Category: Health & Medicine

Ameotrophic lateral sclerosis (ALS) sometimes known as Lou Gehrigs Disease is a disease that leads to progressive wasting of neurons. It is referred to as Lou Gehrig after one of Americas greatest baseball players Lou Gehrig who was diagnosed with the disease. It tempers with the nerve network within the brain and those of the spinal cord. Being progressive, the affected motor neurons (normally charged with the sending of impulses from the brain to the spinal cord and then the muscles and vice versa) eventually die incapacitating the brain from having any control over the affected muscles. This eventually leads to paralysis in advanced stages of the disease (Mitsumoto 12).

So far, the exact cause of this disease has not been identified. Studies are still being carried out to ascertain the real cause. However, some researchers have explained that the disease comes as a result of environmental or genetic reasons. According to data, ninety percent of the cases of this disease are usually not acquired from their parents. This is referred to as sporadic ALS. However, ten percent of the cases are reported to have been transferred to children from parents. These cases are known as Familial ALS (FALS). Comparatively, the symptoms of ALS usually occur earlier in FALS cases than in sporadic ALS. Grandchildren from a child who never inherited the gene will automatically not inherit it. Furthermore, the fact that one inherits the gene of mutation does not guarantee that the person will develop the ALS symptoms (Mitsumoto 26).

ALS is prevalent in people born from parents with the ALS. However, it has also been noted that ALS is more prevalent in people whose age is between the forth and fifth decade. Before attaining the age of six decades, people of the male gender are more likely to develop ALS than their female counterparts. Approximately thirty thousand Americans have ALS at all times. Of the mentioned number, sixty percent are men. In addition, ninety-three percent of the total cases are Caucasians. Although not yet clarified, studies are still being carried out to ascertain the role of smoking and high exposure to lead in the development of ALS. There are also studies pointing that ex-military men are at a higher risk of attaining ALS. The cause is not clearly specified but could be high exposure to lead and other chemicals, injuries, and finally extreme exertion (Strong 32).

ALS initial symptoms sometimes become so slight that most people barely recognize them (Pollin & Golant 49). Furthermore, different people experience different initial symptoms. However, the most commonly experienced symptoms include weakened muscles on limbs and other parts of the body. This includes parts like hands, legs, muscles of the throat including swallowing and breathing muscles and breathing muscles. This results in cases of patients tripping over very small objects like the edge of a carpet. Other people experience weakened muscles of speech. In this case, the person exhibits a slurred speech. For those with weakened muscles of the arms and hands, they have trouble lifting objects. Another notable symptom of ALS is the constant experiencing abnormal fatigue. This could be experienced in the hands, legs, or in some cases both.

Another main symptom of ALS is experiencing cramping and twitching of muscles time after time. In some cases, the disease might be characterized by the patient crying laughing uncontrollably for some period of time. In later stages of the disease, the patient ends up with impaired use of hands and legs. In addition, swallowing and sometimes breathing become difficult for the patient. At advanced stages of the disease, the whole trunk of the body is subjected to weakened muscles or sometimes a totally paralyzed body. In later stages, weakened breathing muscles lead to a complete inability to breath causing the patient to permanently stay on ventilatory support. The disease also leads to thinned limbs due to their inability to function and thus atrophying.

Notably, ALS exhibits variations not only in the initial symptoms but also in the rate of progression after the initial symptoms (Strong 56). There are even cases where the patient experiences zero progress. This is however rare. Averagely, people only live for three years in excess after the detection of symptoms. However, there is a slim chance of about ten percent who can survive for a decade or more.

So far, a cure for the disease has not been developed. In most cases, available medications aim at slowing the process of degradation (Bolen 34). The most commonly used drug and also the only one approved by the Food and Drug Administration is riluzole also known as rilutek. This drug plays the role of slowing the progression of the disease by controlling the level of glutamate, a chemical compound in the brain that is usually found in excess within the brains of people suffering from ALS. Medications can also be provided to alleviate other symptoms like constipation, muscle cramps, excessive salivation, pain, uncontrolled laughing or crying, et cetera. Besides medication, there are other support is provided in order to minimize likely complications and also making a patient independent. It is usually advisable that a patient diagnosed with this disease seeks multiple and integrated attention.

This is especially true considering that the disease is characterized by social, physical, and mental complications. There is therefore need for specialists in social wellbeing, specialists in control and management of the physical challenges and also specialists in mental health to assist the patient in managing his mental health. There are also therapies which include breathing therapy which is aimed at addressing the issue of difficulty in breathing which results from weakened breathing muscles, physical therapy aimed at dealing with pain and issues of mobility, occupational therapy that addresses weaknesses of the arms and hands, speech therapy to deal with the impaired speech production and projection resulting from weakened muscles of speech and psychological and social therapies that are aimed at offering mental and emotional wellbeing to the patient (Pollin & Golant 49).

In conclusion, the real cause for ALS has not been conclusively determined. Equally, a treatment has not been developed so far. However, care and management of ALS includes trying to improve the independence of the patient while at the same time ensuring that his or her social and mental statuses are stable. On the other hand, medication is given to ensure that the progress of degeneration is reduced to the slowest level possible. Other medications are also provided to deal with specific problems that are associated with the disease. All these are done to ensure that the patients are able to live independently and also to ensure their survival for the longest possible period of time.

Works Cited

Bolen, Jean. Close to the Bone: Life Threatening Illness and Search for Meaning. Indiana: Touchstone books, 1998. Print.

Mitsumoto, Hiroshi. Amyotrophic Lateral Sclerosis: A Guide for Patients and Families. 3^rd ed. New York: Demos Medical Publishing, 2009. Print.

Pollin, Irene and Susan Golant. Taking Charge: Overcoming the Challenges of Long Term Illness. New York: Times Books, 1994. Print.

Strong, Maggie. Mainstay: The Well-Spouse of the Chronically III. Bradford Books, 1997. Print.

Types of pain medications

There are many medications that are used to relieve pain. Pain can therefore be best controlled when patients used the appropriate medications. Pain can also be minimized using non-pharmaceutical remedies. This is a list of medications that can be used to remedy pain: Acetaminophen otherwise called Tylenol; Non-steroidal anti-inflammatory medications-NSAIDS; Corticosteroids; Narcotics; Anti-Convulsants; and local Anesthetics.

When Tylenol is used in treating pain, it does not exhibit anti-inflammatory effects. This makes Tylenol a number one choice in treating chronic pains. It can be very effective when it is made use of appropriately. It can however be very dangerous when abused or used in excess.

Caution should be taken to prevent patients from taking regular Tylenol together with Percocet or Darvocet. NSAIDS are very appropriate in treating acute pains (Marcus, 2006). They are also ideal in treating inflammatory conditions. Its use is normally restricted to treating chronic pains to albeit risk of stomach problems despite the fact that components like Celebrex have been made to remedy the above mentioned condition.

NSAIDS should not be administered to patients over longer periods of time. Ibuprofen and Motrin also fall under the category of NSAIDS. Corticosteroids are designed to manage acute pains because of its anti-inflammatory abilities. It can be administered to patients orally or injected into the soft tissues.

Those that can be taken through the mouth include Medrol and Prednisone where as cortisone is given through injections. Narcotics can only be used to control pain on condition that the pain cannot otherwise be controlled because they can be dangerous and addictive. Narcotics are however very effective. Narcotics are only used in treating acute pain.

Protracted use of these narcotics can lead to addiction. Anti-Convulsants are normally used in alleviating nerve pain as they are capable of altering the functions of the nerves. Neurontin is a very popular drug that falls under this category. Local anesthetics only help in relieving the pain temporarily. They are usually topically applied in instances when they are used in treating chronic pain. Lidoderm is one example of such medications used topically.

Pharmacology of Corticosteroids

These steroids stimulate anabolic effect when they bind to protein receptors that assist in creating new proteins in the cell hence increase in RNA activity. This helps in increasing the muscle size and general strength. This is enhanced by the binding of the steroids to the protein receptor sites found on protein cells. Steroids enhance the retention of nitrogen hence the positive nitrogen balance in individuals who use the steroids.

Corticosteroids can be very detrimental to the liver where there metabolism and excretion takes place. This is very dangerous when these steroids are taken in excess. The liver works very hard to ensure that steroids are detoxified and toxins released. The liver labors so hard to ensure that this is done.

This can result into the inflammation of the liver hence liver cirrhosis a health condition that really scares as it can lead to liver failure if not mitigated earlier enough. Corticosteroids can also interfere with the heart as it increases the level of low density lipo-protein.

Opinion

Despite the fact that corticosteroids are the most favored anti-inflammatory medication, care should be taken to avoid over-dosage and prolonged use as this may burden the kidney leading to kidney failure.

Reference

Marcus, D.A. (2006). Treatment of Non-malignant Chronic Pain. American Family Physician, 61(5), pp.1331-8.

Introduction

Oral history is one of the best ancient or traditional methods used to pass information from one generation to another. Aspects of cultural change, education especially on sexuality or health, gender identification and the roles of each individual in the family relied on oral history.

Due to lack of recorded material on critical subjects, oral history becomes the best way to get first hand information. Thus, by use of oral history and narrative/report analysis, my paper critically analyses the way poor people or indigenous communities like those of the aborigine descent are struggling to recuperate from a deteriorating health in their subsequent generations.

Culture erosion, negligence, traumatic past experiences, racism, and colonialism are some of the elements that interplay to hinder the progression of health in the indigenous communities in Taiwan and Canada. The traumatic impact of the colonialists not only eroded the cultural practices, but also altered the health status of the subsequent generations.

Why is health disparity an issue in the western world or Europe especially to those people living in Canada like Aborigines? Which issues contribute to the poor health status the community experience? Mitchell and Maracle cite colonialism as one of the major factors that have led to the deterioration of the health status of the indigenous communities (aborigines) (20).

Due to the invasion of the colonialists, the indigenous people had to succumb to their demands. They also mention Cultural assimilation of the whites as one of the other major issue that had a negative impact on the colonized communities. Unfortunately, the aborigines were not ready to accept the assimilation, which led to conflicts.

Consequently, the colonialists tortured and pressured them to abandon their social or cultural practices and adapt a new culture, which was not only hectic, but also very diverse. Using force and threats, the colonial government was able to establish a uniform cultural practice. Therefore, the traumatic experience inflicted on the minority groups like the aborigines affects the psychology of the subsequent generations.

Mental instability or illness is one of the health crises that the people of most minorities or indigenous communities experience. For instance, Mitchell and Maracle expose the deteriorating mental health of the Aborigines in Canada when they say, mental health issues or issues of imbalance are reflected in high level of depression, additions, and suicides (15). In addition, the psychological problems have persisted in different generations.

Additionally, Mitchell and Maracle put the blame of mental illness to the cultural erosion that the indigenous communities undergo. They also mention that the long-term impact of deculturation or diachronic trauma may integrate in the next generations, thereby leaving behind a disturbing legacy (15). The indigenous/minority groups abandoned their traditional healing methods and lifestyle, which could have solved the current emerging health issues.

The adaptation of a new lifestyle, which consists of different eating habit or human diets, leads to lifestyle diseases like cancer, diabetes, and hypertension among others. Colonialism led to adaptation of new cultural practices. The new generation therefore live this adapted culture; they do not have a chance to learn/know about their cultural practices. Therefore, they not only adapt to foreign culture, which is in the school curriculum, but also practice a culture of a society that overlooks their health.

Therefore, the indigenous communities in the west have a task to seek for their forgotten cultural practices, which may also be a remedy to their deteriorating health status. Besides being cheaper, the practices may also be a form of recuperation of the generations that undergo psychological instability.

According to Drew and Godlewska, the colonial perpetrators separated women from men or girls from boys, which denied the indigenous communities an opportunity to appreciate their familial environment (449). They assert that the segregation not only contributed to the erosion of family/moral values, but also led to racism, an issue that currently contributes to health disparity in the affected community.

Due to racial discrimination, the health priority of the minority groups is not an agenda in most government forums. The minority or indigenous people lack proper health care or facilities because of their skin color. Racism leads to discrimination or isolation in social institutions like hospital and schools.

Thus, the inaccessibility of the hospitals is the reason why the people succumb to ailments, which are treatable. Racism has led to isolation of social amenities in the society, which becomes both traumatic and painful to the indigenous communities and sometimes the psychological consequences culminates into mental instability. Moreover, children who live in racially segregated communities end up developing mental disorders, which can affect the many generations to come.

Racism denies the minority groups to access the higher education facilities of their choice, therefore making them to lag behind on the matters of health. Statistical analysis carried out in Canada comparing the health status of the aboriginal and the non-aboriginals reveal that the whites have a stable health record. Therefore, the impacts of the colonialists are the major issues that need remedy to ensure the healing of the indigenous communities.

Furthermore, Mitchell and Maracle cite the lack of formal education to the indigenous communities that not only locks them out from accessing good jobs, but also denies them adequate information concerning health issues. Health information is critical.

The two scholars call for psychological education to the indigenous people to arm them up incase any member of their families experiences a traumatic event. Most of the higher institutions scrutinize the origin of their students while others bluntly refuse to accept non-white students. On the other hand, the institution that accepts them may lack vital courses within the health sectors, which leaves the communities to depend on the white people in their society.

The menial jobs do not give them a chance to access a good health package. With financial constrains, the indigenous/minority groups are unable to access health insurance systems. Consequently, the treatment cost of chronic diseases like cancer or diabetes among others is extremely high.

Racism promotes inequality, discrimination, and oppression of the minorities/indigenous communities in Europe. The inequality that prevails in Europe is because of the racial segregation. While the whites or the majority enjoy good health, jobs, education and an admirable lifestyle, the minority thrive under impoverished conditions and languish in poverty. The minority are unable to enjoy similar rights in equal quantity hence the poverty.

Although Mitchell and Maracle are unable to unravel the mystery behind the inequality in their society, they intellectually think that the answer may lie within the political docket or sector (14). Besides racial segregation, the politicians want to ensure the minor communities are under their feet. Therefore, the continuous oppression and discrimination ranges from the health, education to the economic issues. The white community fears for their position incase the minor community elevate their status beyond that of the whites.

Thusly, to keep them under control, oppression and discrimination are some of the tactics that politicians apply. Unfortunately, their uncouth tactic eventually denies the indigenous society right to health because they are unable to either access funds or social amenities concerned with their health. Additionally, the role of politicians is to control the economic and social wellbeing of their nation and therefore, when all citizens are unable to have equal rights, the problem definitely originates from the political sector.

Despite the devastating state of the health sector in the indigenous community, Mitchell and Maracle give remedies to the problem. First, the two scholars from the Aborigine community call for assistance from the health providers/sectors to heal the continually ailing community. Scientists, researchers, historians, and philosophers should converge to form a transformation system that will ensure the community recuperates.

Historians, psychologists, and philosophers should research on the ancient cultural practices especially the cultural degeneration of the indigenous communities like the aborigines since the invasion of the whites. Additionally, the ancient political, social, and economical practices should be under scrutiny as a way to ensure their health problems do not originate from the three elements. Furthermore, psychologists should educate adults from the indigenous communities on how to deal with mental illness.

Therefore, psychological education will assist in the healing of the unborn generations because parents will have first hand information on how to deal with their mentally challenged children/infants (Mitchell and Maracle1). Nevertheless, the healing of the community will not occur overnight but it will be a long process with effective results.

Moreover, Mitchell and Maracle insist on the healing of the trauma that occurred during the colonial times (18). The two writers recommend the study of the emotional and spiritual status of the psychologically challenged individuals. The physical stress and wounds will also lead to a clean or healthy generation free of psychological trauma. The psychological and physical therapy will ensure the indigenous people accept the horrific and terrific incidents, events that occurred in their lives.

The third recommendation is that the education system should include the social, cultural, political, and economic practices of the indigenous communities in their curriculum. Consequently, the people will appreciate their origin therefore learning the effect of the elements on their health.

Similarly, the remedy will enable the community to design an effective methodology on how to heal their generations. Additionally, equal educational opportunities will give the communities a chance to learn on the different emerging diseases or disorders in the health sector or human body.

Therefore, they will be able to not only deal with the disease, but also put up preventive measures against the occurrence of the disease. Communal groups should practice unity, which will enable them to support each other, incase of traumatic event, or stress in an individual. The groups will also enlighten each other on the current issues affecting them in their community.

Finally, according to Mitchell and Maracle the racism that remains a barrier to progress in (the) of indigenous people(s) needs abolishment whence all the citizens especially the government or leaders should preach equality (20). Equality will not only lead to eradication of oppression, discrimination, and racism in the society, but also promote good health in the indigenous community. Besides, racism denying the minority communities their rights, it also culminates into hatred in the society, which hinders peace. Establishment of policies will ensure all generations practice equality, which will curb health disparities in the communities or western society.

On the other hand, Geertje asses the impact of mental instability on the family issues and values. For instance, with the use of oral history, he is able to investigate and give the negative effects of psychological instability, which ranges from break down of family ties like marriage, financial instability to lack of peace in the entire or extended families (Geertje 268). Therefore, linking Geertje and Mitchells articles, the two write-ups, confirm that familial psychological trauma is possibly transferable to the next generations.

In summary, using oral history, different articles have been able to produce social issues that never existed in records. These issues negatively affect communities, especially in matters of health. Colonialism forcefully altered the social and cultural practices of indigenous communities specifically, the aborigines. Unfortunately, the psychological, emotional, spiritual, and physical traumas persist in the subsequent generations despite colonialism having ended several decades ago.

Drew and Godlewska, and Mitchell and Maracle among others discuss the health disparities that colonialism caused while Boschma explains through oral history how emotional instability affect generations subsequently. Mitchell and Maracle outline the remedies of the health inequality in western society especially for the indigenous communities.

The two scholars recommend psychological treatment, education, and guidance to parents from these indigenous communities. They also call for unity among community members to solve and cater for the health of their fellow people. Finally, the leaders in the West should work hard to eliminate racism and discrimination in their society.

Works Cited

Drew, Bednasek, and Godlewska, Anne.The influence of betterment discourses on

Canadian Aboriginal peoples in the late nineteenth and early twentieth centuries. Canadian Geographer 53.4(2009): 444-461. Print

Geertje, Boschma. Accommodation and resistance to the dominant cultural discourse on psychiatric mental health: Oral history accounts of family members. Nursing Inquiry 14.4 (2007): 266-278. Print

Giltrow, Janet. Academic Writing: An Introduction. Peterborough, ON: Broadview Press, 2009.

Mitchell, Terry, and Maracle, Dawn. Healing the Generations: Post-Traumatic Stress and the Health Status of Aboriginal Populations in Canada. Journal of aboriginal health 4.12 (2005): 1-20.

Introduction

There are many groups of people social workers and psychologists have to work with to provide them with the required portion of help, understanding, and explanations. However, it is not very easy for even the most professional psychologist to work with particular people and realize what kind of support is necessary.

In this paper, I want to discuss the group of people I would not be eager to work with not because of some discontents or preferences but because of my personal understanding of the needs of such people and the problems that can take place. The current paper is devoted to such population as serious and chronic mentally ill people.

The analysis of the statistics, demographics, and other characteristics of mentally ill people, the evaluation of the circumstances this group of people differs from other people and the preparations for work will be offered to explain the challenges and threats of work with people, who suffer from serious or chronic mental illnesses.

Population Description

Mentally ill people are defined as those, who suffer from the diseases that can affect their brain. The World Health Organization informs that, in the whole world, one of four people usually has some mental disorders (either serious or chronic).

As for the numbers, they are impressive: 450 million people are mentally ill today. Unfortunately, these are the numbers that are officially stated. It is impossible to guess how many people with no ability to inform about their conditions are in the world. The citizens of 40% of countries do not have access to appropriate mental health programs. The question of mental health legislation is closed in more than 25% of the countries.

For example, in America, there are about 61.5 million people, who experience serious or chronic mental problems. In fact, the USA is one of the countries that are properly prepared for treating people with mental health problems. In the UAE, about 24% of students have mental problems. Still, the government of this country does not have enough experts to help people.

As an example, the Americans spend about $193.2 billion to treat serious and chronic mental illnesses, and the Arabs find it normal to spend about $10000 annually. Even more, many Arab people believe that mental illness is a kind of punishment sent by God. There are many parents, who ignore the symptoms of mental illness their children may have.

Many Arabs, Americans, and the representatives of other nations do not want to consider the fact that the first symptoms of mental illness can be observed at the early stages. People just admit that children behavior is hard to analyze. Their mood is hard to understand. Still, there is no place for depressions or other mental problems in a childs mind. This mistake is made in all countries.

Reasons to Avoid Working with Mentally Ill People

The organization that aims at helping mentally ill people do not classify jobs in this sphere but find it more appropriate to use different jobs descriptions and avoid specifications and differentiation of the duties. It is hard to explain what kind of qualities a person should possess to be ready to work with such population.

I am a person with normal reactions to the events that are happening around. If there is something bad happens, I prefer to cry or demonstrate my anger. If something good is about to happen, I want to demonstrate my feelings and expectations. I understand what it means to be guilty. I have my ideas on how to cope with stress or inabilities to achieve the cherished dream. All these personal qualities may become a good basis for the explanation why I am not ready to work with serious or mentally ill people.

First, this population usually lives in the world of illusions and hallucinations. With all my intentions to give reasons and explanations, I am not ready to cooperate with people, who have confused thinking or cannot differentiate reality and delusion. Second, the necessity to control every second of communication under control causes much discomfort. I want to enjoy every minute of this life the only way I have.

There are many people, who may need my help, who want to have the answers to different questions, who are eager to find the point. I am ready to perform the kind of work that may have an evident result. Working with mentally ill people means working with air that can be controlled for a moment and lost in the next second.

Finally, I realize that mentally ill people are full of such symptoms like slowness, grief, difficult interpersonal relations, restricted emotions, lack of motivation, etc. It seems like a person stops understanding what is happening around. I am too emotional to observe such sufferings of people. Besides, I like to reproduce some traits of people I work or communicate with. I am afraid that the nature of mentally ill people can influence my personality and lead to the changes that cannot be understood.

Population Status

In the UAE, people with serious or chronic mental illnesses do not get a special treatment. They are not discriminated or separated from other groups of people. I can hardly hear about the organizations helping the chosen population cope with the challenges they face day by day. On the one hand, it is good to admit that mentally ill people do not undergo some differences.

On the other hand, it is terrible to understand that a number of mentally ill people can be found around, and no help can be offered. I want to believe that the status of this population can be changed the way it was done in the USA. This country and its government know that mentally ill people can be found everywhere, and it is a crucial duty to help such people by any possible means.

How to Get Prepared

The main feature of such illnesses is that usually there is no direct human fault to the problems. A number of causes turn out to be unknown. Still, the experts admit that there are several causes at the same time. It is hard to provide a mentally ill person with the necessary treatment because no particular cure has been invented yet.

On the one hand, it is possible to say that some medications can help to decrease the level of the diseases severity. On the other hand, there is no cure that aims at helping people with such problems. To get prepared for working with this population, it is necessary to understand the truth about the variety of mental diseases and realize that personal attention, support, and understanding are probably the best cure that can be offered.

Responsibility

If a person decides to help a mentally ill person, it is necessary to comprehend the level of responsiveness. It is not enough to be theoretically prepared and recognize the symptoms as soon as possible. It is more important to know how to help or postpone sufferings many people have.

And the most crucial point for consideration is the necessity to analyze all internal and external factors in treating mentally ill people, consider the traits of a particular person, know the circumstances under which a person starts suffering, and only then try to help and improve the situation.

Wound Wise focuses on how to assess the challenges hindering wound care and prevention (Rijswijk 28). In the article, the author highlights means to address these obstacles and compares the outcomes and the cost of the interventions.

Conversely, Noise Control focuses on ways of enhancing sleep in healthcare setting through noise management (Cmiel et al 40). In the article, the authors demonstrate the importance of sleep, mechanism of sound creation, and noise control measures.

A major similarity between the two literatures is depicted through the articles voices. Rijswijk maintains, The quality of healthcare we provide to our patients depend on it (Rijswijk 29). Cmiel asserts, Lying in my hospital bed, I turned off the light at 11 PM (Cmiel et al 40). The use of the first person pronouns in the articles indicates that the authors voices are present. With respect to articles structure, Wound Wise makes use of pictures. On the other hand, Noise Control makes use of charts and tables.

The pictures illustrate how wounds should be treated. The tables and charts illustrate how to measure appropriate sound levels in a healthcare setting. Concerning the rhetoric analyses of the two articles, Wound Wise uses logos and pathos. On the other hand, Noise Control makes use of logos. Logos in Wound Wise are depicted by the way the authors made use of references from credible peer reviewed articles. Pictures used in Wound Wise appeal to the audiences emotions, thus enhancing pathos. In Noise Control, the use of logos has been enhanced by the fact that the authors are medics with knowledge in noise management.

Matrix I: indicating the features of nursing discourse

Works Cited

Cmiel, Cheryl Ann, Dana Marie Karr, Loretta Marie Oliphant, and Amy Jo Neveau. Noise control: a nursing teams approach to sleep promotion.. The American Journal of Nursing 104.2 (2004): 40-49. Print.

Rijswijk, Lia Van. Wound Wise: Bridging the Gap Between Research and Practice Moist dressings are better than dry ones. The American Journal of Nursing 104.2 (2004): 28-29. Print.

Introduction

The introductory section of this study contains a literature review of the dual role of clinical and administrative supervision. The sources used by the authors are relatively old because many of them were published in the early nineties or even seventies, while this article was released in 2007. The literature review indicates there are some important gaps, such as the reasons why some supervisees could express dissatisfaction with experiences in the workplace.

The main purpose of this study is to show how supervisees respond to the cooperation with a person who exercises both clinical and administrative control. This study does not incorporate a specific hypothesis, but researchers formulate several research questions related to the perceptions of supervisees. Although this topic has already been examined by other scholars, the authors of this article show how the attitudes of supervisees are formed.

The sample of this study includes 353 residents (Tromski-Klingshirn & Davis, 2007). The participants were supervised for at least 3000 hours. It was the main criterion, according to which these people were selected. The researchers apply such a measurement tool as a Clinical Supervision Questionnaire. Furthermore, they use Modified Supervision Questionnaire. The participants were surveyed via email. The subjects had three weeks to answer the questions. The collected data was analyzed with the help of ANNOVA.

Results

The findings of the study indicate that supervisees do not usually express any discontent with dual supervision. In particular, only 13.13 percent of the respondents expressed dissatisfaction while working with people who were administrative and clinical supervisors at the same time (Tromski-Klingshirn & Davis, 2007).

Additionally, the results of ANNOVA indicate that there are no statistical differences between people who are exposed to dual supervision and those individuals who worked with two supervisors. The participants were primarily Caucasian. Their age ranges from 23 to 60 (Tromski-Klingshirn & Davis, 2007). Additionally, the majority of them had a post-graduate degree.

Discussion

As it has been said before, the authors do not include a specific hypothesis. Instead, the scholars examine several limitations of this study. In particular, the sample was rather small. This argument is particularly relevant if one speaks about supervisees representing the in-patient group. Moreover, the results can be applied only to those people who have a post-graduate degree. Nevertheless, the findings are consistent with the results derived by other researchers.

Critique

This article can be important for readers who intend to work as hospital administrators. These professionals need to design more effective workplace procedures. This is one of the main benefits that can be singled out. One of the problems is that the researchers do not fully identify the practical implications of this research. In this way, one can clearly benefit readers who read empirical articles in order to improve their work of medical institutions.

Furthermore, the study could have been improved if the writers had included tables and charts because these visual aids are useful for the retrieval of the necessary information. Nevertheless, It is possible to accept the authors conclusions because they are based on sound research design. Furthermore, scholars clearly identify the scope of their research.

Conclusion

This study should not be overlooked because the findings can assist hospital administrators who are supposed to design more effective workplace procedures. This article is not related to the field of child development. Nevertheless, this article may be considered to medical workers who work with children. These are the main details that can be distinguished.

Reference

Tromski-Klingshirn, D., & Davis, T. (2007). Supervisees Perceptions of Their Clinical Supervision: A Study of the Dual Role of Clinical and Administrative Supervisor. Counselor Education & Supervision, 46(4), 294-304.

Introduction

The happiness of an expectant woman is to conceive a healthy and normal baby after carrying a pregnancy for about nine months. She takes good care of herself to ensure nothing interferes with the pregnancy. However, not all women are lucky to carry their pregnancies until they give birth to healthy babies. Some miscarry when their pregnancies are in their first or second trimesters. Pre-term birth is the delivery of a child before it reaches the 37^th week. This essay explores the causes, impacts, and other issues about pre-term births.

Pre-Term Births

Causes

Drug abuse

Smoking and alcoholism are the chief causes of pre-term births. Expectant women are not supposed to smoke or drink alcohol and other drugs that are not prescribed by midwives and other specialists. These drugs contain dangerous substances that interfere with the chemical balance and normal functioning of the human body. Secondhand smoke may cause pre-term births if an expectant woman is exposed to it for a long time.

Accidents

Expectant women are supposed to take good care of their unborn babies and themselves and avoid engaging in activities without consulting their doctors. They should avoid places or activities that may injure their unborn children or themselves. For instance, expectant women are not supposed to participate in demonstrations or activities that may involve violence. They should not fight or engage in physical activities that may injure them because this will affect the growth of their unborn babies.

Stress and Depression

The mental, emotional, and physical health of an expectant woman is paramount to the well-being of her unborn baby. Physical stress occurs when an expectant woman engages in activities that require a lot of energy. For instance, playing games and carrying heavy loads require a lot of energy that expectant women may not have. Emotional stress occurs when expectant women fear the outcome of their pregnancies or are confronted with family challenges like career, challenges, financial difficulties, and marriage instability. Depression is the inability to cope and move on after experiencing harrowing challenges in life. This issue affects the well-being of an expectant woman and her unborn child.

Implications

It is necessary to explain that premature babies usually have undeveloped organs. Their bodies may not function like those of normal ones because they are underdeveloped. They may experience breathing difficulties because their respiratory and gaseous systems are weak and undeveloped. The breathing problems may cause damage to the heart or lungs because of excess strain. In addition, they may experience feeding difficulties because their intestines and other parts of the digestive systems are weak. Vision and hearing impairments may also occur if a child is born prematurely. Moreover, cases of cerebral palsy are common in premature births, especially among women who use drugs. Stunted growth is another implication of pre-term births as the childs body struggles to perform at its optimum despite being underdeveloped.

Diagnosis

Screening

The national center for biotechnology information defines screening as the process of evaluating the possibilities of the existence of a problem. Expectant women are supposed to attend pre-natal clinics and seek other medical services to monitor the progress of their pregnancies. Screening helps nurses and expectant women to know whether the unborn child is healthy or not. The use of ultrasound scans and x-ray machines helps expectant women to know the health of their pregnancies.

Assessment

The screening process provides information about the well being of an unborn baby. Assessment involves understanding and describing a problem to determine a diagnosis and develop specific treatment plans to correct the issue or reduce its severity. Assessment plans are developed from the studies conducted to identify the causes of premature births.

Speech and Language Delays

6 Months

A child is supposed to possess the following abilities at six months after birth. He should calm down and smile when somebody talks to him. This means that he recognizes the voice of people and pays attention to it. The baby should coo and make pleasure sounds when alone or with other family members. He should follow sounds with his eyes and pay attention to music and change of tone of other peoples voices. The child should babble, laugh, and gurgle when excited.

18 Months

The baby should know and follow simple commands and can answer some questions. He can ask simple questions and sing short choruses without assistance from other family members. The child can put together two or more words and seek the attention of other family members by crying if they ignore him. However, a child with speech and language delays may not ask simple questions and uses its finger or eyes to show what it wants.

24 Months

The child should have a word for almost everything and can freely ask about people, places, and events. He should use all consonant sounds without difficulties. However, a child with speech and language delays may not name any objects or people. His language may be understood by family members and close friends but not strangers.

Indicators of ADHD/ADD

Attention deficit hypersensitivity disorders (ADHD) and attention deficit disorder (ADD) have similar presentations and symptoms. The victim does not pay attention to instructions, and this explains why they perform poorly in class and other activities. They are easily distracted by irrelevant issues in the surrounding and disrupt normal activities to divert the attention of other people. Moreover, they cannot pay attention to a single task for more than 10 minutes and have a tendency of shifting from one activity to another without completing the previous one. Their work is usually disorganized and lacks important information because they are always in a hurry. They do not stick to a single conversation and keeps interrupting other speakers.

Dyslexia and Specific Learning Disabilities

Indicators

Dyslexia and specific learning disabilities are associated with pre-term births. They affect a childs ability to grasp information about a specific subject. For instance, the child may not understand the application of arithmetic formulas to solve problems. Most pre-term babies have underdeveloped brains, and their cognitive abilities are poor. Therefore, they may have difficulties grasping concepts in various subjects, yet comprehend others easily.

Impacts

Specific Learning Disabilities and Dyslexia are the main causes of poor memory and comprehension skills. These conditions lower the esteem of individuals because they cannot compete with their age mates. Most people who suffer from these conditions take too long before they understand complex issues. These conditions are the major challenges that cause disparities in learning. They derail learning and make victims lag behind while their classmates proceed with other activities. Pre-term babies may not live normal lives because of the biological and psychological challenges they experience.

The obligation of the doctor to maintain patients confidentiality is one of the fundamental tenets of health care. This obligation is held in high regard and it is articulated in many modern codes of medical ethics such as the American Medical Association and the British Medical Association.

Health care professionals therefore go to great lengths to protect confidential information provided by the client. Even so, there are cases where doctors may reveal information provided in confidence without the patients consent. This paper will argue that such cases are justifiable since there are instances when patient confidentiality should be broken. To reinforce this claim, some of the scenarios were such breaches are acceptable will be illustrated.

In some cases, disclosure even without the consent of the patient is necessary to prevent harm to others. The General Medical Council (2009) advices that personal information may be disclosed if this disclosure will help protect individuals or society from risks such as those posed by communicable diseases. For example, if a patient has a Sexually Transmitted Infection and refuses to inform a sexual partner, the doctor has an obligation to break confidentiality.

Confidentiality can also be broken if doing so will benefit other members of the society. For example, if a patient is found to be suffering from a treatable inherited disorder, the relatives should be informed even if the patient refuses (Kuhse & Singer, 2009). This is because this information will lead to the relatives being screened and treated for the disease. In the two cases highlighted above, the benefits to other members of the society far outweigh the patients interest in preserving confidentiality.

Another instance where it may be necessary to break confidence is when the patient is a victim of violence. Even if the patient insists that the doctor keep the information secret, it may be in the patients best interest that confidentiality be broken since it may assist in the prevention or prosecution of the individual who perpetrated the serious crime against the patient (General Medical Council, 2009). By breaking confidence, the physician can help to prevent further crimes from being committed.

Kuhse and Singer (2009) declare that in order for doctors to do a good job for their patients they often require information of a sort that is generally regarded as private. Patients are unlikely to pass on such information without the assurances of confidentiality. It can therefore be seen that without confidentiality, patients may be reluctant to give health care personnel relevant information which may be necessary for the provision of good care.

While respecting the patients confidentiality is of fundamental importance in health care, it is not considered to be an absolute obligation (Kuhse & Singer, 2009). This reveals the acknowledgement by medical practitioners that there may be times when it is necessary to break patients confidence.

While confidential is central to the establishment of trust between health care practitioners and patients, this paper has demonstrated that it may at times be necessary to break this confidence. In particular, this paper has documented that when the patients right to confidentiality is in conflict with an overriding duty to society, the doctor has a duty to break the patients confidentiality. Even so, the doctor must strive to preserve patients confidentiality at all times since without it, it may be hard to provide quality care to the patient.

References

General Medical Council (2009). Confidentiality Guide. Web.

Kuhse, H. & Singer, P. (2009). A Companion to Bioethics. NJ: John Wiley and Sons.

Surgical sterilization as a birth control option stands out as one of the most effective methods to ensure there is no conception between couples. It is one of the best birth control methods for couples that have had their agreed number of children, as well as those that may have no intentions ever to get children. However, the efficiency of this method emanates from the fact that it may not be reversed. With other birth control methods, a couple may change their minds about not having another child, but surgical sterilization is a one-time decision with which people have to live.

In the current world, the rates of divorce are constantly increasing, and the uncertainties in marriage are ever-growing. People may have to get married again after a divorce, and this would regenerate the desire to have children with their new partners. It is also apparent that accidents may also take away ones child through death, and this would also prompt a couple to have another child. For these reasons, surgical sterilization should be a decision that couples must make. The decision should be made with a clear understanding of the possible consequences.

Pregnancies can be prevented by various other ways that are reversible. Their efficiency in doing the same may not be as effective as having a surgical sterilization procedure done, but they leave people with the option to have a child whenever they are ready. Surgical sterilization is a big decision that couples should only take if they are certain that their marriage will work, and they should ensure they have a permanent desire not to get pregnant again. It is, however, advisable to try other options before going for the permanent solution.

If one has a burning urge to make love, but the partner is not willing to use a condom, the situation can get very tense. It is important to the respective partners to uphold their personal principles with relations to safe sex. If one of the partners does not want to use protection, there should be some compromise between the two. The first approach would be to attempt to inform the opposing partner about the possible risks of not using protection.

For instance, he or she should be advised about unwanted pregnancies and sexually transmitted diseases. If this approach fails, the second option is to use a brand of condoms that feel natural. Most people refuse to use a condom to experience the natural pleasure of having sex. There are super-fine condoms that can give the natural feel of the experience while protecting the couple against unwanted pregnancies and STIs.

If one partner in a couple insists not to have sex with a condom, the last option is to refrain from having sex. There is no need for one partner to compromise everything to have unprotected sex. In any case, being forced into having unprotected sex would only lead to unnecessary worries during and after the lovemaking session. If one does not feel ready to use a condom, sex should be withheld until he or she is ready.

It is better to live with the burning urges than to face the undesirable consequences of having unprotected sex. Making love between couples should be a natural process where both partners respect the other persons desires and principles. One should not accept any reason to take the risk of not using a condom.

Introduction

A health professional carries out his or her duties within a particular legal and ethical framework. The legal and ethical guidelines are meant to regulate the conduct of registered health professionals in order to curb unlawful or illegal acts, which are potentially hurtful to patients and/or harmful to the reputation of medical professionals. This task is a case analysis of a scenario involving a health professional and a patient who allegedly succumbed to death because of the RNs illegal action.

Torts

Any unlawful action that is potentially hurtful to another person committed in the course of a persons duty or general human interaction is referred to as a tort. Tort is underpinned by concepts of wrongs and compensation. Through the tort law, people are compensated for injuries or losses sustained because of another persons unlawful actions (Miller, Cross & Jentz, 2010, p.150; Statsky, 2010, p.2).

Therefore, in a tort lawsuit, an individual brings a personal case against another person or group to obtain financial damages (compensation) or other remedies for the injury or loss suffered. For example, in this case study, the patients family plans to take a legal action against the RN who they allege hastened the death of their loved one. Torts are categorized as either intentional or torts of negligence (Cherry & Jacob, 2005, p. 158).

RN v The Patient Scenario- Tort of negligence

A tort of negligence takes place when a person suffers an injury or loss because of another persons failure to live up to a required duty of care (Goldman & Sigismond, 2010, p.83; Staunton & Chiarella, 2007, p. 39). Contrary to deliberate torts, in a tort of carelessness, the tortfeasor neither purports to cause the outcomes of their action, nor considers that the actions can take place.

Tortfeasors behaviour simply brings about a risk of such consequences. It is pertinent to note that, if the tortfeasors action does not create risk, then, there is no negligence. Furthermore, the risk must be predictable; therefore, it must be such that a reasonable person doing the same activity would foresee the risk and lookout against it (Walston-Dunham, 2008, p.219).

In this scenario, the defendant, as well as her employer, owed the patient a duty of care by virtue of being under their care at their nursing home. The defendant was required to ensure that the patient is not subjected to conditions that could potentially lead to exacerbation of her health, or cause physical and psychological harm. The defendant was also required to take necessary measures to prevent further deterioration of the patients health in opportune time.

The defendant violated the deceaseds duty of care because, instead of giving the patient the expected possible medical attention, she sought to transfer the patient to another hospital contrary to the latters wish. Apparently, the defendant did not take any necessary medical action following a clear deterioration of the patients health. Furthermore, contrary to professional ethical standards as stipulated by Westrick & Dempski (2008, p.58), the RN was more concerned about her situation at the expense of the helpless elderly patient.

The defendant sought to defend herself from a possible legal responsibility due to the demise of the deceased by transferring her to another hospital in a manner that was hurtful. Rather than advising the patients family about where they could access better health services, the defendant sought to cover herself unprofessionally from a foreseeable liability by hurriedly transferring the deceased to another hospital.

The plaintiff (the deceaseds family) suffered a legally recognizable loss because tort law is supposed to protect all of their protected interests including the well-being of their relatives. Their loved one suffered unnecessary distress in the hands of the defendant and eventually lost her life.

Apparently, the defendants breach of the deceaseds duty of care was the cause of the patients death because her failure to take the necessary medical actions and unwelcome transfer to another hospital hastened the death of the patient. Otherwise, if the defendant had dealt with the patients health status carefully, and in accordance to the expected reasonable professional standards, the death would not occur.

The argument that the defendant carried out the transfer based on her duty of care to ensure the patient received the best possible medical attention does not hold any water. There is no evidence to show that the patient would not have received the best medical attention at their nursing home.

Moreover, the RN did not take any other medical action herself at the nursing home that would possibly show that the transfer was ultimately unavoidable and was done in good faith. The manner in which the decision to transfer the patient was made shows that, the RN was more concerned about her situation and how she could defend herself from a foreseeable liability rather than help the patient get the best possible medical attention. She even confined this to a colleague.

Conclusion

The RN in this scenario is under a professional and legal obligation to act and conduct herself in a way that is not hurtful to patients and their loved ones. However, her actions predictably violated the patients right of care. Therefore, the court should grant the deceaseds family damages because of the loss, suffering, and pain incurred due to the death of their loved one. Moreover, the deceased had expressed her wishes to die in the nursing home given her deteriorating condition; hence, the transfer was unwarranted.

References

Cherry, B., & Jacob, S. R. (2005) Contemporary nursing: issues, trends, & Management. New York, NY: Elsevier Health Sciences.

Goldman, A. J., & Sigismond, W. D. (2010). Business Law: Principles and Practices. New York, NY: Cengage Learning

Miller, R., Cross, F. B., & Jentz, G. A. (2010). Essentials of the Legal Environment. New York, NY: Cengage Learning.

Statsky, W. P. (2010). Torts: Personal Injury Litigation. London: Cengage Learning.

Staunton, P., & Chiarella, M. (2007). Nursing and the Law. Sydney: Elsevier Australia.

Walston-Dunham, B. (2008). Introduction to Law. New York, NY: Cengage Learning.

Westrick, S. J., & Dempski, K. (2008). Essentials of nursing law and ethics. New York, NY: Jones & Bartlett Learning.