Pathophysiology Essay Example | Topics and Well Written Essays - 250 words

Pathophysiology - Essay Example This can be as a result of consumption of poor diets or unhealthy lifestyle (Timby & Smith, 2005). Disorders leading to left-sided congestive heart failure can be seen in both children and adults. In children, it can be caused by birth defects involving the heart and heart muscles such as abnormal heart valves or blood vessel connection. In adults, such disorders include hypothyroidism and other inherited heart conditions that can lead to cardiomyopathy. High blood pressure, diabetes mellitus, obesity and coronary artery diseases are other risk factors for left-sided congestive heart failure (Hobbs & Boyle, 2014). According to Robinson, N. E., & Sprayberry (2009), the most common symptom for left-sided heart failure is fatigue, weakness or faintness as a result of insufficient supply of oxygen to the body. Other symptoms include shortness of breath due to excess fluid accumulation in the lungs, decreased urine production and abrupt weight gain due to excessive fluid retention and cough that contains frothy or bloody mucus. Right ventricular systolic dysfunction could occur as a result of left-sided congestive heart failure

Food Process Technology Assignment Example | Topics and Well Written Essays - 3000 words - 1

Food Process Technology - Assignment Example In each of the industry above, there are different heat exchangers used. Below is a discussion of these different types of heat exchangers used in different industries (United States, Hodgson, Hunziker, & Dahlberg, 1942). In fruit and vegetable processing industry, there are a number of heat exchangers used. The first is the juice pasteurizer. These are machines used for pasteurizing fruit juices and preserving fruits in the processing industry (Burch, Rickson, & Lawrence, 1996). In most cases, they are made of stainless steel, has a large heating capacity and suitable for large scale use. The advantages of these pasteurizers are; the equipment manufactured today are highly automated, they are supplied on a modular designed on the principle of plug and play, they are supplied with a control manual to ease the control process, they are designed with the latest microprocessors capable of controlling and holding the required temperatures, and are made of stainless steel which prevent it from wearing out. The second heat exchanger is the blending and mixing vessels. They are used in blending and mixing different types of fruit juices to give birth to new blends. They have different volumetric capacities depending of the financial ability and manufacturing capacity of the firm. They can be single or multiple walled and are purchased to suit the processing industry needs. Some have insulators and others do not. They are fitted with mixing turbines for the purpose of mixing. They also contain two speed scrappers moving in opposite directions to facilitate quality and fast mixing. Depending on the taste of a particular industry owner, they are either supplied with conical or flat bottom and top. In case no one of the vessels suits the client’s preferences, the manufacturing industry can design one for him/her from scratch (Fiore& Severini, 2011).This

Ethics in the Workplace Essay Example for Free

Ethics in the Workplace Essay In 1995 Douglas Durand went to work for Tap Pharmaceuticals as vice- president of sales. Several months after starting at Tap Pharmaceuticals, Durand was in disbelief to find out that the company was bribing urologists to purchase the new Lupron drug for prostate cancer. Durand found the culture at Tap Pharmaceuticals to be in misalignment. In order for Durand to protect his good name, he began to document all his findings over a 6 year period and submitting the information to federal prosecutors. The documentation that Durand submitted to the federal prosecutors was so overwhelming that it caused Tap Pharmaceuticals to plead guilty to conspiring with doctors and cheating the government. As result of the guilty plead, Tap Pharmaceuticals paid a staggering $875 million dollar fine, which Durand received 14% of the settlement for his efforts to remedy the situation. The symptoms found in the Tap Pharmaceuticals case are primarily driven by numbers and monetary rewards. The more the top sales reps could sale or distribute the bigger the monetary reward. Durand tried to institute a more structured environment to help remedy some of the illegal practices he encountered. Many of the sales reps at Tap Pharmaceuticals did not accurately track the samples of Lupron given out to doctors. Durand offered a year salary to sales reps to help the company keep accurate records of distribution of the drugs offered. It worked until upper management shut down the bonus program, furthermore; the reps settled back into their old ways. Symptoms of dishonesty, unethical behavior, inadequate record keeping, crooked doctors, and a complete disregard for laws and regulations set forth by the government are derived from the root cause of poor upper management found at Tap Pharmaceuticals. The root cause and unresolved issues that Durand encountered at Tap Pharmaceuticals are a direct result of the monetary driven culture created by then president Yasu Hasegawa and senior management. Durand found that when he tried to implement new policies or practices that Hasegawa and the sales reps were not interested, or he was undermined by senior management. Tap pharmaceuticals primary sales niche was to bribe and payoff the people who prescribed the drugs offered by purchasing televisions, vacations, and  office equipment. The unethical practices are a direct result of a lack of unethical leadership and ethical standards and practices not being in place. Tap Pharmaceuticals did not have a hose counsel to help keep practices ethical and meet government requirements because it was thought to be a sales-prevention department. Durand eventually found himself excluded from marketing and sales meetings and told that he just did not understand the culture. The lack of ethical leadership in the company is the root of the problem found at Tap Pharmaceuticals and left all the issues that Durand found unresolved. Analyze and evaluate alternatives. Decide on the most valid alternative, and make recommendations. When thinking of alternatives, people think of other options that may apply in order to have a different outcome than the current outcome. When Durand was offered the position as Vice President of Sales with Tap Pharmaceuticals, he had no idea what he was getting involved with. All he saw was a potential for a promotion in an industry where he had already served his time and made a name for himself. Durand has a couple alternatives in this ethical situation. He could have kept his mouth shut and adhered to Tap Pharmaceuticals policies and procedures and unethical practices. The outcome to this alternative could have proven to be very poor for Durand. If Durand continued to allow Tap Pharmaceuticals to conduct business in the sales department as they always had in the past, eventually, the federal government would have caught on to the unethical practices and levied fines against Tap Pharmaceuticals and Mr. Durand. He could have even been prosecuted for the practices he witnessed at Tap Pharmaceuticals. When employees are directed to blatantly break the law in order to keep sales up and to give out medicine samples without charging for them, there is a huge ethical problem. Tap Pharmaceuticals instructed the doctors to charge Medicare for the samples even though they never paid for them in the first place. It seemed as if Tap Pharmaceuticals planned to break every law of the trade in order to make the most money in the least amount of time. This alternative would not work for Mr. Durand. He had a steady head on his  shoulders and would not stand for the unethical practices he had witnessed. But what would he do about the problem? This question would later come into play when Mr. Durand was faced with a tough decision. A second alternative Mr. Durand had was to leave Tap Pharmaceuticals with a resignation. But a resignation would land him and his family out on the streets. He did not want to jeopardize his familys lifestyle and affect the way his children would grow up. After all, Mr. Durand did leave a well paying job with a huge medical pharmaceutical company. This alternative would be even worse than staying with Tap Pharmaceuticals and pretending nothing wrong was going on. He had to support his family and to Mr. Durand this was the most important issue to handle. If Mr. Durand resigned from Tap Pharmaceuticals, he would have to start all over again and work his way back up the corporate ladder as he did 20 years before with Merck Co. Mr. Durand had very few options or avenues to take in his ethical dilemma. He was virtually stuck between a rock and a hard place. He truly made the perfect decision when he decided to file suit against Tap Pharmaceuticals. This was the best possible option he could have used. First, Tap Pharmaceuticals was breaking the law and if they continued to practice unethical business, they could have hurt someone or continued to defraud the United States government and Medicare. Since Mr. Durand was familiar with the practices of the pharmaceutical industry, he had no other choice but to blow the whistle on Tap Pharmaceuticals. TAP Pharmaceuticals, a physician, and 7 employees of TAP Pharmaceuticals were charged and indicted for bribing physicians with kickbacks to use the drug Lupron. The federal grand jury also found them guilty of Medicare fraud, and violation of the Prescription Drug Marketing Act. PSA-Rising (2001) states,The seven individuals charged in the indictment unsealed today are:Alan Mackenzie age 49, of 27068 Wellington Court, Barrington, Illinois, andformerly Vice President of Sales for TAP, Janice Swirski, age 40, of 6 BellinghamDrive, Chestnut Hill, Massachusetts, and formerly a National Account Manager with TAP,Henry Van Mourick, age 43, of 23 Golfwood Court, Roseville, California, andcurrently a District Manager employed by TAP,  Donna Tom, age 37, of 141 East 56thStreet, New York, New York, and formerly a District Manager employed by TAP,Kimberlee Chase, age 35, of 108 Dedham Street, Dover, Massachusetts, and formerly aDistrict Manager employed by TAP, David Guido, age 30, of 131 New London Road,Colchester, Connecticut, and currently a Hospital Account Executive employed by TAP, DR. John Romano, age 48, of 110 Long Pond Road, Plymouth, Massachusetts, an urologistwith a practice in Plymouth, Massachusetts. Four other physicians were indicted before the above indictment. TAP Pharmaceuticals bribed urologists to use the drug Lupron by giving them big screen televisions, golf vacations, and free sample of Lupron. The sales representatives also gave the physicians free samples of Lupron and told the physicians to bill Medicare for full price. Durand tried to change different aspects of how Tap Pharmaceuticals was run, but all to no avail. Whenever he implemented a new structural change, the employees would try it for a short while and return to the way they had done things in the past. Accurate bookkeeping was a logical idea to put into action. This would tell exactly how much each rep gave out to doctors and pharmacies as samples for them to try out. The old way never showed how much they were paid for each sample given because there was no way to know how many had been given out. Whenever new ideas are put into effect, it still takes people to uphold these new rules and regulations. When Yasu Hasegawa failed to show any sort of business ethics, why would any of his employees? A good leader will lead by example. When people follow someone he/she want to emulate his/her actions, not just his/her words. By having a person with little moral fiber lead the company, it allowed some that might have been on the fence about the situation to fall to the same side. Durands cultural change effort failed because senior management and older sales reps refused to change the company for the better. They had been doing things their way for too long and the payoff incentive was too great. The shady business practices were much easier than trying to keep records of exactly how many samples were given out and who all had been bought. When  the president of the company would not even change his ways on how he dealt with his business, how could his employees be expected to change as well? In a business that deals with healthcare, the most important aspect should always be the patients. Since nobody truly cared about them and all the employees concerns were with lining their own pockets, the business ended up being sued for quite a large amount of money. The only way for Durands changes to succeed, would be if there were a total overhaul of management. The company would need to basically start over in order to weed out all the bad eggs. That would take a great deal of time, not to mention a great deal of money. Even though Durand became a whistle-blower on Tap Pharmaceuticals and the company was fined, there are sure to be employees who were guilty but not indicted. In TAP Pharmaceuticals there was an attitude of a misalignment of culture. The profit driven only environment provided no ethical leadership. Upper management including the CEO, who set the tone of weak unethical leadership, held no interest in change. TAP had no formal cultural system. The bottom line was the only factor and how profits were obtained was of little concern. When Durand attempted to make positive changes to the system through a Reward System, upper management put a stop to it even tough it was working and labeled him a trouble maker. TAP was not interested in positive ethical change. The gifts to urologists and doctors TAP pharmaceuticals participated in set an unethical culture. ConclusionIn the end Tap received one of the largest fines in the pharmaceutical industry and the job of rebuilding its image and reorganizing its business practices. Seven of its senior management team received heavy financial and judicial penalties for their part in the Lupron scandal. Douglas Durand in the end had to start over in a new less lucrative position, furthermore; he did receive a large settlement from the federal government under the Whistle-Blowers Act and currently retired and living in Florida. References: Barrett, A. (2002, June 24). A Whistle-Blower Rocks an Industry. Business Week. RetrievedJune 19, 2007, from http://www.fairness.com/resources/relation?relation_id=9650Nelson, K., Trevino, L. (2004). Managing business ethics: Straight talk about how to do itright (3rd ed.) . New York: Wiley. PSA Rising (October 3, 2001). TAP Pharmaceuticals Products Inc. and Seven Others ChargedWith Health Care Crimes; Company Agrees to Pay $875 Million to Settle Charges. RetrievedJune 22, 2007 from http://www.psa-rising.com/wiredbird/tap102001.php

Nursing Home Reflection of Behaviours

Nursing Home Reflection of Behaviours Latoya Mckie Abstract There are numerous of behaviors to observer in a nursing home. Many of the behaviors are related to mental impairment, loss of memory or aliments such as dementia, delirium, Alzheimer’s disease and Parkinson’s diseases. A lot of residents have been diagnosed with aliments; these various mental impairment conditions are concurrent conditions which may overlap. In many cases the impairment gets misdiagnosed outside a nursing home care facility because normally people do not know the symptoms or trained to differentiate the diseases or conditions. Therefore, it is essential that the caregivers and all other professionals are knowledgeable and fully aware of the residents’ cognitive levels to effectively assist them with their daily living. Many seniors and family prefer to go to nursing home facilities due to personalized care seniors receive. It is also difficult for some seniors that are not in nursing home or retirement facilities or neighborhood that are not tai lored to their needs. Behaviors exhibited by the residents I witnessed an array of behaviors at the nursing home, intern site. Most of the residents were energetic and full of life, despite their age. In the department that I mostly worked with consisted of people with memory loss. The group mostly was consisted of women, and had only two men. The women were all on different cognitive levels, but they all were well educated and lived successful lives in their younger age. One of the residents use to be a school teacher, how seemed to lose her memory and it seemed to be very difficult for her to recall any activities she did earlier that day. She and I would do puzzles or art activity. On one occasion I asked her to sign the back of a sheet we were working on. An hour after she left went to her room and came back and could not recognize the picture as the one we both completed earlier although I showed her the back and explained to her that I assisted her to complete it that day. What I realized with her and other residents in that group is that although they had memory loss they were still very intelligent and able to complete mathematical computation when tested. It was also remarkable that most of the residents I worked with can recall early memories from their lives although they had a hard time recollecting what they did earlier that day. There was also one lady who loved to listen to old music from the 60’s and classical music all day; she also walked around with a toy doll most of the day. This lady also never spoke much and not social with the other residents, she liked keeping to herself. The men on both sides of the facility did not come out much except for when they went to the dining area to eat, go to church services, exercise class or outings on the town. The residents were primarily engaged in fun activities and socials. They enjoyed having other people to talk to and having family member visiting them. A number of them were particularly concerned with their health and exercise most mornings, as a result the seemed more energized and happier than the residents who stayed in their rooms all day. I exhibited only two residents who seemed lonely. One of the two was always saying nobody cares about her and she is always walking around all day. At times the other residents look at her and regard her as a c razy person. The other lady who seems to be a loner has had her husband passed away recently, she seems to be sad at times, but she keeps herself occupied with engaging in activities and helping other residents who are on a lower cognitive and physical level than her. Another female resident in the dining room that is always shaking; I believe she has Parkinson disease her behavior varies a lot with the day. She can start arguing for any reason, then nice the next minute. Nobody normally sits at her table at the dining area when it is time to eat. One day someone came in late and sat there and she started to curse the other lady out and the whole time she was shaking the table. Her hand shacking is so bad that most of the time she has to ask one of the dietary aides to assist her in pouring out condiments because she often makes a mess because she cannot control her hands from shaking due to her having Parkinson disease. Explanation for the residents’ behaviors Most of the residents in nursing home suffer from memory loss diseases such as dementia, Alzheimer’s disease and delirium. They also experience other ailments such as Parkinson’s disease. A significant proportion of this elderly population will have dementia (Hartwell, 2013). One in five people over the age of 65 has dementia. The number is expected to double every 20 years (Hartwell, 2013; Potocnik, 2013). Dementia. Dementia is incurred mass impairment of a person’s memory, personality and intelligence who is normally attentive (Potocnik, 2013). It is adequately acute to interfere with social and occupational functioning. In the lack of a stroke or quickly growing cerebral tumors among other factors, the onset is normally progressive and the cognitive decay is always gradual (Potocnik, 2013). In the absence of a remedy for the disease, non-pharmacological concoctions and the careful use of pharmacotherapy may not solely aid the person and ease the stress on the caregiver (Potocnik, 2013). Residents with dementia almost always show neuropsychiatric symptoms (NPS), such as disturbances in mood with psychotic and vegetative symptoms among other spectacles. Dementia affects a large portion of the senior population. Dementia of the Alzheimer’s type is characterized by memory impairment, the inability to learn anything new or recall information which was previously acquired, and one or more cognitive disturbances such as aphasia, apraxia, agnosia or executive function disturbances (Potocnik, 2013). The resident who could not recall the artwork she and I worked on earlier in the day suffers from dementia of the Alzheimer’s type. Alzheimers and dementia is presents in 90% of seniors who expressed their feelings of being lonely or socially isolated (Wilson et al., 2001). The resident who was always walking around saying nobody cares about her suffers from dementia. The characteristic she exhibits was loneliness and isolation from the other residents. This explains why she might have developed dementia. People with early Alzheimer’s disease can benefit from exercise. The hippocampus of the brain plays a vital role in memory (Birmingham, 2008). Brain scan research shows that seniors who are physically active have less brain shrinkage; while those who are less active have up to four times brain shrinkage (Birmingham, 2008). Therefore, exercise is important to counteract Alzheimers disease in the residents. The senior residents behavior to exercise is accepting. They like to engage in physical activities because they know it improves the way they feel, their physical health as well as their mental health. Parkinsons disease. The female resident who is always shaking the dining table and screaming at other resident for no reason has Parkinsons disease. Parkinsons disease is a gradual and degenerative neurological disease, one of a group of conditions called motor system disorders (Carruthers-Czyzewski Dewar, 1998). The four primary symptoms are shaking or trembling in hands, arms, legs, jaw and face; firmness or rigidity of the limbs and trunk; bradykinesia or slowness of motion; and postural instability or impaired balance and co-ordination. As these symptoms become more prominent, patients have complexity walking, moving or accomplishing other regular activities. They may additionally experience migraines, joint pain, periodic respiratory problems, back ache, allergy symptoms, insomnia, mood swings, fatigue, distortion and chronic ailment such as digestive difficulties and arthritis. Modified diet is helpful to seniors with Parkinson disease. Their diet typical includes chlorella, milk thistle, kyolic garlic, and vitamin C (Carruthers-Czyzewski Dewar, 1998). I suspect that is they reason why the lady in the dining hall never misses meal time and she take her nutrition very seriously. Someone with Parkinson disease can also benefit from detoxification as her behavior is normally characterized as confused, fatigue and having mood swings (Carruthers-Czyzewski Dewar, 1998). Delirium. Delirium is a medical crisis characterized by severe onset and impulsive course that is displayed by incisive changes in a person’s cognitive level and function (Gillis MacDonald, 2006). Symptoms includes allayed attentiveness of surroundings with diminished capability to focus or sustain attentiveness; changes in cognition; collapse of higher order functions; psychomotor changes varying from hyperactivity to hypoactivity; emotional turbulences; sleep/wake duration disturbances; nocturnal spasm; hysterical affect, mood and behavior; perceptual disruptions comprised of delusions and fallacies; paranoia; and multilayered etiology (Gillis MacDonald, 2006). The lady who is always walking around at all hours has exhibits the characters of delirium. Although she is diagnosed as having dementia, people with similar behaviors can have delirium as well. Therefore, delirium is often misdiagnosed. Approximately 70 percent of elderly patients hospitalized have delirium althoug h expert nursing care facilities typically are able to identify the symptoms (Gillis MacDonald, 2006). There are three classifications of delirium which are: hyperactive, hypoactive, and mixed. Hyperactive, also referred to as agitated delirium, is described as being anxious and delusion. Hypoactive delirium (quiet) is regarded as a declined sensorium or amplified sedation. The mixed delirium interchanges between the frantic and the sedated type. Nevertheless, no matter how it is exhibited, delirium may be difficult to distinguish, as it can be multifactorial and easily mixed up with dementia, restfulness, and near-death awareness. In many circumstances, delirium is reversible, thus careful assessment is necessary (Rogers, 2006). Judicious nursing observation of a resident’s capabilities to execute activities of daily living can reveal much about the resident’s mental level. A variety of assessment tools are available. A common tool is the Confusion Assessment Method (CAM) (Inouye et al., 1990), which takes about five minutes to conduct, it is steadily reliable and is ap propriate in a number of settings, including acute care (Rogers, 2006). . Aging Typical alters the bodys ability to metabolize medications, tally to the threat for drug reactions. Although any medication may add to delirium in seniors, sedatives, antipsychotics, histamine receptor antagonists and anticholinergics raise the risk for delirium (Hanley, 2004) (Rogers, 2006). Furthermore, seniors have body fat percentage is higher and lower water which effects the fat-soluble drugs by being more concentrated and lasting longer (Rogers, 2006). Environmental adjustments should encourage optimal cognitive functioning, a realism between calmness and activity and consistent nursing care. A numerous of environmental modifications decrease the risk of delirium incidences and facilitate resident independence such as: maintaining the physical surroundings constant and sustain routines, allowing conformity of staffing for accurate assessment of the residents health status and continuous patient care, including family in care and having orientation done often to promote a good perception of well-being. Visits should be declined if hyperactive delirium appears to be onset by the visits, use volunteer sitters if family members are not available. Avoid bedroom changes whenever possible, Use a no-restraint or least-restraint procedure to reduce deterioration of cognitive loss. Remove unnecessary hospital devices, such as urinary catheters and IV pumps. Make sure that the call bell, personal items, glasses and hearing aids in easy reach. Encourage the use of personal items, such as pillows and bed set, to promote familiarity and reduce stress. In addition Have the rooms well-lit, sustain room temperature between 21.1 C and 23.8 C. and diminish noise levels on the nursing unit. Why people go to nursing home Seniors with mental ailment frequently have complicated needs because of the many co-complex needs because of disability, physical illness and social issues (Reynolds et al., 2000). Effective evaluation of long-term and multiple issues may be long-term and multiple problems may be particularly complex without standardized approaches intended at inclusive and methodical assessment of needs. However, certain needs are proposed to be `collective to all humans in general (Maslow, 1954), diverse areas of the population will have more specific kinds of need (Reynolds et al., 2000). Isolation is a difficult problem; the solutions need to be individualized (Owen, 2007). Even seniors who have a widespread social network of friends and family are at jeopardy of being isolated. Anything can easily happen; a senior can slip or fall, loss of their hearing or sight (Owen, 2007). They can also lose a loved one which can completely diminish their self-assurance in and cause conflicts in doing their daily activities. Over a period, social isolation and loneliness can bring on depression and withdrawal. This can also cause an intense drop of self-esteem and confidence (Owen, 2007). Active effort is needed to support seniors to discover the solutions to their social isolation and rejoined with their friends and family socially. Many senior engage in going to day centers, lunch clubs and home visiting services as they provide them with vital way to interact with other people (Owen, 2007). Caregivers and family often resort to nursing home facilities because of the time, cost and stress dealing with an elderly whose memory has deteriorated. Some seniors might feel neglected by their families. Some may exhibit low self-worth as a result of being alienated by their family. Caregivers and family often resort to nursing home facilities because of the time, cost and stress dealing with an elderly whose memory has deteriorated. Some seniors might feel neglected by their families. Some may exhibit low self-worth as a result of being alienated by their family. Some seniors also live in the assisted living section of the nursing home because they want to feel secure as the age that someone is there to help them if they need assistance with anything whether it is health needs or social ones. Living in regular communities tends to make life complex as local services for the seniors might not be available. Most nursing home facility offers numerous benefits such as companionship, availability of services tailored to the seniors, access to around the clock heath care and numerous activities. Benefits of Internship and Supervision Completing the internship course provided a guideline on what I should expect and what should expect to gain from my experience from the intern site. The supervision I received from the intern supervisor and workers were great. They were very detailed in what I needed to get done and how to carry out the task most of the time. Other tasks were self-explanatory. Recommendations for future interns and professionals in the setting I believe education is always good. I think it is especially important when it is to benefit others. Therefore, it is imperative for healthcare professionals and other workers in the nursing home facility to be educated and current on all the new advancement that can benefit the elderly such as therapeutic techniques, and other health related advancements. It is also good to know all safety procedures when in a nursing facility like wearing protective gloves, how to properly disguard hazardous objects, and wearing proper shoes for your safety. The only drawbacks as an intern was not being able to do as much activities as I would have hoped, but that was fine. I assumed senior residents liked to do things they are accustomed better than trying new activities. Although it is not my choice, I would incorporate some new activities for the senior residents who are more active. It seems that all the people who work with the residents are fully aware of their conditions and know how to deal with them. Therefore, I assume they are educated on their mental disorders and cognitive level. Personal Growth Experienced The internship has opened my eyes to all that goes on in a nursing home. Before going in to complete my internship, I thought that the operation of running a nursing home was easy. After having arrived, and starting to get in the routine I found out it was not so easy after all. There are numerous residents to care for with different kinds of needs. It is also challenging to get everyone where the need to be and having a variety of activities to cater to each individuals preferences. That is also the case with almost everything with these residents from their dietary needs to their religious services. Everything has to be done in a multiple or diverse way to ensure everyone is catered to, and their needs are meet. I thought overall I had an enriched experience at the nursing home site. What I have gained from this internship is to be patient, how to multitask and use my time wisely. I also have learned to take initiative and to be a team player, helping out in whatever way I can in order to make things run smoother at the worksite. With the exposure I received I think I am now capable and comfortable working at a health care facility or similar setting. References Birmingham, K. (2008 ). Exercise slows Alzheimers progression. Nursing Older People,  20(7), 4. Retrieved from http://go.galegroup.com Carruthers-Czyzewski, P., Dewar, J. (1998). Seniors health: Parkinsons  disease.CPJ.Canadian Pharmaceutical Journal,131(3), 34.  Retrieved from http://search.proquest.com Gillis, A. J., MacDonald, B. (2006). Unmasking delirium. The Canadian Nurse,  102(9), 19-24. Retrieved from http://search.proquest.com Hartwell, H. (2013). Dementia.Perspectives in Public Health,133(3), 134.  doi:10.1177/1757913913485334 Owen, T. (2007). Working with socially isolated older people.British Journal Of  Community Nursing,12(3), 115-116. doi:10.12968/bjcn.2007.12.3.23038 Potocnik, F. C. V. (2013). Dementia. South African Journal of Psychiatry, 19(3), 141.  Retrieved from http://go.galegroup.com. Reynolds, T.,Thornicroft, G., Abas, M.,Woods, B., Hoe, W., Leese,M., Orrell, M. (2000).  Camberwell Assessment of Need for the Elderly (CANE): Development, validity and reliability BJPsych 176, 444-452. doi:10.1192/bjp.176.5.444 Rogers, S. K. (2006). Delirium in the Home Care Setting. Home Healthcare Nurse: The Journal  for the Home Care and Hospice Professional, 24(6), 366–367.  doi:10.1097/00004045-200606000-00006 Wilson, R. S., Krueger, K. R., Arnold, S. E., Schneider, J. A., Kelly, J. F., Barnes, L. L.,   Bennett, D. A. (2007). Loneliness and Risk of Alzheimer Disease. Archives of General Psychiatry, 64(2), 234. doi:10.1001/archpsyc.64.2.234

The Symbolic Meaning Behind the Black Procession in OConners A Late E

The Symbolic Meaning Behind the Black Procession in O'Conner's A Late Encounter with the Enemy Czechoslovakian philosopher and political mind Vaclav Havel, in his discourse The Power of the Powerless, talks about the danger of "living within a lie" (84). He argues that individuals who refuse to develop a strong sense of self and instead "merge with the anonymous crowd and flow comfortably along with it down the river of pseudo-life" (38) inevitably experience a "profound crisis of human identity" (45). Havel was speaking specifically of communism, but more broadly of the human condition. His warning is similar to moral message of Southern writer Flannery O'Conner in her short stories, specifically A Late Encounter with the Enemy. O'Conner, unlike Havel, sends her message through her fictional characters. They frequently live in contrived worlds the neglect the realities of their lives. O'Conner operates on a highly symbolic and ironic level to demonstrate this to her readers. In A Late Encounter with the Enemy, the General is typical of O'Conner's characters, unwilling to reveal his actual self. But when he is faced with the black procession at graduation, it reminds him of his true, forgotten past, and it is this truth -- the enemy -- which ultimately leads to his death. The General refuses to remember the past. He refers to it as "a dreary black procession" (399). The past is of no importance to him because he is only concerned with the present. All he cares for are parades and "beautiful guls" (400). The General is able to justify his avoidance of the past. O'Conner tells us that he "didn't have any use for history because he never expected to meet it again" (399). There is only one moment from the... ...he gives about him, giving the reader a clear picture of what sort of character he is. But he is weak in his sense of self, content to live as a symbol of a glorious past rather than as a true human. O'Conner exploits this weakness and slowly breaks the General down through the course of the story. She demonstrates the dangers of living a lie, of becoming someone that one is not. Her message is that the fate of the General will be the fate of all man if he chooses to live within a lie. O'Conner warns that life lived without human identity is comparable to Havel's river of pseudo-life. Only she uses the image of a black procession -- dark, solemn and resulting in painful death. The analogies are very different, but the message is the same. Works Cited Havel, Vaclav. The Power of the Powerless. trans. Paul Wilson. Hutchinson Educational, 1985.

Negotiating Ethics as a Two Level Debate :: Philosophy Philosophical Papers

Negotiating Ethics as a Two Level Debate ABSTRACT: As a form of moral debate, discourse ethic, according to Habermas, is based on regulated discussion. Participating moral agents share a common understanding in the ideal speech situation. Following procedures they try to reach consensus on questions of justice and rights. Critics of discourse ethic point to the bias of Western assumptions regarding agents and methods, the danger of elitism, and the optimism and the pacifism that run through the theory. After modification, Habermas distinguishes two types of discourse: the discourse of justification and the discourse of application. The second is inferior to the first. In the second, there is room for negotiating. There is another way of looking at negotiation, one that takes negotiating seriously as an important category of human behavior. This category shows an interesting overlap with moral behavior. Distinguishing four concepts of negotiating and using reciprocity and trust as the moral minimum, Negotiating Ethics is pre sented as a two level moral debate, close to Habermas but morally different in essential aspects. I. Discourse Ethics: Habermas Habermas establishes his moral theory by externalizing the Kantian dialogue interieur. The externalization takes place in three steps. The first step is to transfer the mental deliberation of the Kantian individual into an interactive public deliberation of all those concerned with the moral topic in question. The second step is to conflate rationality with reason. Rationality no longer is a deduction from Reason, but instead it is an underpinning of reasonableness. In discourse ethic rationality means giving good reasons for choices of reasonableness. The third step is to view justice, not according to the categorical imperative, but by concentrating on the following of procedures. Claims concerning the content of moral deliberation must be avoided. What results is an elaborated, interactive Kantianism, concentrating on procedures but still claiming universalism. Continuing the line of critical theory, Habermas avoids the classical standards of Nature, God and Reason and instead presents the ideal speech situation: an attempt to interpret rational consensus procedurally, with no regard for the content. The ideal speech situation serves to summarize the rules to be followed in moral argumentation: symmetry and reciprocity. Symmetry refers to speech acts: each participant must have an equal chance to initiate and to continue communication, and to make assertions, give explanations, and challenge justifications. Reciprocity refers to action contexts: participants must have an equal chance to express their wishes, feelings and intentions, and speakers must act as if each of them has the same capacity to order, to promise and to be accountable. Negotiating Ethics as a Two Level Debate :: Philosophy Philosophical Papers Negotiating Ethics as a Two Level Debate ABSTRACT: As a form of moral debate, discourse ethic, according to Habermas, is based on regulated discussion. Participating moral agents share a common understanding in the ideal speech situation. Following procedures they try to reach consensus on questions of justice and rights. Critics of discourse ethic point to the bias of Western assumptions regarding agents and methods, the danger of elitism, and the optimism and the pacifism that run through the theory. After modification, Habermas distinguishes two types of discourse: the discourse of justification and the discourse of application. The second is inferior to the first. In the second, there is room for negotiating. There is another way of looking at negotiation, one that takes negotiating seriously as an important category of human behavior. This category shows an interesting overlap with moral behavior. Distinguishing four concepts of negotiating and using reciprocity and trust as the moral minimum, Negotiating Ethics is pre sented as a two level moral debate, close to Habermas but morally different in essential aspects. I. Discourse Ethics: Habermas Habermas establishes his moral theory by externalizing the Kantian dialogue interieur. The externalization takes place in three steps. The first step is to transfer the mental deliberation of the Kantian individual into an interactive public deliberation of all those concerned with the moral topic in question. The second step is to conflate rationality with reason. Rationality no longer is a deduction from Reason, but instead it is an underpinning of reasonableness. In discourse ethic rationality means giving good reasons for choices of reasonableness. The third step is to view justice, not according to the categorical imperative, but by concentrating on the following of procedures. Claims concerning the content of moral deliberation must be avoided. What results is an elaborated, interactive Kantianism, concentrating on procedures but still claiming universalism. Continuing the line of critical theory, Habermas avoids the classical standards of Nature, God and Reason and instead presents the ideal speech situation: an attempt to interpret rational consensus procedurally, with no regard for the content. The ideal speech situation serves to summarize the rules to be followed in moral argumentation: symmetry and reciprocity. Symmetry refers to speech acts: each participant must have an equal chance to initiate and to continue communication, and to make assertions, give explanations, and challenge justifications. Reciprocity refers to action contexts: participants must have an equal chance to express their wishes, feelings and intentions, and speakers must act as if each of them has the same capacity to order, to promise and to be accountable.

Passion That Drives School Leadership

Passion That Drives School Leadership As I have read from the article about Passion that Drives School Leadership, the leaders will be effective if he or she is doing work with passion. This article Is Inspiring, informative and challenging to the one aspiring to become a leader. This is Emphasizing the important of passion In leadership. It says that it Is a powerful, Intense emotion or boundless enthusiasm.I can say that If there Is a passion It Is showing of dedication of the leaders doing his work and not all leaders of the efferent school are passionate but according to this article, not all school administrators who lack of passion are losers. Teachers and other school officials and even the superintendent can give best to perform their task with passion. This article Imparted the Indication of administrator who lack of passion. A leader who never prepared everything and never to expend so much time In his duties and responsibility. The one always waits for the free day until h e reaches his retirement.This is also mentioning some example of passionate leaders like the superintendent who decided to go back to a classroom teaching and the one who was an accident victim resulting to her disability but she never been hopeless by the obstacle to do her desire to continue teaching behind difficulties. One of the best in this article, it gave of example of intense passion among teachers and school administrators. Passionate leaders spread passion to others through their love of life, doing new hangs, taking risks, being motivated, having a sense of urgency, and reinventing self.It is a long list, but lye narrowed these descriptions of passion down to four, main leadership behaviors. Passionate people are optimistic, have a great story, involve people, and have a simple, recharge strategy. Passion is the power to simplify our work by providing focus and direction. It helps to inspires others and it has an ability to move leaders and their organization from good t o great and beyond. The teacher or administrator may retire; but the passion doesn't.