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Tuesday, August 25, 2020
Women And Aids Essays - HIVAIDS, HIV-positive People,
Ladies And Aids Understanding the Issues of Women and HIV/AIDS Rachel Seldin, Colgate University, Hamilton NY 13346 ABTRACT: Contamination with the human immunodeficiency infection (HIV) had risen as a significant medical issue for ladies in the United States. Family doctors can assume a significant job in the discovery and care of HIV-contaminated ladies. The study of disease transmission and common history of HIV contamination in ladies were inspected. HIV contamination is presently a main source of dismalness and mortality among young ladies in the United States, especially ladies of racial and ethnic minorities. Most instances of (AIDS) in ladies happen because of infusion tranquilize use or hetero transmission. In view of restricted data, ladies and men seem to have comparable AIDS-characterizing conditions. Gynecological issues are basic n HIV-tainted ladies. Pregnancy doesn't appear to be influenced by early HIV contamination, yet ladies with cutting edge ailment may be at expanded hazard for obstetric complexities. More ladies should be remembered for characteristic history examines and clinical me dication preliminaries. Early consciousness of HIV disease and better access to social insurance administrations are required to improve the treatment and endurance of HIV-tainted ladies. Catchphrases: Acquired Immunodeficiency Syndrome (AIDS), Human Immunodeficiency Virus (HIV), Pregnancy, Zidovudine (AZT), Vaginal Candidasis, Transmission Methods of HIV/AIDS, Perinatal Transmission, Women and HIV Presentation: (AIDS) has been announced ?the general wellbeing danger of the century' (1 refered to in 2). The US Surgeon General has assigned it as the country's main wellbeing need (2). Helps is an infection that influences the insusceptible framework. The term immunodeficiency alludes to the failure of the insusceptible framework to work appropriately, in this way making the individual defenseless to an assortment of contaminations not normally found in a sound invulnerable framework (3). A condition is a gathering of indications or ailments beginning from one reason. The primary operator causing AIDS is a retrovirus known as Human Immunodeficiency Virus (HIV). HIV is the specialist of an explicitly transmitted malady that can likewise be contracted through blood transfusions or IV sedate use; the infection can likewise be given to a hatchling during pregnancy. At the point when individuals are tainted with HIV, they are not really likewise contaminated with AIDS. An individual isn't tainted wi th AIDS until HIV diminishes insusceptible capacity to a specific level or when at least one genuine diseases identified with HIV happens. (4) Everybody is in danger of getting the HIV infection, in spite of the fact that ladies with HIV/AIDS face a bigger number of challenges living with this malady than do men. HIV/AIDS ladies are of uncommon intrigue since they are the significant wellspring of contamination of newborn children. In addition to the fact that they have to consider the consequences for their own lives, yet in addition they should consider their newborn children in the event that they decide to imagine. In my paper, I will survey the manners by which HIV/AIDS influences ladies uniquely in contrast to men, through clinical issues and gynecological indications. I will likewise talk about the infection itself and issues concerning HIV positive ladies who are wanting to consider. WHAT IS AIDS? In mid 1983, a group at the Pasteur Institute in Paris, France drove by Dr. Luc Montagnier first reported the disclosure of HIV (5). They initially named it LAV, or lymphadenopathy-related infection. In any case, it was not until the American group, drove by Dr. Robert Gallo, called the infection HTLV-3 or human T-cell lymphotrophic infection that the two groups worked together and rearranged it to simply HIV (5). HIV can cause a scope of conditions, of which AIDS is the most noticeably awful. For instance, it can prompt determined growing of the lymph hubs (5). Others may have increasingly genuine side effects yet at the same time give no indication of AIDS. This condition is known as AIDS related-complex ( ARC) (5). A portion of the side effects of ARC incorporate swollen organs, extreme or constant looseness of the bowels, extreme weakness, fast unexplained weight reduction, soaking night sweats, fevers, and yeast diseases, Although it tends to be not kidding, ARC isn't deadly (5). The reason for AIDS isn't completely comprehended. There are different elements are engaged with the advancement of AIDS. When an individual tests positive to HIV, liquor or medication use, poor sustenance, high feelings of anxiety, visit introduction to other infection (particularly explicitly transmitted sickness), have all been recommended to expand the danger of growing out and out AIDS (5). HIV
Saturday, August 22, 2020
Security and Privacy Issues in Cloud Computing â⬠MyAssignmenthelp
Question: Talk about the Security and Privacy Issues in Cloud Computing. Answer: Presentation The motivation behind this paper is to build up a report featuring different data and system security issues which can hamper the organizations of a few associations. In present situation, there is an immense accentuation laid upon such digital security and system issues in view of the protection worries of the clients. It is getting hard for the associations to hold the clients because of the protection and security issues. The report will be set up in regard with a little scope association that creates applications in-house and alter off-the rack programming in concurrence with bigger merchants (Liyanage, et al., 2016). The association is intending to differentiate its business by offering continuous data and system security administrations to organizations the executives that have an online nearness. Furthermore, there is a need to viably deal with the online security of those associations, including their sites and customer databases. The target of this report is to investigate t he different potential arrangements which can be taken use by the association in regard with defeating from every single such issue. There will be given a couple of suggestions which can assist the organization with expanding and differentiate its business in the coming five years and to offer the clients with made sure about are ensured administrations with no sort of system and security penetrates. The key accentuation is driven more upon the main concern concerns for example the financial perspectives as the association is little scope and has a constrained money to contribute on to spare the business forms from such issues (Bohli, Langendrfer and Skarmeta, 2013). System Security and its requirement for worldwide organizations There is expanding dependent upon the expanding and nonstop utilization of web in such a digitalised worldwide condition. The majority of crafted by both the little scope just as enormous scope associations are currently needy upon web and cutting edge innovations. In light of such expanding dependent, it is basic to have sufficient shields for ensuring the organizations executing in the digitalised age (Khan, et al., 2016). The essential purpose for the activities taken towards the systems administration and security is the rising dangers and dangers of digital assaults. What's more, this happened as a vital test for the associations and the administrators to take utilization of the advantages of computerized age and mechanical headways yet with supporting the danger of security issues and digital assaults (Stallings and Tahiliani, 2014). It has been seen that there is an expanding abuse of the mechanical headways and the web is representing an extraordinary danger to digital and or ganize security and protection of the clients and hence the organizations are finding a way to beat these dangers. It is likewise vital for the association to distinguish just as relieve the dangers of systems administration issues and digital assaults and make sufficient strides for limiting these dangers (Spiekermann, et al., 2015). Prior to comprehension and investigating the different ways by which the association can effectively grow its business beating the dangers of system security, digital security and protection issue, it is fundamental to under the significance of the part of digital security in the business activities. System security can be comprehend as the field of web security where the principle fixation is on keeping up harmony inside the stronghold instead of centering more upon the dangers which are available outside the mansion (Roman, Zhou and Lopez, 2013). The key spotlight is on shielding against the systems administration issues and dangers which could occur inside the business tasks and break the security. There is a major accentuation drove after making sure about the inward data of the association by having a successful observing the systems just as the workers in a satisfactory way. The organizations introduce programming of system security for ensuring the business activities, applica tions and procedures the board from the digital burglary and protection break. There are programmers that deceived the system security of the associations by infusing the information, individual data and codes just as surpass the physical access to the product and equipment by various hacking strategies (Sadeghi, Wachsmann and Waidner, 2015). What's more, in this manner, it has gotten one of the top most issues in the globalized business world which is a few or the other way weakening the advantages of advanced age and web based innovations. There has been raised essential hugeness of system security as the worldwide organizations need to confront a significant expense in view of any sort of break of system security and protection penetrate. On the off chance that the hierarchical information is auctions off in the business sectors, covertly checked, distorted and have taken abused then it can cost immense for the organizations and explicitly for the ones who are very much perceived in the market (Liang, et al., 2014). Numerous multiple times as a result of the system and security breaks there is spilled down of the companys classified information, change of the associations funds, taken adverse utilization of the clients private information and bolting out of the frameworks of the associations so that even the work force don't reserve a privilege to open them. Such system assaults are taken utilized by the different digital programmers involving phishing, altering, mocking and click jacking. Also, in this way, it turned out to be very basic to spare the associations from these system security issues and protection breaks (Xiao and Xiao, 2013). Advancements, practices and applications in the field of system and data security There are a few accepted procedures and improvements that have been taken sue by number of organizations and association in the innovation business to conquer the danger of protection penetrate and security issues. Following is the portrayal of such practices, advancements and applications which have been utilized by a few of all shapes and sizes associations for making sure about themselves, their business forms and the clients from the system assaults and protection breaks. The firewalls are considered as the top most need of the organizations the board accepting utilization of web as the essential line of safeguard from such issues. It is fitting for the association to set up firewall with the goal that it could help the association is going about as incredible blockade between the programmers and the secret information and data of the association. These firewall must be introduced both inside just as remotely that there can be accomplished extra wellbeing monitor from the system and security challenges. It is additionally fundamental that the representatives who will be working from their homes must have a fixed establishment of firewall on their home as well (Phillips and Sianjina, 2013). This will help in filling the hole and sparing those workers additionally from getting hacked and along these lines this use of the firewalls will assist the organization with expanding its business and enhance its portfolio by dealing with every one of these issues of system assaults (Wang, et al., 2016). It is very basic that the different conventions in regards to the system security are suitably recorded. At the organizations where a security plan isn't applied in an appropriate manner, there can be penetrate of the wellbeing safeguards. Hence, it makes significant for the association to have a sufficient documentation of the system security approach. There isn't just sparing of information through thee organize security approaches yet additionally retainment of the important HR and money related assets (Bayuk, Healey and Rohmeyer, 2012). The different activities that the workers embrace both inside just as remotely have an immediate effect upon the business manageability. Furthermore, subsequently, even the activities and exercises of an individual worker could bring about break of protection of the secret information of the association that involves client/client data, going from individual subtleties, to budgetary records, business exchanges, delicate data and other online login subtleties. There is required to have utilization of the itemized toolboxs as utilized by different associations which can bolster in deciding and reporting the arrangements of system security (Sicari, 2015). Applications for sponsorship up information Indeed, even the business associations send various assets; there are still a few provisos which can allow to the programmers to assault the system security and protection of the clients. In this way, it is essential that there must be successful back up of the considerable number of information containing the records identified with the individual data of the clients, human asset records, databases, money related and operational information, spread sheets and different reports (Rittinghouse and Ransome, 2016). It is basic that the organizations must have an act of support up the information on a customary and ceaseless premise on the cloud just as various areas to defeat the danger of information misfortune and breaking of systems. This won't just help in getting back the lost information yet additionally in getting mindful and make one stride high during a system assault as all the information will be made sure about at a few or the other spot. The association in its coming five ye ars to have more secure business tasks can take utilization of eminent applications, for example, Comodo/Time Machine, Dropbox, and so on for sponsorship up its information. These applications are successful enough in guaranteeing that the business applications and procedures are protected and secure. The records on which the clients and representatives are working are matched up to the introduced application as well as have a total sync with the principle servers of the application. This guarantees all the present work and other information is made sure about and kept securely sponsored up (Botta, et al., 2014). It is an essential and obligatory to be applied information that the different phishing messages must not be opened by the authoritative workers. There was introduced in the reports of Data Breach Investigations by Verizon for the
Friday, August 7, 2020
The Book Riot Podcast, #76 The Virtues of Difficulty
The Book Riot Podcast, #76 The Virtues of Difficulty The Book Riot Podcast, Episode #76: The Virtues of Difficulty In this episode, Jeff and Amanda talk Simon and Schuster reupping with Amazon, another hand-wringing YA essay, an author engaging in light-stalking, news of a new Toni Morrison novel, new books, and much more. This episode is sponsored by Squarespace, Kobo, and TryAudiobooks.com. You can subscribe to the podcast in iTunes (click here) or via RSS (link here). You can also download a free dedicated app for iOS or for Android. Links discussed in the show: SS signs new deal with Amazon Daniel Handlerâs plan to help indie bookstores New Toni Morrison Novel The Percy Jackson problem Kathleen Hale, blogger stalker Waterstones sleepover contest New books discussed in the show: The Republic of Imagination: America in Three Books by Azar Nafisi (Viking) Some Luck by Jane Smiley Beautiful You by Chuck Palaniuk Fahrenheit 451, read by Tim Robbins ____________________________ Browse previous episodes of The Book Riot Podcast. ____________________________ Sign up for our newsletter to have the best of Book Riot delivered straight to your inbox every two weeks. No spam. We promise.
Saturday, May 23, 2020
Emergency Contraception Essay - 677 Words
Emergency Contraception There are many myths surrounding the use of emergency contraception. The question of what it is and when to use it is just a fraction of the controversy surrounding this arguably new practice. Emergency contraception is a method of preventing pregnancy after the act of unprotected sexual intercourse. It does not protect against sexually transmitted diseases. However, emergency contraception can not be obtained without a prescription. Why does the US government not trust women with the choice of making sure they do not get pregnant after having unprotected sex? If abortion is a choice and abortion terminates a life, why can women not have the choice to make sure they do not need an abortion? What is wrong withâ⬠¦show more contentâ⬠¦It slows down ovulation, it stops the fertilization of the egg, and it stops the attachment of the egg to the wall. (2). It is not an abortion pill or RU-486. (2). It does not kill the baby, as the baby is never formed. Emergency contraception can be used in instances of a broken condom, sexual assault, or really anytime after unprotected sex. This is part of the issues surrounding its use. Many physicians do not think that it should be used in any situation, except that of true emergency. This is part of the reason that emergency contraception is not an over the counter drug. It is approved by the FDA, but all but three states in the US require a woman to see a physician before they can get a prescription for it. About one half of unwanted pregnancies are due to the failure of a contraceptive. Similarly, about one half of unwanted pregnancies end in abortion. (3). What would be worse, killing an unborn child or making sure that the child is never biologically formed? However, many pharmacies refuse to stock ECPs. One for example, is Wal-Mart. Many groups, such as the AMWA, see this as denial of emergent care.(3). In fact, the American College of Obstetricians and Gynecologists estimate that emergency contraception could prevent 800,000 abortions and 1.7 million unintended pregnancies in the United States each year. (4). ECPs are available through Planned Parenthood. They are priced on a sliding scale, with the average cost of $20-$25 for pillsShow MoreRelatedSelf Emergency Contraception Is a Right Women Should Have1318 Words à |à 5 PagesI will argue that pharmacists lack an absolute right to object the dispersal of emergency contraception. Further, I will argue that the reasons offered for refusals regarding emergency contraception by pharmacists are not reasonable, even given their moral reservations, providers have a professional ethical obligation to dispense emergency conception. The refusal to sell emergency contraception by pharmacists ultimately infringes on womenââ¬â¢s right to exercise autonomy over their reproductive futureRead More Cause and Effect Essay - Emergency Contraception Causes Abortion952 Words à |à 4 PagesEmergency Contraception Causes Abortion à à à à Brown University associate professor of medicine, Ralph Miech, M.D., Ph.D., stated the abortive nature of EC in the Providence Journal on August 3, 1998: This type of pill causes an abortion. From a pharmacologic perspective, this type of pill should be called an abortion-after pill. à The question must be asked: How is this contraception? Women are being falsely led to believe that these pills are contraceptive in nature. But oneRead MoreEssay on Emergency Contraception871 Words à |à 4 Pagesidea of Emergency Contraception is not a new to society, however it is still igniting many debates just as it did when it was first introduced to the United States. Emergency contraception continues to be a highly emotional and controversial issue, both for advocates who believe EC will lower the number of unintended pregnancies and abortions, and for opponents who believe that using EC amounts to an abortion. The controversy fueling this debate centers around one of the ways that emergency contraceptionRead MoreWhy Do We Continue to Debate the Use of Contraception Essay1572 Words à |à 7 PagesContraception is it right or wrong and are you to young to decide for yourself? Recently we have been hearing a lot about Contraception ad if it is right or wrong and who gets to d ecide. The name of the Scholarly article that I chose to write about is, (Simonds Ellertson, 2004, p. 1285-1297) Emergency Contraception and Morality reflections of health care workers and clients. In the United States our government goes back and forth between trying to be conservative and trying to separate personalRead MoreEthical Considerations Project Essay610 Words à |à 3 PagesConsiderations I believe the ethical considerations in Brownfield v. Daniel Freeman Marina Hospital is for all hospitals to provide all information and access to emergency contraceptives to sexual assault and rape victims. In the defense of Brownfield, emergency contraceptives, Plan B, and oral synthetic hormones is the most common type of emergency contraceptives that should have been disclosed to her upon her request. These contraceptives are often called the morning after pill or Plan B. Some legalRead MoreEthics Paper on Healthcare Policy645 Words à |à 3 Pagesissue? The ethical considerations of this issue, is the responsibility of the hospital to provide all the relevant information concerning access to emergency contraceptives, for rape and sexual assault victims. Brownfieldââ¬â¢s defense supports the idea that emergency contraceptives, Plan B, and oral synthetic hormones are the most common form of emergency contraceptives, and this information must be given to the victim upon her request. These contraceptives are called the ââ¬Å"morning after pill or planRead MoreContraception Is An Entity That Many People Take For Granted1228 Words à |à 5 PagesContraception is an entity that many people take for granted. In the past, women did not have any access to contraceptives because they did not exist at the time. As time passed, the thought of contraceptives began to bloom, but the idea was thought to be ââ¬Å"obscene.â⬠This was in a time where women had very few rights, and one of the rights they were forbidden to have was the righ t to have access to contraceptives and be active in the planning of their families and fertility. Whether in a relationshipRead MoreThe Morning After Pill Essay654 Words à |à 3 Pageslife has begun, by preventing ovulation or implantation of a fertilized egg. The morning pills are a form of abortion. Just because the drug is legal doesnt men county health officials must provide it. Taxpayer money shouldnt be used for emergency contraception. The morning after pill is great in some ways but what about those who cant afford it or just cant stand giving up something they are responsible for. The morning after pill may be a good idea to some individuals but everyone is responsibleRead MoreContraception Insurance Mandate: The Religious Exemption Debate1616 Words à |à 7 Pagesaccessible and affordable to millions of Americans (National Womenââ¬â¢s Law Center, 2011). ââ¬Å"Among the many firsts: employers that offer health insurance must cover certain preventative measures for women, including contraceptionâ⬠(Corbin 2013, p. 1470). This requirement has been coined the ââ¬Å"contraception mandateâ⬠and has generated an uproar among many Catholic employers in the US (Corbin 2013, p. 1470); they believe it is in violation of their basic rights of religious freedom and freedom of speech to beRead MoreWe Live A Democracy?1256 Words à |à 6 Pagesgetting pregnant reason being why some religious companies do not support the coverage of these contraceptives. A sense of man playing God and the intentional disregard of the science spectrum. The employers think that certain forms of contraception (emergency contraception pills and intrauterine devices) cause abortions. Dr. Jeanne A. Conry and Dr. Nancy L. Stanwood. Those type of views, makes the decision of covering contraceptives an issue throughout the nation. Outdated views and inaccurate knowledge
Tuesday, May 12, 2020
Miscommunications in the Workplace - 2148 Words
Miscommunication in the Workplace Communication is a two-way street. Making assumptions and drawing conclusions based on only one frame of reference will usually fail and cause miscommunication between the parties involved. This can be because of differences of gender, culture, age or even education levels. Changing the fundamental way in which a person thinks or feels can lead to better communications between the parties involved. Due to the rapid changes brought about by globalization it isÃâ¦vital to understand that we react to our environment, its teachings and its belief systems. A lack of understanding of our most cherished and deeply held values can lead to considerable stress and feelings of anger. We must be especiallyâ⬠¦show more contentâ⬠¦The diversity of cultures in the workplace of today can lead to misunderstandings, miscommunications and missed opportunities for the improvement of both workers and management. Managers should be equipped with and practice effective communication skills, w hich can transcend any or all kinds of cultural barriers. To alleviate the tension between different groups and their differences by understanding their differences we must practice good communication skills. Many managers and even coworkers are only concerned about themselves, how they can get to the top of the corporate ladder. Managers and coworkers will walk all over others to get where they what to be no matter what the cost to others or who it my hurt, whether it be a promotion, some form recognition, or to just build up their self-esteem so they can feel important. There are very few managers who truly support their people. A good manager should guide and direct at all times, not just during the good times. Keeping employees moral up and conflict down should be a daily task for both managers and employees. As an employee, we have the responsibility to perform our daily tasks while assisting others as needed or directed by our manager. Why do managers need to know how to handle conflict? The main reason is unresolved conflict usually grows intoShow MoreRelatedDifferent Communication Styles Among Genders in Spain and Asian Countries1026 Words à |à 4 Pagesincidents in which males can assert power, at which a strong female response is seen as normal. 4. What conflicts or miss-communications might occur? Despite the relative ease of communication in Spanish culture, there is always the potential for miscommunication. For instance, the need to speak up in Spanish culture, or to speak ones mind, can lead to ones personality and statement being interpreted very differently by various individuals. Those not used with the fast pace and honesty of Spanish cultureRead MoreGender Roles Of Women And Men Essay1485 Words à |à 6 PagesThere are lots of gender stereotypes that exist in the world today and that is why it is so influential to the changes of communication in the workplace. Why it is an important area to study: It is an important area to study this topic because to see how gender equality or inequality can affect or how it influences the changes communications in the workplace. Showing that both genders have the same amount of education or job experiences in the workforce, there should be always a type of equality inRead MoreCommunication Barriers in Workplace1252 Words à |à 6 Pagesï » ¿Communication Barriers in the Workplace Communication barriers in the workplace can have a serious effect on the functioning and of an organization. In the following article we shall understand what some of these communication barriers are and how to overcome them. What are the Communication Barriers in the Workplace? Difference in Perception No two people can perceive an event in the same way. What I infer from a particular incident, the other will not necessarily perceive the same. ThisRead MoreEffective Communication in the Workplace Essay1220 Words à |à 5 PagesCommunication Barriers in the Workplace Communication barriers in the workplace can have a serious effect on the functioning and of an organization. In the following article we shall understand what some of these communication barriers are and how to overcome them. Ads by Google Improve Communication Our NLP Training Program Helps You Overcome Your Fears. Enroll Today! www.EasyNLP.com/ Conflict Management How much is conflict costing you? Assessment, Training, Coaching www.StrategicLeadershipCoachingRead MoreThe Importance Of Communication1104 Words à |à 5 Pagesstill continues to be a big problemâ⬠(Federico, Frank, Fierce Healthcare). Whatever the causes are of all the communicated related issues, physician practices and hospitals must make it a priority to improve communications amongst co-workers in the workplace. Dolighan does a great job getting his point across in this cartoon, but his point is enforced by the use of pathos. Pathos, or the emotional appeal, means to persuade an audience by appealing to their emotions. Dolighan does this by adding someRead MoreThe Relationship Between Patients And Their Medical Professional1019 Words à |à 5 PagesIntroduction: Communication is a substantial contributing factor in providing high-quality healthcare. The relationship between patients and their medical professional is solely dependent on communication. Unfortunately, miscommunication has become increasingly prevalent in healthcare services. Compared to urban cities, the medical services available in rural areas are limited. Indigenous Australians form a greater fraction of the total population in remote regions, therefore are direct recipientsRead MoreMba 540 Chapter 2 Case Study Essay746 Words à |à 3 PagesUniversity What are the potential sources of the problem? The source of these problems seems to be coming from two areas in Interwest Healthcare. The first area is the miscommunication that the hospital administrators are having with upper management. The hospital administrators and upper management are not only having miscommunication issues but they also do not share the same role expectations with each other which is creating tension. ââ¬Å"The hospital people accused Singh of being a bureaucrat who didRead MoreDiversity Of An Organization s Workforce944 Words à |à 4 Pagesbusiness success. To influence managers to utilize every resource when attempting to enhance the cultural diversity in the work place as a ââ¬Å"dynamic atmosphere of collaborationâ⬠. Supervisors want to see high standards of ethical behavior in the workplace. In turn, they must behave ethically themselves, exhibiting important dimensions of ethical behavior including loyalty, fairness and honesty with contribution to an environment that encourage ethical action. Code of ethics and an organizationââ¬â¢s writtenRead MoreReflection About Communication1245 Words à |à 5 PagesOne way of communicating is with words which have the energy and power to help, to heal, to hurt, to harm, or even to humiliate, etc. Communication is said to be the key to success, whether it be in a relationship, workplace, or even at a market. It is used in our everyday lives. Communication can be defined as successfully delivering a message to someone or something, whether we say it, use body language, write it, or even send a message. Every person is different, therefore every person has differentRead MoreEffective Communication in the Workplace Essay1300 Words à |à 6 PagesE ffective Communication in the Workplace The workplace is an environment where more and more Americans are spending significant portions of their time. In fact, 25 million workers reported spending at least 49 hours a week at work, (Schabner, 2013). This means that having effective communication in the workplace is becoming increasingly important. Not just to improve business practices, but to improve the quality of both employer AND employee satisfaction. Effective interpersonal communication
Wednesday, May 6, 2020
Terri Schiavo Free Essays
string(34) " disagreements were denied by Mr\." Nurs 2500: Ethical, Legal and Moral aspects of Nursing School of Advanced Nursing Education The University of The West Indies Melissa Balbosa Craigwell 811005170 Biography of Terri Schiavo On the 25th February 1990, 26-year-old Terri Schiavo suffered severe brain damage when her heart stopped for five minutes. In June of 1990, Michael Schiavo, Terriââ¬â¢s husband, was appointed her plenary guardian by the courts. In September of 1993, Michael Schiavo authorized the nursing home she resides in to write a DNR (Do Not Resuscitate) order for Terri. We will write a custom essay sample on Terri Schiavo or any similar topic only for you Order Now Schiavo spent the following years in rehabilitation centers and nursing homes but never regained higher brain function. In 1998 her husband, Michael Schiavo, filed a legal petition to have Schiavoââ¬â¢s feeding tube removed, saying that his wife had told him before her medical crisis that she would not want to be artificially kept alive in such a situation. Terri Schiavoââ¬â¢s parents, Bob and Mary Schindler, fought this request. Florida judge George W. Greer ruled in 2000 that Schiavo was ââ¬Å"beyond all doubtâ⬠in a persistent vegetative state and that her husband could discontinue life support. But as legal appeals in the case continued, the case became widely known as some religious groups and pro-life activists began to insist that Schiavo should be kept alive. Schiavoââ¬â¢s feeding tube was removed in 2003, but reinserted six days later when the Florida legislature passed ââ¬Å"Terriââ¬â¢s Law,â⬠which allowed the stateââ¬â¢s governor to issue a stay in such cases. The law was later ruled invalid by the courts. At this time, there may also have appeared to be a conflict of interest, as Michael had two children with a long-term girlfriend. In March of 2005 Schiavoââ¬â¢s feeding tube was again removed, and the case became a greater public sensation when the U. S. Congress was called into special emergency session to pass a bill allowing federal courts to review the case, with President George W. Bush flying from Texas to Washington especially to sign the bill into law. However, federal judges and the U. S. Supreme Court refused to intervene. After two weeks without food and water, Schiavo died of dehydration on the 31st March 2005 at the age of 41. Some the ethical issues involved in this case include; autonomy, beneficence and non-maleficence, justice, religious views ââ¬â Roman Catholic ââ¬â sanctity of life, no advance directives, Terriââ¬â¢s pre incapacitation verbal comments, and conflict of interest (familial, financial and institutional). The patient had severe brain damage. This followed a history of a sudden collapse secondary to cardiac arrest which resulted in prolonged cerebral hypoxia. She was diagnosed as being in a persistent vegetative state. Prognosis for patients in this state is poor. This condition is deemed to be chronic and irreversible. The goal of treatment is to alleviate pain and suffering. The probability of success cannot truly be determined as the patient is unable to communicate. In this case rehabilitative efforts were found to be unsuccessful, and a court order was issued for life support to be ended. The patient benefits from medical care through treatment that alleviates any pain or distress. Nursing care also seeks to alleviate pain and distress through palliative care which seeks to provide comfort and maintain dignity. Harm is avoided when there are no conscious efforts to hasten or prolong death. Terri Schiavo was not mentally capable and, therefore, not legally competent. The evidence of her incapacity lay in her inability to communicate. Buchanan 2004, stated that legal competence is specific to the task at hand. It requires the mental capacities to reason and deliberate, hold appropriate values and goals, appreciate oneââ¬â¢s circumstances, understand information one is given and communicate a choice. If the patient were found to be competent, then according to Michael Schiavo, she would be asking for treatment to be withheld and ongoing treatment to be withdrawn. A patientââ¬â¢s ability to self-govern is grounded in cognition (Fine, 2005). So, assuming she had the mental capacity to make her own decisions, her autonomy would have been respected and her decision upheld by the legal system. As a part of informed consent, all information would have been given to the patient concerning benefits and risks specific to her circumstances. She would have voluntarily indicated her understanding of treatment options available and given her consent in a written or oral form or possibly by some type of implied behaviour. In her incapacitated state, the appropriate surrogate should, by moral and ethical standards be her husband Michael Schiavo and indeed, he was her court appointed guardian. Butts and Rich (2008) defines a surrogate as a court appointed individual who has the authority to make decisions on behalf of the patient. The question as to whether Mr. Schiavo used appropriate standards in his decision making can be measured against the principles for proxy decisions with incompetent patients as set out by Olick (2001). These principles in relation to Terri Schiavo say that competent patients have a right to refuse life sustaining treatment, and he testified in court that prior to her collapse she verbalized that she did not wish to live like that, to be a burden to anyone. Incompetent patients have the same rights they are, however, exercised differently. No right is absolute, instances in which a patientââ¬â¢s right to refuse life support is outweighed by societal interests is rare, this case was one of those rare instances. Withholding and withdrawing treatments from a terminally ill or permanently unconscious patient, does not constitute killing or assisted suicide. Terri was not diagnosed to be either terminally ill or permanently unconscious. A subjective standard of implementing the patientââ¬â¢s wishes should have been used, and it was. It is recorded that the patient while competent clearly made her wishes known through informal conversations with several individuals, including her husband. There were no advance directives to rely on for guidance in this case. Local processes of review in the clinical setting in order to facilitate the resolution of disagreements were denied by Mr. You read "Terri Schiavo" in category "Essay examples" Schiavo, therefore, recourse to the courts which should have been rare were frequent. This analysis indicates that appropriate standards for decision making were utilized. Whether they were adequately utilized can be debated. Advance directives, as discussed by Butts and Rich (2008), include the use of formal, written legal documents, which may take one of three forms; a living will, a medical care directive or a durable power of attorney. None of these, however, were used to express the patientââ¬â¢s preferences. Terri had been medically assessed to be in a persistent vegetative state, with no higher brain function. In this state, it was judged that she would have been unable to cooperate with medical treatment. To say that she may have been unwilling would be denying her medical diagnosis, suggesting that she did have the higher brain power necessary to choose between quality and quantity of life. In summary, I do not believe that the patientââ¬â¢s right to choose was being respected to the extent possible in ethics and in law. This is reflected in the absence of compliance with several of the principles for proxy decisions. These would be; the attempt to enable her to express her wishes, respecting societyââ¬â¢s interest for the continuation of life support, facilitating patient review to determine capacity and competence and finally not withholding and not withdrawing treatment from a patient who was not terminally ill or permanently unconscious. The New England Journal of Medicine (1994) discusses the prospect of return to a normal life with treatment. ââ¬ËTherapy aimed at reversing the persistent vegetative state has not been successful. There have been occasional reports of a benefit from dopamine agonists or dextroamphetamine, but the benefit has been modest at best, direct electrical stimulation of the mesencephalic reticular formation, nonspecific thalamic nuclei, or dorsal columns has been attempted experimentally in patients in a vegetative state, with claims of recovered consciousness in a few instances. The quality of the recovered state was not described in detail, however, and these approaches remain experimental. Overall, there is no published evidence that coma sensory stimulation improves the clinical outcome in patients in a persistent vegetative state. It continues to note that ââ¬â¢If the decision is to treat the patient aggressively, diligent medical treatment and nursing care are required to prevent and treat the complications that are likely or inevitable in states of severe brain damage. The survival of patients in a persistent vegetative state is, to some degree, related to the quality and int ensity of the medical treatment and nursing care that they receive. Preventive care is foremost. Daily exercises in a range of movements slow the formation of limb contractures, which otherwise become particularly severe in patients in a persistent vegetative state. Daily skin care and frequent repositioning of the patient prevent decubitus ulcers. A tracheostomy may be required to maintain airway patency and prevent aspiration pneumonia. Bladder and bowel care is desirable for hygienic reasons. Since pulmonary and urinary tract infections are common, appropriate monitoring and, if necessary, treatment with antibiotics are required. Placement of nasogastric, gastrostomy, or jejunostomy feeding tubes is usually necessary to maintain adequate nutrition and hydration. ââ¬ËThe outcome probability at 12 months was determined in patients who remained in a vegetative state at 3 months and at 6 months. In addition, the probability of functional recovery was determined for two possible outcomes: good recovery or recovery with moderate disability, and recovery with severe disability. On the basis of these probabilities, a persistent vegetative state can be judged to be permanent 12 months after a traumatic injury in adults and children; recovery after this time is exceedingly rare and almost always involves a severe disability. In adults and children with nontraumatic injuries, a persistent vegetative state can be considered to be permanent after three months; recovery does occur, but it is rare and at best associated with moderate or severe disability. ââ¬â¢ NEJM (1994) ââ¬ËPatients with a good recovery have the capacity to resume normal occupational and social activities, although there may be minor physical or mental deficits or symptoms. Patients with moderate disability are independent and can resume almost all activities of daily living. They are disabled to the extent that they can no longer participate in a variety of social and work activities. Patients with severe disability are no longer capable of engaging in most previous personal, social, and work activities. Such patients have limited communication skills and abnormal behavioral and emotional responses. They are partially or totally dependent on assistance from others in performing the activities of daily living. ââ¬â¢ NEJM (1994) A bias does exist, according to Viswanathan et al. (2012), a reporting bias is the difference between reported and unreported findings. This would have made a big difference to the results obtained from any form of continuous assessments at the hospice. Based on the very minimal treatment options chosen by Michael Schiavo, reflective in a refusal to allow physiotherapy, oral hygiene or antibiotic administration, we may deduce that a continuation of life, with contractures, infections and poor dental state would be undesirable. There was a plan to discontinue life support by having her feeding tube removed. There was also a DNR order in place. The reason for both of these actions was to prevent prolongation of her death. The documentation suggests that there were plans for palliative care, as Butts and Rich (2008) points out that palliative care includes the choice to forego, withhold or to withdraw treatment, it also includes DNR orders. Palliative care does not hasten or prolong death, but provides relief from pain and suffering and maintains dignity in the dying experience. Michael Schiavo had a long-term girlfriend, with whom he had fathered two children, according to Funaro (2007). There may have existed a conflict of interest in balancing the affairs of his new family with the needs of his wife. He claimed that a part of him had moved, yet he still oved his wife so much that he was willing to fight to carry out her wishes. This conflict may have had an influence on his decisions. Provider issues that may have influenced treatment decisions, lie in the fact that the institution in which Terri was being cared for was one in which end-of-life management was carried out. The treatment provided by t he hospice staff would only have recommended palliative care. Are there financial and economic factors? Yes. Fine (2005) tells us that ââ¬ËFamilies may bankrupt themselves caring for patients in a persistent vegetative state, at which point Medicaid steps in. Medical costs are the leading factor in bankruptcy. her parents objected to her being supported by government funds. The hospice caring for Terri Schiavo provided $9. 5 million of charity care to patients in the past year. Another question of distributive justice relates to insurance. Can a society that cannot find enough resources to insure the 44 million persons (25% of whom are children) with no government or private health insurance really afford to maintain patients in a persistent vegetative state at a cost of $40,000 to $100,000 each per year? The lack of health insurance costs lives. According to the Institute of Medicine, 18,000 deaths per year are directly attributable to a lack of health insurance. ââ¬â¢ Terri Schiavo had been a devout Roman Catholic, Lynn (2005) this religion upholds the sanctity of life. It was difficult for her parents to believe that she would not have wanted to hold on to life at all costs. They questioned whether Terri would have wanted to be starved to death. Theirââ¬â¢s and by extension Terriââ¬â¢s prior existence was a culture of life. There are limits on confidentiality, the incompetent patient still has a right to privacy and confidentiality. This right should be upheld by the legal guardian. Treatment decisions are largely affected by the laws that govern options for patients to be able to choose to accept or refuse care, and for legal guardians to make decisions on their behalf when they are not able to. A great deal of clinical teaching and research is involved on an ongoing basis. It brings about new information and better ways of managing conditions. Yes there was a conflict of interest on the part of the institution. Lynn (2005) ââ¬Ëregulations generally prohibit a hospice from taking a patient who is not terminally ill and expected to live longer than six months to a year. But Felos was chairman of the board of directors of the hospice at the time, according to the non-profitââ¬â¢s annual reports, and was likely able to arrange for her admission. He subsequently stepped down from the post. ââ¬â¢ George Felos was Michael Schiavoââ¬â¢s attorney. The committeeââ¬â¢s specific findings related to this case are as follows; ââ¬Ëdecisions near the end of life, whether to maintain a treatment that may not be beneficial or to withdraw or withhold a life-sustaining treatment, should be effectively handled in the majority of cases by the primary treatment team. Ethics consultations are available and can be particularly valuable in cases of uncertainty or conflict. Palliative care consultations are available in cases of uncertainty or when needed to help manage complex symptoms, including physical, psychological, social, and spiritual suffering. Such suffering is often at the root of many an apparent conflict, and when the suffering is properly addressed, the conflict resolves. When these efforts fail to resolve conflict over decisions near the end of life, the rule of law suggests that the conflict be resolved in a court and not in legislative deliberations for a single patient. At the end of all of the medical, legal, and ethical argument, it is most important to remember that no matter how certain any of us may be of our analysis, decisions near the end of life should never be easy. We must remind ourselves that true wisdom comes with the acknowledgment of uncertainty and admitting that we cannot know all there is to know. This uncertainty is neither an excuse to engage in endless moral relativism or to engage in intellectual nihilism, refusing to search for the best possible solution or the least terrible outcome for a troubling moral problem. ââ¬â¢ Fine (2005). In light of the above discussions, with heavy emphasis on the seven principles for proxy decisions with incompetent patients, the committee has decided against the removal of the feeding tube. The rationale for this decision, lies mainly in the fact that these principles were not upheld as best as they could have been. As shown in the above discourse, a thorough attempt had not been made to closely follow these principles. As such, the committee recommends that the feeding tube not be removed. In conclusion, there is no traditional moral obligation to provide non-beneficial treatments based upon the classic goals of medicine, which are, according to Hippocrates, ââ¬Å"the complete removal of the distress of the sick, the alleviation of the more violent diseases, and the refusal to undertake to cure cases in which disease has already won mastery, knowing that everything is not possible to medicineâ⬠. There is a traditional duty to relieve suffering, nicely restated by Sir William Osler 1849-1919: ââ¬Å"To cure sometimes, to relieve often, to comfort always. â⬠References Author unknown, 2004, Terri Schiavo Biography (Medical Patient), J R Soc Med; 97(9): 415ââ¬â420. PMCID: PMC1079581, retrieved from www. infoplease. com/biography/var/terrischiavo. html Fine, R. , 2005, From Quinlan to Schiavo: medical, ethical, and legal issues in severe brain injury, retrieved from www. ncbi. nlm. nih. gov â⬠º â⬠¦ Funaro, S. 007, Why didnââ¬â¢t Michael Schiavo seek a divorce? , retrieved from www. legalzoom. com/planning-your-estate/living-wills/why-didn Lynn, D. 2005, Life and Death Tug of War-The Whole Terri Schiavo Story, retrieved from www. wnd. com/2005/03/29516/ ââ¬â 115k, Published: 03/24/2005 at 1:00 AM New England Journal of Medicine, 1994, Medical Aspects of the Persistent Vegetative State, N Engl J Med 1994; 330:1572-1579 DOI: 10. 1056/NEJM199406023302206, ret rieved from www. nejm. org/doi/full/10. 1056/NEJM199406023302206 Olick, R. S. 2001. Taking advance directives seriously: Prospective autonomy and decisions near the end of life. Washington, DC: Georgetown university Press, p. 30. Viswanathan M, Ansari MT, Berkman ND, Chang S, Hartling L, McPheeters LM, Santaguida PL, Shamliyan T, Singh K, Tsertsvadze A, Treadwell JR. , 2012, Assessing the Risk of Bias of Individual Studies in Systematic Reviews of Health Care Intervention, Agency for Healthcare Research and Quality Methods Guide for Comparative Effectiveness Reviews, retrieved from effectivehealthcare. ahrq. gov/index. cfm/search-for-guides-rev ââ¬â 148k How to cite Terri Schiavo, Essay examples
Friday, May 1, 2020
Personal Responsibility Essay free essay sample
Personal responsibility is about the integrity to make the choice to do our own work. Therefore, shortcuts that cheat us and take away from the learning experience should be avoided. The reward of hard work and an honest effort is a better understanding and greater appreciation for the subject Schools should work to create a culture of academic honesty. Professors, staff, and students must understand that integrity and honesty are valued qualities to be nurtured and maintained. Those who truly value learning, never even consider cheating. That is academic integrity (ISAAC, 2007).A student must have the courage to own both the good that is accomplished and the mistakes made along the way. The mark of a mature student is to learn from these mistakes and continue to improve. A positive attitude displayed towards constructive criticism is essential in order to achieve the necessary improvements. Personal responsibility is a virtue that should apply to a students thoughts, feelings, and actions. We will write a custom essay sample on Personal Responsibility Essay or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page Ultimately, with sufficient resources available, the time and effort a student contributes will determine their amount of success.Members of the School of Education and Human Development at George Washington University wrote Recent scholarship has emphasized the importance of student effort and involvement in their academic and co- curricular activities as the decisive elements in promoting positive college outcomes. As colleges have struggled to extend opportunities, an accompanying expectation for students to assume responsibility for their own education often has been lacking. Institutions must work to create a climate in which all students feel welcome and able to fully participate.It is equally important to nurture an ethic that demands student commitment and promotes student responsibility. Students can contribute to their own learning and to the development of a campus climate in which all can grow and learn (Davis ; Muriel, 1993). Some classes will be more stimulating to a student than others. Often there are required courses in a subject of less personal interest. The responsible student will display the same attitude and dedication to these classes as in the ones enjoyed the most.For example, subjects such as math may not seem as relevant to an English degree as 20th entry English literature, but they should receive the same level of commitment. A student must set aside both resources and time to complete assignments. For example: An on-line student can have the best computer with all the right software and it wont do a bit of good if they begin working on their thesis two hours before the due date. At the same time, a student can have a week to dedicate to writing their thesis and it wont do them any good if they cannot get to a computer to submit it to the Professor.Before students begin a course they should ensure they have both the time and sources necessary to succeed. When assignments are too difficult, or grades are lower than expected, some students look for others to blame. To quote from California State University, Chics recent guidelines for new students DO NOT BLAME OTHERS FOR YOUR ACADEMIC PROBLEMS. A large number of students blame others for their failure. This is a cop-out for ineptitude (USC, 2011-2012). Students who have accepted personal responsibility will look into themselves to find the motivation to achieve their academic goals. For those who want to get the most from their university experience blaming the lack of time, work, family obligations, the instructor, or the university, is not an option. In order to practice personal responsibility in my education I will do my best to follow the five guidelines outlined by members of the Carnegie Foundation for the Advancement of Teaching. Five Key Dimensions of Personal and Social Responsibility (Colby Sullivan 2009) 1. Strive for excellence: I must do my best at all times.If at the end of the day I can say I have done everything possible with what I have, can accept the outcome with my head held high. . Cultivate personal and academic integrity: I will get what I put into my education. If I cheat and plagiarism from others it hurts me and my team members. In order to be truly proud at the end of this long hard process I have to be able to say I DID IT. I copied it doesnt have the same ring to it. 3. Contribute to a larger community: Working within my team is important. Together we can achieve a better outcome than we could separately.Working with diverse people we can learn from and strengthen each other. 4. Take seriously the perspectives f others: We are all different and look at the world through our own experiences. Nobody has all the answers and everyone has strengths and weaknesses. The trick is to use our strengths to help others while accepting help to strengthen our weaknesses. 5. Develop competence in ethical and moral reasoning: need to gain confidence in my ability to think things through using all available information. I must hold myself to the highest moral and ethical standards both in the academic world and life in general.
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