Food Irradiation Essay Example for Free

Food Irradiation Essay Food illumination has the longest history, over 40 years, of logical research and testing of any food innovation before endorsement. Research has been exhaustive, and has included healthiness, toxicological, and microbiological assessment. Around the world, 38 nations license illumination of food, and in excess of 28 billion lb of food is lighted every year in Europe. Note that food light has an entirely amazing rundown of national and universal supports: ADA, American Council on Science and Health, American Medical Association, Council for Agricultural Science and Technology, International Atomic Energy Agency, Institute of Food Technologists, Scientific Committee of the European Union, United Nations Food and Agricultural Organization (FAO), and the World Health Organization (WHO). In spite of the fact that the US food flexibly has accomplished a significant level of wellbeing, microbiological risks exist. Since nourishments may contain pathogens, misusing, including inappropriate cooking, can bring about food-conceived sickness. Light has been recognized as one arrangement that improves sanitation through the decrease of potential pathogens and has been suggested as a feature of a far reaching project to upgrade sanitation. Be that as it may, food light doesn't supplant appropriate food taking care of. So the treatment of nourishments handled by light ought to be administered by a similar sanitation precautionary measures as every other food. Food light can't improve the nature of a food that isn't new, or forestall defilement that happens after illumination during capacity or readiness. Be that as it may, rewarding nourishments with the illumination of gamma beams offers advantages to shoppers, retailers, and food makers, for example, improved microbiological quality, substitution of synthetic medicines, and expanded timeframe of realistic usability. The flavors and fumigant splashes utilized on organic products can be constrained and killed using illumination. This improves the nature of the organic product. Pathogens in crude poultry or meat can be diminished by a portion of radiation. Additionally, littler portions can disinfest grain and create and can hinder the regular maturing of products of the soil. This all outcomes in the decreased use or end of compound medicines and demonstrates that illuminated nourishments intently look like nourishments in their new state. Light has been contrasted and purification since it crushes pathogenic microscopic organisms. Since illumination doesn't incredibly raise the temperature of the food being handled, supplement misfortunes are little and are regularly significantly less than supplement misfortunes related with different techniques for conservation, for example, canning, drying, and heat sanitization and cleansing. Proteins, fats and sugars are not outstandingly influenced by illumination. Be that as it may, certain nutrients are delicate to food light. However, supplement misfortunes can be limited by illuminating food in a without oxygen condition or in a solidified state. As per the Ames, Iowa Council for Agriculture Science and Technology Task Force Report No. 115, shoppers reliably rate illuminated organic product as equivalent or better than non-lighted natural products in appearance, newness, and taste. With the entirety of the realities recorded above, clearly lighted nourishments are the best choice rather than hurtful substance items. These synthetic substances use and damage are an aftereffect of not utilizing food light to profit buyers. Also, in a time of expanding worry about sanitation, customers must comprehend that illumination is one strategy for upgrading an effectively protected food flexibly.

Strategic Social Responsibilities for Comparison Sites

Regularly in a heap of current papers, the first page subjects that will grab your eye are moral issues behind upper administration pay; for this situation, on March 30th 2009, the issue that surfaced was Rick Wagoner’s leave from GM and his retirement bundle and how his real/base remuneration multiplied in his last year from roughly $7M to $15M. (7) With the current monetary emergency, numerous individuals outside the business society have gotten mindful of the incredibly high pay contrast between top administrators and normal working residents. For example, terms, for example, ‘golden parachute’ have been put under the spotlight and are investigated. Hand-outs are severance pays to CEOs when they leave their organization. The measure of cash is normally affected by the size of the business and the exertion they put in. The freebie was once used to morally to remunerate CEOs who relinquished their time and exertion for the business; nonetheless, this is right now by all account not the only case. Before we dive into more detail, comprehend that the freebie once had a purpose behind being utilized. With numerous mergers and acquisitions during the second mechanical insurgency, CEOs were offered pay corresponding to how much their exertion was worth. As indicated by the Journal of Business Ethics, this was a moral outlook since it was trailed by two constructive outcomes. As a matter of first importance, freebies empowered mergers and acquisitions rather than chapter 11. For example, the CEO would decide to converge with a contender and leave with a luring measure of cash. This limited joblessness and loss of basic capital which is aftereffect of liquidation. Another beneficial outcome in utilizing the hand-out was pulling in a viable supervisory crew. Extraordinary CEOs are basic for the accomplishment of organizations, yet incredible CEOs are low on gracefully. Subsequently, freebies can be ‘recruitment tool[s]’ and can bring the business once again into a monetarily steady position. Basically, hand-outs were can in any case be moral if the CEOs get remunerations corresponding to their exertion that was advanced to the organization. 1) However, in spite of the fact that these pay bundles started as an elective that expands the whole of stakeholders’ fulfillment, numerous CEOs started to mishandle this benefit. Featured by the standard specialist hypothesis, the vast majority would organize individual motivating forces regardless of anything else. Accordingly, it is justifiable for a CEO to seek after close to home motivations. Be that as it may, trustee obligations to investors must be strengthened by sheets. It is human instinct to organize individual needs, however it is dishonest to hurt the business or investors during the procedure. In this way, regardless of whether hand-outs ought to or ought not be obligatory stays an ethical problem. The inquiry despite everything stands; is it defendable that CEOs merit and have rights to gather hand-outs? In a present issue, Rick Wagoner, CEO of GM, was approached to leave by Obama because of his inability to present a rebuilding plan. Subsequently, he got an incredible freebie of $20 million. On the off chance that the choice was placed in the hands of many citizens, he would not have left with $20 million because of his reputation. As per ABC News, under his initiative, â€Å"GM lost several billions of dollars, took billions in citizen financed help, and cut a huge number of occupations, including reported designs to cut 47,000 workers before the finish of 2009†. (2) in addition, he was remembered for an outrage, late 2008, where he was seen to have flown personal jets when requesting an administration bailout. With such presentation, citizens are frozen with the way that their cash is going towards a paying an organization which fizzled rebuild. Subsequently, many contend that he didn't merit the cash since he dismissed his duty as the CEO of GM to glance to the greatest advantage of the partner. Then again, GM and the administration needed to, by law, give Rick Wagoner the compensation since it was at that point arranged; in this way, he was qualified for retirement reserves. Subsequently, another moral issue may emerge dependent on whether he merits the compensation. Let’s likewise not overlook the way that he worked in GM for a long time. 2) in addition, if a hand-out was not offered, numerous proficient CEOs will lose motivating forces and GM’s budgetary position will be unable to recover without a viable pioneer. Generally, the situation a remaining parts in banter with respect to whether the advantages of hand-outs abrogate the conceivable maltreatment of this benefit. To additionally break down this case, this difficulty was applied to the seven stage choice strategy. Moral Standards To begin with, the initial step to the choice methodology is to recognize moral gauges. Since each stakeholder’s interests fluctuate, there is a contention among individual objectives, convictions and qualities. For example, CEOs and board individuals make a move to amplify their compensation because of individual objectives; be that as it may, it may not be to the greatest advantage of the organization. Subsequently, by seeking after this objective, CEOs and board individuals trust in vanity where they look exclusively to the greatest advantage of themselves and think about it as a way to goodness. They likewise accept that with an industrialist economy, the administration ought not intercede and should concede businesses’ their opportunity coming about a free enterprise point of view. Likewise, investors additionally mean to boost their salary and individual motivations. In doing as such, they esteem trust and trustworthiness and anticipate that trustee obligations should be met. Moral Impacts The subsequent advance is to perceive every single good effect and how they either advantage or damage partners. It is additionally essential to distinguish any rights that are connected to qualification and additionally obligation that might be perceived or damaged. The accompanying graph is a cost/advantage investigation if the administration was to permit the act of hand-outs.

Multisystem Case - Free Essay Example

Running head: MULTISYSTEM CASE Multisystem Case Scenario Demis Russu Section Instructor: Josanne Christian Florida Hospital College of Health Sciences July 22, 2010 Abstract Mr. Jones presents to the ED with a complex combination of symptoms. Clinicians must swiftly evaluate and treat his conditions. Air way protection as well as hemodynamic stability is extremely important. Mr. Jones’s case requires rapid intervention as his condition has been worsening for the past week. Pathology and treatment options are explored to enrich the educational component. Emotional support and long term treatment options must be discussed with Mr. Jones in order to meet his needs. Multisystem Case Study Heart failure (HF) is approaching epidemic levels. The statistics are staggering. Approximately 5 million people are currently diagnosed with HF in the U. S. with 550,000 being diagnosed yearly; health care cost is approaching an exorbitant $28 billion annually (Rasmusson Renlund, 2006). Chro nic obstructive pulmonary disease (COPD) is presently the fourth leading cause of death world wide (Kara, 2005). As nurses it is imperative that we educate patients and their family members on risk reduction, identifying early signs and symptoms and latest treatment advances made towards controlling chronic conditions such as HF and COPD. Scenario Mr. Jones 68 y/o male arrives at the Emergency Department (ED) with complaints of increased dyspnea with exertion for the past three days, weight gain of 6 lbs in the last week, swelling to legs and feet and a noticeable decrease in urination. Mr. Jones does have a history of congestive heart failure (CHF), emphysema, hypertension, Type II diabetes nd rheumatic fever as a child. The patient admits to a long history of cigarette smoking having decreased his smoking to ? a pack daily since being diagnosed with emphysema five years ago. On initial assessment Mr. Jones appeared stated age but fatigued, was alert and oriented to time, place and situation, pupils 3 equal and reactive. Blood pressure 156/94, heart rate 102, rhythm sinus tachycardia, heart tones includes S3 gallop, denies chest pain and peripheral pulses were palpable with weak bilateral post-tibial and dorsalis pedis. Lung sounds were clear upper lobes with crackles in bilateral lower lobes, patient is dyspnic on exertion. Pulse oximeter 88% on room air, oxygen was applied at 2 l/m via nasal cannula which improved oxygen saturation to 94%. Abdomen obese had positive bowel sounds in all four quadrants, non-tender, non-distended, last bowel movement was yesterday morning. Mr. Jones reports a decrease in urinary frequency as well as amount, recalls urinating very small amount twice daily in the past two days. Skin was intact, has 3 + bilateral lower extremity edema. Mr. Jones reports the following medication regime: Altace 5mg PO twice daily, Toprol XL 25mg PO daily, Aldactone 25mg PO daily, Advair Diskus 250/50 mcg inhaler twice daily and Spiriva 1 c ap inhaled daily. Mr. Jones reports that he has not taken his medications in the past 7 days because he did not have the money to purchase them. The ED physician orders the following tests: complete blood count, complete metabolic profile, thyroid level, lipid profile, homocysteine levels, Troponin I every 8 hrs x 3, BNP, HGBA1C, ABG, EKG, CXR, 2D Echo and a Cardiology consult. Order for Lasix 40 mg IV every 8 hrs with the first dose to be given stat was written. A urethral catheter was inserted in order to maintain strict IO and 1500 ml fluid restriction was ordered. Chronic Disease Review: Congestive Heart Failure Definition According to Brashers heart failure affects 10% of the population over the age of 65 and is the most frequent reason for hospital admission in this age group (2008). HF encompasses several types of cardiac malfunction which results in insufficient blood supply to the body’s tissues and organs. The most common cause of HF results from left ventricu lar dysfunction which includes both systolic and diastolic heart failure. Right ventricular dysfunction (also known as cor pulmonale) in the absence of left ventricular dysfunction can be attributed to pulmonary disease such as emphysema which is also referred to as COPD. Signs and Symptoms Signs and symptoms of left heart failure result from pulmonary vascular congestion and insufficient perfusion to tissues and organs. Brashers describes patients experience fatigue, edema, decreased urine out put dyspnea, orthopnea, and frothy sputum (2008). Physical exam will reveal pulmonary edema, hypertension or hypotension, S3 gallop and possible evidence of acute or chronic CAD. Mr. Jones did present fatigued with dyspnea on exertion, crackles bilaterally, he does have an audible S3 gallop, and blood pressure is 156/94. Edema of the bilateral lower extremities is evident at 3+ as well as Mr. Jones reports a 6 lb weight gain in the past week as well as decreased urine output. Pathophysi ology Systolic heart failure (SHF) is the inability of the heart to produce a cardiac output sufficient enough to perfuse major organs and tissues. Cardiac output depends on the heart rate and stroke volume. Stoke volume is affected by contractility, preload and afterload (Brashers, 2008). Contractility is affected by disease processes such as myocardial infarction, myocarditis, cardiomyopathies, myocardial ischemias, and inflammatory, immune or neurohumoral changes. According to Brashers preload increases due to excess in vascular volume which can result from intravenous fluid administration, renal failure and mitral valvular disease (2008). Frank-Starling’s law states that increasing the ventricular end-diastolic volume will cause a stretching effect of the myocardium causing a stronger contraction which results in improved cardiac output; however prolonged increased preload will ultimately lead to decreased contractility as this myocardial stretching will cause sarcomer e dysfunction. Aortic valvular disease or hypertension is responsible for increases in afterload. Persistent increased peripheral vascular resistance leads to ventricular hypertrophy. Brashers explain hypertrophy results in deposition of collagen between myocytes, causing ventricular remodeling consequently reducing the contractility properties of the myocardium resulting in a dilated and less compliant ventricle (2008). The vicious (in this case) rennin-angiotensin-aldosterone system gets activated by poor cardiac output and decreased renal perfusion. Our body’s natural instinct to maintain homeostasis is stimulated. Barrow receptors which detect a decrease in perfusion stimulate the sympathetic nervous system to cause further vasoconstriction and antidiuretic hormone is release by the hypothalamus causing the kidneys to hold on to fluid. Mr. Jones fits the above criteria exhibiting symptoms of dyspnea, edema, has the classic HF murmur S3 gallop, is hypertensive and re ports decreased urine out put with weight gain. Diastolic heart failure (DHF) is associated with delayed relaxation and increasing left ventricular rigidity which prevents adequate filling and decreases the ability to properly eject blood (Redderson, 2008). DHF occurring singly is described as pulmonary congestion with a normal cardiac output and stroke volume. Brashers describes DHF as the causative condition of 40% to 50% of all cases of left heart failure with a higher incidents in women (2008). Increased pressure at the end of diastole in the left ventricle is reflected back within the pulmonary circulation causing pulmonary congestion. Causes of DHF include myocardial ischemia, left ventricular hypertrophy induced by chronic hypertension, valvular diseases, cardiomyopathies and pericardial diseases. During exercise individuals with DHF are not able to compensate for the increased demands, therefore the heart is not able to increase cardiac output since the left ventricle is hypokinetic. Signs and symptoms include dyspnea on exertion, fatigue, evidence of pulmonary edema, hypertension coronary disease and valvular disease (Brashers, 2008). Mr. Jones could have DHF as he does present with appropriate symptoms however his symptoms are more indicative of SHF and the test results will help differentiate between the two. Right heart failure may result from left heart failure due to increased pressures in the left ventricle which reflects back into the pulmonary circulation. The right ventricle is not designed to cope with high pressures therefore it hypertrophies and fails. In the absence of left heart failure the cause is related to hypoxic pulmonary disease such as COPD, ARDS and cystic fibrosis causing pulmonary hpertension. Cardiac related conditions which affect contractility include pulmonic valvular disease, myocardial infarction, and cardiomyopathies (Brashers, 2008). Sings and symptoms include decreased cardiac out put during exercise; EKG shows right ventricular hypertrophy, jugular venous distension, peripheral edema and hepatosplenomegalaly. Mr. Jones has a long history of smoking and he continues to smoke despite being diagnosed with emphysema five years ago. Tobacco use is the primary risk factor for developing COPD. Mr. Jones’s symptoms as well as his history and risk factors support a combination of left heart failure as well as right heart failure. Diagnostic Screening and Evaluation: Radiographic Laboratory Diagnostic blood work is ordered in order to support the condition suspected and rule out other conditions that may mimic HF, as well as to determine the severity of HF. EKG will identify the heart rhythm, right ventricular hypertrophy as well as conduction abnormalities or myocardial infarction. BNP level is an indicator of B-type natiuretic peptide which is secreted by the heart in order to maintain fluid balance, elevated levels support HF. CBC will rule out anemia and infectious processes. C MP will give us an indication of electrolyte status, renal, hepatic and pancreatic function. Thyroid profile will show thyroid function, as it can also affect cardiac function, lipid profile will show good and bad cholesterol levels. HGBA1C shows glycemic control for the past 3 months, ABG will demonstrate respiratory and metabolic status. Cardiac enzymes will determine if Mr. Jones is actively experiencing a myocardial infarction. CXR can support pulmonary congestion along with cardiomegally infiltrates, pleural effusion as well as differentiate COPD. A 2D Echo will show valvular function, kinesis of the myocardium as well as ejection fraction. Cardiology consult is requested because cardiologists are specifically trained to treat HF. Mr. Jones’s results were as follows: CBC, thyroid levels are normal; CMP shows elevated creatinine which indicates renal insufficiency. Lipid profile supports hyperlipidemia. Cardiac enzymes are negative, BNP is grossly elevated, and HGBA 1C shows very poor glycemic control for the past three months. ABG shows a compensated pH with a PaO2 of 69. CXR reveals cardiomegally, and gross pulmonary congestion, EKG sinus tachycardia, right ventricular hypertrophy. Echo cardiogram confirms an EF of 30% and right and left ventricular hypertrophy and mitral valve stenosis. In 2001 and again in 2005 the American College of Cardiology (ACC) and the American Heart Association (AHA) collaborated to create a frame work which allows providers to understand the progression and HF. Heart failure progression is defined in four stages A, B, C, and D, beginning with at risk patients all the way to end-stage disease (Rasmusson, 2006). Treatment Interventions Rationale Dr. Heart reviews all the available information and places Mr. Jones in Stage C class of HF. Mr. Jones exhibits acute decompensated symptoms such as dyspnea, lower extremity edema, pulmonary congestion, remodeling of the left ventricle from chronic hypertension resulti ng in structural changes. Also important to mention are the co-morbidities, such as Diabetes and COPD. According to Rasmusson treatment options must focus on reduction of morbidity and mortality. Pharmacologic agents include ACE inhibitors, ARBs, beta-blockers and aldosterone antagonists, as well as diuretics and digoxin. Treatment goal is to block neurohormones preventing the cycle of decreasing contractility, increasing preload and afterload, and relieving pulmonary congestion (2006). In the acute treatment phase emphasis is placed on stabilizing hemodynamics, correcting fluid volume, determination of etiology, and reversing conditions that can be reversed. Long term care includes vital patient and family education, appropriate titration of pharmacologic agents, salt restriction, and possibly cardiac resynchronization therapy (CRT). CRT refers to bi-ventricular pacing which allows synchronization of the left ventricle consequently improving the ejection fraction (EF) which i s normally 55%-70% (Brashers, 2008). Patients with an EF . 12 seconds are at a high risk for arrhythmias and sudden cardiac death therefore an implantable cardiac defibrillator is recommended (Rasmusson, 2006). Treatment for DHF focuses on improving ventricular relaxation, and prolonging diastolic filling times in order to reduce diastolic pressure. Inotropic drugs are not indicated in isolated diastolic heart failure since contractility and EF are not affected although digoxin may be used in patients with atrial fibrillation in order to achieve rate control (Brashers, 2008). Prevention Mr. Jones presented to the ED with exacerbation of HF related to non-compliance with medication regime. In this case patient education is of up-most importance. Hospitalization prevention is important due to the exorbitant costs. Patient education will focus on medication compliance, and signs and symptoms of exacerbations. Having the ability to recognize early symptoms will allow Mr. Jones to visit his physician, which could adjust the medication regime, impose a fluid and salt restrictions, as well as provide aggressive diuresis at the office in order to prevent a hospital admission. A social worker consult should be arranged in order to provide assistance with indigent issues. Chronic Disease Review: COPD or Emphysema Definition Chronic obstructive pulmonary disease includes pathologic lung changes consistent with emphysema or chronic bronchitis (Brashers, 2008). There is a permanent enlargement of gas exchange airways in conjunction with destruction of alveolar walls with out apparent fibrosis. Loss of elastic recoil is the causative factor of airflow limitation. The major cause of COPD is cigarette smoking even though childhood respiratory infections and air pollution are known to be contributing factors (Brashers, 2008). Signs and Symptom Clinical manifestations of COPD include, dyspnea, wheezing, and prolonged expiration. Individuals will have a classic barrel c hest appearance. Late in the course of COPD patients will experience chronic hypoventilation, polycythemia and cor pulmonale also known as righ heart failure. Fatigue, weight loss, poor appetite as well as sleep disturbance may occur. Mr. Jones does have dyspnea, however it is unclear if it is related to the HF or COPD, nonetheless his history and test results do support a combination of conditions all exacerbated by his non-compliance with the prescribed medication regime (Kara, 2005) Pathophysiology The irreversible process begins with destruction of the alveolar septa consequently increasing the volume of air in the acinus. Pollutant particles stimulate inflammation resulting in alveolar destruction and loss of elastic recoil of the bronchi. This destruction produces bullae and blebs which are not effective in gas exchange resulting in hypoxemia due to ventilation – perfusion mismatching. The loss of elastic recoil reduces the volume of air that can be expired making expiration difficult and causing air to become trapped in the lungs. Hyperexpansion is the result of trapped air, which stresses the muscles of respiration, therefore late in the course of disease hyperventilation and hypercapnia develops (Brashers, 2008). In non-smokers and individuals who develop the diseases before the age of 40 the causative factor is a rare genetic condition, which involves a deficiency of ? 1- antitrypsin which does not inhibit proteolysis in the lung tissue (Kara, 2005). Diagnostic Screening and Evaluation: Radiographic Laboratory Pulmonary function testing, arterial blood gas, high-resolution computed tomography and chest x-ray are used for diagnoses. Pulmonary function measurements, such as vital capacity (VC) and particularly forced expiratory volume (FEV1) are helpful in determining the stage of the disease. In 1998 the Global Initiative for Chronic Obstructive Lung Disease (GOLD) was established to generate recommendations for COPD management bas ed on the latest scientific evidence available to date (Kara, 2005). COPD can be classified into four stages Stage I – Stage IV, from mild where the individual is not even aware the condition exists to very severe where essentially respiratory failure is present based on the results of FEV1 and patient’s symptoms. Mr. Jones appears to be in Stage II to Stage III due to fatigue, shortness of breath and recent exacerbation. Again important to mention is that Mr. Jones has multiple processes involved therefore his symptoms are caused by a cumulative effect. Treatment Interventions Rationale Treatment for COPD is based on primary prevention, relieving symptoms, improvement of over all health status and exercise tolerance, diligent treatment of exacerbations and complications (Kara, 2005). Educating on smoking cessation and ensuring immunizations are up to date is crucial. Acute and chronic symptoms will be managed with bronchodilators such as ipratropium and B2-agonist s, in severe cases the use of methylxanthines, intravenous, inhaled or oral steroids and home oxygen may be required. Adequate nutrition is also very important. Lastly pulmonary rehabilitation is aimed at improving functional capacity and quality of life (Kara, 2005). Mr. Jones exacerbation of symptoms is related to medication non-compliance and continued smoking. Nebulizer treatments with DuoNeb (albuterol/ipratropium) every 4 hrs and prn via nebulizer and steroids would decrease the severity of symptoms. In the event that tachycardia persists a switch to Xopenex/ipratropium would be beneficial, as Xopenex has less incidence of inducing tachycardia. Supplemental oxygen was applied upon pulse oximetry reading. Antibiotic therapy would be considered if there were signs of infectious processes. Prevention Prevention focuses on patient education and medication compliance. Assessment of Mr. Jones’s cognitive status is important to facilitate educational conversation that he would understand. Indigent support in order to encourage medication compliance is important although realistically not always available. Chronic Disease Review: Rheumatic Fever Definition Rheumatic fever is an inflammatory disease caused by the group A ? -hemolytic streptococcus, characterized by inflammation of the joints, nervous system and heart. When not appropriately treated, rheumatic fever will cause scarring and deformity of cardiac structures (Brashers, 2008). Signs and Symptoms Rheumatic fever often exhibits symptoms that are common to other conditions such as nausea, vomiting, abdominal pain, fever, arthralagia, lymphadenopathy and epitaxis and fever. According to Kara the American Heart Association and the World Health Organization developed the following criteria for diagnosis purposes: carditis, erythema marginatum, acute migratory polyarthritis and chorea (2005). Pathophysiology Rheumatic fever occurs as a consequence to a pharyngeal infection by group A ? -hem olytic streptococcus which causes an abnormal humoral and cell-mediated immune response. Brashers explains; the immune response cross-reacts with molecularly similar self-antigens on brain, muscle, heart and joints resulting in an autoimmune response that inflames and potentially scars these tissues (2008). The inflammation may subside before treatment; however damage to the heart valves remains. Individuals with CHF and pericarditis suffered significant damage. Endocardial inflammation can cause swelling of the valve leaflets and aggregation of clumps of vegetations containing platelets and fibrin become deposited on valvular tissues causing stenotic valves. If the inflammation is able to penetrate the myocardium it may cause carimegally and left heart failure due to fibrin deposits also known as Aschoff bodies (Brashers, 2008). According to the test results Mr. Jones has mitral valve stenosis, cardiomegaly and HF. Unfortunately Mr. Jones had rheumatic fever as a child which may be the causative factor of his HF. Diagnostic Screening and Evaluation: Radiographic Laboratory In the acute phase rheumatic fever is diagnosed based on clinical symptoms plus by positive throat culture for grop A ? -hemolytic streptococci, antistreptolysin O antibody titers 250 Todd units, elevated values of anti-DNase B, antihyaluronidase, antistreptozyme, WBC, ESR, and CRP (Kara, 2005). Treatment Interventions Rationale Therapy is focused on eradicating the streptococcal infection trough appropriate antibiotic therapy. Other pharmacologic agents include NSAIDS, cardiac glycosides, corticosteroids, and diuretics (Brashers, 2008). In the event that there is significant hemodynamic instability related to damaged valves than surgical intervention may be required. Conclusion In conclusion Mr. Jones presents with an intricate combination of symptoms requiring a systematic approach with focus on alleviating symptoms, and educating the patient on preventative measures. Is the hi story of rheumatic fever a key factor in the patient’s extremely poor condition? It may very well be a component of Mr. Jones’s issues. Risk factors such as poor glycemic control, smoking, and poor nutritional status in addition to the co-morbidities associated with COPD, Diabetes, hypertension, hyperlipidemia and HF certainly add to the severity of the situation. Serious consideration needs to be given to quality of life issues, at this point a Living Will and Code Status should be discussed with Mr. Jones. Frequent hospitalizations and chronic conditions can place a big burden on resources as well as emotional well being. Mr. Jones may requires rehab prior to discharge home, or even decide to try a long term placement facility for better medical management of his condition. Mr. Jones may require a surgical consult for valve replacement and/or a cardiology consult for a bi-ventricular pacer / automated implantable cardiac defibrillator. Much emphasis needs to be placed on education; most importantly smoking cessation, identifying early signs and symptoms of HF and COPD exacerbation and medical regime compliance. As nurses we have to quickly identify educational opportunities and provide our patients the necessary tools for them to actively accomplish positive and therapeutic change. As nurses we are often the first and last row of defense for our valuable patients. References Brashers, V. L. 2008). Alterations of cardiovascular function. In S. Huether, K. McCance, (Ed. ), Understanding pathophysiology (4th ed. ) (pp. 606-675). St. Louis: Mosby Elsevier. Brashers, V. L. (2008). Alterations of pulmonary function. In S. Huether, K. McCance, (Ed. ), Understanding pathophysiology (4th ed. ) (pp. 693-713). St. Louis: Mosby Elsevier. Kara, M. (2005). Preparing nurses for the global pandemic of chronic obstructive pulmonary disease. Journal of Nursing Scholarship, 37(2), 127-133. Retrieved from CINAHL database. Rasmusson, K. , Hall, J. , Renlun d, D. (2006). Heart failure epidemic: boiling to the surface. Nurse Practitioner, 31(11), 12. Retrieved from CINAHL database Redderson, L. , Keen, C. , Nasir, L. , Berry, D. (2008). Diastolic heart failure: state of the science on best treatment practices [corrected] [published erratum appears in J AM ACAD NURSE PRACT 2008 Nov;20(11):576]. Journal of the American Academy of Nurse Practitioners, 20(10), 506-514. Retrieved from CINAHL database. Roodpeyma, S. , Kamali, Z. , Zare, R. (2005). Rheumatic fever: The relationship between clinical manifestations and laboratory tests. Journal of Paediatrics Child Health, 41(3), 97-100. doi:10. 1111/j. 1440-1754. 2005. 00557. x.

The Syrian Government Of Syria - 1652 Words

The Syrian government is facing large opposition in its civil war; however, no single group seems able to truly contest the government, especially with the Russian government openly and actively supporting the al-Assad regime. The main pressure on the government of Syria is coming from native Syrians due to the events of the Arab Spring. The Assad regime held an authoritarian position over its people. Many Syrians protested this authoritarian government, and the Assad regime responded with violent force. This has caused a large split within the nation and has created many rebel groups intent upon overthrowing the Assad regime and establishing a democracy in Syria. The main belligerents against the Assad regime include the Free Syrian Army,†¦show more content†¦The group has been weakened due to the desertions as a result of low pay, poor conditions, and the fragmentation of the group (Lucente). Because of the decrease in force of the FSA and the support the Syrian government has from Russia, the remaining belligerents such as ISIS and the Syrian National Council will have a harder time as the government now has fewer sides to fight on. ISIS does present a fair amount of threat in the long term against the Syrian government because they control over a third of the territory in Syria. Furthermore, they control most of its oil and gas production. This allows ISIS to maintain their grip on their territory much easier even with the combined force of Russia and Syria against them. However this does not present as much of a threat as would seem given the amount of oil and gas that the Syrian government has lost with the territory simply because of the Russian involvement. The support that the Assad regime has from Russia will continuously make it incredibly hard for ISIS and other rebel groups to make a significant enough dent in the Syrian military to overthrow the government. Another significant problem facing the Syrian government and many surrounding states includes the refugee crisis that comes as a result of the fighting in the civil war. It has been estimated that more than four million Syrians have fled the country since the start of the conflict. Over seven million have been internally displaced within the country,

America s First Amendment Right Of Freedom Of Religion

Make America Great Again When the Pilgrims settled into Massachusetts in 1620, they dreamed of a better life, a life away from the persecution they experienced in England from King George. They never would have dreamed that their small colony of Plymouth would blossom to be one of the largest countries in the world. And yet, nearly four hundred years later, it has become apparent to many, that America is in a downward spiral. It has come to a time where, the fate of our country could fall into the hands of one of the many people who believe it is right to persecute those of a specific religion because the actions of a small group of religious extremists. The unalienable First Amendment right of freedom of religion would be denied to more than 2.6 million people, based on uneducated assumptions. In addition to this, America has come to the point where more than forty-five million people live in poverty. Likewise, statistics show approximately 48.1 million people are in the uncomfortable position where they ar e insecure about their next, if not current, meal. In addition to this, our famous government, our renowned democracy, has become belittled by assumptions of political corruption. Furthermore, the morals in America have started to disappear, not only in our government, but also in our society. More kids are getting bullied and more people agree that we should rely less on faith, the very reason we built and expanded our country in the first place. Our once thriving nationShow MoreRelatedThe Amendment Of The Bill Of Right : Freedom Of Religion And Freedom1460 Words   |  6 Pages Civil liberties are individual freedoms which are protected from the government by the Bill of Rights. There were historical backgrounds to guarantee the freedom. 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Fundamentals of Infection Prevention and Control

Question: Write about theFundamentals of Infection Prevention and Control. Answer: Introduction Hospital acquired infections also known as nosocomial infections have been a common incidence in health centers which put the lives of health workers, patients and visitors at risk of infection. The most common nosocomial infections include respiratory and gastrointestinal infections such as pneumonia and tuberculosis among other infections. These micro organisms are highly effective in poorly maintained environments and pose a great danger to patients since their immunity is already weakened. This paper explores the prevalence rate of these micro organisms, the impact of hospital acquired infections and the current infection, control and prevention methods for these micro organisms. Common Micro-Organisms Responsible for Hospital Acquired Infections and the Prevalence Rates Tille, (2015) holds that the most common micro-organisms that cause these infections include Pseudomonas aeruginosa, Escherichi coli, Bacilus cereus and Staphylococcus aureus. The micro-organisms have been classified into several types based on biological and clinical characteristics. These pathogens are readily available since they can be transmitted through various methods such as contact, unhygienic conditions and contaminated food and water. The greatest threat of these pathogens is the fact that some of them such as Staphylococcus aureus and Pseudomonas aeruginosa among others are drug resistant. This raises concern in the control of these pathogens and the diseases they are responsible of causing such as the urinary tract infections caused by pseudomonas. Dinh, et al (2016) explains that the prevalence rates of these micro-organisms largely depend in the hygiene and hospital routine practices. Breaching of the infection and control measures among health practitioners and incompetence may pose several risks to contamination by these pathogens. The existing hospital practices such as putting patients with different conditions in a similar ward may also influence the availability and spread of these pathogens. Overcrowding caused by insufficient resources may also increase and accelerate the spread of these pathogens especially those pathogens that are highly communicable through air such as Staphylococcus aureus. The scale of operation of a health institution also influences the number of conditions they deal with. This raises concern in hospital that deal with so many conditions (Legeay, et al 2015). The prevalence rate of hospital acquired infections is different in several parts of the world. In North America and Europe, the prevalence rate is about 7% as compared to Asia, sub-Saharan Africa and Latin America where the prevalence rate is about 40%. This may than infer that nosocomial infections contribute to more than 20% of mortality in the underdeveloped and the developing world. Rate and Impact of Hospital Acquired Infections Hospital acquired infections have caused profound impacts on the patients, the health care professional and other subordinate workers and the patients visitors. The conditions have mostly impacted on patients especially the in patients who spend most of their time in the wards and whose immunity has been weakened by various other disease infections. Ventilator associated pneumonia is a good example of a disease that affects patients in intensive care units. Research has proven that about 20% of patients who go to ICU develop the condition. It then makes it hard for these patients to survive and it thus poses a risk to these patients survival. The centers for disease control and prevention project that more than two million people suffer from nosocomial infections. Despite the fact that majority of these people survive, these infections are a common cause of mortality. They also weaken the immunity of the patients who later die due to other lesser threatening conditions. The infected individuals also spread these diseases to other parts thus increasing the prevalence of these infections to the unaffected lot. Mitchell, et al (2015) hospital acquired infections have harsh economic impacts on the government and the hospitals. It is estimated that the US government spends at least $4 billion every year in control, management and prevention practices of these infections. The health care centers also register several million dollars in prevention and control of the hospital acquired infections. The financial constraints are also felt by the individuals who spend so much on medication and care of the patients. Social impacts of these infections include loss of relatives and financial constraints resulting to poverty in the affected families. These families may also lose the productive lot hence suffering struggles in family upkeep and access to quality social services due to financial constraints. The families and the community also suffer grief and loss of helpful individuals such as healthcare providers to these conditions that are largely preventable. Infection, Control and Prevention of Staphylococcus Aureus Staphylococcus aureus refers to a bacterium commonly found on the skin surface and the respiratory tract. It is a facultative anaerobe and is known for causing skin defects, food poisoning and respiratory defects. There is no identified vaccine for the micro organism and the emergence of antibiotic resistant strain of staphylococcus has been an object of concern due to the increased risk and infection rates of the gram positive bacterium (Dantes, et al 2013). The bacterium causes fatal bone and heart infection and targets various groups of people such as diabetic people, people with weakened immunity and individuals who have had a surgery in their lives. According to Bennett, Dolin and Blaser, (2014) some of the major preventive and control practices of Staphylococcus aureus include hand washing practices, proper hygiene and sanitation. Keeping clothes clean and other surfaces prevents the spread of the bacterium through the contact and consumption in foods and drinks. Lack of sharing of personal items also prevents the spread through contact from one person to another. Other practices part of prevention includes avoiding overcrowding and ensuring all wounds and cuts are well dressed. In the health centers, specialists have made efforts in ensuring that patients are isolated and both the patients and the staff are decolonized in order to minimize the risk of contamination. Conclusion It is important that people realizes that hospital acquired infection cause detrimental effects to all people that can be avoidable. It is thus very important that every individual adhere to disease center for disease control and prevention interventions and ensure they contribute significant efforts to the eradication of these conditions. the government and research centres also need to become aggressive in fighting these micro organisms and sensitizing people on the possible threats of these micro organisms and the various practices they should engage in to provide a solution to these challenges. References Bennett, J. E., Dolin, R., Blaser, M. J. (2014).Mandell, Douglas, and Bennett's principles and practice of infectious diseases. Elsevier Health Sciences. Dantes, R., Mu, Y., Belflower, R., Aragon, D., Dumyati, G., Harrison, L. H., ... Ray, S. M. (2013). National burden of invasive methicillin-resistant Staphylococcus aureus infections, United States, 2011.JAMA internal medicine,173(21), 1970-1978. Dinh, A., Saliba, M., Saadeh, D., Bouchand, F., Descatha, A., Roux, A. L., ... Perronne, C. (2016). Blood stream infections due to multidrug-resistant organisms among spinal cord-injured patients, epidemiology over 16 years and associated risks: a comparative study.Spinal cord,54(9), 720-725. Legeay, C., Bourigault, C., Lepelletier, D., Zahar, J. R. (2015). Prevention of healthcare-associated infections in neonates: room for improvement.Journal of Hospital Infection,89(4), 319-323. Mitchell, B. G., Dancer, S. J., Anderson, M., Dehn, E. (2015). Risk of organism acquisition from prior room occupants: a systematic review and meta-analysis.Journal of Hospital Infection,91(3), 211-217. Tille, P. (2015).Bailey Scott's diagnostic microbiology. Elsevier Health Sciences.

Personal Growth Inspired by Love in the Epic of Gilgamesh free essay sample

A person who is feared and honored, loved and hated, strong but beautiful while still having a lot of courage has the same characteristics as many Gods. While Gilgamesh resembles this, he was only a man, not a God. Gilgamesh was abusing power and any sense of immortality which led to him breaking every single rule he had ever been given. This all changed one-day as Gilgamesh was confronted by Enkidu’s powers and realized he had met his match, which set Gilgamesh into a change of character. He becomes a more sensible person that ends up in a different kind of bonding relationship with Enkidu than ever seen before while they begin travelling on a quest to concur something bigger than what they have. When Enkidu falls, Gilgamesh goes into mourning and is completely grief stricken and withdrawing from everything else in the world. Gilgamesh seeks further into hell on earth to answer his questions about life and death. We will write a custom essay sample on Personal Growth Inspired by Love in the Epic of Gilgamesh or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page He is a man who is two-thirds god and one-third man. As a man who is two-thirds god and one-third man, Gilgamesh has great power over the people in Uruk with there being no capable competition that could match or come close to having the amount of power Gilgamesh possessed. He is a fearful and powerful man who sacrifices his own warriors and rapes noble women whenever he pleased. He takes whatever he wants from his people and destroys anyone who stands in his way. He is a mean man that lives to display his impressive power. He is a man who gets what he wants in a wrong, dishonest way. The people in Uruk complain that a king is supposed to protect and defend his men like a Sheppard to his people (pp. 62). A Sheppard guides its followers and protects them from danger that may become to them but Gilgamesh did not care or agree with this statement. He has all the power over the people in Uruk where they do actually respect him as a leader but are scared to death of him as a person and believe he is a scumbag who only cares about himself. He was taking such advantage of his powers and abusing them so much that this drew the attention of the Gods. The Gods realized they must do something about this and decide they must call out to Aruru, the sky God, for help from they that created Gilgamesh. Arura needs to make someone who is strong enough to stand up to and conquer Gilgamesh’s unstoppable powers. Aruru created a strong man, Enkidu, hoping this man would be able to give Gilgamesh a challenge so he quits abusing his powers so horribly. He hopes Enkidu will be the man that can make Gilgamesh realize he’s not the only powerful beast and would have an ego to stand up to him without being frightened or giving up. Enkidu is a wild man-beast from nature that had been part of the wilderness that lived with the animals so long and thoroughly that the animals truly thought Enkidu was one of them. He was, however, dislodged from his life in nature by the powerful link between man and women after being seduced by a harlot from the temple of love in Uruk. She trains and tricks Enkidu by seducing her naked body and he falls in love with her beautiful fluent features of a woman. She teaches him life of human beings and takes away his pull to live in the wilderness but teaches him a wisdom and understanding of the world as she tames him. The harlot offers to take him into Uruk where Gilgamesh lives, telling him Gilgamesh is the strongest and he has no competition with him to cause Enkidu to start feeling defensive and weak. Enkidu fell into her trap and wants to prove to her that he can stop him and his wrong doings so he agrees to go to Uruk. Gilgamesh starts having dreams of walking under the firmament and a meteor of stuff of Anu fell down from heaven. He brought this star from heaven that descended from the sky to his mother, the wise Ninson, said to Gilgamesh about Enkidu, â€Å"You will love him as a women and he will never forsake you. This is the meaning of the dream. † (pp. 66). Gilgamesh realizes not only he may have someone who he may call his brother but also a comrade who he can rely to fight amongst his side. Gilgamesh now has a great friendship that he will remember his whole life and will call Enkidu his brother, the only man worthy of his friendship. This is when Gilgamesh starts to change his selfish behavior by giving Enkidu his friendship letting him share his fortune. Boredom causes Gilgamesh and Enkidu to make more bad choices. Gilgamesh decides to make a name for himself. Gilgamesh decides he wants to go the great cedar forest and cut down all the cedar trees but needs to fight the guardian of the forest, Humbaba. Enkidu, the elders and Ninsun try to persuade Gilgamesh that the adventure is not to his best interest and give him different opportunities but he still decides to go forward with his original intent. He continues to make a name for himself. In the middle of the battle Gilgamesh has been given the opportunity to spare the life of Humbaba but still decides to make a name for himself. Sometimes choices not only effect on the one who makes the decision but also could affect others. Enkidu tries to talk Gilgamesh out of it but he still decides to kill Humbaba. In result of killing Humbaba not only did he curse Enkidu but also it resulted into a dramatic effect on Gilgamesh. The second change that dramatically changed Gilgamesh was caused by the cursed death of his brotherly comrade Enkidu. Gilgamesh was overwhelmed with the loss and couldn’t seem to ever get over it. He became overcome with extreme emotions that he could not control. He wept for seven days and nights thinking his friend would come back but he was mainly feeling bad for himself. He was feeling self-destruction and weeping for something to happen to make himself feel better. At this point we can really understand the feelings and compassionate part of Gilgamesh that we haven’t seen from him so far. This grief from Gilgamesh is a whole different side of him compared to the towering pride that he previously had because now he is frightened, confused, and overwhelmingly sad about his loss. This also triggered an obsessive fear in him of his own personal death in the future. After Enkidu dies, Gilgamesh tries to find immortality by venturing off through mountains and crossing oceans to find an everlasting life. The third encounter that changes Gilgamesh is the death of Humbaba. He was a massive, evil creature that protected the cedar forest. Most of the people in Uruk would also say that Gilgamesh is evil as well because most people were scared of him. He does what he wants when he wants to and continuously seems to disappoint the Gods. By going into the forest and facing Humbaba, Gilgamesh gave a different view to the people in Uruk because he was protecting his city. Some would say he was doing this to make a name for himself, showing he could in fact destroy anything and everything but actually Gilgamesh was doing this out of his love of Enkidu and his people. When Gilgamesh set out a quest for Utnapishtism to look for answers, he was told about a secret plant that is supposed to restore the lost youth to a man. Gilgamesh shows a change in character at this point declaring he would take this plant back to the city of Uruk and give the plant to his people so everyone could be youthful and healthy again. Although Gilgamesh wasn’t able to bring back the magical plant to his city, the intention he had showed his people he cared and was attempting to not be selfish for once. He started out as an arrogant and overpowered king that had no respect or kindness for his people and now cares about his people and their well-being more than he did about himself. Whether or not we see Gilgamesh as an epic hero or not, the most important lesson taught through the Epic of Gilgamesh is how love is a bumpy road that connects everything together in the world. We learn from Gilgamesh that our destiny through life is affected by our close friends around us that give us a better understanding of others and ourselves throughout our life. The relationship of Gilgamesh and Enkidu fighting fate on a journey to slay evil with the help of the Gods and to survive and mourn the ones who we love and leave the world while keeping a positive attitude towards others should be an inspiration to all of us.