Position Essay Example | Topics and Well Written Essays - 500 words

Position - Essay Example Cellopharone is an organic substance, polysaccharide in nature (Carlisle 338). Being a constituent of plant cell walls, it is the commonly recognized organic substance. It is appropriate for foodstuff packing due to its limited permeability on various aspects. Cellophane is processed from extremely purified cellulose obtained from bleached sulphide pulp (Carlisle 338). In addition, cellophane is biodegradable, and thus ecologically friendly. However, its processing causes air pollution. It is produced by employing carbon disulfide, found freely in the air. Carbon disulfide, under elevated concentrations, responds when exposed to other unstable chemicals thus forming smog in the atmosphere (Carlisle 338). It also injures ones sight and cause pain in several human systems. Cellophane product and use should be minimized because when produced in large quantity, they lead to environmental pollution and other health complications. Inorganic foods are foods, which are raised by the use of inorganic methods. This is through the use of chemical compounds such as pesticides, synthetic fertilizers, antibiotics and hormones (Carlisle 338). Foods raised in this way contain remnants of these chemicals which are dangerous to health. Inorganic foods are harmful to human consumption as herbicides and pesticides used to raise these crops are very toxic. When these chemicals build up in human bodies, they lead to diseases and other health complications. A good example is a herbicide called glyphosate commonly used for crop production (Carlisle 338). A laboratory study done by scientists in France in the year 2005 proved that glyphosate destroyed completely human placental cells and abnormal embryonic cells. These chemicals lead to birth defects and cancers, in addition to crop and animal losses (Lawson). Inorganic chemicals lead to the gastrointestinal tract erosion, dysphagia, cardiovascular, kidney damage,

Portfolio Annotated Bibliography Example | Topics and Well Written Essays - 2250 words

Portfolio - Annotated Bibliography Example This article is about a study where women are offered a variety of birth control methods. The results from the study stipulate that most women who chose long acting techniques such as implants which lower the chances of acquiring pregnancy other than birth control pills do not worry about unplanned pregnancies. Notably, it shows that birth control reduced rates of abortion in United States from 19.6 abortions per 1000 women to approximately 4.4 abortions per 1000 women. In addition, the article notes that the introduction of birth control measures reduced rates of birth among teenage girls from 34.3 per 1000 girls to 6.3 per 1000 girls. This article exposes an individual to the effects of birth control on abortion rates. National Public Radio (2012, October 8). Cloud Computing Saves Health Care Industry Time And Money: All Tech Considered: NPR. Retrieved  October  8, 2012, from http://www.npr.org/blogs/alltechconsidered/2012/10/01/162080613/cloud-computing-saves-health-care-industry-time-and-money This article explains how cloud computing power makes it less expensive and easier for clinicians and firms to find out newfangled cures and medicinal drugs. Notably, the article portrays that analysis of data that used to take a long time and was expensive can now be done for lesser time and at a lesser cost. In essence, health care organizations can lease gigantic workstation resources per hour at relatively cheap charges. The aptitude to examine and evaluate colossal information in this manner has changed a lot of industries including health care. Needless to say, the article notes that cloud computing has aided medical research where a doctor or any other health care practitioner can use the internet to search for other cases of a disease or a disorder. Cloud computing has aided researchers to evaluate and sequence large amounts of data which is not possible for a person to do on his or her own. Amazon is an excellent

Cause and Consequences of the Great Recession

Cause and Consequences of the Great Recession 1.0 Introduction There was a recession in the United States (US) at the end of 2007 (Verick and Islam 2010). McKean (2010) noted that a healthy economy will proceed into a period of high growth, slow growth or no growth. Power (1996) commented that the economy is needed to be contracting and expanding in order for the economy to be healthy. When the contracting period has last for a long period of time (such as at least two consecutive quarters of a year or 6 months in a row), the economy is considered as a recession (Arnold 2008; Brainard and Perry 2001). According to National Bureau of Economic Research (NBER) (2010), recession was defined as a significant decline in economic activity spread across the economy, lasting more than a few months, normally visible in real gross domestic product (GDP), real income, employment, industrial production and wholesale-retail sales. According to Wang (2009), the US recession has leaded to a global financial crisis shattering businesses and consumers confidence in many countries such as in European Union, China, Japan and Asia countries. As a result, it has been named as the Great Recession which has caused financial meltdown in the US and was spread out quickly affecting almost every corner of the world (Kurki et al 2009). The great recession was seen as the worst economic downturn since the great depression that the world was in recession after World War II (Wang 2009; Verick and Islam 2010). According to economists, this episode of great recession was resulted from a sudden busting of house bubble in US, where the house bubble was caused by rapid growth of improper regulation on sub-prime mortgages (Merriam 2009; Wang 2009; Whitney 2007). This episode of great recession have proven and shown the accuracy of Greenspan prediction who was the former Federal Reserve Chairman predicting that US has one-third probability getting into recession at the end of 2007 (Torres 2007). In order to have a better understanding on the great recession, causes and consequences of this recession will be analysed at the following chapters. 2.0 Causes of the Great Recession Apparently, US was faced many severe problems including banks on the verge of bankruptcy, high record levels of public debt, a falling stock market, a plummeting dollar, frozen money markets and imminent threat of a recession (Lyons 2009; Stiglitz 2010; Taylor 2009). According to Verick and Islam (2010), the global financial crisis was greatly affected by global imbalances, perceptions of risks, interest rates, and regulation of the financial system (Figure 1). With references to the Figure 1, causes of the great recession was summarised as below: 2.1 Housing Crash US housing market are a major determinant of consumers spending and rate of economic growth (Congressional Budget Office 2007). There are various factors affecting house price to rise much faster than consumer incomes, and thus it was created overvalued assets (Eklavya 2008). Taylor (2008) noted that US house prices were raised rapidly until 2006 and experienced a fall of house prices after the boom. Figure 2 shows the trend for house price for 1991 to 2007. When house prices fall to correct the imbalance, it had a significant impact on consumers spending where people cannot remortgage to obtain extra capital for spending (Taylor 2008). 2.1.1 Subprime Mortgages Burst According to Eklavya (2008), there was no regulation of subprime mortgages where the mortgage industry was able to sell mortgages without considering whether the buyers could pay back. Global research (2009) was estimated the value of US subprime mortgages at $1.3 trillion on March 2007, but there was over 7.5 million first-lien subprime mortgages outstanding. It was because the subprime mortgage was spiked to nearly 20% of all mortgage originations during the peak of US housing bubble (Smith 2007). In figure 3, it shows that subprime mortgage was expanded significantly during the period of 2004 to 2006. The huge majority of the subprime mortgages were caused massive foreclosures, and thus it was greatly affected the institutions and independent mortgage brokers which were not covered by the Community Reinvestment Act (Pressman 2008). Thus, it was indirectly affected a slow growth or even started to fall on consumer spending and investment (Taylor 2009). 2.1.2 Low Interest Rate Economists commented that US monetary authorities had adjusted the interest rates at unprecedented levels which created a debt-finance consumption boom leading the way in boosting housing bubble (Taylor 2009; Eklavya 2008; Kurki et al 2009). Similarly, some economists argued that interest rates in the US were stayed too low for too long and even stood at just 1 per cent in 2003 and 2004 which activated the great recession (Figure 4) (Elmendorf 2007; Taylor 2009; Verick and Islam 2010). Verick and Islam (2010) criticized that the monetary policy in US was failed to tackle the overvalued asset bubble, and at the same time contributed to the rapid growth in subprime mortgages. 2.2 Credit Crunch McHugh (2007) commented that high subprime mortgage defaults in US had caused credit crunch which referred to a sudden shortage of funds resulting a decline in loans available. According to Bloom (2008), many investment banks and commercial banks were faced huge losses due to the risky mortgage loans. Therefore, banks were reluctant to lend money to anyone and even to other banks leading a shortage of funds in the money markets (Smith 2007; Verick and Islam 2010). Whalen (2007) commented that the shortage of liquidity in the finance sector had caused borrowing to be more difficult and more expensive which had leaded to a lower consumer spending and investment. 2.3 Budget Deficit and National Debt According to GAO (2009), the US national debt was stood at 65% of GDP for 2007 and it was even worst when pension liabilities were included. With such a large deficit, US government had less room for expansionary fiscal policy because demographics worked against fiscal stability and the stage of economic cycle worsened the deficit (Auerbach 2009). Kurki et al (2009) noted that the deficit has caused difficulties in attracting capital flow because Asian investors who were aware of the US deficit had slowed down the capital flow to US and contributed to devaluing dollar. Thus, it indicated that there is a fundamental imbalance between domestic production and consumption which had become a constraint for future economic growth (Auerbach 2009). 2.4 Devaluation of Dollar According to basic economic theory, a decrease in exchange rates will eventually help to increase exports and stimulate growth in the export sector (Grant and Vidler 2003). However, the depreciating dollar had contributed to cost-push inflation and declining in living standards where consumer goods were more expensive leading to lower spending power of individuals (Bloomberg 2010). Bloomberg (2010) argued that decline in dollar was resulted US to become less competitive compared to its trading partners. 3.0 Consequences of Great Recession Since US went into recession at the end of 2007, it had caused a crisis on economies across the world (Verick and Islam 2010). According to Taylor (2008), middle-incomes countries (especially in Central and Eastern Europe, and the Commomwealth of Independent States) were severely affected (Figure 5), where as low-income countries such as Uganda and Ethiopia were able to grow strongly despite the downturn (Figure 6). Verick and Islam (2010) noted that although most low-income countries have evaded from recession, these countries had experienced a slow growth in economy due to the negative implications for poverty. Lockstein (2010) argued that, in overall, the smaller and more open economies countries had been hit stronger, whereas the larger emerging economies countries could be survived by the supporting from domestic demand and government spending. It had been noted that China and India were able to recover faster from the great recession (Taylor 2009; Verick and Islam 2010). Llaudes, Salman and Chivakul (2010) commented that the great recession had caused various impacts to different countries. Thus, an analytical study on the consequences of great recession towards US and India have stated as below: 3.1 The United States According to Gulzar (2010), the great recession had caused a great impact on US labour market. Laibson (2010) noted that although government had adjusted the inflation rate causing the economy grew 2.2% in 2009 Q3, 5.6% in 2009 Q4, and 2.7% in 2010 Q1, the unemployment rate had stubbornly remained high. The unemployment rate had risen from 9.5% in June 2009 to 10.1% in October 2009, before it felt back to 9.5% in June 2010 (Laibson 2010). Altig (2010) commented that the disconnection between the demand and supply of workers which was reflected in statistics such as the hiring rate, the layoff rate, and the unemployment rate can be expressed by the Beveridge curve (Figure 7). Altig (2010) argued that, with the given average number of job opening in April and May, the unemployed were expected about 10.4 million instead of 15 million as stated in Figure 7. Some analysts have commented that the unemployment benefits policies should responsible for abnormally high unemployment rates (Altig 2010; Gulzar 2010; Verick and Islam 2010). Valletta and Kuang (2010) estimated that extended unemployment benefits may have increased between 0.4% and 1.7% of unemployment rate. Krugman (2010) argued that there is a strong tendency of high unemployment to become permanent because those who have out of work for a long enough periods have become less productive and less competitive in the job market. Ball (cited in Krugman 2010) prompted a problem that high unemployment tend to increase the level of structural unemployment, if there is a weak policy, thus inflation will increase much higher unemployment rates than before. 3.2 India During great recession, India economy was turning down because of Indian companies with big tickets dealing in the US were seeing their profits margin shrinking, and majority of Indian companies have major outsourcing deals with US (Malik and Pandit 2010). According to Alex and Kumar (2009), Indias merchandise has been exported to ASEAN (52%), followed by the EU27 (21%), and the US (13%). However, Malik and Pandit (2010) noted that the global crisis has caused the USs share felt to 11% (March 2009), which was even lower than the United Arab Emirates (13%) (Figure 8). Figure 9 shows that all of the products (except gems and jewellery) were experienced a major contraction during the great recession: petroleum and crude products have the largest contraction (about 45%), whereas agriculture and allied products contracted by 28%, engineering goods exports by 22%, chemical and related products by 9%, and textiles by only 2% (Alex and Kumar 2009). Besides, Indias financial market was hit badly from the great recession where share market was fall, rupee was weakening again dollars, and banks were faced severe cash crunch resulting in shortage of liquidity in the market (Eklavya 2008). Due to Foreign Institutional Investors (FIIs) were the main investors for India, the investors (majority based in US and Europe) had withdrawal their money from Indian Stock Markets to meet their liabilities at their home countries (Mohanty 2009). Alex and Kumar (2009) commented that rupee was lost its strength against dollar when FIIs converted their invested money into dollars. However, India was able to recover faster from the great recession due to Indian Banks were escaped from the ill-effects of subprime mortgage crisis where major Public Sector Banks exercising extremely caution in giving loans to needy people or companies (Eklavya 2008). 4.0 Conclusion In the age of globalisation, every country is affected by the fluctuations of world economy where no country can remains isolated (Eklavya 2008). Thus, great recession has caused a vast impact to the world such as fall in demands, shortage of cash, decreasing growth rate, and high unemployment rate (Taylor 2008; Verick and Islam 2010). On the other hand, recession can help to transform country or businesss outlook for the future (Kurki et al 2009). Although the recession has turned down the growth process, it helps to generate ideas and strategies stimulating the economic growth and maintaining stability of the market in order to become more competitive in the world.

Use of Allegory and Symbols in William Goldgings Lord of the Flies Es

Use of Allegory and Symbols in William Goldging's Lord of the Flies   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   William Golding's Lord of the Flies allegorically shows the good and evil that co-exists in every human being.   Each character and symbol renders this possible by what it represents.   Ralph and Jack allegorically represent opposing political forces: Jack as the dictator or fascist and Ralph as the prototype of a democratic leader.   The island represents the archetypal garden and the conch shell represents power.   Golding uses British schoolboys to show progressive degeneration and to prove that a little bit of evil exists in all of us.   Each of these symbols aid in proving that we all have some evil in our hearts.   Ã‚  Ã‚   Ralph begins the story as a carefree boy who does not understand the tragedy befallen upon the boys.   Ralph soon realizes a need for authority and becomes the true leader of the boys.   He represents a democratic leader and a traditional form of government.   To enforce a parliamentary procedure, he uses to conch shell.   It symbolizes power and authority.   No boys are aloud to speak at a meeting without holding the conch.   He symbolizes the exact opposite of Jack; his evil and rage remain well hidden which aides in keeping peace on the island for most of the time.   In one scene, when Jack and Ralph are brought together physically after Jack refuses to help build the huts, Golding seems to prepare the way for a larger contrast of two life-views as he opposes Jack-the-hunter to Ralph-the-builder.   Ralph also helps to bridge the world of his common sense and Piggy's intelligence.   Golding's comparisons are reminiscent of moral allegories.   Ralph could not defend civilized ideals without his sidekick Piggy's insightful ideas.   Ã‚  Ã‚   Pig... ... parachutist symbolizes as the past, the legacy taught by history, which the older generation always expects the younger generation to accept and follow.   It could also represent the wellspring of evil, which becomes manifest most obviously in the act of one man killing another.   Perhaps it represents fallen man, whom Simon later redeems or sets free.     Ã‚  Ã‚   Lord of the Flies teaches many valuable lessons about evil and its impact on human behavior.   Golding uses allegory effectively to remind us of this potential hazard. Recent events in Afghanistan and New York City painfully remind us of this flaw in human nature.   Hopefully, this powerful novel will open people's eyes to the evil inside of them so they will not make the mistakes made by the characters in this book. Works Cited: Golding, William. Lord of the Flies. New York: Putnam Publishing, 1954.

Congestive Heart Failure Health And Social Care Essay

Approximately five million Americans are populating with Congestive Heart Failure ( CHF ) and each twelvemonth about 550,000 new instances are diagnosed. CHF is a status where damage occurred to the bosom, ensuing in the bosom is incapable to present sufficient oxygenated blood to the variety meats in order to back up the organic structure ‘s demands. There are many causes that lead to CHF, for illustration bosom onslaughts, infection, high blood pressure, valvular diseases and intoxicant. [ 1 ] C: UsersosmDesktoposmdocumentsBio Report about CHFsymptoms of CHF.bmp CHF patients would chiefly endure from fatigue, shortness of breath and swelling in mortise joints, legs and venters. Along with the promotions in engineering, there are interventions to assist CHF patients. So, what are the possible interventions available to command and alleviate the symptoms? Symptoms of Congestive Heart Failure hypertext transfer protocol: //www.clivir.com/lessons/show/symptoms-congestive-heart-failure-is-worsening.html ( 125 words )Solution for Congestive Heart Failure ( CHF )Drugs TherapyThere are two rules in the intervention of CHF. First, take or command the underlying cause such as high blood pressure, valvular disease and thyrotoxicosis. In some instances, the jobs of CHF could be removed if the cause were treated early plenty. Second, command the marks and symptoms. These are done by utilizing three types of drugs: water pills, vasodilatives and positive inotropic drugs.Diuretic drugsFor CHF patients, the important symptoms would be the puffiness of venters, legs and mortise joints. Excess fluid would besides show in or around the lungs, taking to shortness of breath. The cause to these symptoms is sodium and H2O keeping. Therefore, water pills which act to cut down Na and H2O keeping by advancing the flow of fluid through kidneys are normally prescribed. The illustrations of Diuretic drugs are Thiazide water pills ( bendrofluazide ) , loop water pills ( Lasix and bumetanide ) and K sparing water pills ( Aldactone ) . [ 2, 5, 6 ] The pick and the dose of water pills depend on the badness of CHF and age. In mild CHF, thiazide water pills would be sufficient whereas in terrible CHF, cringle water pills or combination of thiazide and cringle water pills are recommended. [ 29 ] Normally, patients are asked to keep a low Na diet as good. In add-on, it is normal for patients taking water pills to see frequent micturition. When there is no extra fluid, the symptoms could be relieved and the external respiration would be easier. Besides frequent micturition, water pills besides cause the organic structure to lose K and Mg. Hence, it is critical for physicians to order K and Mg addendum to patients to guarantee that they do non endure from malnutrition. Other side effects of taking water pills include desiccation, hypokalemia, hearing perturbations, and low blood force per unit area. [ 2, 27 ] ( 408 words )VasodilatorsVasodilators dilate either arteriolas, or venulas, or both to cut down the work burden of the bosom so that bosom could pump with higher efficiency to transport oxygenated blood. ACE inhibitor is one of the vasodilatives. It serves to suppress the action of Angiotensin Converting Enzyme ( ACE ) from change overing Angiotensin I to Angiotensin II. Angiotensin II is a neurohormone which causes vasoconstriction of the bosom vass, taking to high blood pressure. Besides, Angiotensin II besides causes the organic structure to let go of aldosterone – a substance that causes our kidneys to retain Na and fluid, doing hydrops. [ 3, 29 ] So, bEnce, Hdy forestalling the formation of Angiotensin II, both high blood pressure and hydrops could be controlled. Therefore, among vasodilatives, ACE inhibitors are ever the first pick as they have extra action besides vasodilatation. They are besides proven to protract the lives of CHF patients by decelerating down the procedure of bosom harm. [ 25 ] Other illustrations of vasodilatives are hydralazine, prozosin and the illustrations of ACE Inhibitors are captopril, enalapril and lisinopril. [ 4, 5, 29 ] Different vasodilatives have different consequence on arteriolas and venulas. Drug Arterial distension Venous distension Hydralazine++–Calcium adversaries+++ACE inhibitors++++Prazosin++++Salbutamol++++Nitroprusside++++Nitrates+++Opiates+++Consequence of different vasodilatives on arteriolas and venulas Retrieved from â€Å" The Drug Therapy of Cardiovascular Disorders † ( 613 words ) Although ACE inhibitors have been the most normally used drugs for CHF patients, there are side effects. The possible side effects are pecking, dry cough, low blood force per unit area, declining kidney map and electrolyte instabilities, and seldom, true allergic reactions. [ 2 ]Positive Inotropic DrugsPositive Inotropic Drugs serve to increase the cardiac end product by increasing the force of cardiac contraction. Cardiac glycosides are the most normally prescribed positive inotropic drugs. Cardiac glycosides enhance the cardiac contraction by commanding the bearer protein, Na – K pumps in the cell membrane. It inhibits the conveyance of Na ions out of the cells, ensuing in high intracellular Na concentration. This inhibits the map of the 2nd membrane ion pump, NCX, from pumping Ca ions out of the cell and Na ions in. [ 22,29 ] Accumulation of Ca ions inside the cell consequences in a stronger and faster contraction as more Ca is released when stimulated. Q PhosphorusVentricular end- diastolic force per unit areaLow end product symptomsCardiac OutputNormal Congestive symptoms CHF CHF+ Inotropic drug Untitled.jpg The Frank-Starling curve shows the consequence of positive inotropic drugs. It would increase the cardiac end product ( indicate P ) and that would let the ventricular end-diastolic force per unit area to fall without cardiac end product falling below normal ( indicate Q ) , keeping normal cardiac end product. Retrieved from â€Å" The Drug Therapy of Cardiovascular Disorders † ( 811 words ) Other illustrations of positive inotropic drugs are phosphodiesterase inhibitors ( Xanthines, Enoximone ) , adrenoceptor agonists and illustration of cardiac glycosides is Digoxin. Cardiac glycosides should non be used or uneffective in the undermentioned conditions: left ventricular outflow obstructor, constricting pericarditis, chronic cor pulmonale and thyrotoxicosis. [ 25 ] Congestive Heart Failure Positive Inotropic drugs Vasoconstriction Reduced cardiac end product Increased after-load Reduced nephritic blood flow Increases chymosin & A ; Angiotensin Vasodilators and water pills Sodium and H2O keeping ACE inhibitors Diuretic drugs Summary of the mechanisms of action of drugs used in CHF intervention Retrieved from â€Å" The Drug Therapy of Cardiovascular Disorders † By and large, the initial intervention of CHF is by water pills. If the response towards water pills were deficient, combination of water pills and vasodilatives chiefly ACE inhibitors is common. In terrible CHF, a combination of a diuretic with either a vasodilative or a cardiac glycoside from the start, continuing to a combination of all three if necessary is recommended. [ 28 ] ( 962 words ) As mentioned above, to handle CHF, foremost is to take or command the implicit in cause. Thus, for CHF caused by high blood pressure, it is indispensable to handle high blood pressure. A combination of ACE inhibitors and water pills can be used. It is more effectual than utilizing ACE inhibitors or water pills entirely. The chart below shows that the blood force per unit area of the patients is lowest when combination of ACE inhibitors and water pills is used. The chart shows the comparings of the hypotensive effects of Capoten ( ACE inhibitors ) , water pills and the combination of both in patients with indispensable high blood pressure. Retrieved from Handbook of Hypertension ( 1061 words ) In add-on, medical research workers have found that Aldactone can better the endurance rate of patients with CHF. [ 4, 6, 7 ] They besides prove that the consequence of Aldactone, a diuretic which is an aldosterone adversary can be enhanced by ACE inhibitors as it besides inhibits the stimulation of aldosterone. [ 27 ] Through the survey of RALES ( Randomized Aldactone Evaluation ) test, the study showed a 30 per centum decrease in overall mortality with Aldactone ( 35 versus 46 per centum for placebo ) and it is enhanced by ACE inhibitors. [ 6 ] Graph demoing the decreased mortality rate by 30 per centum with Aldactone ( 35 versus 46 per centum for placebo ) hypertext transfer protocol: //cmbi.bjmu.edu.cn/uptodate/congestive % 20heart % 20failure/Treatment/Use % 20of % 20diuretics % 20in % 20congestive % 20heart % 20failure.htm Degree centigrades: UsersosmDesktoposmdocumentsBio Report about CHFchart demoing cut down mortality httpcmbi.bjmu.edu.cnuptodatecongestive % 20heart % 20failureTreatmentUse % 20of % 20diuretics % 20in % 20congestive % 20heart % 20failure.htm.gif Last, drugs therapy should be assisted by lifestyle alterations. Changes like modest exercising, quit smoke, abstaining from intoxicant and diet with low Na and fluid are utile to alleviate the symptoms and better life ‘s quality. In fact, analyze shown by American College of Cardiology in March 2009 stated that 30 proceedingss of exercising twice a hebdomad, under the attention of your heart specialist, can cut down the hazard of hospitalization or decease. [ 16 ] ( 1233 words )Economic DeductionTreatments like medicines or hospitalization has become the basic demand for CHF patient and both caused great fiscal load and economic impact. The cost of CHF admittances to the infirmary ranges from 8 to 15 billion dollars a twelvemonth. [ 14 ] Based on The British Heart Foundation, 2004, over 625 million lbs per twelvemonth in direct medical costs in the UK is used for CHF. Besides, CHF patients are frequently prescribed with more than a individual medicine in a class. [ 15 ] This had further increased the cost for medicines. Degree centigrade: UsersosmPicturesGraph for deduction 2.jpg The chart illustrates Top 4 medicine classs, by New York Heart Association category of bosom failure, prescribed for patients with chronic bosom failure. Retrieved from hypertext transfer protocol: //ajcc.aacnjournals.org/cgi/content/full/11/5/474 Due to the high cost, medical insurance are utile when it comes to medical fees. However, it is of import for the patients to be cognizant that the claiming process is sometimes complex and time-consuming. Therefore, patients should ever be financially prepared. ( 1390 words )Social ImplicationCHF patients would endure from symptoms such as hydrops, weariness and shortness of breath. They have to command their diet, monitor their weight to do certain there is no unstable keeping and take a heap of medical specialties to command the symptoms. For patients who are tobacco user and alcoholic, they would hold to fight to discontinue their bad wonts as good. They will shortly happen it hard to work and finally neglect to carry on day-to-day activities like bath and frock by themselves. Due to the sudden alterations in their qualities of life, they tend to be emotionally stressed. They would go anti-social as they developed low self-esteem and anxiousness. Thus, aid and societal supports from households, friends and health professionals are of import for CHF patients. In my sentiment, the authorities and non-governmental organisations should collaborate to supply aid for CHF patients and advance healthy life style through runs and negotiations to cut down the instances of CHF.Benefits and hazardsMedicines are proven to be effectual in alleviating symptoms and cut downing mortality of CHF patients. Patients barely enjoy their lives like playing with their grandchildren or going as they experience fatigue and shortness of breath. However, with these drugs available, CHF patients get to protract endurance and alleviate the symptoms. Hence, they would hold more cherished clip to be with their households and friends. In contrast, drugs therapy does hold hazards. Different types of medicines have different hazards of side effects. Some of the side effects are mild but some are non. For illustrations, although water pills relieve symptoms of CHF, it has side effects like low blood force per unit area and desiccation. Besides, it is rare but non impossible that some drugs cause terrible side effects. ACE inhibitors, for case, may do an utmost decrease in infection-fighting white blood cells. [ 26 ] Treatments are needed to last but hazards are inevitable. is isTherefore, CHF patients are advised to follow the doses prescribed by physicians consequently and be cognizant of the side effects before taking the medical specialties. ( 1720 words )Alternate SolutionsCardiac Resynchronization Therapy ( CRT )Ventricles of a CHF patient frequently do non pump in unison and the contraction would be out of synchronism. As a consequence, the left ventricle can non pump sufficient oxygenated blood to the organic structure. In this status, CRT is frequently recommended. CRT, besides known as the biventricular pacesetter, is a specially designed pacesetter which treats the hold in the ventricles contraction of the bosom. It keeps the right and left ventricles pumping in unison by directing little electrical urges through the leads. [ 10 ] This device has 2 or 3 lead wires positioned in the bosom. The leads are implanted through a vena in the right atrium and right ventricle and into the coronary fistula vena to gait the left ventricle. [ 11 ] Biventricular Pacemaker Heart Illustration Diagram of biventricular pacesetter hypertext transfer protocol: //www.medicinenet.com/biventricularpacemaker/article.htm CHF patients are at hazard of arrhythmia, which is any upset of bosom rate or beat. [ 12 ] Thus, physicians would urge a combination of implantable cardioverter defibrillator ( ICD ) and biventricular. ICD helps by observing the irregular bosom beat and present a daze to acquire the bosom rhythm back to normal. Surveies approved by the U.S. Food and Drug Administration have shown that an ICD with biventricular better life quality and may cut down mortality by up to 40 per centum in patients with CHF. [ 13 ] ( 1932 words )Heart TransplantHeart organ transplant is a surgical process to take a morbid bosom and replace it with a healthy bosom from a giver who has been declared brain-dead but remains on life support. [ 8 ] It is a accomplishable intervention option for terrible CHF patients when their conditions are beyond control of drugs and devices like CRT and ICD. After bosom organ transplant, energy and mobility of patients can be restored. However, the hazard of bosom organ transplant is high. The new bosom transplanted may neglect to work or rejected as it is considered as a â€Å" foreign organic structure † . [ 17 ] Thus, the immune system is suppressed to forestall rejection. By stamp downing the immune system, receivers are at hazard of acquiring infections and malignant neoplastic disease as their organic structure immune system can non support them any longer.A AGermanyA 22.9 %A AItalyA 10.7 %A AFranceA 10 %A ACanadaA 9 %A ABelgiumA 6.8 %A AAustriaA 5.5 %A ANetherlandsA 3.8 %A APolandA 3.6 %A ACzech RepublicA 3.1 %A ASpainA 2.7 %A AAustraliaA 2.6 %A ANorwayA 2.1 %A ATaiwanA 1.9 %A ABrazilA 1.5 %A ASwedenA 1.5 %A AArgentinaA 1.5 %A AColombiaA 1.4 %A AMexicoA 1.4 %A ADenmarkA 1.3 %A AIrelandA 1.1 % pie chart of bosom transplant.jpg Pie chart demoing the per centum of bosom graft in the state surveyed in 2002 hypertext transfer protocol: //www.nationmaster.com/graph/hea_tra_hea-health-transplants-heart ( 2076 words ) In fact, there are some conditions where bosom organ transplant is non recommended, for illustration for those who have malignant neoplastic disease, infections, hapless map of other variety meats, malnutrition or diabetes. [ 8 ] Consequently, terrible CHF patients would be evaluated by bosom graft squad to make up one's mind whether they are suited campaigners for bosom organ transplant before their names are added into the state waiting list. After the organ transplant, careful monitoring and interventions are ongoing procedure to do certain no infections, rejections and other hazards. [ 9 ]Evaluationâ€Å" Medical research workers have found that Aldactone can better the endurance rate of patients with congestive bosom failure † This infusion is taken from mention, [ 4 ] , hypertext transfer protocol: //www.medicinenet.com/congestive heartfailure/page5.htm. This beginning is dependable since the similar information is found in beginning [ 6 ] . Besides, the wellness information of the web site is provided by professionals and experts in the Fieldss of medical specialty and health care. The physicians of Medicine Internet are besides the writer of the â€Å" Webster ‘s New WorldTM Medical Dictionary † for the first to 3rd editions ( May, 2008 ) . Therefore, with them as the writer or editor, the beginning is dependable. Furthermore, this website complies with the â€Å" HONcode † criterion for trusty wellness information. Another beginning which I found dependable is, [ 8 ] , hypertext transfer protocol: //www.nlm.nih.gov/medlineplus/ency/ article/003003.htm. It is really utile in supplying the elaborate information related to bosom organ transplant. The information of this beginning is a service from the U.S. National Library of Medicine ( NLM ) , the National Institutes of Health ( NIH ) , and other authorities bureaus and health-related organisations which is trustable. Besides, this beginning is one of the five victors of â€Å" 2005 World Summit on the Information Society awards † for e-health and it besides complies with the â€Å" HONcode † criterion for trusty wellness information. [ 24 ] In add-on, Consumer Reports on March 2009 mentioned that the beginning, Medline Plus is recognized as the authorities wellness web site that is â€Å" most dependable and easiest to voyage † . This farther ensures the dependability of this beginning. ( 2385 words )

Importance of Computer Literacy Essay

Introduction Patient safety is described by the US Institute of Medicine as â€Å"the freedom from accidental injury due to medical care or from medical error† (Mansour, 2012). With that being said, patient safety has long been a major issue for hospitals. In the past many patients have been injured during hospital stays, some being injured severely with death being the result. With the growing trend of lawsuits, hospitals were becoming more and more vulnerable to financial liability when patients were injured on their grounds. No one wants to be responsible for the injury or death of another individual. This is why many hospitals have begun doing their own independent research as well as looking at the research from other patient safety organizations. Patient safety goals are being put into place by organizations such as The Joint Commission, as well as falls reduction campaigns being implemented by the individual hospitals. While regulatory agencies like The Joint Commission require hospitals to identify who is at risk for a fall, and gives minimum standards to go by, it is up to the individual hospital to go beyond these required interventions to reduce the risk of a fall occurring within their facilities. Some ideas to prevent falls include the implementation of a new Clinical Nurse Leader position, purposeful hourly rounding, as well as sensors for beds to ensure they are in the low position. Topic One of the first ways to prevent falls in patients is to identify who is at risk. According to the United States Department of Veteran Affairs, the major intrinsic, or physiology-based, risk factors for falls include; altered elimination, cognitive impairment, sensory deficits, altered or limited mobility/gait, and impaired balance (2009). Contributing to these risk factors are, for example, medications that act on the central nervous, circulatory, digestive, or urinary systems; age-related conditions that affect sensory organs; history or fear of falling; and fluid and/or electrolyte imbalances (United States Department of Veteran Affairs, 2009) For most hospitals, there is a list of questions that nurses are asked used in documenting about patients on a daily basis to determine the ever changing status some patients have while hospitalized. These questions make up what is called The Morse Falls Scale. A Morse Falls Scale must be done each day, and with any condition change, to determine a patients risk for falling. The Department of Veteran Affairs also states â€Å"A score of 0-24 indicates no risk for falls. A score of 25-50 suggests a low risk for a fall while a score of greater than 51 indicates a high risk of falling†(2009). To determine the score a person will have several questions must be asked such as: Does the patient have an IV? Is the IV a saline locked or does it have medications infusing? Has the patient fallen in the last three months? How does the patient ambulate? Are they on bedrest, use the nurse to assist, do they have a weak gait, or do they have an impaired gait? Are they taking diuretics/sedatives/tranquilizers? Is the patient over the age of 70? Are they oriented to their own ability or do they forget their limitations? (2009). Answering the aforementioned questions may seem tedious and like busy work however it is very important in the implementation of effective interventions for at risk patients. Now that you have identified who is at risk and how at risk they are, it is imperative to quickly implement the necessary interventions to prevent those at risk from becoming a statistic and more importantly keep them safe from harm. Even those individuals, who are alert, oriented and are at a low risk for falls should still have preventative measures taken to prevent an accidental fall. One of the leading causes for falls in this group is from hospital staff not lowering the bed down after attending to a patient. Also it is important to keep the patients call button within reach at all times, and educate the patient to call for assistance when needing to get up. Make sure the patient has all of their possessions within reach. For some it might be advisable to turn on a night light at night. For even alert patients, waking up in the middle of the night in a strange place can lead to a fall. Non-skid slippers are another way to prevent falls. Make sure your patients are wearing those any time they are out of bed. Side rails at the head of the hospital bed must be kept up on any patient who is hospitalized, but especially on those patients who are over 65 years of age or those receiving narcotics or sedatives (2009). Patients who are at a slightly increased risk for a fall should have the same interventions taken to protect them as a person with a low risk, but additional interventions are also needed. Rounding on patients is supremely important for many reasons, one of which is decreasing falls. (Tucker, Bieber, Attlesey-Pries, Olsen & Dierkhising, 2012). It is usually during these rounding times you will find noncompliance within patients of this category. If you go into a room and find a patient who is at moderate risk up and out of bed, reeducation is required and in some cases it may be beneficial to turn on the bed alarm to prevent them from getting up again without assistance. It is important to use judgment here when deciding to implement the bed alarm or not (National Guideline Clearinghouse, n. d. ). Take into consideration things such as are they hooked up to a central line, suction, is there a chest tube? Typically when patients insist on getting up without help and have various kinds of tubing hooked to them it is recommended to implement the bed alarm for their safety (National Guideline Clearinghouse, n. d. ). Patients who are at a high risk for falls should have all previously discussed interventions taken along with additional interventions, such as having signs posted so all staff knows that a patient is at risk for a fall. A yellow arm band should also be placed on the patient to alert all staff of the patients risk for falls. There is also no question that these individuals should have a bed alarm activated. If possible it’s always a good idea to have these patients close to the nurses’ station (National Guideline Clearinghouse, n. d. ). Having them closer to the nurses’ station improves the response time for when or if the bed alarm does go off. Having patients closer to the desk also given the staff a better opportunity to more closely monitor the patient. When it is not an option for a patient to be moved closer to the nurse station, it may be advisable for the patient to have a one to one sitter. In many cases families will be more than willing to stay with a patient to help make sure they do not get out of bed without assistance. If this is not possible a hospital staff member, usually a nurse assistant, will need to stay with the patient. Most all hospitals have moved away from using restraints. The liability had become too great for hospitals and staff to continue such a practice. As previously alluded to one important tool most facilities have adopted is hourly rounding. Studies have shown that by hourly rounding and addressing the 4 P’s, which are pain, potty, position, and possessions, reduces the amount of falls that occur in an inpatient setting (Ford, 2010). It is also a great way to make the patient feel safe. According to the research done by Beverly Ford in 2010, patients who see that someone from the faculty is coming in to their room each hour to check on them feels that they are being taken care of and safe. More often than not a patient will avoid using the call bell because they do not want to bother their nurse. (Tucker, et al. ,2012). Particularly with these patients it is important to see them as often as possible and at a minimum once an hour. Studies have shown that one factor in reducing the risk of falls is to have the bed in the lowest position when leaving the room. (Tzerg, Prakash, Brehob, Devecsery, Anderson, Yin. ,, 2012). Studies have also shown that 26. 5% of patients who fell during a hospital stay fell from their beds. 3. 6% fell over the bed rails, footboards, or headboards. (Tzerg et al. ,2012). If the bed is raised from the lowest position it dramatically increases a patient’s chance for falling. According to research done in 2012 by Tzerg, et al, the appropriate height of a hospital bed in the horizontal position is the patients’ knee height. For women the average keen height is 19. 49 inches and in men it is 21. 3 inches. (Tzerg et al, 2012). There is also research to suggest that a bed height sensor should be placed on all hospital beds to ensure that a bed is not left in the up position. Many hospitals have started implementing a new nursing position that helps bridge the gap between nurses with a heavy patient load and the patient who needs closer monitoring. According research The Clinical Nurse Lead (CNL) position has been created at the encouragement of several agencies such as The Joint Commission and Accreditation of Healthcare Organizations. (Stanly, Gannon, Gabuant, Hartranft, Adams, Mayes, Shouse, Edwards, Burch, 2008). In the Fall of 2006 the first CNLs graduated from 12 different masters nursing programs across the united states. â€Å"With a heightened awareness these new graduates went out into the workforce to improve healthcare quality and patient safety, national indicators have been identified and they are being used to determine the quality of care being provided to patients† (Stanly, et al. , 2008). While not the answer to improved patient safety, studies have shown that implementing the position, especially on surgical units has improved the level of care received by patients while hospitalized (Stanly, et al. ,2008). There is no question that falls more often occur in the older population. Medicare has taken a huge interest in this factor and many questions are now being asked. Some of the questions being asked involve things such as what were the risk factors leading up to the incident, how did the incident occurred, what interventions were taken to prevent, and what was the response time after it occurred? (Liang, Mackey. ,2011). Because of the association of falls with mortality and disability, especially in the elderly, several studies have investigated the incidence of falls and the associated risk factors. In 2011 research done by Liang and Mackey reported The Centers for Disease Control and Prevention estimation of approximately one third of people 65 years of age and older fall each year, with many of those falls taking place in hospital settings. In October 2008, the Centers for Medicare and Medicaid stopped reimbursing for hospital-acquired conditions, or events, that should never occur during hospitalization (Liang, Mackey. ,2011). The guiding premise on why these â€Å"never events† should not occur is because there is a sufficient evidence base to prevent those events (Liang, Mackey. ,2011). If a patient experiences one of these events during their hospitalization, the hospital will not be reimbursed for the treatment costs associated with the event if the patient’s insurance is provided through Medicare or Medicaid. With the already serious losses most hospitals take each year, they simply cannot afford to have more revenue lost. This pay-for-performance initiative includes some patient outcomes that are considered to be nursing-sensitive, for example, injuries from falls. This phenomenon of hospitals not receiving reimbursement based on patient outcomes is a relatively new phenomenon for nurses in acute care. This is why hospitals are being serious and taking a hard stands on patients’ safety while in their care. Summary While there is defiantly a trend toward improvement to increase patient safety while hospitalized, it is obvious that there is still a long way to go. Nurses more than ever are using their role as a patient advocate to find new and insightful way to reduce risks for falls. Implementing falls precautions before there is a fall is one of the best ways to avoid an incident. Keeping beds in low position reduces the risk for the alert and oriented patients to fall. Implementing unit standards, researching and revising things that needs to be addressed are highly important for patient safety initiatives to be effective with a hospital setting. Continued research is also needed. Hospitals and patient acuity are both changing almost on a daily basis. It is up to those in the medical profession to avoid becoming stagnant and continue to grow in an effort to protect our patients from harm. REFERENCES Ford, B. M. (2010). Hourly rounding: a strategy to improve patient satisfaction scores. MEDSURGE Nursing, 19(3), 188-191. Retrieved from http://ehis. ebscohost. com. ezproxy. gardner-webb. edu/ehost/pdfviewer/pdfviewer? sid=02fda96b-2386-46ab-a942-0c65dcde3704%40sessionmgr113&vid=6&hid=124 Johanson, L. S. (2008). Interprofessional collaboration: nurses on the team. MEDSURGE Nursing, 129-130. Retrieved from http://ehis. ebscohost. com. ezproxy. gardner-webb. edu/eds/pdfviewer/pdfviewer? sid=bfbb16e7-99ab-43bb-8aed-c12cfa010014@sessionmgr14 Liang, B. A. , & Mackey, T. (2011). Quality and safety in medical care what does the future hold. Quality and Safety in Medical Care, 135(11), 1425-1431. doi: 10. 5858/arpa. 2011-0154-OA Mansour (2012). Current assessment of patient safety education. British Journal of Nursing, 21(9), 536-543. Retrieved from http://ehis. ebscohost. com. ezproxy. gardner-webb. edu/eds/pdfviewer/pdfviewer? sid=d98ff6b9-b7e2-4057-a870-c1fdf160b65d%40sessionmgr14&vid=5&hid=20 National Guideline Clearinghouse | Prevention of falls (acute care). health care protocol. (n. d. ). National Guideline Clearinghouse | Home. Retrieved from http://www. guideline. gov/content. aspx? id=36906&search=falls+prevention#top Stanly, J. M. , Gannon, J. , Gabuant, J. , Hartranft, S. , Adams, N. , Mayes, C. , Shouse, G. M. , Edwards, B. A. , & Burch, D. (2008). The clinical nurse leader: a catalyst for improving quality and patient safety. Journal of Nursing Management, 16, 614-622. doi: 10. 1111/j. 1365-2634. 2008. 00899. x Tzeng, H. M. , Prakash, A. , Brehob, M. , Devecsery, D. A. , Anderson, A. , & Yin, C. (2012). Keeping patient beds in a low position: an exploratory descriptive study to continuously monitor the height of patient beds in an adult acute surgical.