Masculinities and Femininities
The roles that the society endows a woman or a man and the roles that women and men are considered to undertake distinguish them. The presence of the testosterone hormone among other physical attributes is what gives manhood a definition. Other defining characters include the traditional status of a man being the head of his family, aggressive nature, catering for the needs of the family including shelter, clothing and food among other needs that are necessary for a family’s existence. Being a woman on the other hand entails possessing feminine characters as well as playing feminine roles. Women naturally have feminine reproductive organs. Women are traditionally considered to be caring, tender-hearted and submissive.
Among the words that are used in describing men include caring, gorgeous, and handsome. Women are described using adjectives that include sexy, charming, beautiful and seductive among others. An ideal woman or man has these good qualities without a fault. As such, finding an ideal human being is impossible because in some ways, everybody has a fault.
The applicable expectations for women in today’s society include their collective responsibility. This is because both women and men have been made equal by justice and equality. As such, the expectation of the contemporary society is that a woman should be considerate, sensitive and hardworking. On the other hand, the contemporary society expects men to be hardworking, caring, loving and gentle. There is a variation in these expectations when compared with those of the older generations since the traditional society had distinct duties and roles for women and men. However, these duties and roles are not distinct in the modern society. The law takes both genders equally.
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- There was an extensive damage caused by Hurricane Sandy in the Caribbean Islands. The hurricane landed in these islands before reaching New York. Here is a description of the damage caused by the hurricane:
- 69 people died within the Islands (Williams 2012).
- 200 people died in New York (Super-storm New York 2:20).
- The hurricane damaged the communication system. It knocked out telephone network completely (Super-storm New York 14:30). A large portion of the infrastructure of the cable companies was lost.
- The hurricane knocked down power lines and over 8 million residents of New York lost power (Super-storm New York 2:35).
- The storm dumped sea water inland causing an explosion of power substations and further destroying electrical grid (Super-storm New York 11:50).
- Fire was sparked by the power lines that were brought down in Queens. This destroyed 111 homes at the Breezy Point (Super-storm New York 19:35).
- The hurricane destroyed a subway system in New York, more so the substation at South Ferry. The storm left it unusable (Tollefson 2013).
- The storm destroyed coastline houses with some being lifted from the ground and later dumped inland. The storm left some houses structurally unsound forcing owners to demolish them.
- The waters of the storm washed away the tracks of overland railway which necessitated their complete replacement.
- The hurricane damaged road network, more so the bridges which were affected the most. The flood waters dumped debris along the roads
2. Hurricane Sandy growing into a super-storm
Several factors created conditions that facilitated the formation of a “perfect storm” which increased Hurricane Sandy (Masters 2012). This hurricane was formed from a huge wave from the African tropics. The wave interacted with the pressure of the low regions found in Central Caribbean. In general, hurricanes that form as a result of huge tropical disturbances grow to larger sizes and this was the case with Hurricane Sandy. This hurricane formed within Caribbean which is a relatively humid region. It is possible for a hurricane to increase in size when it forms within an area where the atmospheric pressure is high.
This storm’s center point passed through Cuba. Despite the fact that this center point lacked energy of a warm ocean since it passed over a land, it had outlying air that was circulating over a warm ocean which kept drawing ocean’s energy. On re-emerging from the ocean, hurricane Sandy had outer portions with extra energy. These may have enabled it to expand further. From Cuba, it moved to the Bahamas. Here, it had an interaction with a trough of low pressure. The upper-level winds of this trough created a shear of a high wind for this hurricane which destroyed it making it weaker. Nevertheless, because of the storm-force winds from the tropics, this storm was able to cover a larger area which compensated for the lost energy.
As it moved towards North Pole, the storm acquired additional spin because of the rotation of the earth. This Hurricane leveraged extra spin which grew its size further. Ideally, hurricane Sandy ought to have entered the Atlantic Ocean to peter out. Nevertheless, the high pressure area over Greenland made the hurricane not to turn into this ocean. It was compelled to double back and move to the continental U.S.
When it approached the New Jersey land fall, it had a contact with a system of low pressure of the extra-tropical region. Cold air was pumped into the hurricane by this extra-tropical storm. This turned it into a system of extra-tropical low pressure. In most cases, the coverage of extra-tropical storms is wider than that of hurricanes. This can be attributed to the fact that their force is drawn from the frontal boundary which may have a length of many miles. As such, hurricane Sandy created a landfall with its strongest winds being spread over a wide area making people in Indiana and Nova Scotia to feel its effects.
Hurricane Sandy grew to form the ‘super-storm’ because several factors were combined in its formation. This hurricane was an event that occurs once per 500 years. Nevertheless, with the changes in the conditions of the global weather that are causing global warming, events similar to hurricane Sandy can become a common phenomenon.
3. Storm surge
Storm surge refers to an increase in water past the predicted astronomical tide (Introduction to storm surge n.d.). The winds of the storm cause this surge while driving water towards the shoreline.
The surge of super-storm Sandy was very large because of two major reasons. One, it was during the full-moon when it arrived in New York (Super-storm New York 37:25). At this time, the earth and moon gravitational attraction is very strong. The bulging of sea water tends to move to the moon. This causes a rise in tides by up to two feet.
Second, this hurricane was already an extra-tropical storm which had winds that were stronger than those of a hurricane. A storm surge was created by these winds. Their combination with high tide caused a large surge of the Sandy storm.
3. Low Manhattan’s damage
Hurricane Sandy caused severe damage in Lower Manhattan because of where it is located. The land on which Lower Manhattan is built was realized after a sea reclamation process. For many centuries, city boundaries were expanded by the residents through damping of different materials into this sea. This created a land where buildings were erected (Super-storm New York 28.00). With increasing land pressure, wetlands of the city became prime real estate that were encroached by the people. Water was taken back after striking of the hurricane Sandy to the initial high line of water. This inundated the settlements of the low lying areas. There were no wetlands that serve as the storms’ buffer. This made the storm hit the human settlements instantly which led to an extensive damage.
There was also a considerable damage in the coastal cities. This is because there were coastal developments near the line of the high tide.
5. Prevention measures
Several measures may be taken as way of reducing the possibilities of the damage of such a storm in future. They include:
- Constructing large walls along the shore or coastline to provide protection against the surge.
- Restoration of the wetlands that serve as buffers of the storm.
- Relocating people to the higher grounds.
- Enforcing and changing the codes of new building to facilitate the construction of storm-resistant structures
Among these measures, some can be implemented with ease. For instance, new buildings that do not conform to new codes should not be approved. People should be encouraged to relocate to high grounds. Barriers might not be effective and building them is expensive. Restoring wetlands might not work either because some are irreparably damaged.
6. New Normal
A ‘New normal’ is emerging. Over the past century, the global temperature has increased sustainably on average. This has an impact on weather patterns globally in different ways. There is a steady rise in the sea level which is reaching high levels that have not been witnessed before. According to the prediction of climate models, such events might start occurring once in every 500 years and eventually once per every 200 years. As such, in the emerging new normal extraordinary weather conditions might become a common place.
- Masters, J. (2012). Hurricane Sandy’s huge size: freak of nature or climate change? Wunderground.com. Retrieved from http://www.wunderground.com/blog/JeffMasters/hurricane-sandys-huge-size-frea k-of-nature-or-climate-change
Introduction to storm surge (n.d). National Weather Service. Retrieved from http://www.nws.noaa.gov/om/hurricane/resources/surge_intro.pdf
National Geographic Superstorm New York What Really Happened. Youtube. Retrieved from http://www.youtube.com/watch?v=bP1EdsiEO8o
Williams, M. (30 October 2012). Superstorm Sandy damage assessment: a round-up. The Guardian. Retrieved from www.theguardian.com/world/2012/oct/30/superstorm-sandy-damage-round-up
Tollefson, J. (13 February 2013). Natural Hazards: New York City versus the Sea. Scientific American. Retrieved from www.scientificamerican.com/article/natural-hazards-new-york-city-vs-the-sea/
What Does Your Group Feel Are The Top Three Cultural Factors That Constrain Change In Governmental Organizations In The Inland Empire? Why
Privatization and outsourcing of public functions and utilities is the topmost cultural factor that hinders change. Many governments in the recent past have shifted towards offering of public services via the private sector. They do this by outsourcing services and selling out of public corporations.
With private companies having their major focus on profit maximization, they still lack proper incentives to serve the public more efficiently. This generates conflict because community service is not their main priority and the public does not receive adequate service, thus creating a society that is frustrated (McNabb, 2009, p. 53).
There is also a decline in commitment of public workers to quality in service delivery and performance. This is mainly caused by low wages compared to private sector where the pay is high. Government workers as such, lack motivation to serve the community efficiently as they are often on an exit plan or looking for ways of making extra cash (McNabb, 2009, p. 53).
Procedures and functions in modern day are also changing because of technological advancements and globalization. Change in state organizations also get constrained by rigid performance standard that does not offer room for flexibility. In decision making processes for instance, trivial matters are often subject to scrutiny causing delays. Such events cripple performance of government corporations and they end up lagging behind in regards to efficiency (McNabb, 2009, p. 53).
Top Two Beliefs That The Public Would Argue As Being Weak In Performance Of Public Service Employees? Why?
The fact that public servants should employ public virtues hard work, wisdom, honesty and wisdom does not define public service staff. Employees lack accountability for their actions and they are not destined to employ any virtues in their operations. When a member of the public for instance needs processing of a specific document, public employees can cause delays and the documents take longer than required.
Such delays may also be caused by laxity to deliver the right documents on time or even making enquiries regarding to the proceedings (McNabb, 2009, p. 56). Additionally, public administrators do not carry out their duties economically and officially, for the greater good of the public in mind. This is based on the fact that they do not observe deadlines and lack responsibility.
Workers in private organizations have targets to meet and they are answerable for their actions. This is something that lacks in public corporations. The worker as a result, performs duties at leisure and at own pleasure, leading to wastage of time and other resources (McNabb, 2009, p. 56).
What would your group recommend to the governor as the three best strategies to prepare for change most effectively and why?
Education and Communication
Learning and communication would be the most ideal strategy for the governor to employ because it creates exposure and awareness to employees and citizens of a country regarding proposed changes. It would also sensitize them on intricacies of needed change, a factor that would enable them to prepare efficiently to embrace expected transformations and to utilize them for their growth and development.
Additionally, communication allows parties to pass information to each other. They can communicate their ideas to the government while the government at the same time, informs them of decisions made by top leadership (McNabb, 2009, p. 63).
Participation and Involvement
Participation and citizens as well as employee involvement in change process is imperative because it makes them feel part of the change. It enables them to gain ownership of activities and ideas that the leadership and government undertake. This is carried out by inviting public ideas and opinions, creating room for discussions before implementations.
The step also creates confidence in top management and allows for ease of implementation of proposed changes (McNabb, 2009, p. 63).
Employee empowerment involves giving employees more power to work on projects past their current job descriptions. By doing so, the governor shows the employees that he has confidence in them and is impressed by their work, thus willing to entrust them with even bigger and challenging responsibilities because he trusts in them.
This not only builds confidence in employees but also creates high loyalty level making it easier to introduce and employ any changes (McNabb¸2009, p. 63).
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McNabb, D.E. (2009). The New Face of Government: How Public Managers are Forging a New Approach to Governance. (pp.47-68). New York, NY. Auerbach Publications, Taylor & Francis Group, LLC.
The role of Glial cells is interesting based on shocking revelation. For many years now, neuroscientists did not think highly of the cells. Their concentration was mainly on neurons that were seen as the major communicating cells in the nervous system and in the brain. Recent studies however prove beyond doubt that the glia is crucial in the body just like neurons.
There are neuroscientists that assert that without the calls, neurons may fail to carry out their roles efficiently. Images and listening instrument reveal a direct relationship between neurons and glia in relation to communication. This also reveals that without the cells, the neurons may not work properly.
It would be interesting to learn what motivated Pathologist, Thomas Harvey to take Einstein’s brain home. The results of such an action are very significant especially in contemporary Psychology. Neuroscientists cannot therefore overlook the role of the cells in the human body. The most amazing revelation is that the cells may not be actually responsible for communication as perceived for a long time because the role of neurons comes from the efforts of Thomas Harvey.
There is also solid evidence that glia is essential to learning, creation of memories and repair of nerve damage. Even though relevant research studies to confirm this is are still in progress, there is still a good reason for scientists to reach such a conclusion because of enhanced imaging and tools have been utilized in the research.
The most significant revelation is that many neuroscientists may not agree with the fact that glia and that neurons work in cooperation with the spinal cord and the brain. The neurons act as communication agents through long axons, and the dendrite to additional neurons but the astrocyte glia transports nutrients and other synapses. This shows that glia just like neurons is significant in the body.
Other types of glial cells are also essential in medical world because specialists associate them with treatment of some diseases. Schwan glia for example can be used in treatment of nerve disease. Other glia cells transport nutrients from capillaries to nerve endings. Such a role signifies that if glial cells are not functioning well, nerves can develop complications.
Occasional communication between glial cells is also essential in ensuring proper functioning of body organs. Schwan glia can be used to treat nerves including MS because they surround tangential nervous system. Another scientific finding is based on the axons ability to manage Gilas existence. Glial cells are therefore able to detect the actions of neurons through ATP, discharged by axons only.
Glia cells can then pass over the message to other cells and get ability to manage synapses. The present studies reveal the cells determine the number of synapses that can be created by solitary neuron and location of the neuron. Astrocyte glia is central in this part and growing neurons with a small amount of the cells leading to low synapse numbers.
These studies no doubt reveal that there is need to adopt Einstein’s advice of thinking outside the norm. Assuming that neurons are central components of the body needed for intelligence creation in the brain and for communication purposes, has limited discoveries from neuroscientists based on the role of the cells. The role played by the human brain cells cannot also be over expressed because they are equally essential for proper functioning of the body.
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Effects of Population Density and Noise
The number of people residing in one unit of area can be termed as population concentration. This is in relation to human beings and it is put in terms of square kilometer or squared unit of quantifying area. Additionally, it is often used for cities, countries, counties and for the world. The world’s mostly concentrated areas include cities, metropolitan states and microstates.
Similarly, population density and noise puts pressure on individuals and in different forms. The time when individual’s space and field is disrupted by persons, short or persistent noise, the resulting effect ranges from simple form of annoyance to severe illness that leads to anxiety (Straub, 2007). Therefore, with continuous population concentration, there will be encroachment of three aspects and proper measures have to be put in place to ensure prevention of psychological effects that result from population growth.
It also helps to check anxiety, violence and frustration. This paper focuses on three concepts, personal space, privacy, and territoriality. It also analyses their impact on the people and solutions that can be employed.
Privacy is known as a ‘‘choosy management of access to an individual or a person’s group’’ Altman (1977). It also revolves around having information power concerning oneself and applying the same principle to control self-interactions with other people. New technologies in modern world bring about different issues concerning the power of information of others. This is necessitated by description of balance as well as clear clarification between public and individual information.
The level of privacy needs as well as values greatly differs from one individual to the other and from one situation to the other and in various cultures.
Personal space is defined as the physical distance between individuals with a purpose of ensuring interpersonal relationships. Personal space combined with territoriality is seen as a way in which privacy is advocated for. Sommer (1969) defines personal space as a location with unseen borders surrounding the body of a person where intruders can easily invade.
This space, just like privacy is subject to change and it varies based on personal attributes, culture to culture and situation to situation. Brain development are scientific research suggests that creation and negotiation of personal space takes place in human brain. Further research studies also reveal that even though personal space has dynamic boundaries, it is of great significance and value to humanity.
Human territoriality is known as the approach of authority or control. It also means an attempt to influence, affect or control people by asserting to enforce authority over a given geographical area. The definition also encompasses attempts by groups or individuals in any geographic scale from a room to global arena. It is also not based on survival as in the case of animals but humans maintain space via specific behaviors suggesting that action is employed in regards to ownership or it should be simply occupied.
Research studies also suggest that it is imperative to emphasize on environmental variables as a major territoriality determination aspect. As vital resources become scarce, individuals also work hard to safeguard their possessions and area residence.
Relationships with increasing population
Research studies point out that population density has major effects on population of animals and humans. It is a major issue in determining psychological effects commonly related to crowds because individuals feel bound and is restricted when they do not have major access to supplies (Straub, 2007).
Crowding occurring from high population growth has also been tied to increased violent activities, increased criminal activities, social withdrawal and inapt social interactions. To reduce crowd effects, it is imperative to ensure privacy, respect territoriality and personal space as a significant human social want. Decreased resources in relevance to space, personal space and privacy call for greater appreciation to check psychological effects.
People often have less control and more competition when personal space and confidentiality is lacking. This leads to increased tendency of negative reactions towards insignificant anger (Straub, 2007).
Perception can be considered as a revealing population density element based on its sufficient space as well as congestion related vices. When ample space is perceived by the people, they tend to build more confidence and command relating to nature and have reduced stress and anxiety.
Influence of Nature on Urban Areas’ Settlers
Zoos and parks with preserved natural settings offer a platform for support as well as a framework for people’s interaction with nature. These interactions offer an opportunity for humans to nurture and create a microclimate that is quite common in urban areas. Natural settings created in residential urban areas enhance the idea that people need to co-exist with nature.
Parks and Zoos in metropolitan areas also play crucial roles in relevance to physical activities. Research has confirmed that inhabitants of urban areas have lower health complications. The studies have also found out that individuals within green spaces areas have low mortality rates. This is because the spaces are known to reduce noise associated stress especially in urban settings.
Additionally, greener neighborhoods tend to allow for less violent and antagonistic conducts, superior intellectual performance and good interpersonal relations as well as enhanced social interaction between community members (Gidlofgunnarsson & Ohrstrom, 2007).
Impacts of Noise
Noise is known as any kind of superfluous sounds. It ranges from annoying and quiet to injurious and deafening noise. Chronic noisy places have been studied psychologically and found out to create negative impact on human populations (Straub, 2007). Damaging noise effects have also been proven scientifically to contribute to increased cortisol levels and hypertension and in the end, upsurge in levels of stress.
Contact with chronic noise levels may cause cardiovascular issues and reduced learning abilities. Loud noise is known to interfere with immediate recall ability and reduce a person’s capability to deliver simple activities. People have different noise appraisal levels and the more disturbing a person finds the noise to be, the bigger the effect on them. Even though the noise is accountable directly for effects on sleep, stress and anxiety disorders, a personal approach towards noise has unswerving effect on the health of the person (Straub, 2007).
Noise Cutback Approaches
Installation of extra fabric to cover wall decors, windows and use of fabric stuffed furnishing aids helps in absorption of noise from homes because noise travels faster on glass than on insulated walls.
This means the process in which sensitivity of sound is subdued by presence of foreign sound. Introducing simulated or second natural sound in a home can lock out foreign sound signals in homes as well as areas affected by external sources of intrusive sound.
Privacy, territoriality and personal space include private insights and preferences of humans in regards to utilization of space for normal performance. In urban settings, limited space leads to anti-social behaviors between members of the community. Noise therefore has a significant negative impact on populations thus; noise reduction approaches should be adopted to reduce chronic noise related issues.
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How Non-Profits and For-Profit Companies Work
Whenever a corporation pursues to expound its undertakings abroad, there are numerous facets that have to be put into consideration. These facets vary in regard to whether the corporation is a for-profit or a non-profit organization.
For Profit Company
Geographical differentiation includes a number of features. Initially, the venture need to be able to ascertain whether clients in the intended market have the buying power to buy the corporation’s commodities or services, as well as whether the organization can set a competitive rate for its commodities and services. Second facet is the regional labor expenses as well as linked labor regulations. Having know-how of the local labor expenses will aid the venture assess whether the growth will be workable due to high wages can mean high operating expenses as well as lessened gains. In the same way, comprehending labor rules and laws in the intended market is essential in certain nations for instance EU member nations, employing fresh workers is expensive and tough labor regulations make it unachievable to dismiss workers. Presence of raw commodity providers is the third factor.
Fruitful production in the intended market relies on the accessibility of raw materials. If suppliers are far from the amenity, the corporation’s expenses of shipping is probable to be high, leading to increased cost of production as well as high price for the end commodity. The same way, a corporation has to look at distribution facets. These incorporate the shipping network via which the commodities will reach last customers. Perishable goods for instance milk or flowers demand an improved supply link to shun losses. Additionally, an organization has to look at the power of its corporate culture as well as uphold known status in all its undertakings. If the company culture is feeble, it is probable to be weakened in the numerous parts the corporation develops to causing loss of market share and brand.
Product, market or technology differentiation
Provided the diversity in interests and preferences, a corporation ought to look at tailoring its commodity to meet residential needs or preferences. For instance, McDonald’s has thrived in its global markets by tailoring the menus to meet the demands of residents.
The most crucial facets for a non-profit corporation connected to working in other parts or nation incorporate divisionalization differentiation and hierarchical differentiation.
To excel in running a company, executives need to grow and upkeep useful subcultures. They are present amongst workers, bosses as well as leaders. Nevertheless, provided that each company has its subculture, operating in another part with sturdy divisional subcultures may lead to battle with the initial company as such subcultures have great standards that are challenging to change. On top of this, via globalization, an organization may find it hard to retort to human resource exercises in all areas it runs. Leaders ought to take into consideration these divisional disparities when making policies to expand.
As a corporation grows its undertakings in areas in a nation or globally, it develops and more stages arise in its structure. As it has been noted, subcultures are there at every stage of a company. Therefore, when the company’s structure grows, there is a possibility that more subcultures will arise. In the course of growing subcultures, they tend to accord to each other or turn out to be independent in their undertakings. Sturdy subcultures may be separated from the feeble ones. Due to the fact that certain executives in the company fail to concentrate to the numerous kinds of subcultures, it causes considerable battles in the company. To avert incidents of such clashes, leaders ought to spur friendly interactions amongst the parent company and the newly established company in another area or in overseas nation.
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Case Study Analysis
This analysis draws basis from a patient’s local hospital. The hospital drew impetus from the case study of a 26-year-old woman who experienced a gradual shortness of breath in a period of three days. Her experience was free of other symptoms like cough, fever, or wheezing. She decided to go to her local hospital when it became increasingly difficult to breath.
Of interest were the wait times that the woman endured before she could obtain a proper evaluation and diagnosis of her condition, which could be a comorbidity. From her case, wait times were determined as follows; after staying in the waiting area before registration for an undisclosed duration, the patient was registered and made to wait for 20 minutes before the triage nurse took the patients history and vital signs. The patient then returned to the waiting area for some time before detailed history, physical exam, blood tests, X-ray, lung scan, and electrocardiogram. Another three-hour wait followed before her evaluation was out. The physician diagnosed the patient with asthma and informed her that it was nothing serious.
Impetus for Performance Improvement
A meeting between the hospital’s administrators, the director of the hospital’s performance improvement, and the physician director revealed worrying trends in the hospital, notably diminishing patient satisfaction, increased elopements, and patients collapsing in the teeming waiting room.
This brought a need to reorganize the department in order to increase efficiency and address the fundamental problem of excess wait time; the physician director believed that the wait time was inevitable given that most of the patients were severely ill, and the existing resources were inadequate. The performance of the hospital in terms of wait time had to improve, though there was need to measure its performance and benchmark with other hospitals
The performance improvement director requested a departmental reorganization. The hospital developed an ine-month plan to measure, analyze, and improve quality of care. The plan focused established wait times, patient satisfaction, patient return visits with same problem within 72 hours as the measures to use.
To do this, the hospital undertook some restructuring to bring in new staff, reorganize staff functions, and institute new procedures and policies that would govern service delivery. The management also added incentives to boost service delivery. The hospital’s changes were;
- Introduction of a ‘greeter’ to welcome patients, guide them through the registration process, and identify serious cases. The greeter could help serious cases to skip the registration process
- The triage nurse moved to the waiting area
- An electronic sign indicating average wait times in the waiting room
To analyze the plan, one must look at quality from the customer’s point of view. ‘Quality’ represents an individual’s subjective evaluation of an output and the personal interactions that take place as the individual obtains the output. It is rooted in that individual’s expectations, which depend upon the individual’s past experiences and needs. Quality evaluations therefore arise from, and are part of, an individual’s value system. One can measure and change,as a value system, quality expectations over time through education.
Several concepts can measure quality. Quality has two main components—content and delivery. Content quality is concerned with the medical outcome that results. It also refers to whether the output does what the customer believes it should do-whether the output functionally meets the customer’s expectations.
Delivery quality refers to all aspects of the organization’s interaction with the customer in delivering the output. It is determined day by day, moment by moment, in thousands of individual, temporary relationships. It reflects an individual customer’s interaction with the health care system—a patient will consider whether the hospital was clean and whether the nurses were caring and offered rapid services.The patients will also have expectations on how their interaction with employees should be,
To analyze the effectiveness of the quality improvement measures, one may use tools like questionnaires and customer focus groups. Patients and their relatives fill questionnaires to convey their satisfaction and their feelings towards different aspects of the treatment. The questionnaires may also require costumers (patients) to comment on the wait times. (Nash,2006)
The measures used in determining quality improvement can transport time for AMI patients, the smoothness of admission or discharge, courtesy of hospital employees, availability of good emergency care, number of emergency department patients who return with the same symptoms, and the time for getting an EKG for patients with chest pain.
According to a research conducted on four leading hospitals by Sharon Silow-Carroll, Tanya Alteras, and Jack A. Meyer Health Management Associates in April 2007, hospitals that successfully implemented quality improvement measures followed a strikingly similar process of change as detailed in the diagram below;
The first step is evident in the hospital’s institution of the quality improvement program after recording alarming declines in patient satisfaction, increased patient ‘elopements’ and alarming cases of patients falling in waiting rooms. The hospital’s performance improvement director proposed a restructuring of the emergency department to reduce wait times and respond to cases that were delay sensitive by allowing them to skip the registration procedure and obtain quick treatment. The hospital introduced a ‘greeter’ and moved the triage nurse to the waiting room after identifying it as a possible avenue for longer wait times.
The hospital’s quality improvement strategies may succeed since the laid out plan follows laid out concepts and uses realistic measures to measure its improvement.
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Carroll, Sharon Silow.Alteras, Tanya, and Meyer, Jack A. Health Management Associates
(2007) Hospital Quality Improvement: Strategies and Lessons from U.S. Hospitals.The Common Wealth Fund.
Nash, David B. (2006)The Quality Solution: The Stakeholder’s Guide to Improving Health Care. Jones & Bartlett Learning,.
Natural Gas Fluidized Combustion
Fluidized bed combustion was first commercially applied in the early 80’s and has seen rapid growth to become a well established heat generation technology today (Johnsson, 2007). This technology originated from attempts to come up with combustion processes that checked emission of pollutants without the necessity of having external emission controls like scrubbers (U.S Department of Energy, 2013). Coal and natural gas are the two main fossil fuels that are employed in Fluidized-bed combustion systems for heat and electricity generation. The design, operating features and environmental performance of coal and natural gas fluidized bed combustors differs substantially. While coal operated fluidized bed combustors are the most widely applied technologies, there are increasing efforts focusing on the development of natural gas operated fluidized bed combustors due to their environmental friendliness and cost effectiveness when compared to coal based systems. This paper focuses on contrasting the design, operating features and environmental performance of natural gas fluidized bed combustor conventional pulverized coal unit.
Conventional pulverized coal fluidized-bed combustor is designed to use coal as the main fuel for generation of heat and electricity, whereas natural gas combustors employ various forms of gas producing biomass such as wood, crop remnants, wood pulp and chips, and municipal solid waste (Crawford, 2012). Regarding the Fluidized combustion technique, the bubbling fluidized bed (in which air is injected at a slightly higher velocity than the fluidization velocity) method is preferred in coal combustion units, natural gas on the other hand is processed using the circulating fluidized bed technique (here a very high air velocity in relation to the fluidization velocity leads to elucidation of particles from the bed and circulated back to the reactor via a cyclone). A more contrasting feature in the design of coal and natural gas fluidized bed combustors is in the turbine system; whereas coal operated systems are designed to use water-based turbines to produce steam, Fluidized-bed combustors that use natural gas relies on gas turbines for production of steam that is used in the generation of electricity.
The natural gas fluidized bed combustors are mostly designed to use relatively low amounts of heat in the disintegration of biomass particles as compared coal-based combustors that require large amounts of heat to operate. Limestone is the main catalyst that is employed in the operation of fluidized bed combustors using coal for speeding up the process, on the other hand, catalytic reactions in natural gas based systems are made possible by use of a range of alkali metals. Natural gas systems essentially do not require large Sulphur Oxides (SOx) and Nitrogen Oxides (NOx) chambers due to the low levels of production of these toxic gases. Coal operated systems on the other hand require substantial efforts in their design and operation features to curb release of these toxic gases.
Absorption of Sulphur IV Oxide in a conventional pulverized coal combustion chamber is made possible by the presence of Limestone on its bed, on the contrary fluidized bed natural gas combustion units are surfaced with calcium and sand that are responsible for SO2 absorption. In terms of the amount of het required, pulverized coal combustion require large amounts of heat to disintegrate coal due to its nature. On the contrary, natural gas combustion systems are laced with relatively low heating features since only relatively low degrees in terms of temperature are necessary for natural gas combustion.
In comparison to coal-based combustors, natural gas-based combustors are more efficient and environmental friendly, this is majorly due to a number of reasons;
- Production and release of Nitrogen Oxides (NOx) gas to the environment can be put under check at a relatively low cost. Further more, NOx emission can be further reduced using add-on control technologies such as selective catalytic reduction (Pembina Institute, 2001).
- The emission of particulate matter in biomass operated systems is relatively low, this implies that there is only a small amount of waste to be dumped and thus requires a small dumping space (Pembina Institute, 2001). Coal produces a large amount of solid waste in form of ash in contrast to natural gas whose level of ash-waste is usually low. Coal combustion is therefore costly due to the costs involved in the storage and proper disposal of the solid waste.
- Biomass systems are more capital efficient due to the elimination of the steam cycle in their combustion process.
- Natural gas driven fluidized bed combustors are more environmental friendly in term of green house gas (CO2) emission into the atmosphere. Research has proven that presence of large amounts of Carbon IV oxide in the atmosphere lead to the depletion of the ozone layer and an increase in global temperatures as a consequence. Natural gas contains a smaller amount of Carbon IV Oxide gas as compared to coal. Pulverized coal fluidized bed combustion therefore requires stringent measures to curb emission of the green house gases in order to reduce the green house effect.
- Coal occurs naturally in a solid form, unless the combustion is done at the site of occurrence, transportation of coal to the processing plant is necessary. Due to its nature, coal is very heavy and requires road transport from site to factory. On the other hand, the gaseous nature of nature of natural gas allows it to be transported via underground and overhead systems making this a fast, cost effective and convenient form of transportation compared to road transportation of coal. Additionally, large storage space is required to store the raw materials in the case of coal compared to natural gas which is in most cases a valve-turn away and does not require storage space.
Since its introduction, fluidized bed combustion technology (a technology for reacting suspended fossil fuel particles with high velocity air) for heat and electricity generation have gained widespread acceptance. Coal, petroleum and natural gas constitute the main fossils utilized in electricity and heat generation.. Initially coal was the most widely used fossil fuel in fluidized bed combustion technologies, natural gas is rapidly gaining appreciation over mainly due to its non-bulky nature, cost effectiveness and environmental friendliness. Coal based fluidized combustors are designed to allow feeding of solid coal of reduced size while natural gas systems are designed to only allow injection of raw materials in form of gas. Both coal and natural gas systems emit SOx and NOx gases as waste produce, the mode of absorption of these gases in the chambers however differs significantly. Although coal is the most commonly used fossil, natural gas producing substances such as biomass have been proved to be more effective, environmental friendly and cost effective.
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Crawford, M. (2012, September). Fluidized-Bed Combustors for Biomass Boilers. Retrieved January 28, 2014, from ASME.org: https://www.asme.org/engineering-topics/articles/boilers/fluidized-bed-combustors-for-biomass-boilers?cm_sp=Boilers-_-Feataured%20Articles-_-Fluidized-Bed%20Combustors%20for%20Biomass%20Boilers
Johnsson, F. (2007). Fluidized Bed Combustion for Clean Energy. the 12 International Conference on Fluidization- New Horizons in fludization Engineering (p. 16). Goteborg: Engineering Conferences International.
Pembina Institute. (2001). Appendix 4: A Comparison of Combustion Technologies for Electricity Generation. Power for the Future , 12.
U.S Department of Energy. (2013). Fluidized Bed Technology – Overview. Retrieved January 28, 2014, from Energy.Gov: http://energy.gov/fe/fluidized-bed-technology-overview
Tuskegee Syphilis Study
The Tuskegee syphilis study took advantage of the level of poverty among African American men. Those involved were ignorant black American sharecroppers from deprived communities. At the beginning of the research, the common issue was malnutrition. A large number of the participants lined in areas that were dirty with poor sanitary facilities and dirty floors. It was stated the mortality levels was high due to insufficient clothing and food. Medical experts were not available for poor blacks due to the high medical fees. During the start of 1930’s, syphilis was widespread in various United States communities. The Rosenwald foundation collaborated with public health services to come up with the initiative in 6 states. However, the program failed due to lack of sufficient funds (Reverby, 2009).
The Tuskegee syphilis study was done between the years 1932 and 1972 by American Public Health Service. The experiments were done with the purpose of monitoring natural succession of uncured syphilis. The research started in 1932, the investigators included a team of the Tuskegee Institute and the Public Health Service. The experiment was done on the countryside of African Americans who knew they were receiving free medical care from the US government. The experiment was carried out on 600 black Americans who were illiterate individual from Macon which was among the regions most deprived in Alabama. 399 of these were already infected while the other 201 were not. They were never informed about the disease they had though the investigators informed them they would be given medication for a “bad blood”.
The experimental statistics were obtained from the post-mortem results of the black Americans, they were as such intentionally left to worsen under negative effects of tertiary syphilis. There are numerous myths about the experiments that cannot be overlooked since in some way, they are true. The first is that the subjects were injected intentionally with the disease. The other is that the black Americans were never given proper medication for the illness (Reverby, 2001).
Using the Black Americans as Laboratory Specimens
Information regarding the experiments was not disclosed to the black men to ensure their cooperation. They were manipulated as a result of poverty and the subjects were easily convinced by the great offers of free meals, burial insurance and health care. The black men failed to take time and find out the actual information regarding the research or the diagnosis made (Hastings Center Report, 1992). They agreed to undergo the experiments without questioning the likely risks and what the terms of study were. During the duration of the experiment, individual wellbeing in the US was linked to economic and social status in addition to race. For the duration of the slavery and division that took place after the conflict era, African Americans were neglected when it came to issues of health research. Eunice Rivers was a black nurse involved in the experiment. She acted as the connection between the US government officials and the subjects in the study.
Throughout the entire 40 year duration, she was part of the study. Her key duties were assisting in the recruitment of black men, to help them in dealing with their issues as well as securing the autopsies of the black men in case they died. Her focus was taking care of the black men other than offering treatment. She believed the men benefited from the experiment as they were offered free treatment. As a nurse, she was taught not to prescribe medication or diagnose. She always followed the instructions that were issued by doctors. The black men had great trust in her as she cared about them sincerely (Rusert, 2009).
The research was aimed at determining the effects the disease had on the bodies of African Americans as opposed to white men. The theory before the experiment was white men experienced more neurological complications from the disease while black men were vulnerable to cardiovascular illness. It was unpredictable how the results from the experiment would change medication procedures of the illness. It took forty years before one of the investigators made the admission that nothing could have cured or prevented a single infectious syphilis case or led to the key objective of controlling the venereal disease in the US. For forty years, the investigators deliberately declined to offer patients proper treatment even after validation of penicillin as the efficient cure for syphilis Reverby, 2009).
By the period the research came to an end, 28 of the African Americans were already dead, 100 passed away as a result of related problems, forty of their companions got infected while 19 children were born infected. These black men were persuaded to endure the fatal disease by a doctor who convinced them it was necessary for the study to be carried out. First, the African American were given Neoarsphenamine and mercury and the disease dosage though in limited amounts as such, they did not show improvements.
The investigators knew the small doses could not interfere with the objectives of the experiment as they did not have side effects. After a while, the syphilis doses were replaced by pink medications known as aspirin. The Public Health Service investigators misinformed the African Americans with a letter stated, ‘Last chance for Special Free Treatment”. This was aimed at ensuring they would show up for spinal tap, which they knew was risky and very hurting. Throughout the duration of the 40 year period, the black men never knew they were only part of an experiment and they were not treated. It was after the news broke out that they realized they were just used (Reverby, 2009).
After the Experiment
On July 25th, 1972, news regarding the experiment broke out in the Washington Star. It was published in an article that was written by Jean Heller. Her source was a disease interviewer from Public Service Health service. The investigators had however insisted the black men were volunteers and were not forced to take part in the experiment. Therefore, the government made the decision to halt the experiment since the public was aware of its initiatives. It was at that point as well that they made the decision to provide the proper diagnosis to the men with syphilis. Penicillin was discovered as the best prescription for the disease by the year 1947. As such, the U.S government offered support to various public health programs so as to wipe the disease out. Several treatment centers got formed and campaigns to address the disease were started. Only seventy four of the 399 black men participants survived to the end of the experiment duration in 1972 (Reverby, 2001).
Fred Gray, a lawyer filed a class suit which recommended that a compensation of $ 10 million should be given to the black men affected. He portrayed the Tuskegee case as one of blacks against the whites however, it was more complicated. The revelation by whistle blowers of the failure in the study later on lead to major changes in the regulations and laws of the US in regard to protection of individuals involved in medical experiments. Recent medical studies demand doctors should seek permission, state diagnosis and provide the individuals with accurate test results (Reverby, 2001).
The National Research Act in 1974 was approved by the American legislature. The congress created a commission that established the regulations and rules that governed experiments involving human subjects. The US president apologized to black American men who were part of the Tuskegee experiment and even held a national ceremony in their honor (Katz, 2008). The study as well destroyed the trust African Americans had in public health efforts which were provided by the government of the US. Majority of the blacks lost trust in the medical community and became reluctant to make contributions to the varying health programs, for instance, the organ donation programs. The study also contributed to the reluctance of poor black people to seek preventive regular measures. The Black American people also developed the belief that the government contributed to spread of HIV/AIDS virus due to the experiment (Rusert, 2009).
Hastings Center Report. (1992). Twenty Years After: The Legacy of the Tuskegee Syphilis Study. Vol. 22 Issue 6, p29. 3/8p.
Katz, R. (2008). Awareness of the Tuskegee Syphilis Study and the US Presidential Apology and Their lnfluence on Minority Participation in Biomedical Research.American Journal of Public Health. Vol. 98 Issue 6, p1137-1142.
Reverby, S. (2001). More than Fact and Fiction. Cultural Memory and the Tuskegee Syphilis Study. The Hastings Center Report [Hastings Cent Rep] Vol. 31 (5), pp. 22-8.
Reverby, S. (2009). Examining Tuskegee : the Infamous Syphilis Study and its Legacy. Chapel Hill : University of North Carolina Press.
Rusert, B. (2009). “A Study in Nature”: The Tuskegee Experiments and the New South Plantation. Journal of Medical Humanities. Vol. 30 Issue 3, p155-171. 17p.
Supportive Employment Policies
Mental illnesses incidences are increasing rapidly at the workplace. Problems related with mental health are major disability contributors globally. They are ranked among top 10 leading disability causes. Countries are affected equally by mental illnesses whether they are poor or rich. The effects are felt across all ethnic groups, genders, ages and races. Additionally, researchers indicate further mental health problems are expected in the near future (Shaw et al., 2003).
The risks and burdens that accompany mental health at work places should not be overlooked. It is established 15 to 30 percent of employees will likely experience mental health complications in the course of work (UN, 2000). This issue has attracted plenty of public policy legislations and political attention. As such, the purpose of this paper is to discuss political issues and state, local policies and federal on employment of persons who are mentally ill.
Political Issues and Policies on Supportive Employment of Mentally Ill Persons
In majority of countries, there exists legislation that a state of disability should not keep one from enjoying a meaningful life. For example, the American Disability Act makes provision that employers are supposed to make noteworthy considerations where employment of persons who are mentally ill is concerned. It is necessary not only to provide support to such individuals but for the employer as well in order to enhance good working environment and relationship (Atkins & Weiss, 2002).
Mental illness is linked to various problems such as unemployment, lack of education and poverty as well as other problems. Depression prevalence is also high among individuals who are unemployed than among those employed. Unemployment as well has significant effects on the health and well-being of the people. On top of this insecure jobs also leads to health complications. For example, temporary workers face more difficulties in working environment than permanent workers (SAMHSA, 2003).
Therefore, government policies are extremely crucial in reducing and promoting unemployment as they have positive effects on the peoples’ mental well-being. A health mental policy for workplaces should be developed as a policy that is separate or part of health and safety policy. This ensures all aspects of mental health are also put into consideration (American Psychiatric Association, 2004). Examples of mental health policies at workplaces include retention arguments and good health. Few employers act on adage that good health equates to good business and even fewer of them recognize mental health importance’. There is however an inclusive approach towards well-being and mental health of employees. These approaches included reduction of absenteeism, acquiring necessary skills, creation of good work relationships, encouragement of productivity, employment of best managers, supporting and ensuring acceptance of all individuals as well as making ones place of work safe as well as efficient.
Many businesses on the other hand address problems of mental health at their places of work through development of policies. A mental health policy, usually aids in defining the vision as well as aim of improving mental condition of the work forces as well as establishing a model of action. After formulation, the policy not only identifies the agreement between the employee and employer but facilitates relationship between the various stakeholders at the workplace. A policy on mental health on employment of personals who are mentally ill can be developed as part of safety and health policy. Putting such a policy in place will involve the analysis of mental illness issues, development of actual policy, establishment of strategies to implement it as well as implementation of the policy. High levels of dedication and commitment are needed on the part of employer towards ensuring policy development (America Psychiatric Association, 2004).
The workplace policy on persons who are mentally ill is normally based on an understanding of the issues that are associated with the illness which is obtained after thorough assessment of the predicament (Shaw et al., 2003). This information might include data records from the department of human resources, occupational health record, health records and financial reports. New information collection is just as important as well. Research and surveys should be carried out on the incidence and occurrence of mental illness at places of work so as to identify occupational health risks and safety matters within the workplace. Interviews are supposed to be conducted with employees, managers, medical officers and families so as to get new information (America Psychiatric Association, 2004).
At national level, the government has the responsibility of promoting mental wellness, ensuring proper mental illness treatment and preventing mental issues as well. The government also targets workplaces in its strategies of prevention and promotion. On top of this, the government is itself, the employer. However, the administrative structures differ greatly in overseeing employment of persons who are mentally ill. The Ministry of Health also aids the government in formulation of mental health policy, suggests frameworks for promotion of employees’ mental health and implements mental health policies. As a matter of fact, mental health policy should define relationship between the health and work of the employees (World Health Organization, 2005).
The ministry of Labor, on the other hand has the mandate of ensuring health and safety at workplaces. This does not just include supervision and regulation of safety and health but protection of incomes for persons who are mentally ill. Improvement of management of mental health issues among the employees leads to changes in legislation of policies which is accompanied by relevant policy implementation.
The government as well has a crucial role to play towards ensuring the policies get implemented and they provide framework that promotes implementation of mental health policy and ensures the employees suffering from mental health complications get proper and adequate treatment. These policies cover issues of discrimination, safe environment, income and other mental health issues noted among employees (America Psychiatric Association, 2004).
The UN has committed to ensure persons with disabilities get the same opportunities as those without and they are allowed to take part in any economic activity which also includes employment. The law on antidiscrimination was introduced in many countries and it has proven to be the most vital and effective legislation so far as improvement and employment of mental health within the workplace is concerned. The United Nations adopted standard rules on equal opportunities for personals with disabilities in 1993 (UN, 2000). The rules further identified a couple of issues that needed quick action and which were lacking for purposes of attaining equal opportunities for all people which includes the disabled. Some of these issues included creation of awareness, health care, support services, rehabilitation services, and protection of income, employment and security among others.
The International Labor Organization in 1998, declared fundamental principles and workplace rights which ensured the commitment of government, workers and employers. On top of this, employer’s organizations upheld standards and principles in 3 main areas of employing people with disability which included elimination, discrimination and promotion at workplace SAMHSA, 2003). Antidiscrimination legislation also prohibits the discrimination of people suffering from mental illness. The effectiveness of these laws depends on model of disability and the inclusive nature of mental health problems, equality aspect for instance, in promotion of access to training and education, appearance of legislation in civil, labor and criminal laws. The laws of antidiscrimination as well include people with mental illness. The US for instance, passed the 1990 Disability Act which prohibits employers from carrying out acts of discrimination against people with mental illness in any aspect as job applicants or employees deserve to enjoy equal treatment (UN, 2000).
The laws of antidiscrimination make it unlawful for employers to discriminate against people with mental illness and requires employers to be responsible in creating environments that are conducive to ensure all people, including those with disabilities, work well in these companies (NIMH, n.d). The national government, on the other hand has numerous strategies that ensure persons with mental illness or disabilities are employed. These include the use of quota schemes requiring certain businesses to employ specific number of people with disabilities; nondiscrimination laws, content that it is unlawful for employers to discriminate against persons with mental illness or disability and job retention requires that employers should retain employees who are disabled while working for them (America Psychiatric Association, 2004).
Employees, in addition need protection against cost of disability and illness. This should include both treatment cost and salaries loss as a result of inability to work. Financial protection is based on three principles (Atkins & Weiss, 2002). First, employees ought to enjoy protection from severe financial expenses through reduction of their cost on mental health care. Secondly, healthy people are supposed to support the sick through subsidizing their health care through strategies such as prepayment services of mental illness. Thirdly, the rich are supposed to offer support to the poor.
Majority of the small business enterprises on the other hand address problems of mental health at their workplace through development of policies. A mental health policy usually assists in definition of the aim and vision of improving mental state of work forces through establishment of a model of action. Once the policy is formulated, it not only identifies the agreement between the employee and employer but it facilitates relationship between the different stakeholders at the workplace. Unfortunately, majority of the employees in small businesses or enterprises, self-employed or on part-time employment do not have access to income protection as a result of mental illnesses (UN, 2000). Such people are at great risk of financial hardship and crisis in case of mental complications which impair their ability to work. As such, the employers and government needs to join hands and devise ways of ensuring all employees are protected adequately against financial crisis cause by mental illness.
Other policies and provisions on mental illness focus on duties of the employer in provision of safe work environment (America Psychiatric Association, 2004). They commit employers to development of safety workplaces. For example, the International Labor Organization develops programs which ensure and promote safety at work places. The main objective of the organization is increasing global awareness on impacts and aspects of mental illness, diseases, injuries and enhancing the capacity of industries and states to implement and develop effective policies and programmes as well as protecting all the employees.
Most of the national laws have addressed employees’ safety. For instance, the 1994 Safety Act and Management of Health and Safety at Work Regulation of 1999 ensures that employers provide safe environments for employers, accesses and controls risks that are associated with mental health (Shaw et al., 2003). The laws as well make employers responsible for ensuring the safety of employees at workplaces and support as well as assisting persons with disabilities. For such policies to be put into place, it demands the analysis of the issue on mental illness, development of actual policy, establishment of strategies to implement it as well as policy implementation. High level of dedication and commitment is needed from the employer in order to ensure development of the policy (WHO, 2005).
Majority of employees are affected by mental issues depending on the health care services that are offered by private sectors, the government and NGOs for their medication. It is crucial that these services should be accessible and of the top most quality. Additionally, a mental health policy on the treatment of persons who are mentally ill should be developed as part of the safety and health policy. High dedication and commitment levels from employers are needed in order to ensure the policy is well developed (Atkins & Weiss, 2002)/
However, there are a couple of challenges that face introduction and implementation of mental health policies in the workplace though they do not come without solutions. First, employers firmly believe profits are higher when employees work for long hours while responding to mental issues can be very expensive to them. Majority of the employees do not understand the link between employees’ mental health and productivity. Second employers who run small businesses and with few employees might only understand the need of addressing mental health issues in large organizations but not small ventures such as theirs. These business owners therefore rely on the government and the existing services of mental health care (Shaw et al., 2003).
Thirdly, stakeholders might resist development and implementation of mental health policy as well as accompanying strategies. This is because they might not be aware of the influence mental health has on productivity and performance at work places. It is important to conduct consultation and assessment with stakeholders during implementation and development of the policies. For instance, demonstration of projects and discussion n meetings can help people get better understanding (NIMH, n.d).
At national level, the Ministry of Health aids the government in formulating mental health policy, suggests frameworks for promoting mental health of employees and implements mental health policies. As a matter of fact, mental health policy is supposed to define relationship between health of employees and work (WHO, 2005). The government has the mandate for promoting mental wellness, preventing mental issues and ensuring mental illness is properly treated. The government also targets workplaces in prevention and promotion strategies. On top of this, the government is an employer itself. However, the administrative structures differ greatly in how they oversee the employment of persons with mental illness.
Mental illness contributes to disability and is linked to numerous problems such as unemployment, poverty, lack of education and other issues. Depression prevalence is high among people who are unemployed than those employed. Unemployment as well has significant effects on the health and well-being of the people (NIMH, n.d.). On top of this, insecure jobs can also lead to health problems. For example, temporary workers indicate more difficulties in working compared to permanent workers. As such, various policies need to be developed and implemented by organizations and government to support persons who are mentally ill. The policies should address issues such as employment, income protection, retention as well as safety for persons who are mentally ill (SAMHSA, 2003). Other policies and provisions of mental illness should focus on the employer’s duties in provision of a working environment that is safe. They should commit employers to guarantee safety at workplaces.
American Psychiatric Association (2004). Diagnostic and statistical manual of mental disorders, 4th ed. Washington, DC: American Psychiatric Association.
Atkins, A. & Weiss, H. (2002). Program evaluation: the bottom line in organizational health. In: Quick JC, Tetrick LC, eds., Handbook of occupational health psychology, Washington, DC: American Psychological Association.
National Institute for Mental Health (undated) Mindout for mental health. Retrieved on 9 November 2013 from <http://www.nimhe.org.uk/downloads/LineMngrPack-FINAL.pdf>
Shaw WS et al. (2003). Employee perspectives on the role of supervisors to prevent workplace disability after injuries. Journal of Occupational Rehabilitation, Vol. 13(3): 129-142.
Substance Abuse and Mental Health Services Administration (2003). National household survey on drug abuse: main findings, 1991. Rockville, MD (DHHS Publication No. SMA 93-1980).
United Nations (2000). The Standard Rules on the Equalization of Opportunities for People with Disabilities. UN General Assembly Resolution 48/96
More than Conquerors
Passage: I Corinthians 7:1-40
Apostle Paul authored this passage in which he uses a detailed and descriptive narrative to share his thoughts. Paul narrates to the Christians of Corinth how they ought to behave in a marriage as well as before they enter into a marriage as an institution.
In this passage verses 1-2, Paul highlights sexuality as an aspect:
Now for the matters you wrote about: It is good for a man not to marry. But since there is so much immorality, each man should have his own wife and each woman her own husband. (NIV)
Apparently, Paul is writing in response to a letter that was written by the Corinthian Christians. As such, the response is a letter. Uncompromisingly, Paul says that marriage is not good for a man. Nevertheless, there are no reasons that he gives for his strong statement. The apostle further says that for sexuality’s sake, a man ought to have his own wife and every woman ought to have her husband (Ellis).
Paul uses a literary style and this says a lot concerning his personality. It depicts him as a principled and God fearing person especially when it comes to handling contentious issues that affect the society. He also employs a conversational style because he uses “you” while addressing the audience. This indicates communication flow between the audience and the author.
Paul talks about the wives and husbands’ responsibilities in a marriage in verses 3-6.
The husband should fulfill his marital duty to his wife, and likewise the wife to her husband. The wife’s body does not belong to her alone but also to her husband. In the same way, the husband’s body does not belong to him alone but also to his wife. Do not deprive each other except by mutual consent and for a time, so that you may devote yourselves to prayer. Then come together again so that Satan will not tempt you because of your lack of self-control. I say this as a concession, not as a command.
In these verses, Paul gives instructions regarding the behavior of wives and husbands vehemently. He strongly states that a person’s body does not belong to them alone. It also belongs to his/her partner in marriage. By this statement, Paul implies that couples are mutually responsible in terms of sex and that they should not deny each other conjugal rights.
Carefully, Paul condemns promiscuity/immorality by selecting the words to use in the passage. He uses the following words: ‘then come together again so that Satan will not tempt you because of your lack of self-control’. In verse 6, he ends by telling the audience that this is not a command but an admonishment for them (Daniel and Collins).
From the way Paul uses a literary style, it is clear that sex is not considered wrong in marriage for Christians. However, Paul notes that Satan uses a strategy through which he encourages couples to engage themselves in extra marital affairs. One can also deduce that the apostle addresses sex in marriage because it was a controversial issue and perhaps, causing divorces during that time.
In the passage that follows (Verses 7-9); Paul shares the benefits of being single while indicating marriage benefits which he all refers to as a gift from God.
I wish that all men were as I am. But each man has his own gift from God; one has this gift, another has that. Now to the unmarried and the widows I say: It is good for them to stay unmarried, as I am. But if they cannot control themselves, they should marry, for it is better to marry than to burn with passion.
Here, Paul uses a controversial style by saying that, “For I wish that all men were as I am…” This is the time when Paul’s life was dedicated to God’s service. Hence, he belonged to the unmarried category. Paul indicates that the unmarried people are better off.
Nevertheless, he is not imposing the idea of being single on the audience. Instead, he notes that every man has a gift from God. In terms of gifts from God, in James 1:17, the scripture says, “Every good and perfect gift is from above, coming down from the Father of the heavenly lights, who does not change like shifting shadows.” As such, Paul indicates that Christians are guaranteed good gifts by the unchanging nature of God and in reference to this case, there are people who have the gift of a marriage while others are gifted to remain single.
It is worth observing that Paul employs a persuasive style in writing because he urges the unmarried and windows to remain as single as he is. Nevertheless, since Paul understands the nature of humans, he tells them that they should marry if taking control of sexual passions is a problem to them. This is a point at which Paul indicates that marriage is beneficial in satisfying the sexual desires of the married people. Just like in the other verses of this context, the apostle upholds the values of Christians by encouraging them to engage in sex only when married.
In verses 10-11, Paul answers the separation and divorce question among Christian couples.
To the married I give this command (not I, but the Lord): A wife must not separate from her husband. But if she does, she must remain unmarried or else be reconciled to her husband. And a husband must not divorce his wife.
Paul uses a literary style in a conversational tone but there are instances when he employs sternness in his statements. He is also authoritative than in the previous statements. Paul changes the discussion topic from making a decision to remain single or to marry and now he discusses the issue of separation and divorce. These verses indicate transition that portrays the organization of Paul in terms of literary works.
Paul indicates marriage gravity because he commands the Corinth couples to strictly avoid separation or divorce. However, Paul adds that if it is a must for couples to separate, they should be reconciled or remain unmarried. This indicates the hatred that God has for divorce and that He is a marriage advocate. The divorce and marriage issue has a connection with the past scriptures in which God allows couples to divorce only on sexual immorality basis (Matthew 19: 3-9).
This command was given by Jesus while referring to marriage when He said, “I tell you that anyone who divorces his wife, except for marital unfaithfulness, and marries another woman commits adultery.” (Matthew 19:9). In response, Jesus’ disciples said, “If this is the situation between a husband and wife, it is better not to marry.”
As such, according to Lord Jesus’ stand on divorce, one can deduce that Paul is an indication of an apostle who was loyal to Jesus and a follower of the scriptures. He also upheld the commands of God strictly. Paul had an uncompromising and principled nature which was evident in the way he does not give reasons for having double standards to his audience.
In verses 12-16, the apostle addresses different couples. It is apparent that Paul addresses Christian couples in the previous verses but in these verses, he now addresses his brother who is married to wife who does not belief as well as a woman who is married to a husband who does not believe.
To the rest I say this (I, not the Lord): If any brother has a wife who is not a believer and she is willing to live with him, he must not divorce her. And if a woman has a husband who is not a believer and he is willing to live with her, she must not divorce him. For the unbelieving husband has been sanctified through his wife, and the unbelieving wife has been sanctified through her believing husband. Otherwise your children would be unclean, but as it is, they are holy. But if the unbeliever leaves, let him do so. A believing man or woman is not bound in such circumstances; God has called us to live in peace. How do you know, wife, whether you will save your husband? Or, how do you know, husband, whether you will save your wife?
There is a new twist that is introduced in Paul’s literary work when he states that, “I, not the Lord.” Paul employs this style to indicate he is giving the audience his opinion regarding this matter. In simple terms, Jesus did not teach about this topic during his time on earth. However, he inspired Paul and that is why he is writing about it.
The apostle urges the Christians of Corinth who are in marriages with unbelievers to avoid divorcing them. One may assume that divorcing unbelieving partners is a spiritual act since a believer ought not to remain yoked with an unbeliever. Nevertheless, the stand of Paul is that in such a scenario divorce should not be considered as an option (Zodhiates).
According to Paul, the unbelieving spouse can be drawn to Christ by the believer and this will glorify God. This is the main reason why Paul does not encourage divorce in this case. Nevertheless, he does not encourage courtship between believers and unbelievers. He only encourages Christians with unbelievers as their spouses. Additionally, Paul has proven a point that believers sanctify their partners and their children.
As an alternative, Paul comes out clearly in terms of separation for such couples. The believer ought not to start a break-up/separation. Instead, they should maintain their marriage. If an unbelieving spouse chose to separate, the believer ought to let them go since this breaks them from the bondage of that kind of a marriage.
Paul says, “For how do you know…” as a statement that concludes the section by giving hope to the Christians with unbelieving spouses.
Paul depicts a leadership skill of an outstanding nature in the following verse as indicated below by the way he authoritatively urge Christians to remain where they have been placed by the Lord (verse 17).
Nevertheless, each one should retain the place in life that the Lord assigned to him and to which God has called him. This is the rule I lay down in all the churches.
Paul in this scenario tells Corinthians that regardless of their position or state (whether separated, married, remarried, etc), it is highly important that they keep walking as Christians in their lives. To a great extent, Paul helps the audience get over their past and also work to please God in their current states.
In verses 18-20, Paul emphasizes on the essence of staying in the state or position that a person has been placed by God.
Was a man already circumcised when he was called? He should not become uncircumcised. Was a man uncircumcised when he was called? He should not be circumcised. Circumcision is nothing and uncircumcision is nothing. Keeping God’s commands is what counts. Each one should remain in the situation which he was in when God called him.
The bravery nature of Paul is greatly depicted in this section because he is not apologetic while handling controversial issues that affect Christians’ lives. While writing to the Christians of Corinth, Paul had noted the discrimination that the uncircumcised were facing. Paul refers to uncircumcision and circumcision as ‘nothing’. This is similar to what was written by Solomon in Ecclesiastes where most things are referred to as ‘vanity’. Paul is highly esteemed by this bravely and it can also captivate the audience (Braxton and Brad).
Between verses 21 and 24 as indicated below, Paul emphasizes on the importance of letting go of past situations as well as living the present in which a person has been placed by God.
Were you a slave when you were called? Don’t let it trouble you—although if you can gain your freedom, do so. For he who was a slave when he was called by the Lord is the Lord’s freedman; similarly, he who was a free man when he was called is Christ’s slave. You were bought at a price; do not become slaves of men. Brothers, each man, as responsible to God, should remain in the situation God called him to.
The audience is motivated by Paul to avoid being troubled by the past lives even for those who were slaves. In these verses, Paul uses a conversational style in expressing his point. He tells the audience that old has gone and that God intends to use his Christians in their current situations because He has placed them in such situations. The apostle makes literary style personal by using the word ‘brothers’ in reference to the audience. He uses a less stern statement and instead he uplifts the discouraged spirits by encouraging statements.
In the verses that follow (25-35), Paul talks about different issues that include marriage, singleness and virginity. Instead of using hidden sayings, Paul speaks in an open manner while motivating all people.
Now about virgins: I have no command from the Lord, but I give a judgment as one who by the Lord’s mercy is trustworthy. Because of the present crisis, I think that it is good for you to remain as you are. Are you married? Do not seek a divorce. Are you unmarried?
Do not look for a wife. But if you do marry, you have not sinned; and if a virgin marries, she has not sinned. But those who marry will face many troubles in this life, and I want to spare you this. What I mean, brothers, is that the time is short. From now on those who have wives should live as if they had none; those who mourn, as if they did not; those who are happy, as if they were not; those who buy something, as if it were not theirs to keep; those who use the things of the world, as if not engrossed in them. For this world in its present form is passing away. I would like you to be free from concern. An unmarried man is concerned about the Lord’s affairs— how he can please the Lord. But a married man is concerned about the affairs of this world—how he can please his wife— and his interests are divided. An unmarried woman or virgin is concerned about the Lord’s affairs: Her aim is to be devoted to the Lord in both body and spirit. But a married woman is concerned about the affairs of this world—how she can please her husband. I am saying this for your own good, not to restrict you, but that you may live in a right way in undivided devotion to the Lord.
The apostle says that the best option to consider was an unmarried state because times are distressing. However, Paul is not condemning marriage. He gives straight tips on different aspects that relate to single life and married life. Paul expounds on all areas. He also tells the audience that getting married is not committing a sin. It is clear that Paul takes adequate time to purposely change the audience’s typical perspective. Additionally, the apostle employs a conversational style which makes his instructions easy to comprehend and lively (Gordon and Dorcas).
In the concluding statements, Paul proceeds to correct possible perspectives that could be held by the Corinthians. In the verses that follow (36-40), the concluding or final statements of Apostle Paul to the Corinthians are shown as indicated in I Corinthians chapter 7.
If anyone thinks he is acting improperly toward the virgin he is engaged to, and if she is getting along in years and he feels he ought to marry, he should do as he wants. He is not sinning. They should get married. But the man who has settled the matter in his own mind, who is under no compulsion but has control over his own will, and who has made up his mind not to marry the virgin—this man also does the right thing. So then, he who marries the virgin does right, but he who does not marry her does even better. A woman is bound to her husband as long as he lives. But if her husband dies, she is free to marry anyone she wishes, but he must belong to the Lord. In my judgment, she is happier if she stays as she is—and I think that I too have the Spirit of God.
Clearly, one can deduce that some Christians of Corinth were struggling with unnecessary ideologies that were related to their relationships. By writing to them, Paul significantly changes their perspectives towards relationships. As such, the literary works that he uses include phrases like “feels he ought to marry…made up his mind…”
Paul highlights another vital aspect clearly that relates to the role of a man. It ought to be noted that Paul explains that the decision not to marry a virgin or to marry her should be made by a man himself. Additionally, the apostle writes that a man’s life determines the marriage life of a woman-a woman can only remarry after the death of a husband.
Paul concludes this section by stating his opinion. He indicates this by saying “In my judgment…” As such, Paul implies that there could be different opinions held by the other people regarding the issue of remarriage of a woman after the death of a husband. The finalizing statement of Paul is astounding-“I think I too have the Spirit of God.” The opinions of Paul on marriage and relationships issue could be justified by this statement. This statement employs a comparison style.
Modern Relevance of the Passage
Several issues of the contemporary society are addressed by this passage. This passage touches on everything that relates to sexual purity, divorce and marriage. The words of Paul are reflected in many generations. Actually, most controversies that emerge in the modern church are solved using these scriptures. Social values that include sexual purity, virginity, faithfulness and holiness are promoted by this passage.
Through his writing, Apostle Paul answered many controversial questions regarding marriage (1-9). When married to unbelieving companions, Christians ought not to seek separation from them. According to verses 10-16, when in fixed positions, people should remain in them. In verses 17-24, sitting loose to the world was desirable because of the risky days of that time. Verses 25-35 says that married people should exercise great caution; it ought to be a type that the Lord orchestrates (36-40).
Marriage and relationships’ holiness as an aspect is the lesson that can be picked from this passage by the modern Christians. This lesson should be picked by the youthful Christians in relationships as well as the married couples since sexual purity is emphasized in majority of the verses of the passage. The apostle has tackled pre-marital marriage as well as sex within marriage issues. This comes in handy for Christians at different stages in life.
Braxton, Brad Ronnell. The tyranny of resolution: I Corinthians 7:17-24. Atlanta, Ga.: Society of Biblical Literature, 2000. Print.
Collins, Raymond F., and Daniel J. Harrington. First Corinthians. Collegeville, Minn.: Liturgical Press, 1999. Print.
Deming, Will. Paul on marriage and celibacy: the Hellenistic background of 1 Corinthians 7. Cambridge: Cambridge University Press, 1995. Print.
Ellis, J. Edward. Paul and ancient views of sexual desire Paul’s sexual ethics in 1 Thessalonians 4, 1 Corinthians 7 and Romans 1. London: T & T Clark, 2007. Print.
Gordon, J. Dorcas. Sister or wife? 1 Corinthians 7 and cultural anthropology. Sheffield, England: Sheffield Academic Press, 1997. Print.
Zodhiates, Spiros. May I divorce and remarry?: an exegetical exposition of I Corinthians 7 from the Greek text. Chattanooga, TN: AMG Pub., 1984. Print.
Medical Ultrasound History and Echocardiography Application
There are many names that are used to describe an ultrasound including sonogram, diagnostic sonography or an ultrasonography (Leonard 89). Medical sonography (ultrasonography) is an ultrasound-based imaging technique used in diagnostic medicals that are utilized in visualizing small and delicate body organs such as muscles, tendons and many internal organs to capture their size, structure and any pathological lesions using the real time tomographic images (Chaudhuri 317). A sonogram utilizes high frequency sound waves to form the image of certain parts of the inside of a human body including the stomach, liver, heart, tendons, muscles among other things (Vaezy 379). This technique uses sound waves as opposed to radiation, hence is considered safer because it does not harm the body (Hoskins 8). Ultrasounds can be used to detect any problems within the parts of the body that are examined. The technology in this case is usually less expensive and mobile, particularly when compared with other modalities such as the MRI and the CT (magnetic resonance imaging and computed tomography) (Alter 56). Hence it is the most popular diagnostic tool currently in the world of modern medicine.
History of Ultrasound
The history of ultrasound dates back to the 19th and 20th century, especially in Europe. Specifically, the during the First World War, the French government had assigned a physician, Paul Langevin, the duty of inventing a device that was capable of detecting the underwater submarines belonging to its enemy using the high frequency sonar.
Over the decades that followed, many experiments were carried out within the military to assess the potential of scientific and industrial ultrasound technology. Despite all these developments being put forward, it was not until the 1940s that the use of an ultrasound as a diagnostic medical tool emerged. This happened when the neurologist and psychiatrist Karl Dussik from the University of Vienna developed the concept of the ultrasound. During this period, while working with his brother, the scientist used an ultrasound beam to look for brain tumors and also locate cerebral ventricles as well as cavities in the brain that contained cerebro-spinal fluid.
Other pioneers from America and Europe also emerged with time and broadened the scope of the diagnostic medical ultrasound during the following five decades (Mamou 19-24). Besides using it to detect a wide array of medical conditions, they also made great advances in hardware and imaging quality. In the 1950s, Ian Donald, while working in Glasgow, became the first person to use the ultrasound to monitor fetal development (Rantanen 1) During the same period, he also published a seminal diagnostic study in 1958 having worked with a group of researchers to invent a prototype ultrasound machine which was specifically designed and dedicated to the task of medical diagnosis. With time, manufacturers were able to use technology advancement to design smaller and portable ultrasound machines.
A development that resulted in future machines taking sharper, clearer and high quality pictures. Further developments and innovation eventually resulted in the invention of the two, three and four dimensional ultrasounds, in addition to the dropper imaging. This latter invention assisted medical professionals and even patients to better fathom the indications and revelations of ultrasound tests. By the 1970s, medical profession had already embraced sonography as a special and distinct occupation and in 1973, the United States department of education even recognized the field as a profession with its own rights. Since this period, sonography as a field and profession has grown immensely and attained its present status in the medical field.
Uses and Applications of a Medical Sonogram
Medical sonography is utilized in various medical studies which include anesthesiology whereby the ultrasound technology guides anesthetists when injecting needles to administer local anesthetic solutions near the nerve of patients. At the same time, this technology is utilized in echocardiography to detect any dilations on the paths of the heart and also check whether the heart and the valves are functioning properly. It is further used in the emergency medicine and emergency departments to expedite the care of the patients who might be experiencing gallstones or feeling intense pain in the upper abdomen. The ultrasound technology is also commonly used in managing pregnancy by determining important things such as the fetal heart of a baby, expected delivery time and the location of the fetus. In fact, this technology can be used to indicate the sex of a baby during pregnancy (Bruno 325). The sonogram has been used and applied in many medical care areas including Neonatology, Neurology, Otolaryngology and gastroenterology fields.
Working Principle of an Ultrasound
An ultrasound works by transmitting high frequency sound pulses (echoes) into a patient’s body and the sound waves in turn travel through the body into different tissues at an average speed of 1540 m / s, even though this speed is different depending on the type of the tissue. Science shows that the speed of the ultrasounds through fat is 1459m/s while through the bones it is approximated at 4080m/s. As sound passes through the tissues with different acoustic properties, there is a reflection of the proportionate of the sound (Hoskins 8). The boundaries between two different tissues are known as acoustic interfaces and the amount of sound reflected through the acoustic interface is determined by the type or properties of materials on the sides of the interface.
Echocardiogram commonly abbreviated (ECG) is an ultrasound that is carried out at the heart that utilizes the process of echocardiography. In today’s society, it has been used in many instances in diagnosing, managing and also following up of patients who may be experiencing heart problems. In cardiology, echocardiography is one of the most common diagnostic tests because it can yield a lot of vital information which may include the size and the shape of the heart, pumping capacity of the heart, location and the extent to which a heart tissue may be damaged. In addition this test can also reveal other features such as the estimates of heart functions which may encompass the calculation of the cardiac output as well as the ejection fraction. Echocardiography can help to detect cardiomyopathies such as the hypertrophic cardiomyopathy and dilated cardiomyopathy among other problems. The echocardiography is also an important diagnostic tool that can be used to test chest pains and other symptoms that are connected to heart ailments. One of the most essential merits of the echocardiography is the fact that it is noninvasive hence it does not involve the breaking of the skin and, as such carries neither risks nor side effects.
Applications of Echocardiography
As explained, the echocardiogram is a noninvasive sonograph analysis of the heart and big vessels which mostly differs from the ordinary ultrasound because of its capacity to provide pertinent information on the human anatomy, haemodynamics, functions, both dynamic systolic and diastolic of the heart as well as regarding the big vessels. It is of high importance to note that echocardiogram can either be performed under a resting condition as a baseline comprehensive assessment or even under controlled stress conditions with the aim of carrying out functional assessment of the significance of the vascular lesion. There are different kinds of echocardiograms that can be utilized in the creation of pictures of the heart and these include the transthoracic echocardiography, which is said to be the most common type of echocardiogram test (St 203).
It entails the sinologist placing a special device on the chest, which then transmits special sound waves through the wall of the chest to the heart whereby the waves are resounded back to a computer and automatically converted into pictures. Stress echocardiography is usually carried out as the part of the stress test where one is instructed to run or take some medicine to make the heart beat faster, after which the technician takes the echo from the heart just before the exercise or taking the medicine and immediately after the exercise of medicine has been taken. This type of echocardiography can be helpful in diagnosing some problems such as the coronary heart disease.
Transesophageal echocardiography is the technique where a transducer attached to the end of a flexible tube is guided down the throat into the esophagus allowing a sonologist to obtain a better detailed picture of the heart. Fetal echocardiography on the other hand is used to test the movement of the heart of an unborn baby and is recommended on 18th to 22nd weeks of pregnancy. Finally, a three dimension echocardiography assists in the creation of 3D images of the heart as it takes the echo and is popularly used to diagnose various heart problems in children as well as in planning and monitoring the heart valve surgery.
Chest pains can result from various issues which may vary from coronary artery disease, aortic dissection, pulmonary embolism and peptic ulcer disease, reflux esophagus among other factors that involve muskeletal pain, neuritis, pleurities, gallstones, psychosomatic and pericarditis. In such cases, many of the clinicians need to rule out the coronary heart disease and the aortic dissections because they are treatable and exhibit most of the presenting symptoms. A thorough echocardiogram is usually carried out to give clues and diagnosis of acute syndrome or any other possible infection that may be found in the patient. If the ECG reveals that there is any abnormality and thinning around the regional wall motions, then it is assumed that the old myocardial infarction is at rest.
Recently, numerous manufacturers have began the production of the harmonic imaging within echocardiography machines. The reason for introduction of such imaging is the fact that reflected sound waves may contain second degree harmonics which are in the form of wavelengths but have a half life or half of the wavelength magnitude, hence the harmonic imaging aids the system by emitting sonography energy at a frequency that is generally of a lower rate. Harmonic imaging also helps to retain the normal frequencies and this does not affect the quality of the image. Nevertheless, care must be taken during its application as continuous usage can cause unusual textures on the image.
Contrast echocardiography is yet another emerging application that is utilized in the demonstration of shunts through the intravenous injection of agitated saline (Walsh 198). The contrast agents are produced commercially and are made up of free and encapsulated gases bubbles. The tiny air bubble enhance the backscatter thus assisting in highlighting the tissue that has the contrast agent. This technique is used in diverse applications including filling of cavity in case blood is visualized in the left ventricle because the borders between the blood and the myocardium are visibly highlighted. Contrast is also used in myocardial perfusion where it is introduced through the intracoronary injection and helps to regulate the changes that are linked with the increased workloads as well as delineating the myocardium that is supplied by each coronary artery.
Contrast is further used in enhancing the flow in the heart whereby it is injected to enhance the number of reflectors and thereby increases the intensity of the resultant spectral trace. It is also essential in the studies regarding the dropper. The three dimensional echocardiography is mostly used together with both the transoephagueal and intravascular ultrasounds and it assists in providing real time imaging of the cardiac structure as well as its functioning. Since it is noninvasive, it is more effective in describing and communicating the abnormalities to specialists and can also help to better identify the location of the structural defects of the heart in connection to each other and other heart structures. Therefore, this technique gives accurate descriptions that can even be utilized when undertaking surgical repair.
Echocardiography is recommended for purposes of initial diagnosis where there is a noticeable change in the clinical status of the patient and as such it is not wise to overuse this test, unless there is a noticeable deteriorating change in the condition of the patient based on the results of the testing. Echocardiogram is essential because it helps the doctor to easily conduct diagnosis, monitoring and analysis of the heart conditions for any abnormal heart rates, heart murmurs, infection in the heart, sources of blood clots and pulmonary hypertension among other problems.
Alter, Katharine E. Ultrasound-guided Chemodenervation Procedures: Text and Atlas. Demos Medical Publishing, 2013.
Bruno, Michael A, and Hani H. Abujudeh. Quality and Safety in Radiology. New York: Oxford University Press, 2012. Print.
Chaudhuri, Zia, and Murugesan Vanathi. Postgraduate Ophthalmology. New Delhi, India: Jaypee Brothers Medical Publishers, 2012. Print.
Hoskins, P R, Kevin Martin, and Abigail Thrush. Diagnostic Ultrasound: Physics and Equipment. Cambridge, UK: Cambridge University Press, 2010. Print.
Leonard, Peggy C. Quick & Easy Medical Terminology. St. Louis, Mo: Elsevier, 2014. Print.
Mamou, Jonathan, and Michael L. Oelze. Quantitative Ultrasound in Soft Tissues. , 2013. Print.
St, John S. M, and Susan E. Wiegers. Echocardiography in Heart Failure. Philadelphia, PA: Elsevier/Saunders, 2012. Internet resource.
Vaezy, Shahram, and Vesna Zderic. Image-guided Therapy Systems. Boston, MA: Artech House, 2009. Internet resource.
Walsh, Catherine A, and Peter Wilde. Practical Echocardiography. London: Greenwich Medical Media, 1999. Print. 198.
Commercialization of Organ Transplants
Medical specialists across the globe have raised a concern over the alarming shortage of human organs for transplant. They have thus suggested commercialization of human cells, tissues, and other organs to be considered as an essentialbiotechnological solution. The views of these scientists have proliferated both legal and ethical debates that deal with the transplant of human organs owing to the strong intuitions and beliefs on bioethics and its implications especially with regard to the commercialization of organ transplant to individuals and the society at large. Such intuitions regarding commercializing organ transplant originate from the moral, cultural, and economic viewpoints (Kurnit et al, 1994, p. 420)
Pro: Commercialization of Organ Transplants
To save the tyranny of patients and medics who are desperately pursuing the commercialization of these human organs, several beneficial units and boundaries have been taken up to make sure that they work within relatively reasonable boundaries.The first successful transplant of human organs of individuals who were not blood relatives was conducted in 1962 and since then, the demand for such magical operations has risen to exceed its supply. Today, it seems that numerous human organs are being traded commercially within the global markets and as research suggests that cloning may become the ultimate alternative for this controversial practice. It is believed that promptly commercializing the human organ transplant process will automatically trigger an accelerated supply of this overburdening demand of these organs by a rapidly increasing number of patients (Gorsline et al, 1995, pp.32).
In the U.S. the legislation and courts have actually legalized the renewal of several body parts including the blood and skin and this has led to commercialization of the body organs. Many donors have thus been lured by the thought of making money to consciously donate their body parts. In some instances, the medics usually seek the consent of deceased individuals to permit the usage of the organs from their dead ones and this has become quite a common thing in donation of blood, sperm, born marrow organs. This activity is actually backed by the code of health and disability rights which clearly spells out that every consumer has a reasonable right to receive returns after disposing of their body substances that are eliminated during a surgical procedure (Radhika, 2000, pp. 360).
The scientists continue to support the commercialization of these body organs so as to enable them maintain medical research services that interest them. They argue that by restraining the commercialization process they will be automatically denied the chance to progress with their scientific research and medical advances. Therefore, to them it is pertinent to ignore other negative implications of the commercialization of the human organs, and for all persons to embrace and accept the practice as a societal norm (Gorsline et al, 1995, pp.32).
Con: Commercialization of Organ Transplants
Thedebate on commercialization of human organs is a concept that has raised controversial issues, some of which are perceptions of human ethical understanding. This has resulted in the rejection of the idea by several focus groups especially because of the numerous negatively perceived answers that are usually elicited by these reports. One of the key arguments is that commercialization is likened to the permission of treating body organs as an imagery of machines, which are replaceable, and posses the necessary spare parts to turn humans into creators. This focus on mechanistic functionality and performance is also in line with the perception of the body as a commodity and deviate from God’s intention of creation (Kurnit et al, 1994, p. 424)
When a person dies, his physical body presence gives its central sense of living hence the laws that enforce the use of the dead body organs are seen to be acting against the wishes of the dead with regard to their body properties. In his research, Sir Edward termed the dead bodies’ burial as nullius in bunis, meaning they do not have any property rights, and this law has been adopted and used many times for decades to mislead the general rule of protecting the bodies of the dead. To date, this rule has been amended many times in order to provide the rights and respect to the dead, hence the use of their organs cannot be allowed to be commercialized by the third parties without theirconsent (Radhika, 2000, pp. 360).
Critical analysis also indicates that legalizing the commercialization of human organ transplant will give rise to some unethical entrepreneurs whose main interest will be to exploit poor people especially in the other parts of the world like the developing countries. This may complicate and strain inter-relations and repress the economic growth of such misused countries. Such unscrupulous entrepreneurs are also perceived to have strong intentions and going to the extent of involving themselves in criminal attacks of killing people to get their organs for the sake of financial gain. This may ultimately lead to extortion of the vulnerable patients and their loved ones who may be in desperate need for the organ transplant (Gorsline et al, 1995, pp.32).
Organ transplants have in some cases failed to conjoin to the recipient hence posing various health threats to both the donor and the recipient. These cases have been witnesses in many transplants of kidney, heart, and liver between unrelated persons. It is thus perceived to have negative effects on both the donor and recipient’s health as well as economic progress. Research also indicates that there is a tendency of enhancing disparity by using the commercialized organs on the basis of the race factor particularly in multiracial countries (Kurnit et al, 1994, p. 426).
In conclusion, the physiological and ethical stance with regard to this motion purely depends on every person’s life beliefs and intuitions. The plurality underlying of its practice in connection to the ethical, cultural, and social norm necessitate an informed approach and liberal comprehension.
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Information Assurance Security Plan
Information assurance is a practice that entails the maintenance of information integrity and safety, and management of risks that are linked to application, processing, storage and distribution of various kinds of data. Information has been associated with a variety of threats. All these have impacted adverse consequences for both clients and organization. The information assurance security plan will help in addressing the data safety requirements of Kemper Corporation, an organization that deals with the provision of different insurance covers for people within the United States of America.
Assessment of Risks
Kemper Corporation has a numerous data bases that hold private information of clients and stakeholders of the company. The information should be safeguarded from misuse or unauthorized access by any third party. As a result of advancement in technology, clients have been given the opportunity to access the services of the company online. Kemper Corporation has also been reported to focus its information assurance on specific systems and has not begun using enterprise approach on its information assurance security plan. Enterprise information assurance information system is whereby an organization makes all conclusive assessment of the whole networks of the company. The concentration on a particular system may not provide a decisive security strategy. There are also challenges faced by the organization when it comes to dealing with its own problems.
If the company does not focus on all the systems used in an enterprise approach, it will be faced with numerous challenges. One of them is that information risks are not consistently mitigated, thereby making some business activities too risky for the company. For example, Kemper Corporation may find that the management of data bases that hold the information of clients could be too dangerous and this could end up hindering the ability of the company to conduct assessment and verification of some of the data.
Enhancements in a single system are negatively impacted by errors in other networks. For example, the client information upgrades could be negatively influenced by the data systems of other stakeholders that have problems. This could be used by third parties for accessing the stakeholders’ information. Without the application of the enterprise approach, the poor cultural assumptions regarding security are not addresses. This could hamper the full implementation of the information assurance policies.
Key Information Assurance Considerations
Because of the fact that the company has a variety of information databases that are run through different systems, the information assurance concern should be improving the security through an enterprise level change instead of the traditional approach of the system level accreditation process. This can be linked to the fact that information systems generally have complex interconnections. This is an implication that securing the whole information system of the company through various inter-relations may be an attempt in futility by the organization. The entire company will only be fully secure when there are no weak links. Vulnerable units in various systems may prove to be quite expensive to the organization with regards to risks. The identification of the ideal investment opportunities and implementation of information assurance should be accorded an enterprise view.
Options for Kemper
An enterprise approach to information security for Kemper Corporation can take a variety of avenues. One of them is obtaining board level commitment for an enterprise strategy for data safety. This will be important in making sure that all departments involve their own information systems in addressing the information security system of the company.
There is also another option of using a business change framework. This can help in making sure that all business approaches are improved towards the achievement of new information assurance security. It will be critical in enabling all the departments and levels to adopt the new strategy of the organization regarding data safety. Besides, it will also make sure that the other activities of the company are simultaneously enhanced with the information assurance security.
The Information Technology of the organization should initiate plans for the identification, consultation and influencing the stakeholders. Even though the company has the responsibility of safeguarding the stakeholders’ information, the interested parties also have certain obligations to a particular degree. This will be critical in making sure that all stakeholders are involved in the information assurance security operations and plans for the organization.
The primary objective of the information assurance security plan should be that of securing information that could be used in harming the company. This is an implication that Kemper Corporation should see to it that all the information pertaining to its stakeholders is protected. This will only be attained if the company takes a holistic approach to the information security plan.
The organization should also make sure that all the stakeholders embrace the holistic approach. With this, all interested parties play their roles in ensuring that the projected goals of the information assurance security plan are met. This will be critical in enhancing the mitigation of all risks, and it could be achieved from different stakeholders.
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Heavy Metals in Water Resources
Heavy metals are the metallic chemical elements which have high density and high amounts of poisonous or toxic substances at low concentrations (Afzal et al, 2013). Cadmium, arsenic, thallium, lead and cadnum are some of the metals listed among heavy metals and they usually get into the human body via drinking water, food and air. Some of the heavy metal elements are useful in maintaining metabolism in the human body and these include selenium, copper and zinc. However, these metals can become poisonous when in high concentrations. For instance, one can develop poisoning from drinking contaminated water that is passed through lead pipes, a food chain or high ambient concentrations of air. This essay thus seeks to discuss both the natural and artificial sources of heavy metals while highlighting the impacts of heavy metals on health and the environment. In addition, it will address the accidents that are related to the heavy metals and associated with the contamination of water resources.
Natural Sources of Heavy Metals
Heavy metals can occur naturally as a result of the physical and chemical weathering of metamorphic and igneous soils and rocks which also release the metals into the water resources. Heavy metals can also be generated from the plan decomposition and animal atmospheric deposition of the airborne particles that come from wind erosion, volcanic activity, plant exudates, oceanic spray and forest fire smoke. Heavy metals that are found within the geological structures of the earth can penetrate and exist in water resources via natural processes. For example, flowing water or heavy rains tend to percolate/leach heavy metals out of the geological formations (Ardau et al, 2006). Such processes are worsened when the geology is upset by economic activities such as mining because these processes expose the mined area to air and water hence causing adverse effects like acid mine drainage (Wyk, 2012).
Man-Made Sources of Heavy Metals
Heavy metals found in water resources can also be man-made whereby the metals permeate the water supply through consumer or industrial waster or via the acidic rainfall breaking into soils hence releasing the metals into the water bodies such as lakes, rivers, groundwater or streams. Urban storm water runoff always contains metals from roadways and atmospheric fallout while wastewaters also carry poisonous heavy metals into the aquatic system and soil through diverse processes, and in particular, irrigation. Metal-containing solids found in polluted places can also be produced from a wide array of artificial sources that are associated with metal mine stakeouts, lead-based paints, leaded gasoline, fertilizer application, and discarding the densely concentrated metal wastes within unsuitably protected animal manures, landfills, sewerage sludge, coal combustion remainders, and petrochemicals, among many others (Afzalet al, 2013).
Environmental and Health Effects of Heavy Metals
Heavy metals can adversely affect the environment hence destroying the aquatic organisms. According to Rai (2008), such destruction can be attributed to the poisoning caused by metal sediment composition and water chemistry within the water system surface. High metal concentrations in water affects the aquatic organisms in the sense that it transforms their morphological tissues, suppresses their development and growth, while altering their chemistry and leading to poor swimming performance. Aquatic plants are also affected because they cannot successfully control the metal uptake.
Ingesting heavy metals via contaminated water can also pose great health risks to human beings. Lead, for instance, can also act as a substitute to calcium especially among children taking into consideration that they need high levels of calcium to develop their skeletal systems. Even though the levels of lead contained in bones are not harmful, high concentrations can cause neurotoxicity, nephrotoxicity and hypertention (Afzal et al, 2013).Cadmium on the other hand can interfere with the ability of metallothionein in monitoring copper and zinc amounts within the human body. Mercury canalso pose a great health risk to humans because when it comes into contact with water it tends to be by the microorganisms, taking the form of poisonousmethyl mercury. Acute poisoning symptoms caused by heavy metals are exhibited through vomiting or other symptoms and chronic poisoning can cause neural damage, liver damage or teratogenenisis. Arsenic in particular can cause one to vomit, experience cardiac abnormalities, and diarrhea while chromium has been linked to adverse health effects such as respiratory and dermatological problems (Afzal et al, 2013).
Accidents Linked to Heavy Metals Contamination of Water Resources
Many regions have suffered heavy metal-related accidents and one of the major examples is the 2005 adverse environmental disaster which happened on Songhua River after a chemical plant explosion within Jilin City hence contaminating the river with about 110 tons of heavy metal pollutants (Gleick, 2009). As a result, the contamination flowed downstream and compelled the authorities to carry out temporary suspension of the water supply to an estimated 4 million people living in Harbin. Another example is linked to the November 1986 ‘Sandoz chemical spill’ in SchweizerhalleSwitzerland. The accident led to the release of toxic agrochemicals that contained heavy metal (e.g.mercury) into the air while massive tons of pollutants were simultaneously released into Rhine River, turning it red. The contamination resulted in massive mortality of wildlife downstream that subsequently destroyed a huge proportion of European eel population within the Rhine River (Halfon & Buggermann, 2006).
This essay has given a discussion of the various sources of heavy metals in water resources and demonstrated that such metals can cause grave danger to human health and the environment. It has also given examples of accidents that are related to water resources contamination through heavy metals.
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