III. If we try to use these four fundamental ethical principles to the case study that was chosen for our investigation beforehand we will be able to evaluate the deeds of nurse from ethical point of view. For example, it is clearly evident that nurse violated the principle of autonomy because autonomy of a mentally ill patient means the opportunity to make decisions about his or her life without interference of others. If taking into account this principle then it was up to a seventy three year old woman to decide either she needs to obtain emergency CPR or not. This principle was thus violated by the nurse, and the reasons for such behavior are not deciding in this matter. She might have ignored this principle basing on the other principles that prevent a nurse from doing harm, meaning to rescue the life of her mentally ill patient because human life is valuable and unique. But while the nurse deprived her mentally ill patient of the possibility to choose life or death, the nurse thus made herself responsible for this decision, which is evidently wrong. At least, the nurse should have noted that the mentally ill patient didn’t want to be rescued. As for beneficence, we may suppose, on the other hand, that it was a demonstration of weak form of paternalism. In such case the nurse protected the good of a seventy three year old lady as she was incapable to resolve end-of-life questions as a result of her depression and decreasing of the quality of her life. Consequently the deeds of the nurse were well-taken and righteous. But the nature of the action is also ambivalent, as the nurse might have been directed by her own notion of good, or the notion that the nurse obtained while studying ethics. The nurse shouldn’t have been define independently if the woman was really unable to make reasonable decisions, the nurse must have at least objectively estimate the problems and conditions of the mentally ill patient that led to such mentally ill patient’s intention.   This thought may also be confirmed and at the same time called in question by the principle of nonmaleficence. The nurse protected the safety of her mentally ill patient, but without mentally ill patients wish. It is questionable, would be the note of DNR be regarded as the injury caused to the mentally ill patient. If the life and conditions of this old woman were so poor, they made her suffer; the nurse must have taken it into account while deciding what would be more or less painful for her mentally ill patient. This may be regarded as the intention to take off responsibility from the nurse. Observing the last principle of ethics, justice, it is necessary to note that this principle was violated by the nurse. Her mentally ill patient was at least due to be heard. Her wishes and demands should have been taken into consideration, moreover, the mentally ill patient did not ask to help her die, and she just wanted to prevent her from suffering in future. Thus taking into consideration these four main principles, the case seems to be contradictory. It seems that the nurse acted basing upon her own notion of what is good, safe and just for her mentally ill patient, without taking into account the demands, wishes, living conditions and problems of her mentally ill patient. Of course, definite peculiarities of these principles allow justifying the actions of the nurse, if we look at the situation form the point of view of value of human life. One more issue that should be examined is the absence of mentally ill patient’s order for DNR. This may also be a reason to justify the actions of the nurse. But as soon as the demands was heard by the nurse, the nurse should have defined this problems with the mentally ill patient and helped the woman write a necessary order, if it was her wish. Nurses often cant decide what their actual point of view about some ethical dilemmas is and how far those perceptions go. Anyway nurses should have to do with their own system of moral values but at the same time to determine whether it fits into the big picture (Stacey, J., 1998, p.8). It is necessary for a nurse to take a turn for the better foreshortening of problems and challenges in the area of care by forming at any rate a bifocal view of the problems (Stacey, J., 1998, p.7) Of course, not all ethical dilemmas concern death. Nurses deal with ethics on every eight-hour shift. †¦for example, the Nursing Code of Ethics says to hold all things confidential, but sometimes there is information others need to know, explains Freeman (cited by Stacey, J., 1998, p.4). However nurses often can appear in the situation of resolving of a complex moral dilemma that regards an appeal for assisted death. This problem is one of the most complicated issues in nursing practice. This question is also a key one in the case study that we have in some way already investigated earlier. Given the poor quality of life that seventy-three years old woman would probable suffer she demanded not to perform any heroic measures in the event of cardiac arrest. So she does not want to live anymore. But when the nurse sees the mentally ill patient next she is being resuscitated as there was no Do Not Resuscitate order (DNR) in her notes. Reference List Hunt, G. (1994) Ethical issues in nursing. Routledge. Silva, M. and Ludwick, R (1999a). Ethical Thoughtfulness and Nursing Competency. Online Journal of Issues in Nursing, 10 December, 1999. Available from http://www.nursingworld.org/ojin/ethicol/ethics_2.htm [Accessed 17 February 2006] Silva, M. and Ludwick, R. (1999b). Interstate Nursing Practice and Regulation: Ethical Issues for the 21st Century. Online Journal of Issues in Nursing, 2 July, 1999. Available from http://www.nursingworld.org/ojin/ethicol/ethics_1.htm [Accessed 14 February 2006] Silva, M. and Ludwick, R. (2002). Ethical Grounding for Entry into Practice: Respect, Collaboration, and Accountability. Online Journal of Issues in Nursing, 30 August, 2002. Available from http://www.nursingworld.org/ojin/ethicol/ethics_9.htm [Accessed 14 February 2006] Silva, M. Ludwick, R., (2003) Ethical Challenges in the Care of Elderly Person. Online Journal of Issues in Nursing, 19 December, 2003. Available from http://nursingworld.org/ojin/ethicol/ethics_14.htm   [Accessed 15 February 2006] Stacey J. (1998) A Question of Ethics. Emory Nursing University[online]. Available from http://www.whsc.emory.edu/_pubs/en/ [Accessed 17 February 2006] Thompson, E., Melia, K. M. and Boyd, K. M. (2001) Nursing Ethics. 4th ed. [n.p.] Wilcockson, M. (1999) Issues of life and death. [n.p.]

The Necklace by Guy de Maupassant Essay Example for Free

The Necklace by Guy de Maupassant Essay In The Necklace by Guy de Maupassant, the main character, Mathilde, fails to realise that happiness comes from within. Mathilde borrows a necklace from her friend in order to go to a fancy ball with her husband. She manages to lose her necklace, with disastrous consequences. Mathilde needed to appreciate what she had and learn that people are charmed by personality. In order to be happy, people have to learn to appreciate what they have. Madame Loisel had a good life. She had a loving husband and a servant to help her run the house. However she was not happy. She yearned for a privileged life. It was only when she lost everything and came to know the life of abject poverty, did she realise, how little is needed to ruin or save. People arent necessarily impressed by appearance or possessions, but rather personality. When her husband gave her the invite to the ball, Mathilde upset. She had no clothes or jewels to wear to such an affair. She thought that the guests at the ball would not be charmed by her ordinary clothes. However, when she reached the ball all of the guests were enchanted by her happiness! She was the prettiest woman at present, graceful, smiling and quite above herself with happiness. Remembering and celebrating happy memories is all you need to be happy. When Mathilde came home from the ball, she was upset, disappointed and sad. It was over. She would never see such riches again. What Mathilde forgot to do though, was to celebrate those happy memories she held from that spectacular night, but sadly it ended to soon for Mathilde, and sadly they walked up to their own apartment. It was the end, for her. Later in her life when she was reduced to a life of poverty, Mathilde realised and cherished the importance of happy memories, shethought of that evening long ago Mathilde had a loving husband, a comfortable home and a wonderful servant to help her. Yet all she was interested in was possessions. This had the effect of not appreciating what she had, forgetting to celebrate good times and not focussing on what is important, your inner self.

Pathophysiology of sepsis | Case Study

Pathophysiology of sepsis | Case Study Thomas, a 70-year-old man, admitted to hospital with a five-day history of coughing with yellow-green sputum, pyrexia, rigors, poor appetite, mild chest pain and increasing difficulty of breathing. The initial observations are: Neurological: Altered neurological status, GCS 11/15. Agitated and confused. Cardiovascular: Sinus tachycardia, HR 135bpm. Hypotension, 90/45 mmHg. Respiratory: Tachypnoeic, RR 35bpm. Decreased saturation while receiving 6L O2 through Hudson mask. Metabolic: Febrile, 39 degree Renal: Oliguric with 20ml/hr urine output. Indwelling catheter (IDC) was inserted. The blood test revealed that the patient was suffering from hypernatremia, hyperkalaemia, hyperglycaemia, elevated urea, poor creatinine, increased WCC and low platelet count. The ABG indicated that Thomas was experiencing combined respiratory and metabolic acidosis. Thomas was finally diagnosed as sepsis complicated by the right middle lobe streptococcus pneumonia. He required intubation and invasive ventilation support. In this case study, the pathophysiology of sepsis will be discussed and the mechanism of synchronised intermittent mandatory ventilation (SIMV) volume control ventilation mode will be explained. Sepsis is defined as the dysregulated inflammatory response caused by severe infection (Neviere 2015). It has the interchangeable definition as Systemic inflammatory response syndrome (SIRS) while the SIRS is resulted by a suspected or confirmed infectious source (Neviere 2015). The concept of SIRS was first introduced by the American College of Chest Physicians (ACCP) and Society of Critical Care Medicine (SCCM) in 1992 (Kaplan 2014). It is characterised by two or more following symptoms. They are fever of high than 38 degree or hypothermia; tachycardia; tachypnoea or partial pressure of arterial carbon dioxide (PaCO2) less than 32 mmHg; deranged white cell count of more than 12,000/Â µL or less than 4,000/Â µL (O’brien et al. 2007). Associated with Thomas’s symptoms, it is clear to see that he was definitely experiencing sepsis. It is because that he was febrile up to 39 degree, tachycardic with heart rate of 135 bpm, and had increased respiratory rate of 35bpm as w ell as the elevated leucocytes count of 14,000 per microliter. The clinical signs are related to the inflammation process which is activated by the body immune system. Due to the severe infection, a large number of proinflammatory mediators are released which in turn result in the serial inflammatory reaction and extensive tissue damage (Neivere 2015). It is reported that SIRS can lead to high mortality rate because of high occurrence of SIRS induced multiple organ dysfunction syndrome (MODS) (Singh et al. 2009). In the following paragraphs, the pathophysiology of sepsis/SIRS will be more comprehensively examined. The pathophysiology of SIRS is complex. There are a few elements that need to be emphasised. They are acute stress response, inflammatory process and cytokine storm. Firstly, stress response is the acute phrase reaction when the body tries to defence against the threatening triggers. Those triggers are also known as ‘stress’. Stress can be caused by daily life events, environmental factors or physical illness (Better Health Channel 2012). In Thomas’s case, the stress response is initiated by infection. Under the influence of stress, the body steady state is disrupted. To maintain the homeostasis, the stress response is activated to reverse the body balance and redistribute the oxygen and energy to maintain the function of vital organs (Kyrou et al. 2012). Hypothalamus plays a vital role in processing the distress signals (Seaward 2015). Once it senses the stress, it triggers the activation of sympathetic nervous system. The sympathetic nervous system then stimulates the adrenal gland to produce epinephrine. It is also known as adrenaline. The adrenaline can lead to increased heart rate and myocardial contractility; dilated pupils and bronchi; peripheral vasoconstriction; accelerated respiratory rate; decreased digestive activity and increased production of glucose from liver (Seaward 2015). In addition, stress can also activate another pathway of stress response. That is the hypothalamic-pituitary-adrenal (HPA) axis (Seaward 2015). It means the stress triggers the release of corticotrophin-releasing factor (CRF) from anterior hypothalamus. The CRF then promotes the pituitary gland to produce adrenocorticoid trophic hormone (ACTH). The ACTH stimulates the production of cortisol and aldosterone through the adrenal cortex. Those corticosteroids can result in increased metabolism, sodium and water retention (Seaward 2015). Therefore, it is obvious that Thomas was under the effect of stress. He was tachycardic, tachypnoeic and slightly hyperglycaemic due to the effect of sympathetic nervous response. He was oliguric because of the acute kidney injury secondary to the vasoconstriction. His hypernatremia status can be contributed by the impact of aldosterone. He had poor oral intake can be cause by the suppressed digestion function. Secondly, the inflammatory cascade plays an essential role in the pathophysiology of systemic inflammatory response syndrome. Sagy et al. (2013) summarised the inflammation mediator related mechanisms in the systemic inflammatory response. It is indicated that the excessive release of pro-inflammatory mediators result in the inflammation, inhibit the function of compensatory anti-inflammatory response, and compromise the immune system eventually (Sagy et al. 2013). Cytokines are the essential components of immune system. Bone et al. (1992) explained that the local cytokines are activated immediately after an insult in order to repair the wound and initiate the innate immune system. Because of the release of local cytokines, a small amount of cytokines go into the circulation. This promotes the production of growth factor and adhesion of macrophages and platelets to help with the recovery of the local damage. However, when the infection is severe and the homeostasis is unable to be restored, cytokine storm occurs. More specifically, cytokine storm is formed from a complex progression. Cytokines are made up by macrophages, monocytes, mast cells, platelets and endothelial cells, which are the initial immune defensive components (Plevkova 2011). The multitude of cytokines can soon induce the cytokine tissue necrosis factor-alpha (TNF-a) and interleukin-1 (IL-1). Those two elements result in the removal of nuclear factor-KB (NF-KB) inhibitor. This in turn prompts the production of more proinflammatory mediators, such as IL-6, IL8 and interferon gamma (Plevkova 2011). In other words, cytokines stimulate the production of immune cells, which in turn induce more cytokines in the circulation. The cytokines have a great impact on the body, including direct or indirect contribution of mortality in SIRS. TNFa is discovered causing fever, abnormal haemodynamic values, low white cell count, increased liver enzymes and clotting problems (Jaffer et al. 2010). IL-1 is reported having connection with fever, haemodynamic abnormality, loss of appetite, general weakness, headache and neutrophilia (Jaffer et al. 2010). IL-6 is found having strong relationship with fever and impaired lung function as well as acting a determinant of severity of SIRS and mortality rate (Jaffer et al. 2010). The massive accumulation of cytokines can cause widespreading vasodilatory effect. It is because the cytokines stimulate the release of vasodilators such as nitric oxide (Sprague and Khalil 2009). Additionally, cytokines promotes adhesion of the immune cells and the endothelial cells, which in turn leads to leaky endothelium and loss of fluid from intercellular space to extracellular space (Sprague an d Khalil 2009). Moreover, the cytokines cascade can also lead to the clotting disorder. It is because of the high concentration of fibrinogen in the inflammation process (Esmon 2005). The fibrinogen is converted from thrombin, which is generated by tissue factor. Tissue factor is a substance that is expressed by the surface of white cell. It can also be induced by TNFa and endotoxin from the infection (Esmon 2005). The fibrinogen can be transferred into fibrin which in turn forms clots. As the excessive amount of fibrin in the inflammation status, it can result in extensive clotting disorder. To sum it up, it can be concluded that Thomas’s fever is highly likely related to the release of TNFa, IL-1 and IL-6. IL-1 could be one of the contributors of his poor appetite and elevated white cell count. IL-6 could worsen Thomas’s existing affected lung function. Thomas had increased white cell count can be contributed by the immune response and IL-1. The hypotension is related to the vasodilation effect. Due to the hypotensive, the kidney perfusion dropped and then led to the acute kidney failure and poor urine output. The acute kidney injury may affect the elimination of potassium so that Thomas was found having high potassium level. The low platelet count could be related to the massive production of cytokines and damaged endothelium. In the next section, the synchronised intermittent mandatory ventilation volume control will be explained as Thomas’s mechanical ventilation management. The synchronised intermittent mandatory ventilation (SIMV) is commonly used in ICU. With the volume control mode, the patient is given the ventilation support with a set tidal volume during the mandatory breaths (Deden 2010). To provide the effective ventilation support, there are a few specific values that need to be set up for the SIMV volume controlled mode. They are tidal volume and respiratory rate. The tidal volume refers to the amount of oxygen delivered by the ventilator or the amount of oxygen the patient breathes voluntarily. The respiratory rate is set up for mandatory breaths. In the SIMV volume controlled mode, the ventilation is trigger by the ventilator or patient self. It means the actual respiratory rate can be upon the preset rate (Goldsworthy and Graham 2014). There is a window of time for the ventilator to sense the patient’s inspiratory effort. This trigger window helps avoid the ventilator deliver the oxygen when the patient exhales (Deden 2010). If the p atient is able to trigger the ventilation within the time frame, the patient-triggered mandatory breath is induced. After reaching the demand tidal volume, the inspiratory phrase ends and expiratory starts. Between each mandatory breaths, the patient is able to initial own spontaneous breath, the breathing volume and length depend on the patient’s respiratory effort (Pierce 2007). If the patient is heavily sedated and unable to initiate the spontaneous breath within the trigger window, the machine-triggered mandatory breath will be activated to provide constant ventilation support according to the set respiratory rate and tidal volume (Deden 2010). Once the ventilator delivers the demand tidal volume, the inspiratory cycle ends and expiratory phrase starts until the next scheduled inspiratory cycle. If the patient’s attempt of breathing is not strong enough to trigger the patient-triggered mandatory breath, the assisted synchronised breath will be provided to achieve t he desired the tidal volume. Like the other mode, the inspiratory cycle ends once the set tidal volume is delivered (Deden 2010). It is believed that Thomas would be beneficial from the SIMV volume controlled mode. It is because that SIMV mode could help him reduce the work of breathing, especially when he was in the high energy-consuming septic status. In addition, due to the SIMV mode, the ventilator allows him to have extra breath to blow off the accumulative carbon dioxide. This can improve his acidosis. Moreover, because of the systemic inflammatory response syndrome and severe pneumonia, his lungs could be stiff and fragile secondary to the inflammation effect and accumulation of cytokines. The volume controlled ventilation acts as a protective strategy to avoid the ventilator related complications, such as volutrauma. It is recommended not to set the tidal volume more than 8-10ml/kg (Deden 2010). In conclusion, sepsis is a systemic inflammatory response syndrome resulted by the infection. The stress response, inflammation reaction and cytokines play essential roles in the progression of SIRS. As SIRS can cause high mortality rate, it is vital to control the infection and manage the widespreading inflammation as well as providing appropriate support to treat the symptoms. In Thomas’s case, the volume controlled synchronised intermittent mandatory ventilation would be the better option of managing his severe pneumonia and respiratory distress. Reference Better Health Channel 2012, Stress, viewed 12th March 2015, http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/stress Bone, RC, Balk, RA, Cerra, FB, Dellinger, RP, Fein, AM, Knaus, WA, Schein, RM Sibbald, WJ 1992, ‘Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. The ACCP/SCCM Consensus Conference Committee. American College of Chest Physicians/Society of Critical Care Medicine’, Chest, vol. 101, no. 6, pp. 1644-1655. Deden, K, 2010, Ventilation modes in intensive care, Dragerwerk AG C0. KGaA, Germany Esmon, CT 2005, ‘The interactions between inflammation and coaulation’, British Journal of Haematology, vol. 131, no. 4, pp. 417-430. Goldsworthy, S Graham, L 2014, Compact Clinical Guide To Mechanical Ventilation : Foundations Of Practice For Critical Care Nurses, New York, NY Jaffer, U, Wade, RG Gourlay, T 2010, ‘Cytokine in the systemic inflammatory response syndrome: a review’, HSR Proceedings in Intensive Care Cardiovascular Anaesthesia, vol. 2, no.3, pp. 161-175. Kaplan, LJ 2014, Systemic inflammatory response syndrome, viewed 19th March 2015, http://emedicine.medscape.com/article/168943-overview#a0101 Kyrou, I, Chrousos, Kassi, E Tsigos, C 2012, Stress, Endocrine physiology and pathophysiology, viewed 12th March 2015, http://www.endotext.org/chapter/stress-endocrine-physiology-and-pathophysiology/#h23 Neviere, R 2015, Sepsis and the systemic inflammatory response syndrome: Definition, epidemiology and prognosis, viewed 19th March 2015, http://www.uptodate.com/contents/sepsis-and-the-systemic-inflammatory-response-syndrome-definitions-epidemiology-and-prognosis O’brien, JM, Ali, NA, Aberegg, SK Abraham, E 2007, ‘Sepsis’, The American Journal of Medicine, vol.120, no.12, 1012-1022. Pierce, LNB 2007, Management of Mechanically Ventilated Patient, 2nd edn, Saunders Elsevier, London Plevkova, J 2011, Systemic inflammatory response syndrome, viewed 24th March 2015, http://eng.jfmed.uniba.sk/fileadmin/user_upload/editors/PatFyz_Files/Handouty/angl/Systemic_inflammatory_response_syndrome_2011.pdf Sagy, M, Al-Qaqaa, Y Kim, P 2013, ‘Definitions and pathophysiology of sepsis, Current Problems in Paediatric and Adolescent Health Care, vol. 43, no. 10, pp. 260-263. Seaward, BL 2015, ‘Physiology of stress’, Managing Stress, Jones Bartlett Learning, Burlington, MA. Singh, S, Singh, P Singh, G 2009, ‘Systemic inflammatory response syndrome outcome in surgical patients’, Indian Journal of Surgery, vol.71, no.4, pp. 206-209. Sprague, AH Khalil RA 2009, ‘Inflammatory cytokines in vascular dysfunction and vascular disease’, Biochemical Pharmacology, vol. 78, no. 6, pp. 539-552. 1 Ying Hu 76898

Blood, Guts and Glory: Thalassemia Patients Battle for a Better Life :: Journalism Journalistic Essays

Blood, Guts and Glory: Thalassemia Patients Battle for a Better Life When his company offered Vikram*, a systems analyst in Toronto, a transfer to Montreal with a promotion and pay raise, he was delighted but concerned. The 31-year-old unmarried Vikram worked twice as hard in his job to make up for the time he took off for medical reasons. The promotion was a justified reward for his hard work. But the question bothering Vikram, the issue that would determine his decision whether to accept the posting, was: Will I find a Thalassemia care center in Montreal? It was not the first time this unique blood disorder was the deciding factor for the choices Vikram made. â€Å"Thalassemia makes all the decisions for me,† he said. At nine months, Vikram was diagnosed with Thalassemia, a genetic non-communicable blood disorder. Born and raised in India, he spent his early years in and out of hospitals. His parents moved to Canada but Vikram had to stay back with his grandparents because his parents could not cope with earning a living and paying his medical bills. â€Å"After my grandparents passed away, I struggled with the costs and poor facilities for Thalassemia care in Delhi before deciding to move to Canada,† said Vikram, who shifted to Toronto when he was in his twenties. He has needed consistent and frequent blood transfusions, ranging from one unit (or bag) of blood every two months to one unit every seven days. Currently, he needs three units of blood every four weeks. Vikram explained that he visits a clinic for the transfusion. Here, a pump pushes blood into his veins at a constant speed. Each unit takes about two hours to be transfused which means Vikram must spend from six to eight hours in the clinic. This transfusion gives his blood an iron overload. Vikarm then has to take iron chelation (kee-LAY-shun) which involves infusions of the drug Desferal to remove excessive iron from his blood and organs for five full days. The Desferal infusion, he added, is more painful. He has a portocathetor, which is a device under his skin in his chest. This is connected to a needle which is attached to a syringe pump every Monday to infuse the drug continuously for five days. The pump, which Vikram wears on his waist, is about the size of an oversized palm-pilot and weighs a pound-and-a-half. It buzzes every time it pushes the medicine.

Stock Price Valuation and Beta Calculation Essay -- Finance

There are many choices in the market for the investors to generate more money and income with the capital that they able to invest. These tools are categorized into many different types of market such as equity market, bond market, and mortgage market, according to their characteristics. The markets are well-growing and establishing all around world due to the people’s awareness of investment, the globalization, the governments’ policies, and the change of technology. Equity market is one of the well performing markets. The companies raise fund from the public by listing themselves in the stock exchanges. Such objective can be done by distributing the common stock, preferred stock, and convertible securities. The voting rights, priority claim, ownership, and types of compensation are determined by their characteristics. The investors will purchase the stocks based on their requirements and preferences. Two types of market are found in the stock markets, which are the p rimary and secondary market. The primary market enables the companies to gather the funds directly from the investors when the secondary market provides the liquidity to the shares by enabling the investors to trade among themselves. Stock price valuation In Malaysia, the only stock exchange is the Bursa Malaysia. The Kuala Lumpur Composite Index (KLCI), also known as the FTSE Bursa Malaysia KLCI, is the main stock index. The basket consists of the 30 largest market capitalization companies in Malaysia (The Edge Malaysia, 2009). 70 % of the market capitalization for the local bourse is made up by these 30 companies (The Edge Malaysia, 2009). Its performance will signal the investors about the market condition in Malaysia. Next, Genting Berhad (GENTING, 3182) is ... ...sdate=2012-03- 29&lang= Bloomberg.(n.d.). Genting Bhd. Retrieved April 5, 2012 from http://www.bloomberg.com/quote/GENT:MK Bursa Malaysia. (n.d.). FTSE Bursa Malaysia KLCI. Retrieved April 5, 2012 from http://www.bursamalaysia.com/website/bm/market_information/fbm_klci.html Genting Berhad. (n.d.). Annual report. Retrieved April 5, 2012 from http://www.genting.com/annualreports/gb/2010/gb2010_02_11.pdf Genting Berhad. (n.d.). Group profile. Retrieved April 5, 2012 from http://www.genting.com/groupprofile/gent.htm Palm oil traders await price forecasts seen as bullish. The Star Online. Retrieved April 5, 2012 from http://biz.thestar.com.my/news/story.asp?file=/2012/3/5/business/20120305141244&sec= business Yahoo!.(n.d.), FTSE Bursa Malaysia KLCI (^KLSE). Retrieved April 5, 2012 from http://finance.yahoo.com/q/hp?s=%5EKLSE&a=01&b=17&c=2012&d=02&e=29&f=20 12&g=d