A Young Lady With Feet Swelling Health And Social Care Essay

A 29-year-old Indonesian domestic assistant, Ms MH, was admitted to medical section, Queen Elizabeth Hospital, complaining of bilateral pess and mortise joints swelling and bubbling piss for 1 hebdomad. There was no hematuria, dysuria, urinary frequence, urgency, febrility, joint hurting, tegument roseolas, sore pharynx, recent upper respiratory piece of land symptoms or GI symptoms. She denied taking any herbs or nonprescription medicines. Her past medical history and household history were everyday. She was a non-smoker, and denied history of unprotected sex. She recalled that her first twenty-four hours of last catamenial period was approximately 2 hebdomads before the admittance. On scrutiny, she was afebrile, with bosom rate 103 beats per minute and blood force per unit area 144/71mmHg. She had periorbital hydrops, facial swelling and opposing hydrops of 4 limbs. There was no lividness. Her fundoscopic scrutiny was normal. Jugular venous force per unit area was elevated. On ausc ultation, her thorax was clear, her bosom beat was regular with a non-displaced cardiac vertex, and there was no bosom mutter. Abdominal scrutiny did non uncover any abdominal mass or bruit. She did non hold any skin roseolas or joint puffiness. Dipstick uranalysis showed 3+blood, 2+protein, and negative for glucose. Urine gestation trial was negative. Her blood trial showed normochromic, normocystic anemia ( haemoglobin degree 10.5g/dL ) and deranged nephritic map trial ( serum creatinine: 168i? ­mol/L ) . Her white cell count was 10.4 ten 10^9/L, the albumin degree was 24g/L and the liver map trial was normal. Her serum entire cholesterin degree was 5.2mmol/L, low denseness lipoprotein degree was 3.7mmol/L and fasting plasma glucose was 4.5mmol/L. The everyday microscopy of piss was positive for ruddy blood cell, ruddy cell dramatis personae, and was negative for white blood cell. The urine sum protein was 1.13g/day and the creatinine clearance was 10 mL/min. Mid-stream piss for civilization was negative. The clinical image was compatible with nephritic syndrome or quickly progressive glomerulonephritis ( RPGN ) , and anemia. Further probes showed that serum anti-nuclear antibodies ( ANA ) , antineutrophil cytoplasmatic antibodies ( ANCA ) , anti-streptolysin O ( ASO ) antibody, and anti-glomerular cellar membrane ( anti-GBM ) antibody titres were undetectable. Serum C3 and C4 complement degrees were normal. Hepatitis B surface antigen, anti-hepatitis C virus antibody, serum cryoglobulin and blood civilization were negative. Ultrasound scan of nephritic system revealed normal-sized kidneys with increased echogenicity, which was suggestive of nephritic parenchymal disease. Nephritic biopsy confirmed Immunoglobulin ( Ig ) A nephropathy. The reticulocyte count was normal, peripheral vilification showed mild poikilocytosis, and serum Fe profile was non implicative of Fe lack. Faecal supernatural blood trials were negative in all of the 3 stool specimens. Serum and urine paraprotein were n egative, and bone marrow scrutiny showed active marrow. Ms. MH was given low dose frusemide for diagnostic alleviation of peripheral hydrops, and was given angiotensin change overing enzyme inhibitor ( ACEI ) for control of blood force per unit area. She was assessed by nephrologist and was suggested to go on these medicines, and to mention to renal clinic for consideration of steroid therapy when serum creatinine is on increasing tendency or when albuminuria progresses to nephrotic scope. She tolerated the medicines and was on a regular basis followed up in the medical out-patient clinic. Discussion ** ( entire words for instance history and treatment must be 1000-2000 ) : Ms MH, a healthy 29-year-old lady, presented with 1 hebdomad history of dependent hydrops, high blood pressure, microscopic hematuria, and a low grade of albuminuria ( urine sum protein: 1.13g/day ) . Urine microscopy revealed white blood cell, ruddy blood cell and ruddy cell dramatis personae. This clinical image is compatible with glomerulonephritis, which can be loosely classified into renal-limited primary glomerulonephritis or secondary glomerulonephritis perplexing systemic disease. Further blood trial for serologic markers of glomerulonephritis, viz. ANA, ANCA, anti-GBM antibody, ASO titres, hepatitis serology, blood civilizations and cryoglobulin titres were undetectable, therefore excepting secondary glomerulonephritis. Nephritic biopsy remains the gilded criterion for unequivocal diagnosing of glomerulonephritis. The biopsy specimen can be examined under the light microscopy in order to find the primary histopathological hurt to the uriniferous tubule. Under light microscopy, immunofluorescence survey is able to place three major forms of deposition of Ig, viz. farinaceous, additive and dearth of immunofluorescence staining. Farinaceous deposition of Ig is a trademark of immune complex glomerulonephritis. Linear deposition of Ig along the glomerular cellar membrane is characteristic of anti-GBM disease. Dearth of Ig and positive circulating ANCA represent glomerulonephritis caused by ANCA-related vasculitis. ( 1 ) Ms MH was eventually diagnosed to hold IgA kidney disease, which is the commonest cause of primary glomerulonephritis throughout the universe. ( 2 ) Typical oncoming of the disease is in the 2nd and 3rd decennaries of life, as manifested by our instance. Majority of patients are diagnosed during an rating for symptomless microscopic hematuria or mild albuminurias. Macroscopic, and frequently perennial, hematuria that occurs shortly after an upper respiratory tract infection is a authoritative but less common presentation. Patient with IgA kidney disease may besides presented with nephrotic-range albuminurias, RPGN or, seldom, malignant high blood pressure. ( 3,4 ) As demonstrated by our instance, the complement degree is typically normal in IgA nephropathy. Light-microscopically, IgA nephropathy can change from mild mesangial proliferation and enlargement to spread proliferation with glomerular crescents. Immunofluorescence staining typically showed farinaceous deposition of Ig, decl arative mood of immune complex glomerulonephritis. ( 1 ) Ms MH was put on ACEI for blood force per unit area control. There are groundss that patterned advance of IgA kidney disease may be slowed by ACEI and angiotonin II receptor blockers ( ARB ) . ( 5,6 ) The drugs act by cut downing the intra-glomerular force per unit area and by straight bettering the size-selective belongingss of the glomerular capillary wall, lending to their anti-hypertensive and anti-proteinuric consequence. ( 1 ) In a randomized controlled test, 44 patients with biopsy-proven IgA kidney disease, proteinuria more than or equal to 0.5 gram/d, and serum creatinine less that or equal to 1.5 mg/dL ( 133 umol/L ) were indiscriminately assigned either to have Vasotec or to a control group in whom blood force per unit area was controlled with anti-hypertensives other than ACEI or ARB. At followup of about seven old ages, nephritic endurance, defined as lupus erythematosus that a 50 per centum addition in the serum creatinine concentration, was significantly more likely in the Vasotec group than in the control group: 92 % versus 55 % ( p & A ; lt ; 0.05 ) . There was a important lessening in albuminuria in the Vasotec group, whereas an addition in albuminuria was observed in the control group ( P & A ; lt ; 0.001 between groups ) . Control of blood force per unit area was similar in the two groups. In decision, ACEI significantly improves nephritic endurance in proteinuric IgA kidney disease with norm al or reasonably impaired nephritic map. ( 5 ) High blood pressure, albuminuria of more than 1 gram per twenty-four hours, impaired nephritic map at the clip of diagnosing, relentless microscopic hematuria, and high glomerular histopathological tonss stand out as consistent and strong forecasters of hapless nephritic endurance harmonizing to literatures and cohort surveies from around the universe. ( 3,7,8 ) Ms MH demonstrates the first three hapless predictive factors of the above list and therefore she is expected to be at hazard of holding progressive disease in following few old ages. IgA kidney disease is a global disease and the cause of end-stage nephritic failure in 15-20 per centum of patients within 10 old ages and in 30 to 40 per centum of persons within 20 old ages from evident oncoming of disease. Harmonizing to Cochrane Database of Systemic Reviews in the 3rd one-fourth of 2009, the optimum direction of IgA nephropathy remains unsure. Consequences from small-scaled randomised controlled tests favoured the usage of immunosuppressive intercessions, with the most promising agent being steroids, which were associated with a lower hazard of patterned advance to end-stage nephritic failure ( comparative hazard [ RR ] 0.44, 95 % assurance interval [ CI ] 0.25 to 0.8 ) and lower urinary protein elimination ( leaden mean difference [ WMD ] -0.49 g/day, 95 % CI -0.72 to -0.120 ) . Urinary protein elimination was lower for patients treated with alkylating agents or cyclosporin compared to placebo or no intervention. Further survey is necessary to determine which pa tients would profit from these intercessions. ( 9 ) Tables and figures ( non more than 2 ) : Reference ( non more than 10 ) : ** Brady HR, O'Meara YM, Brenner BM. Glomerular diseases. In: Kasper DL, Braunwald E, Fauci AS, et Al, explosive detection systems. Harrison ‘s rules of internal medical specialty, 16th edition. New York: McGraw-Hill, 2005:1674-94. Julian BA, Waldo FB, Rifai A, Mestecky J. IgA kidney disease, the most common glomerulonephritis worldwide. A ignored disease in the United States? Am J Med, 1988 ; 84:129-132. Donadio JV, Grande JP. IgA nephropathy. N Engl J Med 2002 ; 347:738-48. Li PKT, Lai KN. IgA nephropathy in Hong Kong. Journal of the Hong Kong Medial Association, 1989 ; 1:93-5. Praga M, Gutierrez E, Gonzalez E, Morales E. Treatment of IgA nephropathy with ACE inhibitors: A randomized and controlled test. J Am Soc Nephrol, 2003 ; 14:1578-83. Li PK, Leung CB, Chow KM, Cheng YL, Fung SK, Mak SK, Tang AW, Wong TY, Yung CY, Yung JC, Yu AW, Szeto CC ; HKVIN Study Group. Hong Kong survey utilizing Diovans in IgA nephropathy ( HKVIN ) : a double-blind, randomized, placebo-controlled survey. Am J Kidney Dis, 2006 ; 47:751-60. Li J, Zhang H, Zhou Y, Li G, Zou W, Wang H. Natural history of Ig A kidney disease and prognostic factors of forecast: a long-run follow up of 204 instances in China. Nephrology, 2008 ; 13:242-6. Chacko B, John GT, Neelakantan N, Korula A, Balakrishnan N, Kirubakaran MG, Jacob CK. Presentation, forecast and result of IgA kidney disease in Indian grownups. Nephrology, 2005 ; 10:496-503 Barkat R, Molony DA, Samuels JA. Immunosuppressive agents for handling IgA kidney disease. Cochrane Database of systematic Reviews. 3rd One-fourth, 2009No of words ( excepting mentions ) : ____1260 _____**The instance study will be REJECTED if the campaigners fail to adhere to the above format.DeclarationI do solemnly and unfeignedly declare that the instance study submitted represents my ain work. I have been in clinical contact with the instance selected. The instance study has non been submitted to any assessment board or publication and it is NOT related to my 2nd forte ( Internet Explorers ) , if any. My consent is herewith given to the College to maintain a transcript of my instance study, in written and/or electronic, at the College Secretariat and let the populace to hold free entree to the work for mention.______________________( Signed by _______________ )

A Class Divided Documentary Review

A class divided is a documentary about a teacher named Jane Elliot who teaches her students about racism first hand. She divides the students into two groups, the blue eyes, and the brown eyes. For the first day, the â€Å"brown eyed† children are not able to go to recess, or lunch at the same time as the rest of the children. They wear a blue collar around their necks so that they are obviously different at a distance from the other students. They are not allowed to drink from the same water fountains, use the playground equipment, or even play with the blue eyed children.The next day, the roles are reversed. During these two days Jane Elliot would make comments about the children wearing the collars to degrade them. She would point out if one of them wasn’t ready on time, or if they forgot something. She would say things like â€Å"That’s how blue eyed people are† â€Å"Brown eyed people are better than blue eyed people† (J. Elliot, A Class Divide d, 1985). After the children who weren’t wearing a collar noticed Mrs. Elliot saying these kinds of things, they would also chime in and begin saying things about the kids wearing the collars.Mrs. Elliot said â€Å"I watched wonderful, thoughtful, children turn into nasty, vicious, discriminating little third graders. †(J. Elliot, A Class Divided, 1985) . The movie showed the students come back for their fifteenth class reunion to talk about this life long lesson that their third grade teacher taught them. All of the students said it was a lesson they have never forgotten and something that changed their lives forever. They talked about how it affected their lives growing up, and how it affects the way they raised or were currently raising their children.Since she got done teaching, Jane has been doing trainings are conferences to teach others. Her movie A Class Divided has been shown in prisons to inmates who are trying to earn a degree. She also did training at a pri son in Iowa for the guards and other staff members. When people signed into the meeting they had to log whether they had brown eyes or blue eyes. Those with blue eyes had to wear a green ribbon. The people with brown eyes were able to go in and sit when the training was scheduled to start, where the blue eyed people had to stand out in the hall. The bathrooms were labeled â€Å"browns only†.The blue eyes weren’t told what was going on, they were just told to wait outside, and administration would come out and tell them to be quiet. Meanwhile, Jane Elliot talked to those with brown eyes and told them that they were not to allow blue eyed people to sit beside them. She told them that brown eyed people were better than blue eyed people. She said that blue eyed people were no good and the brown eyes were to treat them as such. A while after the meeting started the blue eyes were able to come into the room. They had to sit in the back, and some people didn’t even hav e a seat.During the meeting Jane talked to the people with blue eyes a lot like she did to her students 30 years ago. The reaction she got from the adults were a lot like they were in her experiment with the children, however there was one woman who was a lot more out spoken and rebellious toward Jane. Jane Elliot does a great job at not only telling people about racism and discrimination, but also showing how it affects us, and how easy it is to go with the crowd. Some of the movie takes place in a school, and this is a place where children are taught to socialize.Teachers play a huge role in how students are molded, especially at such a young age. In this day and age, I don’t think teachers really think about how much of an influence they are on their students. Most of the children spend more time with their teachers than they do with their own parents. Jane took on this role and helped her students understand that there is an issue with discrimination and taught them a val uable lesson. When this documentary was filmed not everyone was taught that the color of your skin doesn’t make up the type of person that you are.They were taught that if you are not white, you aren’t â€Å"normal†. They associated people that had a different skin color as â€Å"bad† or even â€Å"stupid†. In those times it was totally acceptable and some people sincerely believed this. Things that are social acceptable change over time and this is something that has changed in a big way. I’m not saying that everyone doesn’t care about the color of your skin. There is a lot of racism going on in our world today, but it is no where near as bad as it was forty years ago.It reflects what we are taught by our parents also. If we are taught that â€Å"black people† are bad then we are going to believe that they are, and look at all of the bad things they do. We like to be the same as everyone else; we do not like to stand out. In t he film a lot of people didn’t dare to stand up for those wearing a collar because that would require them to stand up and go against what the authoritative figure was saying. This video relates to several chapters in our sociology book, the main chapter being chapter ten, race and ethnicity.This movie focused on the struggle in our country with discrimination of those with a different skin color, concentrating on â€Å"blacks† being the minority. At the time, people thought of black people are dirty, stupid, and bad people. They didn’t think they were able to do anything as good as white people. Jane Elliot turned her classroom into a small discriminating society in a sense. She had the brown eyed students wear blue collars the first day and they were not able to do any of the same things that the blue eyed students did.She divided this class that was once a united class who played together, into a class that was split into two groups and mocked and made fun of each other, solely because of the color of their eyes. I also think we could relate this movie to chapter fourteen, where the book talks about education. Like I have stated before, teachers play a major role in their interaction with their students and how they can be molded. Jane talked about going over the phonics card packs with the brown eyed students on the day that they wore the collars around their necks and it took them five and a half minutes to get through the card pack.On the day that they didn’t wear the collar around their necks, and were treated with respect and felt as though they were sufficient, they only took two and a half minutes to get through the card pack. Jane talked about the time she performed this exercise for the second time with her third grade class. She said that the students score went up on the days where they were â€Å"on top† and went down on the days they were on â€Å"bottom†. After going through the exercise their overall scores would have a significant incline. Mrs.Elliot sent the results to Stanford University’s Psychology Department to have them study and examine why this would be so. We could also relate this video to chapter seventeen, which talks about social change: collective behavior, social movements and technology. Like I said, things that were once socially acceptable in those times are no longer acceptable now. In those days it was ok for people to say the word â€Å"nigger’ it was a term that people used for black people because that’s the term everyone else was using. Now, it is considered a derogatory word and it is not acceptable to say it.I thought that this documentary was very interesting. I loved what Jane Elliot did with her students. I wish it was something more teachers could do, but now-a-days it probably couldn’t be done because of the stink people would put up about it. I feel that some teachers spend too much time talking about topics and not n early enough actually teaching. Jane taught her students a lesson that they have remembered and will never forget. It is something that they have taught or will teach to their children. The town I grew up in was quite a bit like Riceville, Iowa. It was a small town, primarily Christians who were white.In fact, there were only two black people in our town and they happened to be two of my cousins who were adopted. From as far as I can remember I was taught that skin color doesn’t make up who the person is, â€Å"It’s what is on the inside that counts. † My cousins and I had a great relationship with my cousins and it wasn’t because of the color of their skin, or the color of mine that made the difference. I have met black people who I didn’t like, and I have met white people who I didn’t like. To me color makes no difference. I am very grateful that I was taught this lesson, and I feel and for those who haven’t been taught.I think it w ould be incredibly useful for this to be used in school. There are many other forms of discrimination other than people with different skin colors. Just because it is the form that is most widely talked about doesn’t mean it is the only one. I hope in some way, maybe not by putting collars around their necks, but I do hope that this is taught in schools through out the years. References Peters, William. (1985). A Class Divided. PBS, Frontline Benokraitis, Nijole. V. (2012). SOC, (Student Edition) Belmont, CA: Wadsworth, Cengage Learning

The Hyogo Framework For Action Environmental Sciences Essay

The construct and pattern of cut downing catastrophe hazards through systematic attempts to analyze and pull off the causal factors of catastrophes, including through reduced exposure to jeopardies, lessened exposure of people and belongings, wise direction of land and the environment, and improved readiness for inauspicious events. In short it is a program or action that is in topographic point to decrease the consequence of a catastrophe before or after it strikes.Definition of DRMCatastrophe hazard direction is a planned method of utilizing administrative instructions, organisations, and operational accomplishments to set into pattern schemes, constabularies and â€Å" improved header capacities † in order to cut down the unfavorable force of jeopardies and the opportunity of catastrophe. ( Kesten A. R. , 2005 ) ( United Nations: International Strategy for Disaster Risk Reduction ( UNISDR ) . , 2004 )Hyogo Framework for ActionThe Hyogo Framework for Action ( UNISDR, 2011 ) provides the undermentioned precedences for action. Priority Action 1 States that develop policy, legislative and institutional models for catastrophe hazard decrease and that can develop and track advancement through specific and mensurable indexs have greater capacity to pull off hazards and to accomplish widespread consensus for, battle in and conformity with catastrophe hazard decrease steps across all the sectors of society. Ensure that catastrophe hazard decrease is a national and a local precedence with a strong institutional footing for execution. Priority Action 2 The starting point for cut downing catastrophe hazard and for advancing a civilization of catastrophe resiliency lies in the cognition of the jeopardies and the physical, societal, economic and environmental exposures to catastrophes that most societies face. Of the ways in which jeopardies and exposures are altering in the short and long term footing. This is followed by action taken on the footing of that cognition. Identify, buttocks and proctor catastrophe hazard and heighten early warning. Priority Action 3 Catastrophes can be well reduced if people are good informed and motivated towards a civilization of catastrophe bar and resiliency, which in bend requires the aggregation, digest and airing of relevant cognition and information on jeopardies, exposures and capacities. In short people need to cognize about the catastrophe they could be faced with and what they need to make to remain alive if one stikes. Use cognition, invention and instruction to construct a civilization of safety and resiliency at all degrees. Priority Action 4 Catastrophe hazards related to altering societal, economic, environmental conditions and land usage, and the impact of jeopardies associated with geological events, conditions, H2O, clime variableness and clime alteration. These topics are addressed in sector development planning and programmes every bit good as in post-disaster state of affairss. Reduce the implicit in hazard factors. Priority Action 5 At times of catastrophe, impacts and losingss can be well reduced if governments, persons and communities in hazard-prone countries are good prepared and ready to move and are equipped with the cognition and capacities for effectual catastrophe direction. Strengthen catastrophe readiness for effectual response.Question 3The current world in South Africa with respects to Disaster Risk ManagementSouth Africa is invariably threatened by several types of catastrophes of different beginning and nature. These jeopardies, which are technological, environmental and natural in beginning, include terrible hydro meteoric events, such as inundations, drouths, terrible storms twisters and veld fires. Hazards of biological beginning, such as epidemic disease incidences, which affect worlds and farm animal, have shown an addition in recent old ages. In the excavation industry and in urban environments, risky stuff and transit accidents continue to present major challenges. Gauteng in the last few hebdomads has experienced a figure of localised implosion therapy incidents including a detrimental hailstorm on 20 October 2012 in the Germiston country ( Kesten, A.R. 2012 ) . Large Numberss of rural people migrate to urban countries in hunt of employment, although governments continue with attempts to cut down the high degrees of poorness and to rush the proviso of substructure and entree to services. They are invariably exposed to a scope of menaces due to the fact that they have to settle in insecure environments and are badly vulnerable to conditions such as inundations, H2O borne diseases and domestic fires. Vulnerability of rural communities in footings of sustainable supports and poorness are impacted on by alterations in societal behaviour in these specific communities. Poverty, due to high degrees of unemployment leaves people, families and communities missing resiliency to the impact of jeopardies. The bequest left by the Apartheid authorities impacted communities, which are now disadvantaged and urgently destitute and as a consequence, capable to high degrees of catastrophe hazard. Smaller local communities are more often prone to catastrophes w here loss of life and belongings, and the fiscal load thereof, are high. Socially disadvantaged groups are more vulnerable to jeopardies, reflecting their societal, cultural, economic and political environment. Catastrophes, in bend, are a beginning of impermanent adversity and hurt and a factor lending to relentless poorness. At the family degree, location of lodging ( e.g. on flood plains ) , primary types of business and entree to resources ( including fiscal ) ; reflect how poorness is the individual most of import factor in finding exposure.Factors lending to exposure in South AfricaThere are many factors lending to exposure in South Africa. They are: dearth ; HIV/AIDS ; uninterrupted struggle and Globalization. Famine – there is non plenty nutrient available, failures of administration and utmost degrees of predominating poorness which has led to alone degrees of adversity for many people in South Africa. HIV/AIDS – HIV/AIDS has eroded the lives and supports of 1000000s of Africans. It has left Africans vulnerable at homeowner and macro-economic degrees. Continuing struggle – struggles have really high costs, destructing past development additions and go forthing of damaged assets and substructures that impedes future additions. Globalization – developing states like South Africa can non utilize their primary merchandises to guarantee economic growing and development, because of this international market. Therefore this ensures that the rich get richer and the hapless are dragged down into poorness. Other factors lending to exposure in South Africa are: Erratic rainfall Climate variableness Break to nutrient handiness Extreme degrees of poorness Paraffin wellness menaces Failures of authorities Crippling foreign debt Collapsing trade good monetary values Limited export net incomes Animal diseases Capacity edifice, public consciousness and research Communication and information Catastrophe alleviation Drought Early warnings Energy Environmental exigencies Floods International facets Mining catastrophes Radiation related catastrophes Refugees Technological accidents Veld and forest fires Weather warningsQuestion 44.1 Emergency and Response ManagementEmergency response direction is familiar to disaster response bureaus and catastrophe victims. It includes emptying processs and shelters, hunt and deliverance squads, needs assessment squads, activation of exigency line of life installations, response centres and shelters for displaced people. Catastrophe response refers to activities that are put into action instantly anterior to catastrophes, when there is equal early warning and instantly following catastrophes. Response includes early warning and emptying of the readiness measures or programs and short-run exigency steps of alleviation every bit good as long-run recovery and Reconstruction activities. The purpose of this response is to salvage lives, to guarantee the endurance of the maximal possible figure of people affected, to restore ego sufficiency and reconstruct indispensable services every bit quickly as possible and to mend or replace damaged substructures and economic installations, place, appraise and implement development aims which cut down exposure. Response covers a scope of activities depending on the nature of the catastrophe. The activities are warning, emptying, migration or response, hunt and needs appraisal and exigency alleviation. The indispensable elements of response and exigency direction are logistic and supply, communicating and information direction, subsister response and get bying mechanisms, security and the demand to protect basic human rights, accent on the most vulnerable group, exigency operations and direction, Reconstruction and execution of rehabilitation steps. Effectiveness of response and exigency direction will be influenced by a figure of factors. They are: First, the type of catastrophe will impact the effectivity of mobilisation and application of response. Second, the badness and extent of the catastrophe. Third, the ability to take pre-action will depend on the type of catastrophe every bit good as the capacity. Fourth, the capableness for sustainable action4.2 Key countries and jobs associating to exigency and response directionResponse activities will usually be carried out under disruptive and sometimes unsafe or traumatic conditions, and therefore it is hard to implement. Heavy demands will be made on personal, equipment, installations and resources. Effective response will therefore depend on the good readiness, capacity put in topographic point as portion of a hazard decrease scheme. Sound planning, organisation and preparation are hence indispensable for accomplishing optimum success. Catastrophe hazard decrease activities should be put in topographic point as long-run steps that increase the capacity and resiliency of vulnerable groups in order to cut down the impact of future catastrophe events. The response period provides an chance for measuring bing catastrophe hazard decrease steps and thought of what needs to be improved and what needs to be put in topographic point. Weak institutional model includes unequal policy way, hapless organisation and coordination, unequal planning, unequal readiness ( out-of-date programs, low criterions of preparedness, deficiency of clear determination devising system, deficiency of clear allotment of functions and duties ) . Therefore weak institutional model may interpret into failing in early warning and public consciousness, deficiency of capacity for impact appraisal, deficiency of anterior hazard appraisal and exposure analysis, hapless information direction system and hapless status and response operations. An extra consideration is the deficiency of standardisation or the deficiency of execution of criterions which have been developed by the South African Bureau of Standards in line with subdivision 7 ( 2 ) of the Disaster Management ActQuestion 5ResilienceThe ability of a system, community or society exposed to jeopardies to defy, absorb, suit to and retrieve from the effects of a jeopardy in a timely and efficient mode, including through the saving and Restoration of its indispensable basic constructions and maps. Resilience means the ability to â€Å" jump back from † a daze. The resiliency of a community in regard to possible jeopardy events is determined by the grade to which the community has the necessary resources and is capable of forming itself both prior to and during times of demand. ( Harmonizing to the most current US/ISDR definition. )VulnerabilityThe features and fortunes of a community, system or plus that make it susceptible to the detrimental effects of a jeopardy. There are many facets of exposure, originating from assorted physical, societal, economic, and environmental factors. Examples may include hapless design and building of edifices, unequal protection of assets, deficiency of public information and consciousness, limited official acknowledgment of hazards and readiness steps, and neglect for wise environmental direction. Vulnerability varies significantly within a community and over clip. This definition identifies exposure as a feature of the component of involvement ( community, system or plus ) which is independent of its exposure. However, in common usage the word is frequently used more loosely to include the component ‘s exposure. ( Harmonizing to the most current US/ISDR definition. )Question 6The national catastrophe direction model says that it is indispensable to fit community leaders with consciousness of good patterns in bar, readyings and be aftering for these catastrophes, which may be built-in in the environment, a nd of the pressing demand to educate members of the communities in catastrophe hazard direction accomplishments. The national catastrophe direction model discusses the constitution of effectual agreements for the development and aboption of incorporate catastrophe hazard direction policy in South Africa it addresses the agreements for the incorporate dirction and execution of catastrophe hazard direction policy, it sets out the agreements required for stakeholders engagement and the battle of proficient advice in catastrophe hazard direction planning and operations and it describes agreements for national, regional and international co-operation for catastrophe hazard direction. Disaster hazard direction introduces the procedure involved in transporting out a catastrophe hazard appraisal, addresses procedures for bring forthing a National Indicative Disaster Risk Profile, describes demands for monitoring, updating and circulating catastrophe hazard information and looks at steps to guarantee quality control in catastrophe hazard appraisal and monitoring. Disaster hazard decrease addresses deman ds for catastrophe hazard direction planning within all parts of authorities. Response and recovery requires an incorporate and coordinated policy that focuses on rapid and effectual response to catastrophes and post-disaster recovery and rehabilitation. The catastrophe hazard direction procedure is the key to the effectual operation of an full squad sourced from many different subjects, involved in the catastrophe direction operation. It consists of several procedures, they are Establish the Context, Identify Risk, Analyse Risk, Evaluate and Priorities Risk, Treat Risk, Monitor and Review, Communicate and Consult. Establish the context so that there is a thorough apprehension of the context in which risk/s is present. Hazard designation is to foremost place all the possible jeopardies, whish could hold an impact on the country being assessed. Analyse hazard is to find the bing control mechanisms for the identified jeopardy and its strengths. Evaluate and precedences risk to a certain standard that is necessary towards the prioritization of the hazard. Risk intervention is necessary after they have been prioritized. Different hazards have different types of interventions and different degrees of interventions. Monitor and reappraisal is a non-stop procedure throw out the hazard direction procedure. This done to do certain the right program was implemented and the right action was taken. Communicate and consult is to pass on with the relevant people so that all the right actions can be taken, so that there is less loss to the country. The extenuation and preparedness stage starts as catastrophe direction betterments are made in expectancy of a catastrophe. Mitigation measures include constructing codifications and zoning, exposure analyses and public instruction. Preparedness is holding a: program of action at a clip of crisis ; preparedness programs ; exigency exercisings and preparation every bit good as warning systems. Preparedness has two chief purposes. These purposes are to assist people to avoid possible catastrophes and to authorise those who may be affected through programs and resources which raise their degrees of resiliency. These purposes are put into topographic point to salvage lives, to minimise the inauspicious effects of a jeopardy through effectual precautional steps and to guarantee seasonably, appropriate and efficient organisation for exigency responses. The nine following classs reflect the chief constituents of catastrophe readiness. These constituents are vulnerability appraisal, planning, institutional model, information systems, resource base, warning systems, exigency and response direction, public instruction and preparation and dry runs. Vulnerability appraisal is an ongoing procedure of people and organisations that assess jeopardies and hazards, map out possible jeopardies and predicts the alleviation demands and available resources. Planing involves many signifiers of extenuation and readiness schemes and eventuality programs for reacting to peculiar jeopardies. Institutional model is well-coordinated catastrophe readiness and response system at all degrees, with committedness from relevant stakeholders where functions and duties are clearly defined ( Twigg, 2004:288 ) . Information systems are systems put in topographic point for assemblage and circulating information between stakeholders. Resource base refers to the reso urces that are at your disposal to alleviate the general public of a catastrophe ( e.g. nutrient, shelter, medical attending, etc ) . Warning systems are ways of conveying warnings efficaciously to people at hazard. Emergency and response direction is the actions that should be taken every bit shortly as a catastrophe has occurred. Public instruction and preparation includes preparation classs, workshops and extension plans for at hazard groups and catastrophe respondents so that the populace will cognize what action to follow when a catastrophe work stoppages. Rehearsals are the chances to practise the drills which need to be implemented as a catastrophe work stoppages. Catastrophe planning is required to do certain that all the mechanisms are in topographic point to cut down the hazards and impacts of a catastrophe when it happens. Disaster planning should take into history the socio economic, environmental and other factors that cause hazard and menaces. Disaster readiness for effectual response is the system put into topographic point so that the response to catastrophes is done right and effectual. Effective information flows are needed for a figure of valid grounds that in general all consequence the extenuation of catastrophes. Preparedness planning as the challenges of the educational system in Africa is non that good due to the growing rate of African states, nevertheless the undermentioned agency of instruction to be in Africa can be used to offer catastrophe consciousness programmes and causes. Preparedness planning and developing harmonizing to Erdih ( 1988 ; 37 ) and effectual instruction and preparation programmes for catastrophe readiness should be peculiar in design, be community specific, based on a rational appraisal of the information needed, be integrated with an bing catastrophe and response system, include information bar, extenuation and recovery, be established as an on-going procedure and included as the most vulnerable sector of the population precedence. Fiscal facets of readiness planning are a large facet of catastrophe extenuation is the direction of fiscal resources. Many beginnings of fiscal aid could be considered during the direction of catastrophe in footings of catastrophe extenuation. It is good pattern to guarantee there is bar, readyings and be aftering for catastrophes and instruction for communities so that they know what action to take before, during and after a catastrophe.

ASTON MARTIN BRAND AUDIT Assignment Example | Topics and Well Written Essays - 3000 words

ASTON MARTIN BRAND AUDIT - Assignment Example Moreover, the company holds various elements, which constitute its success factor in the highly competitive automobile industry. Such strengths define the resilience of the grand logo of the company, despite the weathering challenges in the markets. The founders of the corporation were Lionel Martin and Robert Bamford, both of United Kingdom. However, over the years, it changed ownership with various parties buying shares in the company including the Ford brand among others. Today, the leading individual shareholders and owners are David Richards and Baimler AG (Dowsey, 2010). The other shareholders are companies with shares in Aston Martin. Aston Martin is a company whose existence now spans 100 years of operation. The company was established in 1914 and has been operating since its institution (Dowsey, 2010). Further, this forms a heritage factor for the company, which makes it a preferable choice for many of its consumers. Aston Martin is an automobile company whose operations focus solely on the manufacturing of vehicles and wares of vehicles. The company products feature in the motorsport industry, as well as, the personal car industry. The company also factors the production of cars for luxury purposes, a leading service that it facilitates to its consumers (Dowsey, 2013). The operational elements of its products and services entail the highly competitive automobile industry, where the company products feature as leading operator and identifiable market share leader. The company Aston Martin has its base in the UK market. The head office operations are in the UK. However, it also features its operations in other sections such as America and Asia. The notable market leader in the UK has its products across the globe; hence, its scope is global (Dowsey, 2013). The company utilizes its networking ability to venture into markets across the continent accordingly, incorporating its strategic marketing features and management

How should children in trouble with the law be responded to by Essay

How should children in trouble with the law be responded to by prioritizing their welfare or by prioritizing justice - Essay Example The cognitive development of children is not at the same level as it is when they have reached adulthood. The way in which they understand complex social concepts is not the same as the concepts that adults have developed. Therefore, when children commit crimes they do not have the same perspective from which to draw logical choices. The decisions that lead to an illegal act are driven by concepts that have been twisted to include the acceptability of those decisions. Children have a centralized need to draw in all of the education that they can take, which often includes exploring less than legal experiences. As well, sometimes they perceive an action that must be taken because they do not see an alternative. The problem with treating children as criminals is that they begin to behave and adopt the identity of a criminal. The crime that they commit later in life can be far worse than the crimes of childhood, thus creating a scenario where society has the choice of growing a better a dult or creating a new criminal. Because the actions of a child do not define the future identity of the potential adult within, the welfare of the child should be protected and nurtured in order to prioritize the security of justice in the future by implementing a welfare approach to handling youth offenders. According to Barrouillet and Gaillard (2011), children do not have the capacity to understand all of the factors involved in situations that have sophisticated complexities in forming the circumstances. Cognitive capacity increases with age allowing for more information to be considered in making a decision (p. 2). Children do not have the capacity to considered highly complex situations, thus creating impulsivity and spontaneity in the way in which they react to different situations. Circumstances are often such that the immediacy of the benefit will outweigh any ability to fully consider the consequences of the action. Therefore, it is often the case that illegal activity is not framed from the point of view of an understanding of all of the potential outcomes. Without the ability to form and recognized all of the outcomes, a child does not have the ability to make a true decision about right and wrong. Using the perspective of prioritizing justice does nothing to address the causes of youthful crime. It does nothing to attend to the safety of the public and causes more harm further down the line when now trained criminals are released from prison. This is not to suggest that children cannot be taught right from wrong, but it is too much to expect that every situation can be successfully framed within that conceptualization. According to Smith, Cowie, and Blades (2003), children are seeking to learn what is right and wrong and why it is right or wrong and as they grow, they are better able to comprehend more complex concepts (p. 270). However, children will not necessarily understand what makes a situation right or wrong and this misunderstanding can c reate a gap between understanding the action in regard to the outcome. As an example, take into consideration a childhood activity of throwing apples at cars as they pass. The child is aiming at a moving target, creating a game out of the explosion of the apple as it hits the car. However, the possible outcomes of startling the driver and causing an accident, causing damage to the car, or of breaking a window and injuring the passengers, may be well beyond the capacity of the child to understand. Even if those concepts are known, the child may still believe that nothing bad will happen and give into the temptation of throwing the fruit to see what will happen. Pearson (1984) writes eloquently about a world that has become more dangerous and filled with socially reforming do-gooders who have tied the hands of those

Nutrition Essay Example | Topics and Well Written Essays - 2000 words

Nutrition - Essay Example A closer look at my daily diet showed that I was not consistent in meeting the food requirements that are set in the basic food pyramid guide (health.stateuniversity.com, 2009). My diet varied highly from day to day, with very high-energy intake on day 2, followed by day 1. On day 3, there was a very drastic reduction in my food and energy intake to less than half of what I normally take. This was due to my busy school workload, which made me neglect the preparation of food for that day. The third-day food intake was sufficient to lower my daily average to 2200 cal day-1. However, my food intake was much higher than what I really needed considering my very low level of physical activity. Being relatively young, I still do not have a medical condition that will require an immediate change in diet, however there is a major discrepancy in my diet compared to the set guidelines. The food pyramid sets the minimum and maximum levels of food servings that are required from each of the different food groups namely cereals, vegetables, fruits, meats, dairy and sweets and oils. Servings were calculated based on standard recommendation (Healthy Eating Guide, 2001). The average number of servings was calculated from my diet and is presented in Appendix Table 2, Table 1, and Figure 1. On a weight basis, the meat group contributed the most to the daily energy intake, followed by the cereals group. The least contribution came from the vegetables (Figure 2). This was in agreement with the very large number of servings obtained from meat. Figure 3 presents the percentage of contribution of the different major nutrients to my diet. Carbohydrates make up more than half of my nutrients, while proteins and fats have almost equal contribution to the other half. Analysis of foods and how they affect our metabolism and health should be done by taking an overall picture of the whole. However,

Research on brand strategy, Chinese brand issue and countermeasures Dissertation

Research on brand strategy, Chinese brand issue and countermeasures - Dissertation Example Chinese brands lack the global standards of competitiveness. They have been focusing on the development of self-owned brands but they continue to face issues such as a weak brand and lack of brand protection consciousness. Thus with the aim to recommend an affective brand strategy for Chinese enterprises, three objectives were set in the study. Extensive literature on the subject was reviewed and then based on a qualitative study, and purely on secondary data the study objectives have been achieved. Reason why Chinese brands have not been able to establish in international markets range from low quality perception, to adherence to Chinese brand names and the lack of competency to decide on brand positioning and brand personality. Chinese brands are known to simply respond to opportunities without implementing brand strategy. The benefits of an effective brand strategy have been amply highlighted throughout the study which includes loyal customers, higher market share and larger reven ues. Brand strategy helps brands adopt a differentiation strategy and focus on specific elements. Citing the examples of Haier and Lenovo, the study finds that an effective brand strategy can help domestic Chinese brands to achieve success in the international markets. Through brand positioning, through a planned growth strategy, Chinese brands can develop sustained competitive advantage even in foreign markets. An effective brand strategy helps overcome the negative perception associated with Chinese brands. The study concludes by suggesting counter measures that Chinese brands can adopt to establish in international markets. Limitations to the study have been highlighted and recommendations for further research on the subject have been made. Table of Contents Chapter I Introduction 1.1 Background 1 1.2 Rationale of the Study 3 1.3 Research Aims and Objectives 5 1.4 Structure of the Study 5 Chapter II Literature Review 2.1 Chapter Overview 7 2.2 The concept of brand 7 2.3 Concept o f Brand Strategy 8 2.4 Theories governing brand strategy 11 2.5 Reasons for poor brand strategy 15 2.6 Chapter Summary 17 Chapter III Methodology 3.1 Research Philosophy 18 3.2 Research Design 18 3.3 Chosen Method 19 3.4 Research approach 20 3.5 Data Collection Strategy 20 3.6 Data Analysis 22 3.7 Ethical concerns 22 Chapter IV Findings and Discussion 4.1 Chapter Overview 23 4.2 Findings 23 4.3 Discussions 30 4.4 Chapter Summary 33 Chapter V Conclusion and Recommendations 5.1 Conclusion 34 5.2 Countermeasures 36 5.3 Limitations of the Study 38 5.4 Recommendations for further research 38 References 39 Tables, Charts and Figures Chart 1.1 Brand-consciousness Chinese consumers 2 Figure 2.1 Brand Equity Pyramid 9 Table 4.1 Guangdong Tea Exports 28 Chapter I Introduction 1.1 Background With the economic development and improvement in people’s living standards, products have become increasingly rich, offering value to the customers. In fact, competition in every field has made busi nesses and markets turbulent prompting marketers to create a distinctive brand image for their products. This requires change in the way organizations build and sustain brands. Most powerful brands in the world support their brand as an asset, essential to the organization’s long-term strategy (Davis, 2002 cited in Tregert & Westerlund, 2003). Since brand is an asset with an assumed value, brand awareness, brand associations and brand loyalty have to be actively managed. Global brands across the world have

Presenting for the Future Essay Example | Topics and Well Written Essays - 2500 words

Presenting for the Future - Essay Example Immigration accountability requires earnest action beyond executive orders unleashed by President Obama. The remedy will stabilize immigration procedures, boost tax, and offer fight illegal crossing at national borders. Organizational influences immigration through the structure in place. An organization structure for example within United States Citizenship and Immigration Services will influence ethical behavior of the staff working in various departments. An immigration system that has rigid and hierarchical structure will limit the capacity of employees towards implementing reforms in the documentation process. An autonomous decision-making process will result in a department that offers employees relevant experience and moral development in handling immigration dilemmas. Flexible structure allows immigration departments to make high-level decisions irrespective of their level to realize the sound and ethical practices; hence, the need for such a structure. An organization that handles immigration should hire employees legally. The human resource department will be charged with implementing immigration policies and reforms if it adopts a legal process to acquire employee fit for the job. Compliance in a public office is essential as opposed to labor costs that will be saved after hiring unqualified employees. Decentralization and ad hoc structure defines the human resource department of USCIS. The structure has hampered efforts to modernize immigration procedures and match the economic and national security agendas. The department has shielded efficient transformation initiatives that have the potential to heal the immigration wound. Restructuring of USCIS human resource department has paved way for critical immigration practices entrusted with the organization. Structure does not foster anti-fraud and homeland security measures as required by state and federal governments. Department of Homeland

Fredricksons various models in the story of Stephen Cruz by Studs Essay

Fredricksons various models in the story of Stephen Cruz by Studs Terkel - Essay Example For Stephen Cruz, who was taught and brought up by his father to work hard in whatever he does and avoid taking things that he does not deserve, is seen in the story being told to fall in the line and learn the way of doing business as the dominant and powerful group does. The Civil Acts of 1964 is used in this story to signify the way policies and legislations are used to assimilate minority groups. Fredrickson’s one way assimilation methods is apparently used in this story as the minorities are being accepted and employed to and by the dominant group, but they still play a subordinate role and are not allowed to fully enjoy the freedoms nor fulfill their American dream (Fredrickson, 335). As Stephen Cruz rises up through the corporate ladder slowly with his sheer hard work, he continues to discover that maybe the American dream he is working on is not meant for him. This is because he discovers that the dream and the relations between the minority-weak and dominant-powerful, are to the advantage of the later. This relation is described by Fredrickson as group separatism. Although the method of doing so might not be as direct as it may be perceived to be, through taking advantages of various legislations and policies to their (dominant group), can be seen as a way to separate the dominant and the minority. The dominant and powerful in America continue to get stronger and wealthy and the expense of the minority. This separates the two groups even further and no equally is presented.

Improving Health Insurance Market from Nursing Perspective Term Paper

Improving Health Insurance Market from Nursing Perspective - Term Paper Example This search for lower costs in the labor for providing these services will translate into nursing services taking up additional responsibilities in the providing of health care services at least in the community settings. Though not all medical professionals agree to the taking up additional responsibilities by nursing services in the provision of healthcare services, nevertheless there is enough evidence to show that there is no deficiency in the quality of healthcare services provided by nursing services in nursing independent care settings. Reducing costs of health care and providing more access to health as the means to improving the healthcare insurance market will require a greater role for nursing services and quite likely as independent services in the community settings. In conclusion, health insurance started in America in the 1930s under skepticism on its success. Since that time health insurance has become the way by which people meet the costs of health care needs. Howev er, this growth has come at the cost of high costs of health care and the poor accessibility to health care. Factors intrinsic and extrinsic to the health insurance industry have led to this situation in the healthcare industry, which has led to the need of the hour being improvements in the healthcare insurance market, with particular emphasis on lowering health care costs and enhancing access. Nursing services can and will play an important role in the efforts to improve the health insurance market.... nwards private insurers did provide accident, burial, and sickness policies, while some of the railroad, mining, and timber companies provided workplace health benefits. However, health insurance in its complete form and in an organized manner took root from the 1930s onwards. Against a backdrop of skepticism prior to World War II of a greater proportion of commercial insurers that hospital and medical costs were an insurable risk, health insurers did offer accident, burial and in America became a reality through the efforts of Blue Cross in the mid 1930s. The success that Blue cross achieved in its health insurance offerings brought competitors into play to share in the health insurance pie in America. This rising potent competition resulted in the erosion of market share of Blue Cross and changed the competitive scenario of the health insurance market. The health insurance market now consisted of the non-profit organizations of Blue Cross or Blue Shield and the for-profit commercia l health insurers (Austin & Hungerford, 2009). Towards the end of the 1950s health insurance had become a standard component of the compensation offered by most of the large employers in America. The Federal Employees Health Benefits Plan (FEHBP) which was created by Congress made available to federal workers across the country Blue Cross and Blue Shield health insurance benefits. However, this was the period of time when for the first time a sharp increase in health care costs were experienced. Fuelling this were several reasons that included emergence of new hospitals; growing capital intensity for providing inpatient care; the change from, flat-rate per diem reimbursement for hospitals to full cost payment; and the widening of health insurance benefits that enhanced the ability of

Methods to Stop Different Cyber Crimes Essay Example | Topics and Well Written Essays - 500 words

Methods to Stop Different Cyber Crimes - Essay Example Internet users should chose passwords with that consist of at least five characters. These passwords are not easily guessed by the criminals. Passwords that are made based on names, nicknames, telephone numbers, and other obvious words should be avoided. Passwords should consist of both uppercase and lowercase character. However, such passwords may be difficult to remember. Internet users should aim at creating the most unique passwords that do no appear in dictionary entries (Standler, 2004). Internet users are required to activate their spam blocker whenever they use the Internet. Spam blockers enable individuals to block messages that are not needed from getting into the inbox. In addition, a spam blocker ensures that phishing emails that may be used to defraud Internet users are prevented from getting into the inbox. Most Internet providers have spam blocking features (Ehow, 2012). Antivirus software such as McAfee, Norton, Kasperskey and Avast should be installed on computers. The installation of an antivirus alone is not an adequate measure in preventing viruses from infecting the computer; the anti virus must be updated on a regular basis. Malware, spyware and viruses can only be eliminated from the computer if the antivirus is allowed to scan the whole computer system (Ehow, 2012). Further, Internet users can stop cyber crime by using their computer’s firewall protection feature. Firewall is a digitally created barrier that enables Internet users to prevent cyber criminals from accessing their computer systems. The Firewall should always be turned on in order to prevent the illegal activities of cyber criminals (Ehow, 2012). Also, cyber crimes can be prevented if Internet users constantly encrypt useful information as they send it to intended recipients. This can be done through the use of encryption software which ensures that personal and confidential information

Work and Environment Essay Example for Free

Work and Environment Essay Work may refer to: Human labor: †¢ Employment †¢ House work †¢ Labor (economics), measure of the work done by human beings †¢ Manual labor, physical work done by people †¢ Wage labor, in which a worker sells their labor and an employer buys it †¢ Work (project management), the effort applied to produce a deliverable or accomplish a task Environment may refer to: Environment (biophysical), the physical and biological factors along with their chemical interactions that affect an organism †¢ Environment (systems), the surroundings of a physical system that may interact with the system by exchanging mass, energy, or other properties †¢ Environments (series), a series of LPs, cassettes and CDs depicting natural sounds †¢ Built environment, constructed surroundings that provide the setting for human activity, ranging from the large-scale civic surroundings to the personal places †¢ Knowledge environment Social environment, the culture that an individual lives in, and the people and institutions with whom they interact Work environment means the milieus around a person. It is your social and professional environment in which you are supposed to interact with a number of people. All of them are to be there with you. They are working there. They are supposed to co-ordinate with you in one way or he other. They may be working under you or you may be working under them. It depends upon your position at status at a work place. It is not important that an office would always be called your work place. It can be your home environment where you use to work for all the time where you are supposed to interact with your family members by and by. This environment is all about the people at your home and those who have any concern at your home. Work environment does not only counts the living world tings but also the materialistic world stuff. It may count the room or home where you are working. It may counts the things that you are using in one way or the other. It is all about things and livings that are around you where you are working. Hope it is clear now. A work environment can be identified as the place that one works. i. e. -in an office building in a cube, at home at the kitchen table, from a car or truck, at a construction site. All are work environments. We tend, however, to hear about healthy work environments. This can point to other factors in the work environment, such as co-workers, air quality, ergonomic seating, management (the boss! ), child care, parking, noise, and even the size of ones cube. A work environment doesnt require a job. It requires that work has to be done in some place. Say you need to do homework. Where do you do it? At school in study hall? At your kitchen table? On the floor at a friends house? These can also be considered work environments. A hostile work environment exists when an employee experiences workplace harassment and fears going to work because of the offensive, intimidating, or oppressive atmosphere generated by the harasser. A hostile work environment may also be created when management acts in a manner designed to make an employee quit in retaliation for some action. For example, if an employee reported safety violations at work, was injured, attempted to join a union, or in some way caused trouble for the management, then their response might be to harass and pressure the employee to quit. Actions that could be taken in furtherance of this might include inappropriate disciplinary procedures, reduced hours or wages, unreasonable scheduling or workload or similar things. The company’s behavior in lieu of termination avoids the need to pay unemployment benefits. The anti-discrimination statutes governing hostile work environment are not a general civility code. Thus, federal law does not prohibit simple teasing, offhand comments, or isolated incidents that are not extremely serious. Rather, the conduct must be so objectively offensive as to alter the conditions of the individual’s employment. The conditions of employment are altered only if the harassment culminates in a tangible employment action or are sufficiently severe or pervasive. An effective work environment is vital to the success of small businesses and large corporations alike. When problems remain unsolved and rules never get implemented, the result can be an unproductive staff and a stale work environment. People working together with a common denominator will accomplish tasks with greater ease and have higher expectations of themselves and their work. (success and passion)A positive work environment is critical no matter how many employees you have. It is management that fosters the work atmosphere so they are responsible for conducting things in a way that helps raise peoples spirits. There are four basic beliefs: †¢ Hope †¢ Trust †¢ Pleasure †¢ Opportunity

Socrates And Epicurus And Life After Death Philosophy Essay

Socrates And Epicurus And Life After Death Philosophy Essay The idea of death is discussed by both Socrates and Epicurus, with both philosophers having a mutual belief that it should not be feared. Socrates view is that there is either an afterlife, or that death is an eternal sleep. Whereas Epicurus bases his belief on the fact that we should not fear that which does not inflict suffering. In this paper, I will examine both Epicurus and Socrates view on death and argue why I feel Socrates view on death is more rational than Epicurus. If we begin with Socrates and his idea of life after death, we can see that he implies death brings the soul to a better place. In Socrates final speech to the congress that denounces him to death, he states that either death is a state of nothingness and utter unconsciousness, or, as men say, there is a change and migration of the soul from this world to another (Plato, p. 8). His reasoning for this view is that death will free him from judgment associated with his present life, and allow him to face judgment by the true judges outside of the present world. He states that once he dies, he would be able to converse with Orpheus and Musaeus and Hesiod and Homer? Nay if this be true, let me die again and again (Plato, p. 8). This again re-iterates the fact that Socrates feels that his death sentence should not be seen as a bad or painful event. Furthermore, Socrates other view on death is that if it is anything like a sleep in which there was no disturbances by dreams, anyone would agr ee that it is a pleasant state of being (Plate, p. 8). In the works of Epicurus  Principal Doctrines,  we are introduced to his distinct views on death. His reason for not fearing death is the absence of suffering; if one does not suffer through death, then one shall not have a reason to fear death. Everyone is either alive or dead, death does not cause suffering to the living since we are not yet dead, and death does not cause suffering to the dead simply because they are dead and have no feelings (Epicurus, pp.  26-28)1.  Therefore, fear should only be present if one undergoes suffering, and since one does not experience suffering during death, then death should not be feared.  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   When comparing both philosophers, it is evident that Socrates view of death is more credible than Epicurus. In Socrates view of death, there are two possible outcomes, either eternal sleep or an afterlife. Socrates provides possible ends to post death, whereas Epicurus definition is perplex and draws several questions, such as his classification of pleasure and justice.     Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  As with most philosophers, Socrates views werent shy of criticism. Most critics of his work question the idea whether an after-life may even exist. It is easy to diminish such an argument since Socrates was never concrete about his view of the after-life, he himself thought of a possibility of a death without an after-life. To this, Socrates argues that if there were no after-life, it would be a state of nothingness, and would be a state of eternal sleep which would be as enjoyable as an afterlife, enjoyed in the same sense as much as a dreamless sleep is enjoyed. Another criticism to Socrates work is by the author Thomas Nagel in his writing Death. In his writing Nagel criticizes Socrates view of a conclusive life stating that death cuts short the ability of people to live a just life as long as possible, and asks the question if one were to achieve a just life, wouldnt they want to achieve it for as long as possible. Socrates replies stating that if it was truly a just life, it would be fulfilling regardless of the amount of time. In contrast, Epicurus rebuttals to his critics are not as concrete as Socrates. Epicurus perception of death creates confusion in regard to his idea of pleasure and justice. He had stated in his context that it is impossible to live a pleasant life without living wisely and honorably and justly, and it is impossible to live wisely and honorably and justly without living pleasantly (Epicurus, p. 26). Hence, Epicurus definition of justice lies in the pleasure of the majority of people. His belief had only risen among his own thoughts and not others since he based the affiliation between justice, pleasure, honour and wisdom on the single supposition that the majority of people would reciprocate these same beliefs, yet not everyone feels the same. Epicurus design of justice can be closely related to the Holocaust, also known as World War II. The persuasive Adolf Hitler took charge of the destruction during this time period by compelling the majority of the country to absorb his political views as he governed that it was the best for all of them. Hitlers forceful method is seen as plausible through Epicurus theory, since the greater part of the country found pleasure in his views in thinking that they were prospering the country. Epicurus justifies the notion of murder by inducing rationality into the picture, the more rational one thinks, then the more logical they will act, hence preventing deadly acts from occurring. Hitler had solely relied on swaying people into believing that his path was the only rational path that can lead their country justice. Epicurus too fell on this proposition in using only raw thoughts to conclude his theory that his definition of justice and pleasure would be consented amongst everyone. Culture, religion and society all influence a persons perception on the simplest fixations. From this notion, it is evident to see that Epicurus proposal of allowing rationality to claim superiority over murderous intention is a result of his unproven beliefs. Epicurus was too naÃÆ' ¯ve in thinking that everyone would side on his definition of justice and pleasure, concluding him with an imprecise theory. Residing on purely rationality does not validate Epicurus theory of justice and pleasure, for anyone can rationalize any means of destruction through their own perception. As mentioned before, there are several concepts that are taken into consideration when a person performs an act, and depending on just one thought is not an erroneous way to justify a theory.considering the complexity of the human mind and Therefore, purely assuming that through rational thinking, murderous thought can be eliminated is not so simple, for human minds are too complex for such a generalization to have ef fect. In comparison to both perspective of Socrates and Epicurus, Socrates had a more justifiable and plausible method to his beliefs, hence making it more persuasive that Epicurus. Socrates had a solid foundation and a reasonable definition to his idea, whereas Epicurus simply presumed on rational thinking to motive his beliefs. Therefore in my opinion I would choose Socrates, for her had a realistic ground by taking into consideration the complexity of the human mind and addressing both possibilities to our end.

Sociology Of Health And Illness Assignment Social Work Essay

Sociology Of Health And Illness Assignment Social Work Essay The aim of this assignment is to discuss the strengths and limitations of the social model of disability and how nurses can promote anti-discriminatory practice in relation to people with disabilities. Defining disability is said to be very difficult due to the fact that disability is a complicated, multidimensional concept (Altman 2001). Furthermore Slater et al (1974) has gone as far as stating that constructing a definition that would fit all circumstances is in reality nearly impossible. However attempts have been made by various different people, legislation and models in different ways. According to Altman (2001) these attempts are the reason why there has been a lot of confusion and misuse of disability terms and definitions. The Disability Discrimination Act defines a disabled person as a person who has a physical or mental impairment that has a substantial and long-term adverse effect on his or her ability to carry out normal day to day activities. (DDA 2005) However the medical model of disability sees disability as the individuals problem and that it should not concern anyone other than the disabled person, for example, if a student who is in a wheelchair is unable to get into the building due to the steps, the medical model would assume that it is due to the wheelchair rather than the steps. Whereas on the other hand the social model would say that the steps are acting as a barrier to the student, therefore the barrier should be removed. The social model of disability was brought about by activists in the Union of the Physically Impaired Against Segregation (UPIAS) during the 1970s. This model is seen as the main theory which tests disability politics in Britain (Shakespeare et al 2002). The UPIAS argued that there is a major difference between impairment and disability. They defined impairment as lacking part or all of a limb, or having a defective limb, organ or mechanism of the body. They have also defined disability as the disadvantage or restriction of activity caused by a contemporary social organization which takes no or little account of people who have physical impairments and thus excludes them from participation in the mainstream of social activities (Giddens 2006). The social model of disability can be defined as an idea that it is society that disables an individual with the way everything is constructed to meet the needs of the majority who are not disabled (Shakespeare et al 2002). Whereas, the social model can be compared with the medical model of disability which tends to focus purely on finding a cure and that to be able to fully participate in society they need to treat their impairment (Crow 1996). The model has several key points. First it describes disabled people as an oppressed social group (Shakespeare et al. 2002) meaning that on top of their impairment, disability is something more deep that excludes and isolates them from participating in society (Oliver 1996). The difference between the impairments that people have to deal with and the oppression which they experience is fundamental to the British social model. Finally, the model defines disability as a form of social oppression, not a form of impairment (Shakespeare et al. 2002). Therefore the aim of the model is to empower disabled people so that they dont feel as though their condition is the problem, but that society is the problem due to the number of barriers it places on disabled people (Giddens 2006). For example, everywhere you go there will be steps, steps to get into a building, steps to climb floors and it is this barrier which causes problems for disabled people therefore the social model provides a soluti on saying that ramps and lifts should be fitted in all buildings, the problem of not being able to stand for too long should be tackled by placing more seats in public places. It is barriers like these that the social model aims to find solutions to. The British disability movement has found great importance in the social model in various different ways. Hasler (1993) describes it as the big idea of the British disability movement. For example, identifying a political strategy to remove barriers in society that played a large role in disabled peoples lives, which was also the main strength of the social model (Shakespeare et al. 2002). Examples of barriers that disabled people faced in all areas of life were the inability to access public transport systems due to the fact that a person was in a wheelchair or had visual or hearing impairment, their inability to find work because employers felt that the disabled person was incapable of doing the job, housing problems and so forth (Thomas 2004). The removal of such barriers would mean that if those people with impairments felt disabled by society then by taking away these barriers would help to empower and promote the inclusion of people with impairments (Shakespeare et al. (2002). The model tries to bring about change in society to suit the individuals need rather than taking up a medical view where you try and look for a cure, or rehabilitation (Shakespeare et al.2002). For example, people who have schizophrenia have to take medication in order to live normal lives. However it is argued that the social models complete view of changing society has become too simplistic or rather an over- socialised explanation. Furthermore, Vic Finkelstein (2004) argues that the social model looks at enabling people to be human in a society rather than having access to their rights. However the medical model of disability has a different perspective. They believe that people with disabilities need to be assessed, that they are incapable of making their own decisions, that they are the problem and that people with disabilities have to be adapted to fit into the world, but if this is not possible then they are placed in specialised institutions or isolated at home where only basic needs are met (Rieser, 2009). A second strength seen from the model was the actual impact on the disabled people themselves. The social model made disabled people feel free as they lifted the view of a medical approach, where the problem was the individual and placed it on society saying that social oppression was the root of the problem. This as a result made people feel liberated and empowered as they were made to believe they were not at fault: society was, that society was in need of the change: not the individual (Shakespeare et al. 2002). The social model helped to bring disabled people to come out like raising feminist consciousness in the seventies, or lesbians and gays coming out (Shakespeare et al. 2002). The social model has played a very important part in many disabled peoples lives, however, despite these strengths to the model there are a number of limitations. Firstly, the social model has been criticised for being unable to deal with the realities of impairment (Oliver, 2004), meaning that the model is not about peoples personal experience of impairment (Oliver, 1996) but about peoples collective experiences of disablement in society (Oliver, 1990). Another point criticised is that other social divisions such as race, gender, ageing, sexuality and so on are not incorporated in to the social model (Oliver, 2004). However Oliver (2004) that just because the social model hasnt incorporated these divisions does not mean that they are unable to. Oliver (2004) states that those who criticise the model are the ones who should try and forge the social model into action when dealing with issues such as race and gender and age and sexuality. Cultural values have also been pointed out to be ignored by the social model. There is an argument about the issue of otherness, meaning that it is the cultural views that people hold which place disabled people as others, not the physical and environmental barriers (Oliver, 2004). Furthermore, another limitation of the social model is that it clearly neglects and ignores the experiences of impairments and disability which are the main cause of problems in most disabled peoples lives (Giddens, 2006). Shakespeare and Watson (2002) argue that we are not just disabled people, we are also people with impairments, and to pretend otherwise is to ignore a major part of our biographies. Against this accusation, Oliver (2004) finds it difficult to accept that disabled peoples experiences are not considered because it is after all the main reason why the model emerged to begin with-due to a number of disabled activists in the 1970s. Furthermore defenders of the model argue that the social model merely focuses on social barriers that disabled people face rather than denying them of everyday experiences due to their impairment (Giddens, 2006). The social model has been criticised as being inadequate as a social theory of disablement (Oliver 2004). Corker and French (1998) talk about social model theorists and then conclude that the social model is not a theory, however Oliver (2004) argues that how can people criticise the social model for something it has never claimed to be? Oliver (2004) states that most people who have developed the social model have claimed that they have said the social model of disability is not a theory of disability. Leading on from the strengths and limitations, there is a substantial amount that nurses can do to promote anti-discriminatory practice in relation to people with disabilities by maintaining a positive attitude towards people with disabilities as they are constantly involved with the treatment and care of people with physical or intellectual disabilities (Klooster et al. 2009). Nursing schools as like other professions, tend to be based around the medical model of care where they aim to diagnose and treat diseases (Klooster et al. 2009). However as Byron et al (2000) has stated that not all disabled people are unwell and may not have a disease. Nurses have an important role, like other health professionals, in influencing a disabled persons response to treatment (Oermann Lindgren, 1995). Therefore Carter et al (2001) has stated that inappropriate attitudes and behaviours from staff are the biggest barriers which disabled people face, which has led to further research indicating that nursing students should move away from the medical model of care when working with people with disabilities and should focus on a more social model perspective (Scullion, 1999). Further research has indicated that nursing students attitudes towards disabled people may be improved by educational programmes which can help nurses to be in direct contact and to work with disabled people (Oermann Lindgren, 1995). However, the research literature suggests that this is currently not happening in nursing practice (Klooster et al 2009). For example, Brillhart et al (1990) found that nursing students had more negative attitudes then the person with the disabilities themselves. Nurses can help to provide clear information as Hammel (2003) states that professionals need to listen to what people are telling them and that actions and non-verbal messages can speak very loudly. Nurses can form strategies to communicate with disabled people in order to make their life easier (Hammel, 2003). However it is common that fewer health care professionals are reluctant to provide services for disabled people as they age (Hammel, 2003). By providing clear information nurses also involve other people who are important in the disabled persons life and ensuring that they are informed about options and benefits for the disabled person as well as themselves. Nurses can also act as advocates for disabled people so that they have equal use of services or even provide information of advocacy groups for the disabled person for example Centres for Independent Living (Hammel, 2003). Furthermore, where young people are concerned nurse can give advice to families about possibilities for independence and can also refer them to community resources that may help young people pursue further education, find a job and live independently (Blomquist et al. 1998) Lastly the Disability Discrimination Act is a guide for nurses to help them provide better care for people with disabilities and also how they can develop their practice (Aylott, 2004). There are many aspects with which nurses can help promote anti-discriminatory practice in relation to people with disabilities however, nurses need to keep a positive attitude towards people with disabilities in order for the anti-discriminatory practice to work. In conclusion for there to be equal rights for people with disabilities, Oliver (2004), states that people spend too much time discussing the strengths and limitations of each model therefore he suggests that both models should be integrated, ideas of both models should be put together and used in concordance so as to actually help people with disabilities. Oliver (2004) claims that if we imagine that throughout history carpenters and builders of the world had spent their time talking about whether the hammer was an adequate tool for the purpose of building houses, we would still be living in caves. Therefore there is a hammer in the disability movement and if it was used properly then the social model of disability can become the hammer of justice and freedom for disabled people (Oliver 2004). References Altman, B.M., (2001). Disability definitions, models, classification schemes and applications. In G.L. Albrecht. K.D. Seelman, M. Bury, (eds.) (2001). Handbook of Disability Studies. Sage, California. Ch.3. Aylott, J., (2004). Learning disabilities. Autism: developing a strategy for nursing to prevent discrimination. British Journal of Nursing, 13(14), 828-833. Blomquist, K.B., Brown, G., Peersen, A., and Presler, E.P., (1998). Transitioning to independence: challenges for young people with disabilities and their caregivers. Orthopaedic Nursing, 17(3), 27-35. Brillhart B.A., Jay H. Wyers M.E. (1990) Attitudes toward people with disabilities. Rehabilitation Nursing. 15(2), 80-82. 85. Byron M. Dieppe P. (2000) Educating health professionals about disability: attitudes, attitudes, attitudes. Journal of the Royal Society of Medicine, 93(8), 397-398. Carter J.M. Markham N. (2001) Disability discrimination. British Medical Journal, 323(7306), 178-179. Crow, L., (1996). Including all of our lives: Renewing the social model of disability. In C. Barnes. Geof Mercer, (eds.) Exploring the divide. Leeds: The Disability Press, pp.55-72. Finkelstein, V., (2004). Representing Disability. In J. Swain., S. French., C. Barnes., and C. Thomas, (eds.) Disabling Barriers- Enabling Environments. 2nd edition. Sage, London. Ch.2. Giddens, A. (2006). Sociology. 5th edition. Polity Press, Cambridge. Hammel, J., (2003). Technology and the environment: supportive resource or barrier for people with developmental disabilities. The Nursing Clinics of North America, 38(2), 331-349. Klooster, P.M.ten., Dannenberg, J.W., Taal, E., Burger, G., and Rasker, J.J. (2009). Attitudes towards people with physical or intellectual disabilities: nursing students and non-nursing peers. Journal of Advanced Nursing, 65(12), 2562-2573. Oermann M.H. Lindgren C.L. (1995) An educational programmes effects on students attitudes toward people with disabilities: a 1-year follow-up. Rehabilitation Nursing 20(1), 6-10. Oliver, M. (1990). The Politics of Disablement. Macmillan Press, Basingstoke. Oliver, M. (1996). Understanding Disability: From Theory to Practice. Macmillan Press, Basingstoke. Oliver, M. (2004). If I had a hammer: The social model. In J. Swain., S. French., C. Barnes., and C. Thomas, (eds.) Disabling Barriers- Enabling Environments. 2nd edition. Sage, London. Ch.1. Rieser, R. (2009) The Social Model of Disability [online article]. Available from [accessed 6th January 2010]. Scullion P.A. (1999) Conceptualizing disability in nursing: some evidence from students and their teachers. Journal of Advanced Nursing. 29(3), 648-657. Shakespeare, T., Watson, N. (2002). The Social model of disability: an outdated ideology?. Research in Social Science and Disability, 2, 9-28. Thomas, C., (2004.) Disability and Impairment. In J. Swain., S. French., C. Barnes., and C. Thomas, (eds.) Disabling Barriers- Enabling Environments. 2nd edition. Sage, London. Ch.3.

When I Was Hit by a Car, and then Realized the Importance of Family :: Siblings Personal Narratives Essays

The Importance of Family It is hard to grow up as a young child without getting a few scraps and bruises. Kids are so active and have to have fun and burn off a little bit of energy. Imaginations are key to fun and to life. As a child one must come up with the most unusual games. Children do not realize at their age how important family is and just how much they give up for their child. It was 4 o’clock pm. The sun had just started to go down. Kids are outside playing after school. My brother Jason was in the 8th grade and I was in 3rd. We had another brother that always played with us too, but I guess that day he was currently busy at the time or just did not like the game Jason and I were playing. My brother, Jason, and I had come up with this game. It involved a soccer ball and a few lines and the only thing that really had made the difference, the garage door. We have a three-car garage and the two-car portion was always open when my brothers and I were in the front playing. We had to use the small door that only one car could fit through. It was the perfect size for the goal. Of course the oldest one would always come up with the rules, it itself was an unspoken rule. Jason had come up with some weird and out of this world rules. I do not remember all of them. One that sticks out the most was whoever was the goalie; they had to get the ball if it went onto the street or out of bounds. The ball we had played with was my favorite ball or toy in the world. It had my two favorite colors on it, purple and green. The ball was a size five, I was little so it had to fit me and how I played. I was pretty good at soccer and was a goalie on my school team; every now and then I would play the field. It was my favorite sport and Jason’s as well. He was very good at the sport and much bigger and stronger than I was, I was only 10. I was doing pretty well he would just hit is harder and harder. The traffic that day was at its usual.

The Horizons of Theory: Jameson, Marxism, and Poststructuralism Essay

The Horizons of Theory: Jameson, Marxism, and Poststructuralism Fredric Jameson's The Political Unconscious is a work which crosses theories' boundaries, which walks (or polices?) Marxism's border on poststructuralism. It may easily be read as a refutation of poststructuralism, or as an embrace of it; as a flight from Marxism (though under its own banner), or as its theoretical redemption – this is not a contradiction (we might read Jameson as replying), but a dialectical, productive exploration of the tension between these philosophies. Indeed, Jameson's exposition of his Marxist hermeneutic may be taken as a reply (from within a discourse he perceives as Marxism) to the poststructuralisms of Jacques Derrida and Gilles Deleuze, and as a conversation with the structural Marxism he calls "Althusserian"; but Jameson attempts to reconcile these views with the Marxist tradition. We may read The Political Unconscious as positing a mode of reading which is acceptable to – or which subsumes – both a "demystifying" Marxism and the ap oria or irreducible contradiction of deconstruction; but in so doing, as Jameson perhaps realizes, the text is drawn into the clear contradictions between these theories, and only partially resolves (or evades) them. The central thesis of The Political Unconscious is the presence of History as the "untranscendable" or "absolute horizon of all reading and all interpretation" (17). We may immediately note that this "untranscendable presence" apparently contradicts deconstruction's mistrust of all presences within and behind texts, to say nothing of Derrida's derisive references to "transcendence." To look for History in the text, to find the hidden meaning of History through it, would evidently not be a sa... ...rificing the individual text to a broader structural analysis – "that a Marxist cultural study can hope to play its part in political praxis, which remains, of course, what Marxism is all about" (299). It is revealing (from a Marxist standpoint) that this final aside marks the only reference to concrete political involvement in the volume; perhaps more tellingly, The Political Unconscious treats this sacrifice of the traditional, individualistic literary text as a price which, however unfortunately, must be paid (in order to satisfy the demands of Marxism). But as a reconciliation of the poststructuralist, anti-transcendent insistence on specificity with some of the theoretical imperatives of Marxist cultural thought, The Political Unconscious remains a breakthrough; and as a proposal of a newly political, poststructuralist historicism, it is undeniably persuasive.

High School and Prom Essay

‘’ Did I dream that we danced forever, in a wish that we made together on a night that I prayed would never end ‘’ One of the most unforgettable moments in my life is in my high school days particularly the most awaited event of high school student is the junior and senior prom. I’m in my third year high school It’s Friday February 15, 2008 all the junior and senior students are required to join this once in a lifetime event. I’m so excited I can’t wait to wear my dress which is color pink, to put make up and to fix my hair. Before the prom begins I my friends and my classmate met on the gate we kept taking photos of us. We were so noisy at the entrance. And when the marshal said we have to go to the covered court because the prom is going to start now, I was so nervous. I kept on thinking ‘’what if i fall while I’m walking?’’ there’s so many ‘’what if’s’’ in my mind. The court where our prom held was beautiful. I was amazed and our court was so huge. I was excited to start the prom because I am one of the student chosen to be part of the cotillion and my partner is Darwin. Darwin is one of my closest friends during high school days. The cotillion was perfectly done. After the cotillion our student president made her speech I and my other friends were so bored and some complained that they were starving. After the speech of our president we could finally eat our dinner. After our dinner the program continued there was a lot of funny moment during the program. It was hilarious. But for me, the best part of that night was party party time. We all dance like crazy animals and the best part of it is that all my guy friends asked me to dance. I also dance with my girl friend we were laughing and just have fun. After the dance I decided to go home and change my clothes at the bathroom but my bestfriend Christal told me to wait for the party to end so I change my heels and put my slippers. The speaker starts mentioning those people who are nominated to be the prom queen and king of the night. And I was busy chattering with my friends when one of my classmate told me that my name announced by the host and I was shocked i said that I can’t go to the stage because I’m wearing my slippers already. But my best friend told me that it’s ok. So I went to stage with my slippers on and walk in front of the crowd. I am so shy and embarrassed because of this but thank God that I am not the one who choose to be the prom queen. And this is one of the unforgettable moments of my life it’s just a natural moment but because of this I gain more confidence and faith in myself.

Case Study Primary Hyperaldosteronism Health And Social Care Essay

The unhurried presents with an exalted demarcation king per whole bowl. Our deterrent example critique does non include extra critical marks. inflated gillyf pitifuler posture per building block res publica is an of significance portion of a name of aldosterone-secreting tumour. The tumour outgrowths the sum of aldosterone in the relationship piddlecourse, which has a direct affect on Na and peeing marks. This status is c eithered radical aldosteronism ( John E Hall, 2011, p. 220 ) . Aldosterone increases the tread of resorption of salt and piss by the tubules of the kidneys, thereby skip downing the pass of these in the do while at the same clip doing an amplification in rootage hatful and extracellur silver volume. This addendum in volume will increase arterial crash per social whole ara. in that respect is a sequence of events that mother an addendum in ocellus push back per unit ara modify magnitude extracellular smooth volume ap purtenances descent volume. argumentation volume increases the average circulatory filling military unit per unit theater. This force per unit argona increases venous return of bank line to the bosom. The increase decline to the bosom will increase cardiac end product which in bends increases the arterial blood force per unit state ( John E Hall, 2011, p. 217 ) . at that placefore, the arterial blood force per unit area humanitarians due to sodium and weewee system assiduitys. This can go a inglorious state of affairs if left untreated.Reason the laboratory Tests Were OrderedSerum osmolality is apply to set up baseline for stirful position. Critical prise to be cognizant of in respects to blood blood serum osmolality are respects less than 265 mOsm/kg Ha0 and greater than 320 mOsm/kg HaO. This lab streamlet is legitimate to aspect into into the mobile and electrolyte balance and law out possible issues for diligents with ictuss, ascites, hydration p osition, acid-base balance, and suspected antidiuretic endocrine ( ADH ) abformcies ( Pagana & A Pagana, 1998, p. 314 ) . In ruddy grownups the expected normal determine are 285-295 mOsm/ kilogram Ha0. Our tolerant nowa mean solar dayss with a serum osmolality value of 289 mOsm/L, and is in spite of appearance the recognized normal scope, nevertheless he is on the low terminal, which could bespeak all over hydration, syndrome of inappropriate antidiuretic endocrine favouritism ( SIADH ) , or paraneoplastic syndromes associated with carcinoma ( Pagana & A Pagana, 1998 ) .Urine osmolality is apply to keep up fluid and electrolye maps. It looks at the kidney concentrating abilities, and as a tool in criterion the diligent for ADH abnormalcies. expression degrees harmonizing to Pagana are 50-1400 mOsm/kg HaO in a random specimen, and for the 12-14 hr fluid limitation, normal value is 850 mOsm/kg Ha0 ( Pagana & A Pagana, 1998 ) . Urine osmolality is of signification i n measuring the concentrating ability of the kidney, and is a great deal evaluated along with blood osmolality consequences ( Pagana & A Pagana, 1998 ) . The long-suffering nowadayss with the value of 520 mOsm/L, but the type of hookup is non indicated. If this is a random specimen the consequences are within normal scope. If this consequence is from a 12-14 hr fluid limitation, the consequence is low, and could be bespeaking diabetes insipidus, extra fluid up communicate, nephritic tubelike mortification, or dread(a) pyelonephritis ( Pagana & A Pagana, 1998 ) .Blood Na is portion of a elemental metabolic write or serum electrolyte panel. This is a marker for fluid and electrolyte baseline. Normal comeings are 136-145 meq/L. Sodium is an of import portion of serum osmolality. Many computes queer Na balance, including aldosterone favouritism from the kidney, natriuretic endocrine, and ADH. pissing and Na play a conclude interaction in the balance of the cardinal ( Pagana & A Pagana, 1998 ) . Our enduring nowadayss with a value of 142 meq/L, and is within normal value scope.Urine Na is another(prenominal) streak to measure the fluid and electrolyte balance of the persevering from the point of view of the kidney. Normal value for piddle Na is 40-220 meq/L/day or greater than 20 meq/L in a topographic point cheque. This trial helps to measure sodium impairment in the piss in comparing the the Na degree in the blood. In some incidences the Na degree is low in the blood and exalted in the kidney, and this is declarative of continuing nephritic failure or Addison s disease ( Pagana & A Pagana, 1998 ) . Our persevering nowadayss with a normal value of 60 mEq/L.Blood K is anyway a portion of the basic metabolic profile ( BMP ) or serum electrolyte panel. It is frequently evaluated as a baseline for unhurrieds showing with cardiac symptoms. Normal value are 3.5-5.0 mEq/L in grownups. Our uncomplaining is infra the critical low value o f 2.5mEq/L ( Pagana & A Pagana, 1998 ) . Serum K degrees are regulated by many factors including aldosterone, Na resorption, and acid-base balance. Decreased degrees of serum K could be caused by several(prenominal) factors including deficient dietetic consumption, lacking IV consumption, Burnss, GI upsets, water pills, aldosteronism, Cushing s syndrome, nephritic cannular acidosis, licorice consumption, alkalosis, insulin disposal, glucose disposal, ascites, nephritic arteria stricture, cystic fibrosis, injury, and operating room ( Pagana & A Pagana, 1998 ) .Urine K is evaluated to go out electrolyte balance, and is say in this instance to find if the longanimous role is egesting K through the kidneys. The normal degrees are 25-120 mEq/L/day harmonizing to Pagana ( Pagana & A Pagana, 1998 ) . Our patient in the instance conform to has a value of 55mEq/L and is documented as being blue. There are many causes for urine K being marvelous, including chronic nephritic fai lure, nephritic cannular mortification, famishment, Cushing s syndrome, hyperaldosteronism, inordinate consumption of liquorice, alkolosis, and diuretic therapy ( Pagana & A Pagana, 1998 ) .Blood chloride is as well portion of the BMP or serum electrolyte panel. Chloride is used in measuring the hydration province and tart base balance of the patient. Normal values are 90-110 mEq/L in an grownup. Our patient s value is within normal bounds.Over all the consequences of the ordered trials, give a chain of the patient s electrolyte position, and excretory product of the electrolytes. This information guides the health professional to look at the cause for the patient s symptoms, and find if they are related to the serum degrees or the excretory degrees.Necessity of Laboratory psychometric testsThe secure ordered twain a blood chemic acquaintance trial every(prenominal) bit trade comfortably as a urine chemical substance science trial for our instance go off patient. An el evated blood force per unit area of 160/110 millimeter Hg, particularly while the patient is in the supine place, is declarative of volume overstatement in the extracellular fluid. Volume effusion is a consequence of increased Na satisfy in extracellular fluid ( Costanzo, 2010 ) . The physician must measure the Na ion assiduity in the blood every bit good as in the piss to find how the addition in blood force per unit area is related to a Na imbalance and the nature of the instability. The patient s sickness of helplessness can be a important mark that the patient is fixed from hypokalemia. Harmonizing to Hall and Guyton ( 2011 ) , When the K ion stringency waterfall below about one-half normal, terrible musculus failing frequently develops ( p. 926 ) . With the patient s ailment of failing during the debase s appraisal, it is necessary to measure his K ion absorption to find if so his failing is a symptom of hypokalemia. The rating of K ion concentration in the patien t s piss is a simple trial to let the heal to find if the patient s hypokalemia is related to an addition in potassium secernment taking to an addition in potassium elimination in the piss or if there is another cause for the low K ion concentration in the blood.In our instance survey, the patient s serum Na ion concentration is 142 mEq/L and his urine Na ion concentration is 60 mEq/L, twain values within normal scope. However, with much(prenominal) an lift in blood force per unit area without a perceptibly direct addition in serum Na ion concentration, it is declarative that the patient s kidneys are resorbing to a greater extent H2O with a proportionate addition of Na contentedness ( Costanzo, 2010 ) . This combination of increased Na content and entire primitive structure H2O content explains our patient s spirited blood insistency ( Costanzo, 2010 ) .Our instance decompose patient s serum K ion concentration is 2.1 mEq/L and his urine K ion concentration is 55 mEq/L. T he serum K ion concentration is good below the normal scope of 3.5-5.0 mEq/L and the urine K ion concentration is amply bespeaking that there is an addition of K secernment taking to a lessen in plasma K ion concentration and an addition in urine K elimination ( Costanzo, 2010 ) .Our patient s serum chloride ion concentration is 98 milliequivalent and his serum osmolarity is 289 mOsm/L, which are two within their several normal scopes. His urine osmolarity concentration is 520 mOsm/L, which is in addition within its normal scope.The research lab trials, including blood chemical science and urine chemical science, ordered for our instance survey patient were some(prenominal) necessary non merely to obtain baseline values for prospective follow up testing, but specifically to concentrate on the patient s Na and K ion concentrations in both blood and urine specimens to find their relationship to one another given his launching of supine high blood extort and his ailment of fa iling.What are the physiological rules that explain the patient s symptoms?A Our patient nowadayss with an elevated systolic and diastolic blood force per unit area and symptoms of weakness.A This is the harmoniumic structure s response to an change in electrolyte instability caused by the loss of K together with increased belongings of Na and H ion secernment. Primary aldosteronism is characterized by over production of aldosterone by the adrenal secretory organs ( manoeuver, 1955, p. 6 ) . Aldosterone is the rule mineralcorticoid that is secreted by the zone glomerulosa in the adrenal cerebral mantle of the adrenal secretory organs. The simple coil map of aldosterone is the prevail of intravascular volume ( Ganong, 2005 ) .Aldosterone acts on the distal tubules and form uping canals of the uriniferous tubule to originate the kidney to conserve Na, secrete K, increase H2O keeping and change magnitude blood force per unit area. Aldosterone binds the mineralcorticoid recepto r ( MR ) and the building complex interacts straight with the genomic DNA via a steroid hormone response component ( SRE ) . Transactivation of cistron look leads to written text of the aldosterone induced proteins SGK ( serum and glucocorticoid inducible kinase ) , Ki-RAS and CHIF ( corticosteroid endocrine induced factor ) .A These proteins increase the activity of Na, K, and ATPase by increasing pump turnover and recruiting latent ATPase to the basolateral membrane ( Gerhard Malnic, Matthew A. Bailey, Gerhard Giebisch, 2004, p. 484 ) .The first symptom to show is high blood pressure and occurs in a bulk of patients. An aldosterone mediatedA addition in extracellular fluid volume enduring more than 1 to 2 yearss also leads to an addition in arterial force per unit area ( Guyton and Hall, 2011, p.925 ) . This status can be for every bit long as aldosterone continues to be secreted in abnormally high amounts.A Hypokalemia of & lt 3.0 milliequivalent in blood and elevated K de grees in urine insinuate mineralcorticoid surplus. Muscular failing is caused by the change of the electrical irritability of the musculus and mettle fibres which prevents the transmittal of normal musculus potencies ( Guyton and Hall, 2011, p.926 ) . former(a) patient symptoms of concerns, nycturias and in really archaic instances palsy may happen. Numbness and frisson in the appendages are related to alkalosis that may take to tetany ( Tyrell, 2000, p.555 ) . Metabolic alkalosis is a consequence of lessening in H ion concentration in extracellular fluid when H ions are secreted in alter for Na ions in the cortical parade tubules of the kidney ( Guyton and Hall, 2011, p.926 ) .Why each trial consequence supports or repudiates the doctor s preliminary diagnosingThe doctor ordered the undermentioned lab trials for this patient serum Na, K, chloride, and osmolarity, and urine Na, K, and osmolarity. The patient was diagnosed with an aldsosterone evacuant tumour of the zona g lomerulosa of the adrenal secretory organ, ensuing in primary hyperaldosteronism ( Conn s syndrome ) . McCance and Huether ( 2006 ) province primary hyperaldosteronism presents a clinical image of high blood pressure, hypokalemia, nephritic K cachexia, and neuromuscular manifestations ( p. 723 ) . The patient s low degrees of serum K and high degrees of urinary K indicate the patient has increased K secernment, hence back uping the doctor s diagnosing. High degrees of aldosterone cause the mind cells of the late distal tubule to increase Na resorption and increase K secernment ( Costanza, 2010 ) . Increased urinary elimination of K leads to reduced degrees of serum K ( Costanza, 2010 ) . The patient s Na and osmolarity degrees in the blood and piss were within the normal scopes for an grownup. This entirely would non name this status. However, since these normal Na and osmolarity degrees are present with the patient s elevated blood force per unit area, the patient has proportio nally increased his sum of H2O in the extracellular fluid ( Costanzo, 2010 ) . This addition in extracellular fluid volume explains the patient s high blood pressure, and supports the doctor s diagnosing. Serum chloride degrees are frequently drawn with K and Na to look into the relationship between these ions ( Kee, 2009 ) . The chloride degrees were build to be normal in this patient and would non help in the diagnosing of Conn s syndrome.If the intervention was successful, what was the ground? word of Conn s syndrome consists of disposals of an aldosterone adversary much(prenominal) as Aldactone, followed by surgical removal of the aldosterone-secreting tumour ( Constanzo, 2010, p. 422 ) . Aldosterone stimulates the head cells of the distal tubule and footslog uping canal to resorb Na, which promotes H2O resorption, and increases the elimination of K and H ion ( Huether, 2008 ) . Our patient is displace on Aldactone, which is an aldosterone adversary, a steroid, and a pot assium-sparing water pill, to barricade the effects of aldosterone on chief cells. This accrues sodium resorption, doing a decrease in extracellular fluid ( ECF ) volume, and besides decreases K secernment, leting the patient s plasma K to increase ( Constanzo, 2010 ) . The patient s blood force per unit area will diminish due to the decrease in the ECF volume. Our patient is pose on a sodium-restricted diet, which will besides assist to diminish blood force per unit area by lessen the ECF volume.Our patient has surgery to take the adrenal tumour. With the remotion of the aldosterone-secreting tumour, aldosterone degrees return to normal. Our patient s blood force per unit area and blood and urine chemical sciences return to normal. The interventions of Aldactone, Na restricted diet and surgery were successful for our patient.If the Treatment was defeated What was the ReasonThe intervention was successful for our patient. The adult manlike s high blood pressure was treatable by remotion of the adrenal tumour. He was given spironalactone and his diet was modified to cut down his Na, while expecting surgery. His lab values and critical marks returned to normal.DecisionOur instance survey involved a 50-year-old adult masculine who presented to his doctor s office with high blood pressure recorded in a supine place, failing, and electrolyte instabilities indicated in both his blood and piss. It was determined that he had an aldosterone-secreting tumour of the zona glomerulosa of the adrenal secretory organ which had resulted in primary hyperaldosteronism, besides cognize as Conn s syndrome. Trial consequences were closely examined and a intervention program was established for our patient. Surgery was suggested to take the tumour. He was placed on Aldactone and a sodium-restricted diet to handle his high blood pressure. Our patient opted to hold the tumour remove surgically, which was successful. Following surgery his blood force per unit area, blood, and urine chemical sciences all returned to normal degrees. He was encouraged to go on to eat a healthy diet and to hold one-year scrutinies with his primary doctor to guarantee optimum wellness.