Saturday, March 14, 2020
Clinical product assesment Essay Example Clinical product assesment Paper Clinical product assesment Paper Ã Clinical Evaluations Assessment Tool. Project Activity #1: Product 1- Noni Juice Brand Name: Goodnoni Website Goodnoni Description of Product- Noni Juice Noni Juice is produced from Noni fruit. Noni is an exclusive tropical fruit believed to be beneficial and useful food. The juice contains bitter and typical taste that is of the mature Noni fruit. It is brown in color and the juice contains some rich fruit thick sediments. It is recommended shaking the bottle before opening to let sediments to be mixed with the juice. Rely on the cyclic array of Noni fruit, some time the juice may appear watery, even though no water is mixed. This is known as Folk medicine, and in other terms called as traditional medicine. Folk medicine is used as substitute health option which is made from Herbs and shrubs during the ancient days to cure ailments and diseases.Ã Noni juice, is believed to be with many health values in curing many of the diseases. Description of Product Use It is recommended daily to use the dosage of 30 60 ml juice. It is vital and significant to take the noni juice before any thing is eaten, otherwise stomach acids digest most of the helpful components of the juice. Noni juice is to be taken twice or three times in a day, depending on the patient condition Product Evaluation Outcome: Package condition: The Product has acceptable package conditions with juice in tight plastic bottle with labelling and titles. The product label clearly displays the product details and product administration details. The label also comes with attractive promotional logo with Noni fruit and suitable captions. The bottle is inturn packed in an attractive Cardboard box that displays all the promotional material. The product comes in an reusable mode of container, i.e.,Ã the juice bottleÃ once opened can be used within 2 months period of time. Teh packaging offers the safety and efficacy to the product. Natures Products, fromÃ noninz.com/ Product Information Product 2- Aloe Vera Topical Brand Name: Aloe Juice Concentrate 16OZ Website www.aloelife.com- Description of Product- Noni Juice Aloe Vera is believed to be a anecdotal health claim. Many folk medicine believers assume that this product is good for immune system and can cure diseases related with fungus, constipation, virus, bacterial and inflammation. This is also used as nutritional supplement in many parts of the world. Description of Product Use Aloe Gold Juice Concentrate 16OZ Aloe Gold Whole Leaf Aloe Vera Juice Concentrate is the highest quality Aloe Vera in a bottle providing maximum benefits when taken daily. It comes as 3:1 concentrate containing yellow sap To be administered as 1-2 OZ daily, special applications 3-8 OZ. The cup of Ã juice is recommended to drink by the patients in mixing with water. Product Evaluation outcome: Aloe Juice comes in The product comes in Dim: 8.0 x 2.5 x 2.5 inÃ Ã Wt: 1Ã Lb Plastic bottles. The bottle material and package offers the safety and efficacy by informing the use of the product details. Ã The label displays the Aloe Leaves as a mark of product information Aloe Gold Juice Concentrate 16OZ, from aloelife.com/ezStore123/DTProductZoom.asp?productID=15 Project Activity#2: Noni Juice Type of Disease: Diabetes is caused by the imbalances in insulin hormone in body. Safety and Efficacy: The safety measures that are claiming by the manufacturers are the sealed package, sterilized and free from any contamination. Medical Threat:Ã The Long term effects of diabetes are generally because of patient maintaining their glucose levels high for long periods of time. The excess blood sugar levels have a terrible result on the body. Few of the general effects from diabetes consist of nerve damage, vision problems, damage of kidney, Problems of heart and circulation. Diagnosis in early stages of diabetes will help a person to keep away from serious related diseases. Strategy: The strategies that are using to promote the NONI product are by showing the scientific researches which took place in recent years stating, Noni is confirmed as an amazing supplement for promoting best possible health. General conditions connected with Western culture and problems of diet with blood circulation, blood pressure and blood sugar levels appear to be stabilizing by a regular consumption of Noni. Reason why patents purchase: In the present days people are becoming so much health conscious. The NONI product is illustrated in such a way that any one who cares about health will easily purchase, the other reason is regarding the package and safety measures and because of no side effects. They are mostly got promoted by doctors which any one are impressed to purchase. Role as practitioner: Even though it is used by many, it has not been certified by the international standards like other medicines. Any medicine which is not properly tested by the international standards cannot be consumed with out the suggestion of doctors. Self Diagnostics: During the consumption of any unproven products, consulting doctor and getting self diagnosed is the must, because some of the elements which the product contains may not be suitable for the patient, which may yield to side effects. Jeanette Pollock, Ã¢â¬Å"The Effects of DiabetesÃ¢â¬ from http://ezinearticles.com/?The-Effects-of-Diabetesid=130351 Product-2 Aloevera Juice: Type of Disease: the disease that is considered for the product of Aloe-Vera is psoriasis. Safety and Efficacy: The masseurs are displayed on product container Medical Threat: Psoriasis is a skin disorder which can occur to anyone of any age in both men and women. Researchers believe that psoriasis is an immune-mediated condition. Strategy: The manufactures says that, the Aloe Vera topical is being used to help out in the healing of minor wounds, burns, eczema, and psoriasis. Reason why patents purchase: The vendors telling that product Aloe Vera Topical is made purely from the extract of Aloe Vera and showing the benefits of Aloe Vera which attracts the patients. Role as practitioner: The products which are not certified by FDA are to be used by the consultation of doctors which may prevent the threats like side effects or any harm like burning sensation etc. Self Diagnostics: Any products which are not FDA tested are not suggested to used directly by the patients, Ã except under the guidance of the experts. The self treatment can cause major side effects especially with the unproven products. Ben W Taylor, Ã¢â¬Å"Aloe Vera and PsoriasisÃ¢â¬ from http://ezinearticles.com/?Aloe-Vera-and-Psoriasisid=520370 Project Activity#3: Credentials of Noni Noni has its own website on which the product Noni Juice is displayed in attractive colours and offering free delivery on all their products. When suggesting any product regarding health, the Product must be FdA certified. Even though it is said to be FSA certified, the vendors who sell the products are not the certified doctors to suggest some one regarding their product. They can tell any thing to advertise their product but consumer who purchases must be very careful to use.Ã The product when taken with out the guidance of the physician it may cause harm or side effects. Some of the contents in the product may not be suggestible to some people which may turn harmful. The one who sells the product may not know to whom to sell the product and they are not supposed to suggest the patients with out proper diagnosis. Natures Products, fromÃ noninz.com/ Credentials of Aloe Vera Juice The product Aloe Vera Topical is advertised by the health site called aloelife.com. Ã By publishing the product information on the site the people who visit it for medical information will get a range of products to choose. Ã However, the site did not publish more information psoriasis cure with the product. So if product is not suitable to any one it may give the itching and burning sensation and can develop the psoriasis more. Even though the site gives the precautions to use the products it is better to take the advice of the physician before considering any product. Aloe Gold Juice Concentrate 16OZ, from aloelife.com/ezStore123/DTProductZoom.asp?productID=15 Project Activity# 4 Strategies of promotion: These Health care products are popularized through the TV Channels, Home magazines, Brochures, pamphlets, websites and Internet Ads.Ã Also these health care products are promoted by sale representatives or commission agents as a means of direct sales to the end user. Sometimes sales representatives consult the medical or Para medical practioners to stall their products in the shelf. Such product sellers use social community as the major medium for selling utilizing the close contacts. Many of the times the products are pushed on the basis of buying capacity of the patients but not on the basis of actual need. The most adaptive promotional strategy is Multilevel or Chain marketing that offers high commissions to the people who refer or make others buy these products. These people who sell or recommend such health products do this sales promotion without much medical knowledge.Ã These promotional push these health products with their product and consumer knowledge, without any right diagnosis of the patient condition. Such product marketing convinces the people with the quick relief of the disease by showing the photos and testimonies of the people as a proof to make others believe their words. However their prescription is not based on the patientÃ¢â¬â¢s clinical diagnostic condition. The products some times are pushed as bundle- buy two get one free basis, resulting the compulsory usage of additional product even without the actual necessary. Many of the times, the Para medical professionals assist in promotion by testifying about the results of the product due to some expected benefit from the product seller or manufacturer. Healthcare Marketing That Grows Your ReputationÃ And Your Bottom Line, from healthcaresuccess.com/ Assessment of such strategies: Such promotional strategies are becoming popular day by day in the health car products. Though they have any scientific evidence or medical proof of the performance of the product in al the patients in a similar manner, the products are pushed on the conviction made through the promotional material. When the products are attested by Para medical professionals, buyers will be easily convicted to buy without knowing the actual outcome. Sometimes such products may give side effects due to the lack of proper clinical prognosis and prescription. Project Activity#5: I will design my product market plan in such a way to commercialise it fromÃ Ã early stages by communicating its utility and value to the targeted users.Ã First I will identify the major therapeutic areas where my product can meet the need. Then I will design the promotional material to acknowledge the rightÃ consumers of the product. Not only that I will produce a leaf let that will be inserted in the product packing. This leaf let will be with pre conditions and post conditions of the product usage. This will prove my safety measures and efficacy. Also, on outer pack , i will strictly mention that the product should be used under the medical prescription only. However, I will not give the product administration dosages to avoid he personal and direct administration of the product by the user. This will help the user to depend on the medical practioners help to use the product. Promotional Media: I will target the customers of the product in the following ways: 1. Geographics: Basing on the area of residency, location, population density, size of the area, climatic conditions of the zone of the product customers. 2. Demographics: The Gender, age, gender, family size and structure, Education, occupation, income of the customers. 3. Psychographics: The personal behaviour, life-style, needs of the customers, expectations of the customers. 4. Behaviours: The needs and wants of the product user. Information expectation levels and attitudes and cost issues can be considered here. Then I will try to create value to my products than my competitors by pointing out the benefits towards one of the life-improvement benefits: like-Ã Pain relief ,Abilities, Appearance, confidence, Productivity, Peace in Life, Cost Value etc., I will use the Targeted Social contacts at eh clinical centres and will give the product education under clinical observations only. Ã The major promotional channels would be organised in this way Conducting the disease awareness programs at the clinics and social gathering halls that help in positioning and for the expansion of markets Pre product launch initiatives to create demand and excitement Product launch programs with distributors and dealers that can take up the immediate spur in the sales. Wall posters and message boards that not only creates brand image but also will educate people about the disease. Stewart Gandolf and Lonnie Hirsch, What Is A Health Care Marketing Plan?, from healthcaresuccess.com/articles/what-is-marketing-plan.html
Wednesday, February 26, 2020
Construction safety - Research Paper Example ons of the predominating safety approaches, this paper has looked into the major methodologies that have been actualized to enhance word related safety in the construction industry. Assessing the noteworthy methodologies regarding strategies and adequacy, it was discovered that all the methodologies, exchange the trouble of obligation on the foremen. While the part of foremen in guaranteeing the safety of laborers are evident, scientists are of the sentiment that perfect time to consider construction safety is a mid configuration stage. Considering the delayed association from the period of beginning, modelers and designers can assume vital part in recognizing and relieving potential risks to the construction specialists. The new approach of avoiding mischances and episodes through configuration has been proposed in this paper as the future course of safety change in the construction business. Construction work sites are mind boggling or rather complex because of successive work procedures, levels of technology utilized, association in the middle of specialists and supplies, and the changing degrees of safety mindfulness and preparing of the laborers. The erratic and complex nature of the construction assignments has made safety a worry wherever construction exercises occur. The quantity of word related fatalities and injuries in the construction business is exceedingly high. Separated from the societal expense of word related mishaps, the monetary impact can have a sizeable effect on business execution. In 2002, the aggregate expense of fatalities and non-deadly wounds, whether the expense were direct or indirect, was 13 billion dollars. These measurements highlights the essentials of wellbeing and safety in the construction business. Enhancing safety in construction remains a need in just about every nation around the globe, on the grounds that the construction business emerges among all different businesses as the primary giver to extreme and lethal mishaps.
Monday, February 10, 2020
How to make university more international Essay Example | Topics and Well Written Essays - 500 words
How to make university more international - Essay Example Foreign students, while in lectures, are comfortable sharing with their comrades. Once classes are up, they tend to retreat into their respective ethnic and cultural cocoons (Wu, 2012). This is damaging to the principle of integration of the academic community that University education is grounded on. Universities in the East and Africa have also introduced original, western sports curricular in their programs. This has led to foreign students feeling welcome. Universities in India, for example, have introduced Soccer to integrate foreign students from Europe. This has seen over 80% of Indian sub-continent Universities introducing Soccer into their sports curriculum (SuaÃ rez, 2007). While lack of foreign sport is not a problem per se, it is a limitation that, if addressed in the right manner could have a dramatic impact on the UniversityÃ¢â¬â¢s social community. The best way to introduce this into schools would be via provision of funding for the construction of new sport gymnasiums and playfields, while also increasing funding for research into these sports, since sports science is not a priority in Eastern countries (SuaÃ rez, 2007). Naturally, this would start with one sport that would act as the pilot project. A review of its success after a set period would act as a pointer at the potential foreign sport has in integrating foreign students fully into University programs & curriculum. Introduction of foreign sports on campus grounds would achieve much more than integration. Foreign teams that specialize in this sport would provide funding for sport science studies, with native students benefiting from this via increased funds to the University sport kitty. Native students would also be encouraged to try their hand at these games. Examples include Tae Kwon do from Korea, Ping pa from China, and American football. Since some are Olympic Games, foreign athletes would use the facilities for training, thus giving native students who try their hand at these
Thursday, January 30, 2020
Government Capital Punishment Essay Theories of punishment have significant role to play in the ongoing debate on capital punishment, especially for murder. Some retributivists appeal to the lex talionis, the law of retaliation, to determine the appropriate amount of punishment . This principle specifies that the punishment should inflict on offenders what they have done to their victims; Ã¢â¬Å"an eye for an eye, a tooth for a toothÃ¢â¬ , and Ã¢â¬Å"a life for a lifeÃ¢â¬ . Capital punishment is therefore the only appropriate punishment for murder. But the lex talionis is deeply flawed. It focuses on the harm done by offenders without regard to their mental states. A life may be taken intentionally or accidentally; a person may be killed for personal gain or in order to relieve him or her of the agony of a terminal illness. Even if we restrict the scope of the lex talionis to cases in which the wrongdoing is fully intentional, there is still the problem about the level at which the punishment should imitate the crime (Singer, 1993). Should murderers be killed in exactly the manner that they killed their victims? In any case, it is impossible to apply the lex talionis to many offenders; the penniless thief, the tooth assailant who knocks out his victimÃ¢â¬â¢s teeth, the tax evader, etc. If conscious of the defects of the lex talionis, retributivists merely insist that the punishment should be appropriate to the moral gravity of the offence, then this requirement can be satisfied so long as the murderer is punished more severely than less serious offenders. There is no need for capital punishment. From the utilitarian point of view, capital punishment can only be justified if it produces better consequences than less severe forms of punishment. This condition would be satisfied if capital punishment is a superior deterrent to alternative forms of punishment such as long periods of imprisonment. So a utilitarian will try to settle the issue on the basis of the evidence about the effects of capital punishment. The statistical evidence is based on comparisons of murder rates in countries where there is capital punishment with those in socially similar countries where there is no capital punishment, and no comparisons of the murder rates in one and the same country at different times when it had capital punishment and when it later abolished it, or when it restored capital punishment after a period of abolition. The evidence does not show that capital punishment is a superior deterrent. However, the utilitarian approach is rejected by those who wish to place greater value on the lives of the innocent victims of murder than on the lives of convicted murderers. It is suggested that the evidence does not conclusively rule out the superior deterrence of capital punishment, and in the presence of such uncertainty, it is better to have capital punishment. If there is capital punishment, and it turns out that capital punishment is not a superior deterrent, then convicted murderers have been unnecessarily executed. If, on the other hand, we abolish capital punishment, and it turns out that it is a superior deterrent, then there would be additional victims of murder. But this argument is unacceptable because where there is capital punishment, it is certain that convicted murderers will die, but in the absence of capital punishment and in the light of available evidence there is only a remote probability that there would be more innocent victims of murder (Conway, 1974). In any case, there is a risk of a few innocent people being wrongly convicted of murder and executed if there is capital punishment. This has to put on the scales against capital punishment.
Wednesday, January 22, 2020
In "The Story of an Hour" by Kate Chopin, there are many moments when Chopin's craft of writing feeds the irony of the story. One perfect example, "assure himself of its truth by a second telegram" (772). This sentence subdued me into believing that Mrs. Mallard's husband was dead, when in fact, we learn that he never died. In addition, Mrs. Mallard is a woman with a strong sense of passion and detest. In the end, she dies by the nature of story. Chopin brings a style of writing that has irony. In the beginning of the story, Chopin's introduces you to the heart trouble that afflicts Mrs. Mallard. Her condition is significant later because this ailment drives the story. However, the notion of this heart condition can be overlooked as being meaningless. Many readers could argue that this heart condition foreshadowed the climax of the story instantaneously but it does not. In the end of the story, we realize the significance of her sickness. It was a clever way to secretly introduce the weakness that ends Mrs. Mallard's life. Another, well deceptive measure used by Chopin'...
Tuesday, January 14, 2020
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, TerriÃ¢â¬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.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 Schiavo'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 Schiavo's parents, Bob and Mary Schindler, fought this request. Florida judge Georg e W. Greer ruled in 2000 that Schiavo was Ã¢â¬Å"beyond all doubtÃ¢â¬ 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. Schiavo's feeding tube was removed in 2003, but reinserted six days later when the Florida legislature passed Ã¢â¬Å"Terri's Law,Ã¢â¬ which allowed the state'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 Schiavo'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 Washin gton 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 Ã¢â¬â Roman Catholic Ã¢â¬â sanctity of life, no advance directives, TerriÃ¢â¬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 one'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 patientÃ¢â¬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 meas ured 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 patientÃ¢â¬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 patientÃ¢â¬â¢s wishes should have been used, and it was. It is recorded that the patient while competent cl early 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. 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 patientÃ¢â¬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 coop erate 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 patientÃ¢â¬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 societyÃ¢â¬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. Ã¢â¬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 Ã¢â¬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 intensity 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. Ã¢â¬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: goo d 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. Ã¢â¬â¢ NEJM (1994) Ã¢â¬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. Ã¢â¬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 the hospice staff would only have recommended palliative care. Are there financial and economic factors? Yes. Fine (2005) tells us that Ã¢â¬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 direct ly attributable to a lack of health insurance. Ã¢â¬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. TheirÃ¢â¬â¢s and by extension TerriÃ¢â¬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) Ã¢â¬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-profitÃ¢â¬â¢s annual reports, and was likely able to arrange for her admission. He subsequently stepped down from the post. Ã¢â¬â¢ George Felos was Michael SchiavoÃ¢â¬â¢s attorney. The committeeÃ¢â¬â¢s specific findings related to this case are as follows; Ã¢â¬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 c omplex 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 pro blem. Ã¢â¬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, Ã¢â¬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 medicineÃ¢â¬ .There is a traditional duty to relieve suffering, ni cely restated by Sir William Osler 1849-1919: Ã¢â¬Å"To cure sometimes, to relieve often, to comfort always. Ã¢â¬ References Author unknown, 2004, Terri Schiavo Biography (Medical Patient), J R Soc Med; 97(9): 415Ã¢â¬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 Ã¢â¬ º Ã¢â¬ ¦ Funaro, S. 007, Why didn'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/ Ã¢â¬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, retrieved from www. nejm. org/doi/full/10. 1056/NEJM199406023 302206 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 Ã¢â¬â 148k
Monday, January 6, 2020
Every society has mythology. In some societies, its religion. Our religion is consumerism.Ellen Weis, San Franciscos Museum of Modern MythologyConsumerism fuels the capitalist fire. In a capitalist society, the goal is to make money, by whatever means possible, exploiting whichever potential weakness that might exist. The human race is one with a wild imagination, and this wild imagination, though a great strength, can, like all great strengths, serve as a potential weakness.It is our imaginations that advertising exploits, and it is our imaginations that religion and myth traditionally played the role of satiating, telling stories that have morals to them, lessons to be learned. Now consumerism fulfills this role. The consumerÃ¢â¬ ¦show more contentÃ¢â¬ ¦All of its lessons seem to be based upon this underlying assumption that more is better, that we need the things were being sold, and that somehow buying them will make us happier and better people.Of course the medium for these lessons are the ads themselves. Advertising nearly always has some emotional appeal to them. Instead of catering to our intellect and giving us rational reasons why we should consume the products they flaunt, rather they cater to our emotions. What better way to stimulate our imaginations? This is almost directly analogous to the emotional appeal traditionally found in sermons. Especially before our society has become so secular and scientific, sermons were heavily driven by emotion.One heavy emotion that were susceptible to is fear. Fear tactics are used in advertising just as they are in sermons. For example, the Dial soap ads use the slogan, quot;arent you glad you use Dial? 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