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