Comprehensive Mental Health Services ( Cmhs ) Essay

Comprehensive Mental Health Services (CMHS) is an organization in Kansas City, Missouri dedicated to serving those with mental illnesses, ranging from both low- to high-functioning. This group has a for-profit and non-profit side. The for-profit side utilizes doctors, nurses, and a pharmacy to aide in the non-profit side. Case workers, therapists, addiction recovery, and group homes are all funded via the organization. With diverse staff involvement, CMHS has a multitude of positions ranging from full-time salary doctors, to full-time hourly case workers, to volunteers. Volunteers vary between other organizations that CMHS collaborates with, including Harvester’s food pantry, and even patients who want to donate their time to some of the less-fortunate. While those with mental illnesses are oppressed, this report is not about their oppression, rather their open-mindedness on the oppression of those around them. Rachael Miller is a case worker at CMHS. She works with a m ultitude of mentally ill individuals ranging from low-functioning white women, to high-functioning, gay black men (2015). Most of these mentally ill patients are understanding that they are oppressed; and with that, understand the oppression of others that surround them. For instance, almost all of Miller’s patients are completely tolerant toward other races and those of other sexualities; however, there was one individual, cover-named â€Å"Tim†, that was both homophobic and racist when he began hisShow MoreRelatedClinicas Del Camino Real, Inc. ( Cdcr )881 Words   |  4 Pagesprovided quality primary care services to the medically underserved communities of Ventura County for 45 years. CDCR started as â€Å"The Free Clinic† in Santa Paula, California in 1971 and now operates 13 Joint Commission and NCQA-Level 3 accredited health centers and three mobile units throughout the County. In addition, CDCR provides counseling services at several elementary school, high school, and adolescent group home sites. At most of the sites, patients now receive services in family practice, pediatricsRead MoreDescription Of A Service Program1808 Words   |  8 Pages Reviewer:_______________________________________ Name and location of CMH Programs: First CMH service program: The first person, I interviewed was Dawn Sarna M.S., MFT, LADC and she is the owner of premier behavioral healthcare. Second CMH service program: The second person, I interviewed was Prachi Sharma, who holds a Psy.D. and is a staff psychologist with Student Counseling and Psychological Services (CAPS) at UNLV. Interviewee(s) and how interview was conducted: I interviewedRead MoreThe And Location Of Cmh Programs1832 Words   |  8 Pages Name and location of CMH Programs: First CMH service program: The first person, I interviewed was Dawn Sarna M.S., MFT, LADC and she is the owner of premier behavioral healthcare. Second CMH service program: The second person, I interviewed was Prachi Sharma, who holds a Psy.D. and is a staff psychologist with Student Counseling and Psychological Services (CAPS) at UNLV. Interviewee(s) and how interview was conducted: I interviewed Dawn Sarna M.S., MFT, LADC for an in personRead MoreDescription Of A Service Program1813 Words   |  8 Pages Reviewer:_______________________________________ Name and location of CMH Programs: First CMH service program: The first person, I interviewed was Dawn Sarna M.S., MFT, LADC and she is the owner of premier behavioral healthcare. Second CMH service program: The second person, I interviewed was Prachi Sharma, who holds a Psy.D. and is a staff psychologist with Student Counseling and Psychological Services (CAPS) at UNLV. Interviewee(s) and how interview was conducted: I interviewedRead MoreNegative Physical And Mental Health Consequences Among Children And Adults ( Steele ) Essay2253 Words   |  10 Pagesphysical and mental health consequences among children and adults (Steele Malchiodi, 2012). Studies of the last three decades on ACEs and traumatic stress have emphasized the impact and the importance of preventing and addressing trauma across all service systems utilizing universal systemic approaches (Oral et al., 2016). The short and long term outcomes of these childhood exposures include a multitude of health and social problems including heart disease, alcoholism, drug abuse, mental health diagnosisRead MoreThe Journal Of Traumatic Stress1838 Words   |  8 PagesViolence and Other Potentially Traumatic Events† by Cindy A. Crusto of Yale University School of Medicine, Melissa L. Whitson of the University of New Haven, Sherry M. Walling of Fresno Pacific University, Richard Feinn of the University of Connecticut Health Sciences Cente r, Farmington, Stacey R. Friedman of the Foundation for Advancement of International Medical Education and Research (FAIMER), Jesse Reynolds of the Yale-Griffin Prevention Research Center, Mona Amer of the American University at CairoRead MoreShiawassee County Community Mental Health Essay2344 Words   |  10 PagesShiawassee County Community Mental Health Shiawassee County Community Mental Health (SCCMH) is an agency that provides various services to the people of Shiawassee County Michigan. This paper will explain SCCMH and their mission to the public, core values, and vision of the future. Mission Statement. To provide individualized behavioral health care services to members of the community to assist them in improving and maintaining quality of life by reaching their personal goals. CoreRead MoreBridgestone Behavioral Health Center: Cost-Volume-Profit (Cvp) Analysis3372 Words   |  14 PagesBridgestone Behavioral Health Center: Cost-Volume-Profit (CVP) Analysis INTRODUCTION In June of the current year Dr. Thomas Russell, Executive Director, and Susan Smyth, Accountant, at the Bridgestone Behavioral Health Center were discussing the necessity of gaining a better understanding of how to monitor the Center’s operating and financial performance. Located in Cleveland, Ohio, Bridgestone provides prevention, intervention, and treatment services for individuals with substance abuse problemsRead MoreBridgestone Behavioral Health Center: Cost-Volume-Profit (Cvp) Analysis3370 Words   |  14 PagesBridgestone Behavioral Health Center: Cost-Volume-Profit (CVP) Analysis INTRODUCTION In June of the current year Dr. Thomas Russell, Executive Director, and Susan Smyth, Accountant, at the Bridgestone Behavioral Health Center were discussing the necessity of gaining a better understanding of how to monitor the Center’s operating and financial performance. Located in Cleveland, Ohio, Bridgestone provides prevention, intervention, and treatment services for individuals with substance abuse problemsRead MoreWrite a Memo to Bridgestone Director4238 Words   |  17 PagesISSN 1940-204X Bridgestone Behavioral Health Center: Cost-Volume-Profit (CVP) Analysis for Planning and Control A. Ronald Kucic University of Denver IntroductIon Thomas: In reality, securing some outside assistance seems James E. Sorensen University of Denver Lisa M. Victoravich University of Denver In June of the current year Dr. Thomas Russell, Executive Director, and Susan Smyth, Accountant, at the Bridgestone Behavioral Health Center were discussing the necessity of gaining a better

The Great Gatsby By F. Scott Fitzgerald - 913 Words

â€Å"Gatsby? What Gatsby?† Daisy’s infamous line, when all the pieces begin to line up for Gatsby’s demise. It is also the line that sets the theme for the entire novel. Who is Gatsby, where did he come from, and what does he want? These are the inquiries that boggle the readers throughout the novel. Gatsby was like a monster created by his own Frankenstein, Daisy and Nick Carraway, is the ominous narrator, god, the eyes that were always watching and making judgments upon others. During the Jazz Age in New York, it was a time of little frugality and great extravagance. â€Å"It was in such a profusion around you.†(p.3) and the prodigality was attained in each class through lust (Tome and Daisy), deceit (Gatsby and the world), and murder (Wilson and Myrtle) of Jay Gatsby. Gatsby hosted several large gaudy parties where it was like stepping into another world. He hosted these parties in hopes that Daisy would wander into one; although, she never did. The people who attended his parties were classified as â€Å"new money†Ã¢â‚¬â€celebrities, socialites, and etc. The kind of people that came into money recently, inferring that it was not generational wealth. Daisy was classified as â€Å"old money†Ã¢â‚¬â€those whose families always had wealth and their posterior are entitled to a life of carelessness. Gatsby’s parties incited rumors from people who thought they knew who he was; however, of all who poured in, no one knew who him or at least not the real him. This was evident from the stories ofShow MoreRelatedThe Great Gatsby by F. Scott Fitzgerald1393 Words   |  6 PagesF. Scott Fitzgerald was the model of the American image in the nineteen twenties. He had wealth, fame, a beautiful wife, and an adorable daughter; all seemed perfect. Beneath the gilded faà §ade, however, was an author who struggled with domestic and physical difficulties that plagued his personal life and career throughout its short span. This author helped to launch the theme that is so prevalent in his work; the human instinct to yearn for more, into the forefront of American literature, where itRead MoreThe Great Gatsby By F. Scott Fitzgerald1343 Words   |  6 PagesHonors English 10 Shugart 18 Decemeber 2014 The Great Gatsby F. Scott Fitzgerald s 1925 novel The Great Gatsby is a tragic love story, a mystery, and a social commentary on American life. The Great Gatsby is about the lives of four wealthy characters observed by the narrator, Nick Carroway. Throughout the novel a mysterious man named Jay Gatsby throws immaculate parties every Saturday night in hope to impress his lost lover, Daisy Buchanan. Gatsby lives in a mansion on West Egg across from DaisyRead MoreThe Great Gatsby By F. Scott Fitzgerald1155 Words   |  5 PagesThe Great Gatsby The Jazz Age was an era where everything and anything seemed possible. It started with the beginning of a new age with America coming out of World War I as the most powerful nation in the world (Novel reflections on, 2007). As a result, the nation soon faced a culture-shock of material prosperity during the 1920’s. Also known as the â€Å"roaring twenties†, it was a time where life consisted of prodigality and extravagant parties. Writing based on his personal experiences, author F. ScottRead MoreThe Great Gatsby By F. Scott Fitzgerald1166 Words   |  5 Pagesin the Haze F. Scott Fitzgerald lived in a time that was characterized by an unbelievable lack of substance. After the tragedy and horrors of WWI, people were focused on anything that they could that would distract from the emptiness that had swallowed them. Tangible greed tied with extreme materialism left many, by the end of this time period, disenchanted. The usage of the literary theories of both Biographical and Historical lenses provide a unique interpretation of the Great Gatsby centered aroundRead MoreThe Great Gatsby by F. Scott Fitzgerald845 Words   |  3 PagesIn F. Scott Fitzgerald’s novel, The Great Gatsby, colors represent a variety of symbols that relate back to the American Dream. The dream of being pure, innocent and perfect is frequently associated with the reality of corruption, violence, and affairs. Gatsby’s desire for achieving the American Dream is sought for through corruption (Schneider). The American Dream in the 1920s was perceived as a desire of w ealth and social standings. Social class is represented through the East Egg, the WestRead MoreThe Great Gatsby By F. Scott Fitzgerald Essay970 Words   |  4 Pagesrespecting and valuing Fitzgerald work in the twenty-first century? Fitzgerald had a hard time to profiting from his writing, but he was not successful after his first novel. There are three major point of this essay are: the background history of Fitzgerald life, the comparisons between Fitzgerald and the Gatsby from his number one book in America The Great Gatsby, and the Fitzgerald got influences of behind the writing and being a writer. From childhood to adulthood, Fitzgerald faced many good andRead MoreThe Great Gatsby By F. Scott Fitzgerald2099 Words   |  9 Pagesauthor to mirror his life in his book. In his previous novels F. Scott Fitzgerald drew from his life experiences. He said that his next novel, The Great Gatsby, would be different. He said, â€Å"In my new novel I’m thrown directly on purely creative work† (F. Scott Fitzgerald). He did not realize or did not want it to appear that he was taking his own story and intertwining it within his new novel. In The Great Gatsby, by F. Scott Fitzgerald, he imitates his lifestyle through the Buchanan family to demonstrateRead MoreThe Great Gatsby By F. Scott Fitzgerald1607 Words   |  7 Pages The Great Gatsby is an American novel written in 1925 by F. Scott Fitzgerald. One of the themes of the book is the American Dream. The American Dream is an idea in which Americans believe through hard work they can achieve success and prosperity in the free world. In F. Scott Fitzgerald s novel, The Great Gatsby, the American Dream leads to popularity, extreme jealousy and false happiness. Jay Gatsby’s recent fortune and wealthiness helped him earn a high social position and become one of the mostRead MoreThe Great Gatsby By F. Scott Fitzgerald1592 Words   |  7 PagesMcGowan English 11A, Period 4 9 January 2014 The Great Gatsby Individuals who approach life with an optimistic mindset generally have their goals established as their main priority. Driven by ambition, they are determined to fulfill their desires; without reluctance. These strong-minded individuals refuse to be influenced by negative reinforcements, and rely on hope in order to achieve their dreams. As a man of persistence, the wealthy Jay Gatsby continuously strives to reclaim the love of hisRead MoreThe Great Gatsby By F. Scott Fitzgerald1646 Words   |  7 PagesThe 1920s witnessed the death of the American Dream, a message immortalized in F. Scott Fitzgerald’s The Great Gatsby. Initially, the American Dream represented the outcome of American ideals, that everyone has the freedom and opportunity to achieve their dreams provided they perform honest hard work. During the 1920s, the United States experienced massive economic prosperity making the American Dream seem alive and strong. However, in Fitzgerald’s eyes, the new Am erican culture build around that

Power of social norms Free Essays

In our day of age, technology has influenced many aspects of our everyday lives. There is not a day where we cannot go without our phones, computers or television sets. If all of that were to be taken from us, most likely we would be in an uproar. We will write a custom essay sample on Power of social norms or any similar topic only for you Order Now Being exposed to such technological devices, we have become consumed with social media. Social media has definitely shaped the way we communicate, get Information and the way we Interpret things. For example, Just recently Mile Cyrus released a music video called Wrecking Ball. Mile Cyrus is known for her innocent Disney role, Hannah Montana, a young teen who is trying to live a normal life as she Juggles being a high school teen and her secret blonde wigged pop star career as Hannah Montana. However, when the music video Wrecking Ball came out, Mile traded her innocent, parent-friendly Image for a pixie-cut, red lipped and cropped attire. The video consisted of a naked Mile riding a steel giant ball destroying cement walls and licking a sledge hammer. When the video was released, many were shocked to see this coming from the former Disney starlet. Some were disgusted by the nudity. Others loved the singer’s video and thought It was a great Interpretation of the song. Either way, the video shattered the Vivo record for most watched music video and caused many to correctly. Mile Cyrus did something that many here In America are not so exposed to, she broke a personal appearance norm. In America, we are not exposed to such nudity; and if so, the content is usually censored. But we also, have to include the gender roles. If a male is nude, it mostly likely considered as funny, but if a female is nude, it is most likely considered taboo and gets labeled a slut. Once, Mile appeared fully due riding a giant steel ball; many labeled it as inappropriate and calling her names, such as slut. However, if you were to show this to people in Europe, they would not be bothered by it. In Europe, they are exposed to nudity; many would consider It as an art form. So why are people concerned with the imagery of the video rather than the meaning behind the song? It all has to with our culture and environment we are exposed to. Culture consists of language, the behavior and any aspects that surround you In that moment. It Influences the way you see and accept at things in society. Every culture has a norms and sanctions that are considered acceptable. Norms are appropriate behaviors based on specific values and sanctions are prizes or punishment you receive when you go against the norm (Carl 54). Once you go against the norm, you are deviant and going against the social order. â€Å"Winners are the good and the normal; Losers are the sick, the crazy, the evil†¦ † (Introduction to the Sociology of Deviance) Social Norms cover almost every aspect of the way we live. However, with standards and guidelines of behavior, it does lead to some pressure to conform (Social Norms, Sociology Norms, Basic Concepts of Sociology Guide). We see people conform every day because they fear society will shun them. Conformity and social norms In society all have to do with past generations culturally transmitting their values to us and the social Institutions teaching us hidden curriculum (Carl 50, 94) For Instance, In school whenever we see the American flag, we Immediately put our right hand over our heart and say the pledge of allegiance. If we don’t do it, the America. By not placing our right hand over our heart, we would be considered deviant towards America. (Introduction to the Sociology of Deviance) Growing up, cheers and parents teach us to be proud of your culture and nation. As you can see, both the nature and nurture aspects come into play when we react towards a norm either being â€Å"broken† or â€Å"obeyed†. To get a better understanding of breaking a norm, I had to experience what it was like to break a norm. My task was simple; I am to only speak Toga, a native Filipino language. But the problem was who, where and when am I going to break my norm. Luckily, my friend Alyssa, who I have known for three years, wanted to meet with me for a day of catching up as we shop at varies malls, local boutiques and stores in the San Diego area. I only speak English to Alyssa. So I thought this would be the perfect time for me to break my norm. However, to really comprehend the power of norms in society, I decided to perform the task on strangers too. Now with my mission already planned out, all I had to do was put into action; I had to only speak in Toga to my friend, Alyssa and strangers I encounter during my one-day visit to San Diego. My experience in my norm breaking experiment, I realized the norm of speaking a language other than English, people react and look at you as if you were an alien. To be honest, I did expect people to react in this manner. However, I was blind sighted by the incident in the Anthropologist store. For me, growing up in a different country and traveling exposed me to the norms of different cultures. I find myself learning something new; that does not mean I conform to the behavior or lifestyle. But I accept norms that I am not familiar with and have an open mind. But not everyone is accepting of different cultures or lifestyles, they are not familiar with. A huge percent of people in any society would feel uncomfortable and try to steer clear to those that are different from what they are used to. Society tends to Judge and criticize things because it’s to something they are used to or exposed to. We have all experienced or witnessed something that was different from the way we live or behave, so we feel uncomfortable in the situation. We can change that, every society should look with culturally relativistic perspective. We don’t have to accept their behavior, but that does not mean, we should Judge the way someone acts or behaves in life. We have to be open-minded and make an effort, rather than be in an ethnocentric perspective (Carl 54). This world consist of diverse cultures and lifestyles, we all could learn from one another. Man has the ability to expand his knowledge. How to cite Power of social norms, Papers

Congestive Heart Failure Case Study for Cardiology- myassignmenthelp

Question: Discuss about theCongestive Heart Failure Case Study for Cardiology. Answer: Congestive heart failure can be defined as the situation when the heart cannot pup enough amount of blood in order to meet the metabolic needs of the body. Heart failures can be characterized as a chronic condition with acute exacerbations as well as with periods of abrupt worsening of the different symptoms. There are different causes of congestive heart disorders out of which coronary arterial disease is one of them (Smith et al. 2018). This disorder mainly results in the development of fatty deposits also known as plaques in the arterial walls. Blood cannot flow easily through the arteries and often results in cardiac ischemia. If this ischemia lasts for long, it may lead to the death of the heart muscles resulting in severe chest pain. High blood pressure may also result in heart muscles to work harder and this extra exertion of pressure for the muscles to work makes them stiff. They thereby become weak and cannot pump efficiently. Abnormal heart beat may also be a cause of conge stive heart failure as such heart rhythms may make the heart beat too fast casing the heart to work extra. Slow beating also leads in failure of the heart. Cardiomyopathy is the damage of the heart muscles that may take place from the excessive use of substances by patients (Chester et al., 2018). It may also lead to congestive heart failure. In other cases, virus also become responsible for the causing inflammation of the heart resulting in left sided heart failure. Some of the risk factors that remain associated with congestive heart disorders are the high blood pressure as well as coronary heart diseases. Besides, heart attack as well as diabetes may also act as risk factors for the disorders. Some diabetes medications also expose the individuals to the different forms of congestive heart failures. Viruses, tobacco and alcohol use, congenital heart disorders, sleep apnoea and many others all lead to the occurrence of the diseases. The congestive heart failure mainly has a very ne gative impact on the patient as well as the family. The patient has to lead a restricted life where he or she may not conduct all activities that he or she could do when they were well. Moreover, they also have to be very careful so that they do not go through similar symptoms that might be harmful for them and threaten their life. Such life may make them depressed and anxious and they feel frustrated about their life (Mehla et al., 2018). The caregivers or family members also undergo depression when they see their dear one suffering like this. They also go through financial turmoil due to flow of money on the healthcare and through physical turmoil, as they have to take care of the patients and keep them safe form danger. The first symptom that remains associated with congestive heart failure is the congested lungs as well as shortness of breath. This is also noted in the patient who was admitted in the emergency ward. Researchers are of the opinion that when fluid is accumulated in the lungs, it can result in the shortness of the breath. Lung congestion is also responsible for developing a dry, hacking cough as well as wheezing. The second symptoms that remain associated with the disorder is the occurrence of dizziness, weakness as well as fatigue. Such symptoms were also noted in the patient who was admitted. Improper blood flow from the heart had resulted in less blood entry to the major organs as well as in the muscles (White et al., 2018). These resulted in the feeling of tiredness and weakness. Researchers are of the opinion that as blood that flows to the brain in this condition is quite less, therefore, the patient also feels dizzy. Another symptom that was observed in the patient and is a com mon sign for all patients with congestive heart failure is the edema or swollen features in the body. Researchers are of the opinion that congestive heart failures cause less blood flow to kidneys (Morisawa et al., 2018). These result in the retention of the amount of water and fluid in the body that result in swollen ankles, abdomen causing, legs and weight gain. The patient also had swollen body parts in the case study. Another important symptom is the rapid irregular heartbeats. In order to make blood reach to all parts of the body, the heart tries to beat faster and this causes rapid as well as irregular heartbeats. Another important symptom that is also noticed in patients is the loss of appetite and feeling of nausea. This is mainly because the fluid is accumulated in the areas surrounding the digestive tract that causes different issues where the patients feel loss of appetite as well as nausea (Qian et al., 2016). ACE inhibitors (angiotensin converting enzyme) help in treatment of congestive heart disorders by mainly blocking the action of hormones that causes such disorders. The main function of the drug is seen to be helping the heart to pump well by opening the vessels of the blood and thereby reducing the blood pressure. Such inhibitors are seen to block the action of the protein that causes the blood vessels to get narrow (Shojiet al., 2018). With the help of this class of drug, the professionals can help the patients to relieve them of their heart failure symptoms such as build and swelling and help them to live better. Some of the medicines that can be seen are quinapril, ramipril, preindropil, altace, benazpril, lisisnpril and many others. Another class of drug which are also used in the beta blockers. There are certain epinephrines, norepinephrines as well as other similar hormones that are seen to act on the beta-receptors of the body tissues that thereby produce a harmful stimulativ e effect on the body (Ruppar et al., 2016). These hormones mainly provide pressure on the beta-receptors of the heart that result in more forceful contraction of the heart muscle. Therefore, in such situations, beta blockers are fond to be highly helpful as they cause the blockage of the actions of these stimulating hormones on the beta receptors of the tissues of the bodies. Some of the beta blockers which are used extensively is the acebutolol (Sectral), bisoprolol(Zebeta), nadolol(Corgard),timolol(Blocadren), atenolol(Tenormin), metoprolol(Lopressor,LopressorLA,ToprolXL), and many others. Once the patient is brought to the emergency department, it becomes important for the healthcare professionals to evaluate critical step for determining the severity of the cardiopulmonary instability. The nurse should undertake objective measurement of the dyspnoea severity including the monitoring of the respiratory rate, intolerance of the supine position, degree of hypoxia and effort of breathing. It would also involve checking heart rhythm and heart rate. Different laboratory tests should be done which include ecg, chest xray and many others. Bnp test should also be conducted (Vedel Khanassov, 2015). The nursing interventions should mainly include triaging to appropriate environment for providing safe clinical care to the patient. The nurse should also conduct objective monitoring that would include change in signs and symptoms to state whether the patient is responding to treatments. This would be followed by proper discharge planning or transfer of the patient to multidiscipl inary department for further treatment. Here, although oxygen therapy is important for patients but researchers say that it is best when the value of SpO2 90%. In case of the patient, it is about 92percent and hence oxygen therapy is not that important. However, noninvasive ventilation is found to be extremely important for the patients with respiratory distress. It decreases respiratory distress and helps in reduction of the rate of mechanical endotracheal intubation. Intravenous diuretics as well as vasodilators need to be administered. 20 to 40 mg intravenous furosemide can be provided to patient in such conditions. Intravenous vasodilator therapy can be also provided to the patients who blood pressure is normal to high. Sublingual nitrates can also be considered (Unverzagt et al., 2016). Evidence based, diseases modifying oral therapies can be provided to the patients in such conditions like the beta blockers, ACE, MRA, diuretics, nitrates and others. This should be then followe d by proper reassessment of the patient by the nurses. The patient should be checked in every proper ways by which the stability of the patient should be ensured. The nurses should continue to monitor the heart condition of the patient from time to time in order to entertain that the patient condition is gradually becoming stable (Shah et al., 2018). The total monitoring would be contributed for about 24 hours until the damage of the heart is stopped and the patient is out of danger. Following the condition of the patient for about 24 hours, the emergency nurse would conduct meeting with the other specialists and then transfer the patient to the general ward where she should be then treated by the multidisciplinary team. The nurses should properly document all the information so that the ongoing care of the patient is not disrupted and care provided is of high quality (Jonkman et al., 2016). References: Chester, R., Horwich, T., Srikanthan, P., Gornbein, J., Hundley, G., Watson, K. (2018). Reflection Magnitude, A Measure Of Arterial Stiffness, Predicts Incident Congestive Congestive Heart Failure In Men But Not Women: Multi-Ethnic Study Of Atherosclerosis (MESA).Journal of the American College of Cardiology,67(13 Supplement), 1314. Jonkman, N. H., Westland, H., Groenwold, R. H., gren, S., Anguita, M., Blue, L., ... Kempen, G. I. (2016). What are effective program characteristics of self-management interventions in patients with heart failure? An individual patient data meta-analysis.Journal of cardiac failure,22(11), 861-871. Mehla, P., Galin, I., Baksh, S., Bailey, S., Passik, C., Jarrett, R. (2018). Spontaneous fistulization of caseous mitral annular calcification: case of recurrent congestive heart failure.Journal of the American College of Cardiology,67(13 Supplement), 1122. Morisawa, D., Hirotani, S., Sugahara, M., Fukui, M., Nakabo, A., Naito, Y., Masuyama, T. (2018). Hemodynamic Response Of Sildenafil Depends On Left Ventricular Chamber Stiffness In Patients With Decompensated Congestive Heart Failure.Journal of the American College of Cardiology,63(12 Supplement), A931. Qian, G., Fu, Z., Guo, J., Cao, F., Chen, Y. (2016). Prevention of contrast-induced nephropathy by central venous pressureguided fluid administration in chronic kidney disease and congestive heart failure patients.JACC: Cardiovascular Interventions,9(1), 89-96. Ruppar, T. M., Cooper, P. S., Mehr, D. R., Delgado, J. M., Dunbar?Jacob, J. M. (2016). Medication adherence interventions improve heart failure mortality and readmission rates: systematic review and meta?analysis of controlled trials.Journal of the American Heart Association,5(6), e002606. Shah, K., Parekh, N., Clopton, P., Anand, I., Christenson, R., Daniels, L., ... Neath, S. X. (2018). Improved survival in patients with diastolic heart failure discharged on beta-blocker and ace inhibitors.Journal of the American College of Cardiology,61(10 Supplement), E634. Shoji, S., Kanazawa, H., Yanagisawa, R., Tanaka, M., Fukuoka, R., Akita, K., ... Yuasa, S. (2018). Percutaneous Occlusion of Patent Ductus Arteriosus for an Elderly Patient With Refractory Congestive Heart Failure.Circulation: Heart Failure,11(2), e004764. Smith, G., Shore, S., Mitchell, A., Moore, M., Morris, A., Speight, C., Dickert, N. (2018). Discussing Out-Of-Pocket Costs With Patients: Shared Decision-Making For Sacubutril-Valsartan In Congestive Heart Failure.Journal of the American College of Cardiology,71(11 Supplement), A2626. Unverzagt, S., Meyer, G., Mittmann, S., Samos, F. A., Unverzagt, M., Prondzinsky, R. (2016). Improving treatment adherence in heart failure: A systematic review and meta-analysis of pharmacological and lifestyle interventions.Deutsches rzteblatt International,113(25), 423. Vedel, I., Khanassov, V. (2015). Transitional care for patients with congestive heart failure: a systematic review and meta-analysis.The Annals of Family Medicine,13(6), 562-571. White, M., Tremblay-Gravel, M., Khairy, P., Roy, D., Leduc, H., Wyse, D. G., ... Andrade, J. (2018). Blood Pressure Levels Modulate Mortality In Patients With Atrial Fibrillation And Heart Failure With Depressed But Not In Patients With Preserved Ejection Fraction.Journal of the American College of Cardiology,61(10 Supplement), E734.

Souldice Hospital Marketing Strategy Essay Example

Souldice Hospital Marketing Strategy Paper Unlike physical products, a service cannot be seen, tasted or felt before it is bought. There is always an element of uncertainty and the service seeker looks for evidence of quality. People will draw conclusions from the place, the people, key influencers, communication material and most importantly from people who have already gone through the experience. Therefore the service providers task is to supply this evidence, to tangibilize the intangible [Kotler] Shouldice marketing strategy is one of a kind, in the sense that it is different, which is the secret behind every successful strategy. Its ? thinking out of the box. Its sensing a need and fulfilling it in a remarkable manner. Everything we have studied in the past classes seems to be embodied in the strategy of Shouldice hospital from experiential marketing, brand loyalty, providing a memorable experience, the importance of good word of mouth advertising, to focus and using ones competitive advantage to such an extent that although people might try to copy it, there are slim chances of them getting it right. Shouldice hospital is marketing a well-developed, focused service delivery system, it is providing an experience. Core Competency Dr. Earle Shouldice who founded the hospital started this operation from an idea and then developed the idea further by dedication and passion, he operated on men who wanted to be soldiers but were denied because they needed hernia treatment, during the war in 1940, hospital space and doctors were scarce, especially for this non-emergency surgery that normally took three weeks of hospitalization. Dr. We will write a custom essay sample on Souldice Hospital Marketing Strategy specifically for you for only $16.38 $13.9/page Order now We will write a custom essay sample on Souldice Hospital Marketing Strategy specifically for you FOR ONLY $16.38 $13.9/page Hire Writer We will write a custom essay sample on Souldice Hospital Marketing Strategy specifically for you FOR ONLY $16.38 $13.9/page Hire Writer Shouldice stepped in and operated without taking any fee, he performed an innovative method of surgery on seventy of these men, hastening their induction into the army, and thus the idea developed into a surgical technique which survived him and is still thriving. As Bruce Lee once said I fear not the man who has practiced 10,000 kicks once, but I fear the man who has practiced one kick 10,000 times. The focus on doing what you are best in, and developing it to such an extent that people are trying to copy it, it makes sense to just stick to that and thats what Shouldice did. A Strategic Service Concept- Focused Service Factory Shouldice defined the one thing they do to perfection and built a whole integrated system around it. Removal of external hernia were their forte and they stuck to it. The patients at the Shouldice center take some of care of themselves. Before the operation a questionnaire is sent to them which is simple to understand and the purpose is to determine the type of hernia and other risks associated with surgery. In Shouldice, all the patients were encouraged to walk up and down the halls and to get in dialog with the other patients and the surgeons. In thought of encouraging the patients, the steps between the floors are constructed with a smooth inclination, there are not TVs at the bedrooms and the rooms were designed as if it were a home instead of a hospital. Every square foot of facility is carpeted to reduce the hospital feeling and the possibility of a fall. ?Market Segment: Shouldice hospital is staying focused because it has not changed its target market and the methods that made it a success; the target market for Shouldice Hospital remains the people who were detected with a primary inguinal, which was the most common kind of hernia. They treated only external hernias. More complicated cases, especially those involving patients with other health problems, were not undertaken. The primary advantage of admitting only healthy people was that the duration of the patient in the hospital was drastically cut down. Thus new patients could be admitted with a higher frequency. Great Word of mouth advertising Part of the success of the Hospital from a psychological point of view is the opportunity for the patients to meet one another. I certainly enjoyed the other patients and I did not hear a single one express any negative attitude toward the hospital and I heard many glowing words about it. RON KENYON-THORNHILL, ONTARIO Other qualities that help it stay focused in short are ?A Flat Organizational structure Top Management Commitment to Quality Dr. Shouldice and his sister Mrs. Uquhart each owned 50% of each, i. e. , the hospital and the clinic. ODell as the administrator was responsible for all the five departments ? surgery, nursing, administration, maintenance and housekeeping. T ? Customer Value Satisfaction As is evident by the questionnaire and response and the fact that most of its customers are referrals. Which according to most is the one number you need to be concerned about. ?Focused Differentiation Stayed focus on treating external hernias ?Self Service Technologies Patients self screen Self Serve Walk about Dont need bed pans Q2. Is Shouldice hospital a good place to work and why? Excellent service providers know that positive employee attitudes will promote stronger customer loyalty, so the best employees must be found to do the job and then they must be retained. At Shouldice the turnover rate is minimal, only four nurses a year, which for hospitals is quite remarkable. Shouldice hospital is great place to work pretty much for the same reason that it is a great place to be operated on. There is an atmosphere of warmth of family rather than a workplace. The nurses work more as psychologists. And a lot of the dirty jobs so to say are avoided since the patient is healthy enough to walk around the place, his linen need not be washed regularly and can be changed only after he leaves the hospital after four days plus patients do not need bed pans. This also reduces the amount of time that the nurses need to devote to each patient in terms of individual care. Nurses could better utilize this time by conducting orientation programs for the patients and also counseling them. This kind of work keeps the work force motivated and they do not have to deal with the drudgery of day-to-day work. There s a profit sharing plan for both doctors and nurses. As far as the doctors are concerned they get a chance to see ? their children grow up, meaning that the hospital does not take over their entire lives as this profession normally does. The doctor on call is rarely called to the office and has regular hours. A surgeon day ends at 4 p. m.  which in medical terms is quite a ? miracle. And although hernia repairs are traditionally seen as mundane the Shouldice technique is a trick anatomical procedure and thus it gives a doctor a new skill. Salary and bonuses are good too. Since the patient base is healthy post-operative care required is lesser. There is an ? open door policy that was in place for the staff. Employees can go to ODell could come in and discuss their problems ranging right from their personal problems to their official problems. This kind of close staff and management interaction helped in keeping the staff. Nobody gets fired; the pay scale is higher than comparable jobs in other areas. There is a feeling of family as people often pitch in to do work. Alan ODell went on to further elaborate the happy and feeling involved. Yet another policy prevalent is that of job rotation, which removes the monotony from the job, also helps in keeping the staff prepared to face crisis situations, which could possibly arise due to some staff member remaining absent or suddenly taking ill. The staff functioned more as autonomous units loosely controlled by the administration. This freedom served as a motivating factor and propelled them to achieve higher efficiency results. Q3. How is Shouldice providing a unique and memorable experience to its patients? The Provision of an Experience rather than a service! The first thing that struck me while reading the case that its not like a hospital at all its more like a home where people for retired people or even in fact a hostel. Shouldice has been remarkably successful in its ability to not only provide its patients with a quick, quality and low cost surgery but also providing an unforgettable experience and comfortable environment to all of its patients. Shouldice Hospital success is due to a number of factors ? Warm and friendly environment [carpets to dispel the hospital feeling and disinfectant smell] ? Communal Dining; which is psychologically appealing to patients receiving surgery, they are able to associate with other patients as well as doctors receiving the procedure to compare notes and discuss concerns and ultimately alleviate any anxieties with other patients. ?Patients encouraged to exercise and walk around meeting other people making friends. 58% appreciated friendship with other patients as ? very important and 34. 57% rated exercise as ? very important ? Shouldice Hospital has a high success rate; only 0. 8%. Dr. Shouldice technique is far superior to others. 72% rated that as ? very important ? Building of partnerships and sharing of medical notes. Patients are given rooms that they share with a roommate who is generally from a similar professional background or shares similar hobbies. ?Post-operative treatment that they get. No television or telephone is kept in the room. Thus the patient compulsorily has to walk down the specially constructed stairs and come to the common room to avail of these facilities. This helps the patient recovers mentally and considers himself fit and healthy. Patients in fact want to stay longer; they can explore the premises make new friends, You are not alone and isolated feeling scared for children their parents are allowed to stay with them without charge. At every customer touch point the feeling of intimacy and caring putting yourself in the patients shoes is available Q4 Should Shouldice hospital expand? Why? Group 13 Shouldice should expand but be very cautious not lose out on its uniqueness, because bigness and the cost associated with it often can lead to undifferentiating. Q5. If it were to expand, what are the options available to expand what are the options available to expand and which option do you recommend? What is going on presently? 1. Alan ODell wants to increase capacity he doesnt want to lose control over quality. He thinks himself as a doctor first then as an entrepreneur. 2. They cant market their services as they dont know if they will be able to fulfill the demand. 3. Other doctors are using the Shouldice technique without results. 4. Saturday operations, if they expand further there is danger of change in attitude. 5. Dr. Obney is resisting change and opposes operations on Saturdays. 6. Even when hey expand capacity backlog declines but climbs once again 7. The selection of the next chief surgeon So what should they do? The were established as a focused service factory and that hs led to their success so they should definitely not move away from that into other areas, stick to external hernia operations. Since patients are attracted to the hospital in part by rates, any expansion plan has to ensure that the cost des not have to be borne by the patient. They should definitely copyright the Shouldice technique. Teach it to other surgeons and make sure that people check if the surgeon who says he is using the Shouldice technique has a certification much like the board certification needed. This is to protect their intellectual property. Or have a campaign that makes people aware that others are copying their technique and its not endorsed. Since you cant stop them from copying you can train them yourselves. There is a demand for the same operation from other hospitals. Besides, some of the other hospitals are imitating the same method wrongly. So, they should develop a self-contained branch in northern part of US. And by the help of their good image in medical care, they can brass to offer new specialty medical service first in Toronto. If the demand is enough, they can expand their new specialty medical care service area. Brochures saying that Shouldice Hospital is the only hospital having the technical expertise to practice the Shouldice method and warning the people against fraudulent practices will ensure that the failures of such fraud operations are not blamed on the Shouldice method. They can videoconference now that technology permits. This technique can be done over the world. They can hire new surgeons and nurses to deal with the expanded capacity, especially for Saturdays. If Saturday surgery is causing a rift a compromise can be reached by limiting the number of operations that would be actually performed on Saturday. Although addition of Saturday operations will result in increased workload. Since the patients stay at Shouldice for average of 5 days, an increment in capacity will be inevitable. There should be a lot of talks and Saturdays should definitely be utilized since patients whos  operations are scheduled late in the weekend stayed in the hospital over the weekend Adding another floor of beds which could increase MON-FRI surgeries by 50%. In my opinion adding a half day Saturday is the best option. Although 42% of their patients come from the U. S. Im not sure whether opening a hospital in the U. S. would allow them to stick to their strategy or the differentiation they have created. An organization like this is very characteristic of the place it belongs ? Canada. America is a different ball game and it could cause them to lose its distinctive edge and ? soul.

The Safavid Empire of Persia

The Safavid Empire of Persia The Safavid Empire, based in Persia (Iran), ruled over much of southwestern Asia from 1501 to 1736. Members of the Safavid Dynasty likely were of Kurdish Persian descent and belonged to a unique order of Sufi -infused Shia Islam called Safaviyya. In fact, it was the founder of the Safavid Empire, Shah Ismail I, who forcibly converted Iran from Sunni to Shia Islam and established Shiism as the state religion. Its Massive Reach At its height, the Safavid Dynasty controlled not only the entirety of what is now Iran, Armenia, and Azerbaijan, but also most of Afghanistan, Iraq, Georgia, and the Caucasus, and parts of Turkey, Turkmenistan, Pakistan, and Tajikistan. As one of the powerful gunpowder empires of the age, the Safavids re-established Persias place as a key player in economics and geopolitics at the intersection of the eastern and western worlds. It ruled over the western reaches of the late Silk Road, although the overland trade routes were quickly being supplanted by ocean-going trading vessels. Sovereignty The greatest Safavid ruler was Shah Abbas I (r. 1587 - 1629), who modernized the Persian military, adding musketeers and artillery-men; moved the capital city deeper into the Persian heartland; and established a policy of tolerance towards Christians in the empire. However, Shah Abbas was fearful to the point of paranoia about the assassination and executed or blinded all of his sons to prevent them from replacing him. As a result, the empire began a long, slow slide into obscurity after his death in 1629.

Human nature vs. Human condition Essay Example | Topics and Well Written Essays - 1250 words

Human nature vs. Human condition - Essay Example But it needs to be noted here that everything that relates to us is inbuilt. Some features that build up our personality are depending on our past rather than having a scientific background. Things that build up the human condition are marriages, deaths, terrorism, physical activities like sports etc. which are not applicable to any scientific reasoning need to be studied in a more humanly manner. "Thinking about humans and the rest of nature has focused on shared biological properties and environmental attitudes." (Levin, 9) The reason why people confuse these very different branches of anthropology is that these branches despite being quite different share certain features which are quite similar when it comes to human development and growth. It needs to be discriminated here the difference between those features that symbolize the human way of living as we take it to be and the reasonable claim that it has taken origin from the human nature.at times it is easy to discriminate. For instance, cooking is part of one's everyday activity and despite how essential it is to us humans we can still not consider to be part of our nature although it has a past but still the utensils, material etc. required to produce food is not innate but a creation. Likewise sports is not something we were naturally interested in or has an evolutionary history but it is more of a requirement of one's prevailing conditions and desires. But the problem arises with certain issue that is quite intriguing for even researchers because of their dominating biological nature. The philosopher I would like to mention here are Thomas Hobbes and Plato who both in their distinct manner have contributed to propagate this theory. Although "The interpersonal structures of humanity, the genesis of social order cannot be conveyed from a philosophical perspective" (Klein and Sitling, 191) In Hobbes book Leviathan he provides a very detailed analysis about the human condition. In this book he tells that our internal desires, motives and behavior are all because of the biological processes that are taking place inside us. The choice between good and bad, right and wrong is merely the choice of the individual and his/her personal preferences. When one is not bounded by society and is only answerable to him then the objective of living fades. In a natural atmosphere one does not need to abide by justice or injustice but can choose what he prefers and neglect what is not a part of his conscious choice o0r ill for his existence. Apparently the picture Thomas Hobbes tried to draw was fairly vague with no practicality in itself. He believed that the humans did not require moral or ethical values to survive. There was no room for justice, fairness, trust, equality etc. which are such virtues without which a society can never prosper. For instance if the people constituting a society have only desires of basic necessities like food etc. then the one in power and dominance on the basis of hi s position would oppress the one underneath depriving the oppressed one of his basic necessities. The reason behind such representation was not to portray a scary sort of a depiction but was consciously based on the ethics of society. For instance if today we are bound to morality, value and principles it is merely because we have a sense of responsibility and certain infused respect for others which we have learnt from our surroundings. If these values vanish and humans are not liable to others then an environment will be created that would be free from justice with bloodshed and injustice everywhere. Furthermore an environment would be created that w

Refund Anticipation Loans Research Paper Example | Topics and Well Written Essays - 2500 words - 1

Refund Anticipation Loans - Research Paper Example In spite of the high fees associated with RAL’s, most of those coming from the poor families are the ones who usually apply for it. There is an on-going battle between the government, the consumer advocates and tax preparation companies on the continued offering of Refund Anticipation Loans. A refund anticipation loan is a type of short-term loan that is applied by a taxpayer, who wants an early claim on his tax refund. The amount that is acquired through the loan will be repaid by the taxpayer’s anticipated tax refund. It may also be called â€Å"Rapid Refund† or â€Å"Instant Money.† A contract is provided by the financial institution to be signed by the taxpayer that serves as an assurance that the loan will be paid back through the taxpayer’s tax refund (â€Å"Refund Anticipation Loan Fraud†). Common interest rates for RAL’s start from 50% up to over 500%, the basis of which is the length of the time that is needed to process tax forms at the Internal Revenue Services (IRS), that is According to the Center for Responsible Lending. Although this type of loan has been claimed as a way for taxpayers to have their tax refunds earlier in their pockets, more often than not it is advanced only for just a few days or less as compared to the actual date that the IRS releases the tax refund (â€Å"Tax Refund Resources for Consumers†). RAL’s give taxpayers the opportunity to get their tax refund at a sooner date and be able to use the money earlier rather than wait for a couple more days. Even so, problems occur when someone opts to use a refund anticipation loan. Basically the lender knows that the money borrowed will be paid no matter what since the guarantee is the taxpayer’s tax refund; therefore, it is considered as a safer type of loan compared to the other types, but then risking everything just to get the money sooner seems to not sound good at all (Pritchard).

Assignment Example | Topics and Well Written Essays - 2500 words - 5

Assignment Example This means that when a company makes an agreement, they must honor this agreement even if the terms are beyond the constitution. In this case, the cat contract with Feline Fertility Pty Ltd is enforceable since company willing entered the contract while understanding that the their constitution did not allow them to trade in cats. Lassie Ltd argues that since the company constitution does not allow the company to trade cats, the contract was invalid and unenforceable. However, going by the law, the fact that the company entered the agreement with Feline Fertility Pty Limited, it remains valid even if this goes beyond the constitution. Therefore, Feline Fertility can move to the court to have the contract enforced and to avoid termination. Alternatively, Lessie Ltd should finance any losses that the other company may incur as a result of this termination. The Company act of 2001 states that a director of the company must act within the constitution while conducting business on behalf of the company. Since the director of the company conducts the business on behalf of the stakeholders, the constitution limits their actions.5 However, this must be in tandem with the requirements of the constitution. In this case, Willy Woof has the power to make decisions regarding the business process, as long as these decisions do not infringe the constitution. The company current constitution allows the director to enter the lease with Hot Ltd.6 However, the other company directors intends to include a new clause that requires that â€Å"the establishment of any store outside the state of Western Australia requires the approval of all the directors.† If the amendment is successfully integrated in the constitution, Lessie will not be able to enter into the agreement with Hot Ltd since the constitution will empower other directors to object suc h a move7. Therefore, changes in the constitution will help

Intrathecal Chemical Neurolysis With Phenol

Intrathecal Chemical Neurolysis With Phenol CANCER PAIN Intrathecal neurolysis with 6% phenol for intractable and opiate resistant perineal pain secondary to terminal bladder cancer . Name : Dr R Srivastava Department: Heart of England NHS Trust, Solihull. E-mail: [emailprotected] Abstract Background: Intrathecal chemical neurolysis with Phenol is a neurodestructive technique to provide saddle anaesthesia for perineal pain, in patients unresponsive to pharmacological therapy or not ameneable to surgical treatment. Its use has been advocated in patients with terminal illness with a short life expentancy of less than a year. Phenol’s neurodestructive mechanism relies on precipitation of proteins in the nerves with myelin sheath separation and axonal oedema, resulting in fibrosis. Neurolysis can be induced with chemicals like phenol or alcohol or by physical methods of radiofrquency or cryoablation Neurolytic saddl block is a high risk procedure leading to almost irreversible neuro-destruction with significant risks including failure, paralysis and incontinence.Careful patient selection and psychological evaluation is mandatory and comprehensive risks and benefits assessment should be carried out before embarking on this technique. Communication with patient is vital due to the resultant side effects of the block. Results: Patient was extensively evaluated for the procedure with all co-morbidities and life expectancy considered and underwent subarachnoid chemical neurolysis with hyperbaric 5% phenol leading to drastic pain relief and significant reduction in opiate consumption. Case Report: Mr JJ ,a 73 year old gentleman was referred form a hospice with complaints of severe abdominal and anal pain due to a surgically inoperable bladder tumor with extensive pelvic involvement and distant metastases . He was referred to our clinic from hospice with severe opiate resistant pain. Mr JJ was diagnosed with the Transitional Cell Carcinoma: T2a N0 MX(Pulmonary nodules) G3,TCC Bladder, eight months ago when he initially presented with back and pelvic pain. He had pulmonary metastases and bladder biopsy and cystoscopy revealed a large tumor on the back wall of the bladder. Mr JJ underwent a radical course of radiotherapy. Subsequently he was admitted to the hospital with rectal pain . Examination under anaesthetic revealed a large mass extending from the bladder in to the prostrate. MRI scan confirmed the tumor with invasion of seminal vesicles and of the prostrate.He underwent ureteric stenting for his right hydronephrosis and hydroureter. His background included history of chronic obstructive airway disease, hypertension, diabetes, Ischaemic heart disease(Coronary stenting 5 years ago) and hypothyroidism. His pain at the time remained unsettled with associated symptoms of tenesmus, nausea and vomiting and profound weakness. Mr JJ lived alone and was unable to cope on his own and was referred to hospice for further palliative care. He was initially treated with Zomorph 30mg twice a day and with Oromorph as a PRN dose for breakthrough pain. Pain worsened over a period of six weeks when it was decided to start him on a syringe driver of diamorphine 30 mgs and metoclopramide30 mgs. Inspite of some relief, he remained extremely confused and constipated. His syringe driver was changed to alfentanil 5mgs and haloperidol 3 mgs to reduce the confusion and drowsiness. Subsequent increment of alfentanil dose via the syringe driver did not resolve his rectal pain. In view of his worsening symptoms and prognosis ,saddle block with phenol for rectal pain remained the only viable option. After a careful assessment and explanation of the risks ( double incontinence and possible paralysis) and benefits of the procedure explained, patient was transferred to our centre as a day case and underwent intrathecal neurolysis with phenol. 1 ml of 5% phenol in glycerol was injected intrathecally and flushed with 0.2 mls of 0.5% hyperbaric bupivacaine. Patient was sat up for 30 minutes to achieve a saddle block. In recovery he seemed to be pain free with no loss of motor power. Mr JJ was transferred back to the hospice the same day. During follow up it was noted that within a few days Mr JJ’s alfentanil infusion was stopped and he was more awake and was managing on small doses of oral morphine of up to 40 mgs a day. His tenesmus completely disappeared but he still complained of some dull aching and deep visceral pain. Case discussion: There are more than 5000 deaths/year related to bladder cancer in the UK and it is the seventh commonest cause of cancer related deaths. Our patient had an extensive spread of his bladder tumor resulting in a combination of background visceral pain involving the rectum causing intractable tenesmus Prevalence of cancer pain in patients with incurable or advanced disease ranges from 43 -63%. More than one third of the patients complain of significant pain during the terminal stages of the disease.[1] Pathophysiological Mechanisms: The mechanisms involving cancer pain are complex and can not be solely attributed to either nociceptive ,musculoskeletal , visceral or neuropathic pain . Pain presents itself as a combination of various mechanisms, which would be dependent on the characteristics of disease progression. Visceral pain as was the case with our patient has both spinal and vagal innervation with feature of dull and diffuse pain with poor localization. Cancer cells in combination with the stromal cells will result in release of inflammatory markers like endothelin, bradykinin , tyrosine kinase and proteases which would lead to sensitization of the nerve fibres. Tyrosine kinase seems to play an important role in the sensitization of the afferent nociceptors.[2] Growth of the tumor may cause direct compression of the nerve fibres resulting in ischemia related neuropathic pain. Cancer induced bone pain is a result of proliferating osteoclasts which lead to bone resorption. This also leads to stimulation of TRPV1 and acid sensing channels expressed on the nerve fibres resulting in cancer associated bone pain. Periosteal sensitization of afferent fibres in an acidic melieu contributes to the persistence of cancer pain.[3] Assessment of cancer pain remains complex and is influenced by patient population, variability in assessment tool ,scoring systems and under reporting of severity of pain by patients.[4] Assessment of patients with cancer requires a multidimensional approach in order to evaluate the physiological, psychological and social impact on life. A careful assessment of history, symptoms, signs and disease progression is crucial. Patient’s expectations with regards to treatment should be discussed and the impact of pain on patients functional activity should be assessed. Patients with cancer complain of background pain and exacerbation of pain (Breakthrough Pain), which might be related to movement or due to progression of tumor resulting in compression of underling tissues and organs . Metastases to the bone can be the primary cause of pain in up to 75% of the patients. Assessment of localization, severity, duration, exacerbating and relieving factors is a must. Cancer pain patients are often on high dose of opiates for their pain control, which may have a detrimental effect on their daily living due to side effects of tolerance to opiates, opioid induced hyperalgesia, leading to inadequate pain control. Management of cancer pain: Cancer pain management in a palliative patient is challenging and requires consideration of all aspects of pain in the terminally ill. Optimum control can only be achieved if pharmacological and bio-psycho-social element of treatment are carefully reviewed. Most patients understandably are depressed and more than 75% suffer from moderate to severe pain. Surgical management is rarely appropriate in patients with distant metastases but may be indicated in some circumstances like internal fixation for pathological long bone fracture. Chest drainage may be required for patients with mesothelioma for recurrent pleural effusion. Radiotherapy which can be localized or wide field and may be useful in patients with metastatic bone disease with proven efficacy of up to 60%. and 25% respectively. Radioisotopes like strontium are also used to treat metastatic bone disease but may not be cost effective in all healthcare systems. Chemotherapy may be helpful in some types of cancer,provided that the tumor remains chemo-sensitive. Assessing the benefits of chemotherapy with regards to prognosis and life expectancy is crucial as the side effects of chemotherapy may be more detrimental to the patient than the pain itself. Hormonal therapy has been useful in prostrate and breast cancer with anti-androgen and anti-oestrogens as both types of cancer are hormone sensitive. Pelvic pain may result from the tumor invasion to organs and The World Health Organisation (WHO) 3 step analgesic ladder of 1986 recommends a staged approach from non-opiods like paracetamol and non-steroidal anti-inflammatory drugs to weak opioids and if necessary ,strong opioids for moderate to severe pain. However, the role of adjuvants like tricyclic anti-depressants, selective serotonin reuptake inhibitors and anticonvulsants like gabapentin and pregabalin should be considered and individualized depending on the symptomatology of the patient. NMDA antagonist like ketamine may help reduce central sensitization[6] Heavy reliance on strong opioids can lead to troublesome side –effects which should be appropriately managed with laxatives and anti-emetics. Opioid rotation should be considered for opioid induced hyperalgesia as in the case of Mr JJ where diamorphine was substituted for alfentanil infusion. Evaluation of psychological factor of perception of pain and the behavioural responses has a significant impact on patient’s lifestyle. Cognitive behavioral therapy may help elicit these perception and help individuals with chronic pain ,forming coping strategies. Pain management programme is helpful for the patient in identifying all aspects of pain and are aimed at improving the quality of life. Physical therapy for pain is aimed at improving functionality and reducing the physiological deconditioning. Lifestyle adjustment in terms of daily routines ,tasks and adapting to new envoirement should be planned for facilitating any coping strategies. Intervention techniques are aimed at targeting the source of pain involving destructive and non-destructive techniques which could involve local anesthetics and steroids for nerve blocks .Continuous infusions of local anaesthetics and opioids via a catheter placed intrathecally, can be used for spinal cord modulation and pain control. Catheter is connected to a programmable pump to administer the desired dose. Nerve destructive techniques should be only considered in a multidisciplinary framework . Patient selection and progonostication of the illness is paramount. It is important that the patient has a full understanding of the procedure and the benefits at the expense of the undesired consequences of such a block like incontinence or motor paralysis. Trial of local anaesthetic is desirable in most cases to predict efficacy of further neurolysis. Neurolytic blocks necessiate the need for close monitoring and evaluation of patient’s pain scores in order to titrate the strong opioids accordingly. Indications and contraindications to Intrathecal neurolysis: Although there has been a decreasing trend in the use of intrathecal neurolysis following advancement in the techniques of spinal blocks with infusions of local anaesthetics and opioids; intrathecal neurolysis has its place in a select subset of patients in whom the pain remains refractory inspite of conventional therapies and treatment with strong opioids . The distinct advantage with neurolysis is of reduction in the opiate consumption and the associated side effects. Complications of subarachanoid block include bladder and bowel dysfuction along with motor weakness .[5]. Pain relief associated with neurolytic blocks is short lived(less than 6 months), and disease progression may lead to refractory pain .In view of our patient’s limited life expectancy of less than two months with pre- exsisting bowel and bladder dysfunction ,intrathecal neurolysis was the quickest and the most cost effective way to provide pain relief. Neurodestructive techniques used in clinical practice range from cryoablation, radiofrequency lesioning to chemical neurolysis with Alcohol (50-100%),Phenol (7-12%) , Hypertonic saline and glycerol. Intrathecal neurolysis: It involves the destruction of nociceptive afferent fibres ,both myelinated and unmyelinated leading to almost instant pain relief. It is effective in well localized pain. The effect of neurolysis is short lived but it involves a short period of hospitalization in comparision to neurosurgical procedures like cordotomy. Phenol(7-12%) causes nerve destruction by coagulating protein in both small and large fibres which leads to degeneration of the nerves within the nerve roots involving more of the posterior than anterior columns. Nerves tend to regenerate faster with phenol than alcohol . Phenol is hyperbaric and when mixed with glycerol, it tends to diffuse more slowly out of the solution causing a more targeted destruction compared to alcohol. It can be mixed with water but the nerve destruction will be more extensive. Phenol compared to alcohol is not painful on injection and for this reason alcohol injections are administered with a local anaesthetic. In concentrations of lower than 5%, phenol tends to exert local anaesthetic action rather than neurodestructive. Phenol when mixed with glycerol or radiopaque dye can provide a higher concentration of up to 15%. Neurolysis with phenol in comparision to alcohol is milder and short lived. Due to the hyberbaric nature of phenol in comparision with alcohol, the patient is positioned with the affected side down to target the dorsal roots. Phenol being highly viscous requires a wider bore spinal needle for injection. Phenol can cause skin and tissue necrosis along with neuritis if the nerve destruction is incomplete. For patients undergoing neurolysis with alcohol the targeted side is positioned up due to the hypobaric nature of the solution. Patients are initially in the lateral position followed by proning to 45 degrees to target the dorsal roots. Alcohol may cause mild burning on injection. Hypertonic saline(10-15%) for intrathecal neurolysis can provide a significant relief of more than 50% but has significant side effects. Conclusion: Management of cancer pain is very complex and challenging and requires considerable expertise in providing appropriate care to terminally ill patients. Significant reliance on strong opioids is not without it’s side effects and a multifaceted approach towards pain control is warranted. Our patient was treated with chemical neurolysis as a last resort since all other measures had failed. Although it helped in reduction of opiate requirement and drowsiness, it still remains difficult to judge the correct dosage and concentration of phenol and balance it against the duration of pain free interval with minimum side effects for the patient before leading to death. Intrathecal neurolysis is not a routine procedure and outcomes of this type of intervention are variable. The extreme complications of this procedure and availability of other techniques makes clinicians reluctant to use in their regular clinical practice. However, cancer pain treatment needs to be tailored in accordance with the patients condition and chemical neurolysis may perhaps be the only option to relieve pain in specific patients. References: [1]M. H. J. van den Beuken-van Everdingen, J. M. de Rijke, A. G. Kessels, H. C. Schouten, M. van Kleef, and J. Patijn, â€Å"Prevalence of pain in patients with cancer: a systematic review of the past 40 years,† Ann. Oncol. Off. J. Eur. Soc. Med. Oncol. ESMO, vol. 18, no. 9, pp. 1437–1449, Sep. 2007. [2]S. Pezet and S. B. McMahon, â€Å"NEUROTROPHINS: Mediators and Modulators of Pain,† Annu. Rev. Neurosci., vol. 29, no. 1, pp. 507–538, 2006. [3]â€Å"Review of Cellular Mechanisms of Tumor Osteolysis.à ¢Ã¢â€š ¬Ã‚ ¯: Clinical Orthopaedics and Related Research,† LWW. [Online]. Available: http://journals.lww.com/corr/Fulltext/2000/04000/Review_of_Cellular_Mechanisms_of_Tumor_Osteolysis_.13.aspx. [Accessed: 23-Nov-2014]. [4]C. Shute, â€Å"The Challenges of Cancer Pain Assessment and Management,† Ulster Med. J., vol. 82, no. 1, pp. 40–42, Jan. 2013. [5]A. Watanabe and M. Yamakage, â€Å"Intrathecal neurolytic block in a patient with refractory cancer pain,† J. Anesth., vol. 25, no. 4, pp. 603–605, Aug. 2011. [6]Cancer Pain Management. The British Pain Society 2010

The Canadian Governing System is not Fair or Democratic Essay -- essay

There are Canadian citizens who thought that the Canadian government we have is perfect, citizens who believed that every aspect of the government was truly democratic, and citizens who believe that government could do no wrong. Truly this group of believers has been living a lie. In our Canadian system of government, large aspects within are far from democratic and need to be changed. Liberal-minded people will cry out for a change in order for government to serve the people better, and on the other hand the more conservative thinkers will argue that no change is needed because our government is efficient and considerate. However, our voting system, our Senate, and the power vested to the Prime Minister are far from democratic, do not meet the actual needs of the people and definitely need to be addressed. Canada itself claims to be democratic, yet the Canadian Senate is appointed to office by the current Prime Minister rather than elected by the citizens. The original purpose of the Senate was to give fair representation between provinces and to the citizens. Having failed its purpose, clearly there are issues within the Senate that need to be addressed. Because of the Prime Minister appointing the Senators, they will now serve the Prime Ministers needs rather than the people who they should have been listening to. As if this were not enough of a show of power for the Prime Minister, the Senators cannot be lawfully kicked out of office until the age of seventy-five. An example of Senate idiosyncrasy in Canadian government is Ross Fitzpatrick, who was appointed to office by former Prime Minister Jean Chretien of the Liberals in June 1990. His official opponent, Preston Manning, rightfully questioned the circumstances regardin... ...e a lot of parties are going to be running for office. However, for the fringe parties this creates a major advantage for them. With the load of political parties in the House of Commons, there would be a wider range of interests for people but there would be a lot of indecision and coalitions. It is cold hard fact that Canadian government is not entirely democratic. The question remains of how to deal with this. Canadian government, as effective as it currently is, has major factors in their system that have a negative effect on Canadians. Our current voting system favors the higher-populated provinces and creates a tyranny of the majority. Our Senate is distinctly undemocratic as it is an assigned position. Our head of State, the Prime Minister, holds too much power. Unless we resolve these issues, our government will remain far from a perfect governing system.

Balancing Penn Foster Studies Essay

Balancing Penn foster studies with work and family Being a full time working father of one, I have the responsibility of taking caring of my mother, wife and son. However this doesn’t hinder me to continue my studies, though it has some difficulties on adjusting the life in between my studies and family life. The hardest part for me in balancing my studies, work and family demands is just how to set up the time so everything is balanced out. I guess that we all must have to make personal sacrifices in order to be successful and have a fulfilling life. With proper planning however the balance between work, family, and collage studies is possible to obtain. Everyday I must make choices on how I will manage my time so I can keep the balance of my studies, work, and family demands. Maintaining the balance between everything is an everyday process. This is where the real task of balance takes place. While attending the Penn foster online courses and sitting time back for my studies, I also have a family to take care of, which requires most of my time. I also have    a full time job that requires me to work on the grave yard shift. Despite the fact that each of the responsibilities need more time on their own I have to set specific times up in a daily planner and discuss these set of specific times with my family and friends so that they can help me keep the balance between work, family demands, and my collage studies. I know that people struggle everyday to balance their studies, work, and family demands. However, I also believe that each person must come up with their own way of balancing things out in their life, so they are happy and successful. Keeping the balance between work, family demands, and college can be a very difficult process to do, but with the support from family and friends it can be done. Generally speaking, nothing is in possible in this world. Many people think that once they have their own family they ignore their studies and focus on their work. This is all because they think they will not get enough time to concentrate on their studies while looking after their work and family. I was also of such kind of people for long time until I got the advice from friends and families and got the courage to continue my studies. The difficulties of adjusting time cannot be denied however, managing ones time will solve all the difficulties. The idea of online studies has also contributed a lot in encouraging many working people who have family as well to continue their studies at their convenience time and place. Besides, going through the difficulties of attending your studies while taking care of your family and work is also worth as it will lead you to a better and successful life in the future.

Every Day Use essays

Every Day Use essays In Alice Walkers story Everyday Use the two sisters, Maggie and Dee are foils or opposites. They have nothing in common except that they have the same mother. They have many opposite characteristics through out the story and one major opposing viewpoint that contributes to the meaning of this story and its theme. The central theme of the story concerns the way in which an individual understands his present life in relation to the traditions of his people and culture. Dee tells her mother and Maggie that they do not understand their "heritage," because they plan to put "priceless" heirloom quilts to "everyday use." The story makes clear that Dee is equally confused about the nature of her inheritance both from her immediate family and from the larger black tradition. The two opposite beliefs of the sisters teach a valuable lesson about family and heritage and how it should be considered. There are many factors leading to Maggie and Dee being foils. One way they are opposite is that Maggie is younger than Dee and is shy and timid whereas Dee can look anyone in the eye and talk to them, meaning she is very outgoing and not quiet. For example, when Dee arrives at the house, Maggie tries to hide behind her mother and does not speak because she is scared of even her own sister. It also says that Maggie is not very articulate, whereas Dee is very bright. In the story where Mrs. Johnson says She used to read to us without pity; forcing words, lies, other folks habits, whole lives upon us two sitting trapped and ignorant underneath her voice (1556). Also, Maggie only has a high school education compared to Dees college education. When Mrs. Johnson says, Maggie sometimes reads to me. She stumbles along good-naturedly but cant see well. She knows she is not bright. Like good looks and money, quickness passed her by (1557). She knows that Maggie and Dee are nothing alike, but tends to love th...

Founder of the Black Panther Party Huey P Newton A Forgotten Legacy essays

Founder of the Black Panther Party Huey P Newton A Forgotten Legacy essays In the late 1960's and early '70's posters of the Black Panther Party's co-founder, Huey P. Newton were plastered on walls of college dorm rooms across the country. Wearing a black beret and a leather jacket, sitting on a wicker chair, a spear in one hand and a rifle in the other, the poster depicted Huey Newton as a symbol of his generation's anger and courage in the face of racism and classism. He is the man whose intellectual capacity and community leadership abilities helped to found the Black Panther Party (BPP). Newton played an instrumental role in refocusing civil rights activists to the problems of urban Black communities. He also tapped the rage and frustration of urban Blacks in order to address social injustice. However, the FBI's significant fear of the Party's aggressive actions would not only drive the party apart but also perpetuated false information regarding the Panther's programs and accomplishments. In recent years, historians have devoted much attention of the e arly 1960's, to Malcolm X and Martin Luther King and have ignored the Black Panthers. The Panthers and Huey P. Newton's leadership of the Party are as significant to the Black freedom struggle as more widely known leaders of the Civil Rights Movement. A typical American history high school textbook not only neglects to mention Huey Newton but also disregards the existence of the Black Panthers altogether . Therefore, we must open this new chapter in American history and discover the legacy and story of Huey P. Newton's Black Panthers, which has been hidden for far too long. Huey's experiences growing up were central in his conception of the Black Panthers. Unlike King and many other civil rights leaders who were religious Southerners, from middle class and well-educated families, Huey P. Newton was a working class man from a poor urban black neighborhood. Born February 17, 1942, in Oak Grove Louisiana, Huey moved to Oakland, California shortly after his ...

Ethics In The Workplace Essay Example | Topics and Well Written Essays - 500 words

Ethics In The Workplace - Essay Example The worst thing about Bob’s act in cheating the old man is lowering the belief in the basic nature of a fellow human being. Part C: Yes, it is very important to keep a word of promise, irrespective of whether the promisee is known or not or whether we see that person again or not. Failure to keep a promise is an act of cheating that is violating the other person’s right not to be abused. For the person indulging in cheating, it also involves living with that guilt feeling forever and consequently suffering a loss of self-esteem. While deciding on the policy with its ethical implications, I would be guided by not sentimental or political considerations but by the consequential results of my action. The larger question would then be: Will doing business in China, albeit with censored version of services, lead to opening a window of opportunity, however small an opening it may be, for the people of China? Most certainly it does. According to Google’s policy, politically unacceptable information would be blocked out and the viewer informed of the same. This act by itself and the frequency with which such blockades take place are most likely to be a source of embarrassment to the authorities who can be expected to slacken the controls – in other words, open the window a little more. Thus, Google’s policy, while being Utilitarian morally, also has the desirable objective of contributing to the common good of the customers in the longer run. iii). ‘Ends do not always justify means’ is my new perception, after the lessons. In personal life or professional life, even when difficult decisions are to be taken, I would act in as transparent a manner as possible to make my objective clear and ethically

Ethics and the college Student Essay Example | Topics and Well Written Essays - 750 words

Ethics and the college Student - Essay Example These resources are used to enhance and promote conversations and curricula on issues relating to ethics designed for college students, staff, and even the administration. Among the code of ethics include integrity which is to be present in any manner of relationship. Moreover, must treat others in respect, fairness and honesty. Competence is paramount any college for it to realize its educational objectives. Students in any college are to ensure equality and acceptance so as to prevent harassment, discrimination, and intimidation. Finally, it is honor and trust in all academic assignments thus avoiding plagiarism in any given assignment. Discussion A code of ethics must be there in colleges so as to curb cheating and related vices. Cheating is an epidemic in most of the colleges as it affects almost fifty percent of the total student population. The code of ethics is affected by the social characteristics and demographics of students like sex, age, levels of test anxiety, academic s tanding, and internal social control. Thee factors have been found to contribute to cheating in colleges which is unethical (Loveland & Rayna, 2000). This is because many students have rationalized their behavior in cheating and they do so without having to challenge the norm of honesty that is required. Most of the commonly cited technique they use is the denial of responsibility. In addition they use the neutralization technique of appealing to the higher loyalties. Here, they have been arguing that it is more vital to aide a friend than to avoid cheating which quite unethical. By the students recognizing and accepting cheating as a very undesirable behavior but nonetheless they see it as an excuse under certain circumstances thus the presence of situational ethics. To some students cheating is planned, expected and their opinion it is rewarded by good grades. This leaves the ethics and internalized control of the student as a barrier to cheating (Corll, 2007). However, the neutra lizing attitude gives the students the green light to side step issues of guilt and ethics and going ahead to place the blame for their behavior on another front. This concept of neutralization in relation to the ethics of college students permits them to state that cheating is wrong but to some extent in special circumstances it is acceptable, and even necessary. David Matza and Gresham Sykes (1957) are the first who developed the concept of neutralization so as to explain the concept of delinquent behavior. They explained the expression of delinquent behavior through the process of situationally defining deviant behavior in this case the college students through naturalization justify the violation of accepted behavior (Labeff et al, 2010). Plagiarism is considered as an act of dishonesty in academic spheres whereby a person takes the work of others and presents them as his or her own without proper attribution. Plagiarism can have numerous effects on both the student and the educ ational sector as a whole. Plagiarism leads to the student failing to develop sharp critical thinking skills which are paramount in any learning process. Also, it damages the relationship between the students and teachers by eroding their mutual trust and the students who legitimately earn their grades. Plagiarism can lead to loss of a degree or a job. This includes the college students, the college faculty members who may plagiarize the work of other scholars, and finally professors who face

An individual research based report on the rold of business and Essay

An individual research based report on the rold of business and conceptual modelling within the context of information systems d - Essay Example The framework of conceptual model develops the information systems as abstract models around which an organization environment is created (Davies et al, 2006). The conceptual model emphasizes the applications of the system rather than its functioning and implementation. Conceptual model is broadly termed as abstract model of the information systems. It finds widespread uses in modeling of electronic systems which are modeled in the form of circuits and systems. Circuit analysis techniques aid in representation of the systems in the form of conceptual models. These models then aid in solving various complex problems in industries like huge power plants and circuit boards designing. Purposes of Conceptual Modeling The purposes of the conceptual modeling are described below. Helping analysts in terms of perceiving the domain of enterprise Aiding communication between users and developers of the system Providing valuable input for the process of design and development Recording the origi nal requirements for referencing them in the future Importance of Conceptual Modeling The electronic systems have been part of many large industries and business environments. In past, the analysts employed vague methods for analyzing systems and always came up with wrong results and hence errors were found in implementations. They must analyze the users’ requirements in electronic systems with some formal approach that perceives the system in abstract manner. However, the analysts could understand the issue with the discovery of such method which could bring satisfactory results. They couldn’t manage to waste too much time in finding novel methods. The idea of conceptual models was developed that aids in timely detection of errors in analysis of systems and proceeds for correct implementation (Wand & Weber, 2002). Process of Conceptual Modeling The importance of conceptual models can be easily comprehended from its role in treating systems’ development. This pr ocess consists of analysis, design and implementation. Analysis section transforms the real world information system into the framework of conceptual model of the system. The design is related to conversion of conceptual model of the subject into information system. Implementation step is related to conversion of the information system into an implemented information system. Conceptual Modeling Language Conceptual modeling language (CML) is involved that defines various rules and regulations for representing components of the developed model. The components used in conceptual modeling of the system contain activities, relationships, entities, processes and objects. The CML shouldn’t be too restrictive to diminish the aspects found for the relevant systems. The modeling should take into consideration all the properties and dimensions of the system. It shouldn’t be too complex either making the situation rather complex (Lindsay et al, 2003). Conceptual Modeling Sources T he conceptual modeling can be drawn from the models of wisdom and general knowledge. Three sources are normally mentioned for making conceptual models

Conflicts Are Important Worksheet Essay Example for Free

Conflicts Are Important Worksheet Essay 1. Pseudo conflicts: A pseudo conflict is where two people are arguing on the same thing only because of their own misunderstandings and misperceptions of what the other person is saying they are arguing on the same side without realizing. In truth they are arguing for the same side they just cant realize it because of their own misconceptions. A pseudo conflict can be easily resolved by people just understanding one another better. 2. Fact conflicts: Fact conflicts are caused by being misinformed, not having enough information to make good decisions and determining what data is relevant. Conflict can also arise when there is disagreement on information collection and communication. 3. Ego conflicts: An ego conflict is where one person goes around picking on and teasing everyone else. They think that they are better than them in every way shape or form, these conflicts can easily be avoided by not thinking your better than everyone else. Everyone is equal whether they like it or not. No one is better than anyone else. It just happens that some people think they are better than other people and so ego conflicts arise. 4. Value conflicts: Value conflicts arise from two different people or groups with different views on something, Such as world views. Or a common one is two groups with different views on good and bad. One group may be stricter than the other on whats good and whats bad, it will then clash with the other group who is less strict. 5. Need conflicts: A need conflict arises when someone starts acting so that they can get one need and it is contradictory to how they need to act to get another need and it presents a major conflict. This conflict can be resolved by getting both needs one at a time but humans by nature want all needs at once and this makes a conflict. Part 2: The Five Conflict Management Styles Describe each of the five conflict management styles and explain the strengths and weaknesses of each. Use paragraph form. 1. Avoiders: The avoider style of managing is not actually thought as a management style at all by many but it reality it is. It arises when someone runs from a conflict or ignores it. Someone may use the avoider style out of outright fear or sometimes many other concerns that can come from an unresolved conflict. With the avoider style it doesnt solve anything and very often makes things worse the people do not understand why the avoider refuses to face the conflict at hand and the avoider cannot understand the problem or the other side’s views. 2. Accommodators: The Accommodator is much the same as the avoiders only slightly different in the way that he just agrees to everything, avoids solving the actual problem to placate the other side. If forced to face the problem an accommodator will back off and just follow in the footsteps dictated by the other side, they will be in total denial of any personal needs in favor of meeting the other sides personal desires. The unfortunate downfall of this solution is that problems continue or grow worse or new problems may arise from it. Imagine a mother who gives her daughter whatever she wants whenever she wants simply to keep conflicts from arising. Yes it stops her daughter from whining and complaining. 3. Forcers: The very opposite of an accommodator would be a forcers also known as the competitor. With the forcer they drive to win the argument/battle at all costs even if it means ending a relationship. The competition style can be healthy when it is focused solely on the issue at hand and not on the people around the issue. Such as when someone starts in on each other it can be friendly banter until someones mother is brought into it. Fights between two people often happen during the forcers style but never is it healthy. 4. Compromisers: With the compromiser style it is used to try and meet some of the demands of both sides. Unfortunately with this style everyone wins a little but also they lose a little. Like with two teenagers fighting over the remote to a TV the mother comes in and takes away the remote all together. It resolves the situation but no one is happy with it. It leaves the solution gone but no one happy. People who use compromise are actually making a lazy halfhearted attempt at collaboration. 5. Collaborators: With the collaborating style it gets all parties in the conflict together to come up with a peaceful solution that leaves each party happy. In this type everyone is heard, everyone is happy, and above all relationships are preserved, whether they are relationships between a man and a woman or a relationship between friends or business people. The collaborative style takes a while to plan and execute. While the problem may become worse as time goes on it always leaves everyone happy. Part 3: Collaborative Communication List two methods of collaborative communication and describe how using them can help you avoid conflicts. Two methods of collaboration communication are Boards and Huddles. With Boards its good to have something for the all to see besides hand outs when you have the group all together. That is where white boards or chalk boards come in major handy. That way you can right now main ideas and topics for all to see. This will help stop conflicts because everyone is seeing the same thing so they cant say that their not or say that some are getting more details then they are. The second method is called huddles. Huddles means when you get your group together to brainstorm or think about something make it small little focused groups. Having it in small focused groups will cut down on misunderstandings and confusion which will then help you prosper and fewer arguments may break out.

Richard Wrights - Black Boy :: essays research papers fc

Richard Wright's - Black Boy A Teacher's Guide for Secondary and Post Secondary Educators Introduction Richard Wright: An Overview Questions and Activities Before Viewing Questions and Activities After Viewing History: Questions and Activities Education: Questions and Activities Literature: Questions and Activities Psychology: Questions and Activities Sociology Political Science/Cultural Studies: Questions and Activities Bibliographies INTRODUCTION Although RICHARD WRIGHT: BLACK BOY focuses mainly on the life and history of an internationally acclaimed American author, the visual and audio components of the documentary richly contextualize the literature that Wright produced. In that sense, the documentary synthesizes a great amount of historical, social and cultural information about the twentieth century. It can be used to prompt extensive discussions, to stimulate students to undertake special research projects, to write papers or combine the arts and/or cultural knowledge into a learning experience. Since the documentary is ninety minutes in length, planning and scheduling viewing time for students is essential so that the documentary can be viewed in either one or two class periods. Teachers are encouraged to view and discuss the documentary together and decide whether it is more efficient to use it in teaching one discipline or if students might profit more from discussions that are not discipline bound. The Teacher's Guide is designed for those teachers who want to use RICHARD WRIGHT: BLACK BOY to enhance the experiences of their students as they explore many and various school subjects. The guide is not designed to be exhaustive. It provides ideas for student activities and assignments, bibliographies of Wright's work, and a selected listing of background sources. Some older materials are included to suggest the state of scholarship and thinking about issues within Wright's lifetime or as reminders of what works might have influenced his thinking. In making assignments, it is suggested that the teacher add current articles and books that are deemed appropriate. The pre-viewing questions and activities are designed to help students gain background knowledge. The post-viewing student assignments focus on ways Wright's works mentioned in the documentary can be used to promote broader inquiries among the disciplines. Because the documentary contains scenes that portray Negro lynchings and an African woman's bare breasts, it is recommended that teachers and administrators below the college level review the program before showing it to students. Questions and activities are provided in the following disciplines: History, Education, Psychology, Literature, Sociology, and Political Science/Cultural Studies. The bibliography completes the guide.