Implementation of Project Management Essay Example | Topics and Well Written Essays - 2250 words

Implementation of Project Management - Essay Example Founded essentially as an automotive component manufacturer, the company started manufacturing electronic components for the military during the Gulf war. Soon after the Gulf war the company emerged a major component supplier for the space programme and when that business segment did not grow well, the company embarked upon the production of various other items relating to energy management, building products and machine tools in addition to automotive components. With a turnover of $ 600 million, the automotive components manufacture remained the major business activity of Hyten Corporation. The coordination of any new project or a new product from concept to market is the responsibility the ‘Business Development Department’ started to substitute the non-existent project management department. The business development department was taking decisions on the undertaking of any new products or services in a crude way based on macro factors like economic and industry indica tors without really going into the other details of the product or service. The activities of the department were conducted through informal meetings of the functional directors and the manpower for the department was met with people both from within and outside the organisation. With a view to redefine the functions of the business development department as a full fledged project management department Wilbur Donley, with five years experience as a project manager was hired by Hyten Corporation. When the process of establishing the formal project department in Hyten Corporation, there were different ideas and views expressed by the various departments of the company about the implementation of the project management which are summarized below: 3.0 General Observations on the Introduction of Project Management in Hyten Corporation: As a result of the discussion between Wilbur Donley, the project manager, Frank Harrel, the Manger for quality and reliability and George Hub, the Manager of manufacturing engineering the following points about the integration of formal project management in Hytel Corporation emerged: Presently due to lack of coordination among different departments, the marketing and manufacturing departments do not understand and appreciate the functions of the quality department

Interest in pursuing graduate studies(Masters, Business Information Essay

Interest in pursuing graduate studies(Masters, Business Information Technology) - Essay Example As a child, I was deeply interested in technology and its applications in the daily life of people. How comfortable it made everyone's life! During my teenage days, the computer boom occurred and just about overnight, everyone owned a PC- and they refused to ever shut it down! My first computer was brought in the house amid huge excitement; everybody was amazed by the functions a simple dull-grey box could perform at the click of the button. Perhaps it was due to such an introduction that my interest for 'technology' soon developed into a curiosity for exploring the world of 'information technology' in particular. With encouragement from my parents, and a determination to take my interest to another level, I undertook several courses to develop skills in this field, many of which were far beyond my academic curriculum. I armed myself with knowledge of Microsoft Office, Visio, and Kofax Ascent Capture. I mastered languages like C, C++, HTML and XML. The more I studied it, the more pas sionate I become for this field. When the time came, I had no doubts deciding to pursue IT for undergraduate school. But that was not my sole career aim. As much as I wanted to contribute to IT, I wanted to venture into the business world and manage a company of my own. Thus, besides doing a Bachelors of Commerce Degree in IT Management at college, I successfully completed a Diploma in Business Management.

Referring to your Wider Reading Essay Example for Free

Referring to your Wider Reading Essay By Comparing Extracts A, B and C and Referring to your Wider Reading, Examine how Typical in both Style and Treatment of Subject Matter these writings are of Literature from or about the First World War The experiences of men and women within the war differed drastically, due to the different roles played by each gender; women lacked knowledge of the trauma undergone by soldiers on the frontline, due to their lack of personal experience. However, there was not only contrast between men and women in their attitudes and view of the war: Depending on the nature of their involvement in the war, attitudes of women were many and varied, as were those of men. Written by Jessie Pope, a writer well-known for the propaganda portrayed by her poetry throughout the war, Whos for the Game? harbours an extremely motivational, patriotic tone. This is due to the fact that Pope was commissioned to write poems that would encourage young men to join up and fight for their country. As such, this poem illustrates Popes utilisation of certain literary techniques in order to rouse an arguably ill-founded passion inside young men to fight to defend their country. Popes use of rhetorical questions throughout this poem acts as a gripping device, and holds the attention of the reader; Whos for the game, the biggest thats played, The red, crashing game of a fight? Wholl give his country a hand? As well as demonstrating Popes use of rhetorical questions and the patriotism within her poetry, this quote also illustrates her technique of comparing the brutal war to a sports game, which is further supported by her statement; Wholl grip and tackle the job unafraid? in which sports terminology is utilised, in order to enable her target audience, the young men of the time, to relate to what is being said: Sports games were popular amongst boys of the early Twentieth Century, and by comparing the war to a such a game, Pope appeals to these boys. The above quote also demonstrates Popes technique of challenging the masculinity of the young men, as she implies that those who dont fight are cowards, again this is further developed by the statement; Who would much rather come back on a crutch Than lie low and be out of the fun? As she was ignorant of the brutality of the reality of war, Popes idealisation of, and her naà ¯Ã‚ ¿Ã‚ ½ve, patriotic approach to the war enraged many of those who were actively involved in the fighting. World War One poet, Wilfred Owen, particularly despised Pope for her habit of romanticising the aspects of war that she was ignorant of. He was in fact so passionate about his dislike for her that he directly addresses her, in Dulce et Decorum Est, when he states, If you could hearthe blood Come gargling from the froth corrupted lungs My friend, you would not tell with such high zest To children ardent for some desperate glory The old Lie: Dulce et decorum est Pro patria mori. Expressing a similar attitude to that of Pope, Marian Allen glorifies the war in her poem, The Wind on the Downs, in which she speaks of her inability to accept the death of a loved one. In support of this subject matter, a disbelieving, longing tone is conveyed, with a sense of naivety also conveyed by Pope in Whos for the Game. This naivety is present due to the lack of personal experience that these two writers have had of the brutal reality of the First World War. As Pope remained on the home front in order to write poetry for the newspapers, Allen was typical of many more women at the time of the war; she remained at home whilst her lover went to fight in the war, and consequently she had view of war that was such due to the propaganda portrayed by the media and writers such as Pope. Allens use of soft and endearing language develops this idea of Allen as a naà ¯Ã‚ ¿Ã‚ ½ve writer in terms of the War, as her failure to accept her lovers death is symbolic of her genuine ignorance to the nature of his death, and in fact life, whilst serving. The repetition of this denial towards her loss reinforces this point; You have not died, it is not true That you are round about me, I believe How should you leave me, having loved me so? It seemed impossible that you should die. That were introduced to the concept of his death through her line, Because they tell me, dear, that you are dead, carries with it an air of denial, due to her expression that she was told, and not that she actually believes it herself. The line would be much less effective had it said Because you are dead. Allens idealisation of her lover and his life in, and out of the war, may be due to the manner in which she received the news of his death, and how little of the truth she was told. This is a subject directly addressed by Siegfried Sassoon in The Hero, as he speaks of the gallant lies an officer had delivered to the mother of a soldier who had actually died a horrific death. It is portrayed by Allen that her and her lover thought of many things and spoke of few when he returned home on leave, thereby conveying that he found it difficult to speak of the truth to her. This seeming feeling of not being able to confide in anyone one the home front was common amongst soldiers in the First World War. R.C Sherriff demonstrates it in his play Journeys End through Stanhopes reluctance to take leave, and Susan Hill illustrates it through Hilliards emotional isolation from his family in Strange Meeting, as he cannot even speak to his sister of the nightmares he encounters whilst at home on leave. Had Allen known the honest nature of her lovers death, and life at war, she may have expressed a different view through this poem. Vera Brittain did gain an insight into the reality of what life must have been like for the men at war, through receiving her dead fiancà ¯Ã‚ ¿Ã‚ ½s uniform via post. The refined view she adopted of the war was aided by the condition of the uniform; damp and worn and simply caked with mud, exhibiting the hole made by the bullet that killed him. These quotes are taken from Extract C, an extract from Letters from a Lost Generation. In this particular letter, Brittain is writing to her brother about the terrible ordeal of examining the uniform, an experience that proved to be somewhat revelatory for Brittain, as it was this following the loss of her fiancà ¯Ã‚ ¿Ã‚ ½ that spurred her to join up and become a V.A.D. Brittain composed this letter in 1916, which was a pivotal year within the war; a year in which many attitudes of those who previously supported the war were manipulated by its seeming newfound futility. Owen expresses in Futility, Was it for this the clay grew tall? which strongly conveys his view that the war became superfluous, and that the Earth did not develop to be destroyed in such a brutal, futile way. Siegfried Sassoon also made a famous declaration stating his opposition to the continuation of the War in 1917, as a result of events in 1916, such as the infamous Battle of the Somme. This declaration, and therefore Sassoons change of view towards the war is a component of Pat Barkers Regeneration. The form of a letter allows Brittain to utilise several literary techniques, such as varying sentence lengths and use of the five senses to create impact. Effective examples of blunt sentences used by Brittain are, It was terrible And No, they were not him. These two statements demonstrate how Brittain made use of short sentences in order to reflect the blunt, direct nature in which her realisation of the reality of war hit her. In contrast to these short sentences, Brittain displays many complex sentences in order to convey a vivid image of the scene of the uniform before her; The mud of France which covered them was not ordinary mud; it had not the usual clean, pure smell of earth, but it was as though it were saturated with dead bodies- dead that had been dead a long, long time. This sentence illustrates Brittains use of powerful adjectives, such as saturated, to strengthen her intended effect, and her application of the repletion of long, and dead, in order to emphasise certain factors of what she is conveying. Varying sentence lengths is not a facet of either Allens The Wind on the Downs or Popes Whos for the Game. This is due to these extracts taking the forms of poems, which makes it difficult for such a technique to be applied. However, Pope manages to exploit her chosen form of a poem in order to aid her purpose. She imposes a strong marching rhythm, which is supported by the typical ABAB rhyme scheme, thereby giving her poem a sense of soldiers marching to war, which can be perceived by the young men reading it. Similarly, Allen makes use of a regular rhyme scheme in order to give her poem fluidity and enhance the idealised depiction of death, which inevitably highlights Allens ignorance to the truth of conditions at war. Pope employs simple language and colloquialisms in her poem, due to its form and audience: As it appeared in a national newspaper, the audience was broad, and so the use of simple language meant the poem would appeal to everyone. The colloquialisms, such as lie low give his country a hand illustrate Popes ability to relate to her intended audience, as boys of the time would find this language common and therefore easy to relate to. The patriotism conveyed by Pope is also illustrated through the latter of the two colloquialisms above. This patriotic attitude was shared by Rupert Brooke, as is conveyed through his poem, The Soldier when he writes; A dust whom England bore, shaped, made aware, Gave, once, her flowers to love, her ways to roam Brooke died of dysentery before carrying out any active service in the war, and therefore, he too was ignorant of the true conditions of life in the trenches. Thus, his poetry often illustrated naivety and patriotism, similar to others, like Pope and Allen, who were ignorant of the brutal reality of war. Through comparing these three texts we can consequently deduce that although one would assume women to have adopted a romantic view towards the act of fighting for ones country due to their lack of active involvement in the war, there were actually a range of views produced amongst women as a result of the first world war, expressed through their various pieces of literature.

Features of Goodpastures Syndrome

Features of Goodpastures Syndrome Introduction Goodpastures syndrome, a rare autoimmune disease is characterized by anti-GBM (anti-glomerular basement membrane) antibodies attacking glomerular and alveolar basement membranes of the kidneys and lungs respectively. It was first reported by Dr. Ernest William Goodpasture in 1919 and first used by Stanton and Tange in 1957 in their case studies involving nine patients with the pulmonary-renal syndrome. [1, 2] Clinical Features   Ã‚   The onset of this disease ranges from the ages of 20-30 and 60-70 especially in young men in their late twenties or in men and women over sixty years of age study. [3] The diagnostic techniques involved in detection of Goodpastures syndrome include i) urine analysis that detects kidney damage by presence of high number of red blood cells or protein in the urine sample ii) blood tests showing the presence of anti-GBM antibodies iii) x-rays that can show anomalies in lung anatomy or iv) biopsies that involve imaging of a kidney tissue sample to demonstrate glomeruli characterised by crescent-shaped structures and lines of antibodies attached to the GBM. [4] While Goodpastures syndrome constitutes the representation of clinical features like rapidly progressive glomerulonephritis (RPGN) and pulmonary hemorrhage from any cause, Goodpasture disease also includes the presence of anti-GBM antibodies in addition to the other characteristics. The term anti-GBM disease constitutes a patient with the typical autoantibodies, irrespective of clinical symptoms and characteristic features. [1,5] The clinical manifestations associated with Goodpastures syndrome include acute renal failure resulting from rapidly progressive glomerulonephritis along with pulmonary hemorrhage that might prove fatal. The symptoms in relation to it consist of bleeding of lungs, kidney failure, hematuria, proteinuria, general malaise, fatigue, and weight loss. [1,6,7,8,9] The exact etiology of this syndrome is not known however there seem to be genetic and environmental risk factors. The factors being i) exposure to organic solvents or hydrocarbons ii) smoking and drugs iii) infection iv) exposure to metal particulate matter v) lymphocyte-depletion therapy. [1,5,10] The characteristic pathology in individuals experiencing the Goodpastures Syndrome can be detected by immunofluorescence staining technique of the IgG on the GBM that shows smooth diffuse linear patterns. [11] Hemodialysis, plasma exchange, cyclophosphamide drugs and immunosuppressive agents like methylprednisolone pulse therapy or oral administration of prednisolone are possible treatments for Goodpastures syndrome. [12,13,14] Basic Cellular and Molecular Mechanisms The localization of immunoglobulin IgG deposits at sites of inflammation within the pulmonary and renal basement membranes shows Goodpastures syndrome (a form of the anti-GBM disease) to be an antibody-mediated autoimmune disease. The pathogenic role of these antibodies has been confirmed by  transplantation of circulating or kidney-eluted anti-GBM antibodies to Rhesus monkey or human kidney allografts that result in the development of the disease.  A type II hypersensitivity reaction occurs when antibodies are targeted against extracellular matrix (ECM) specific antigens. [15]   The hypersensitivity response affects all organs in the body of which collagen is a constituent but the alveolar and glomerular basement membranes are more prone to the effect. This discrepancy is a result of increased accessibility of epitopes (antigen molecules facilitating attachment to a matching antibody) linked to overexpression of ÃŽÂ ±3 collagen chains in the respective basement membranes allowing access and formation of antibodies. [16] While ÃŽÂ ±3NC1 antibodies are the most common in patients with Goodpastures syndrome, ÃŽÂ ±5NC1 antibodies are less prevalent. Sometimes antineutrophil cytoplasmic antibody [ANCA] can also be present. [5,17] The disorder develops antibodies that target ÃŽÂ ±3 chain of basement membrane collagen (type IV collagen) present in alveoli in lungs and in the glomeruli that form the filtering units of the kidneys within the nephrons. These structures contain the basement membrane with collagen as its essential component that differentiates the epithelia from the underlying tissue. The conformational epitopes of the Goodpasture antigen are localized within 2 regions in the carboxyl terminal, noncollagenous (NC1) domain of a type IV collagen chain, ÃŽÂ ±3(IV)NC1. [1, 5, 18]. Upon interaction of the anti-GBM antibodies with the conformational epitope of the GBM glycoproteins, the complement pathway of the immune system gets activated. This results in infiltration by polymorphonuclear leukocytes (PMNs) and monocytes. The severely damaged GBM induces reflux of fibrinogen into the Bowman space, fibrinogen polymerizes to fibrin through the proliferation of procoagulant factors from activated mono cytes, leading to a crescent formation.[19] Goodpastures syndrome is linked with specific HLA types. Both positive (HLA-DR15) and negative (HLA-DR7) associations are defined and being used to develop an understanding of antigen presentation, tolerance and autoimmunity. [20,21,22] Recent Developments Recent developments like the plasmapheresis technique, steroidal drugs, and immunosuppressive therapy have drastically ameliorated the course of the medical condition in comparison to yesteryears, in which Goodpasture syndrome was deemed fatal. [23] Zhao et al., demonstrate the significant role of ÃŽÂ ±5NC1-specific antibodies in pathogenesis of Goodpastures disease and also re-confirm ÃŽÂ ±345 collagen IV molecule as the original GP autoantigen. [17] The invention of a drug, now patented, with its active element containing boron  that constitutes inhibitors of arginase activity has claimed remedial effects in the pathological state of Goodpastures Syndrome. [24] A recently developed, patented prophylaxis for glomerulonephritis resulting from Goodpastures syndrome comprises of administration of a therapeutically effective amount of an IL-6 antibody that binds with or regulates the expression or activity of a mammalian IL-6 polypeptide. [25] Conclusions Goodpastures Syndrome is an autoimmune disease characterized by anti-GBM antibodies attacking glomerular and alveolar basement membranes. The innate immune response comprises of (i) cell death; (ii) polymorphonuclear cell releasing neutrophils, basophils, eosinophils, antigens and monocytes to infiltrate the glomerulus. The adaptive immune response triggers the classical pathway of complement activated by antigen-antibody complex formation, and type II hypersensitivity reaction. Here antigens are targeted against cell- specific and tissue specific antigens (chiefly the connective tissue). Unanswered Questions Currently, there is a lot of research focusing on deciphering the causative agents of the harmful antibodies that lead to the development of Goodpastures syndrome. Evidence from this research can lead to novel drug discovery, eventually leading to a potential definitive cure for Goodpastures syndrome. [17] The exact the genetic determinants that constitute the etiology of Goodpastures syndrome are yet to be found. Bibliography Salama AD, Pusey CD. Goodpasture syndrome and other antiglomerular basement membrane diseases. In: Gilbert SJ, Weiner DE, eds. National Kidney Foundations Primer on Kidney Diseases. 6th ed. Philadelphia, PA: Elsevier Saunders; 2014: chap 21. Benoit, F. L., D. B. Rulon, G. B. Theil, P. D. Doolan, and R. H. Watten. Goodpastures syndrome: a clinicopathologic entity. The American journal of medicine 37, no. 3 (1964): 424-444. Hudson B, Tryggvason K, Sundaramoorthy M, Neilson E. Alport syndrome, goodpasture syndrome, and type IV Collagen. New Engl J Med 2003; 348:2543-56. Fervenza, Fernando C. Goodpasture Syndrome | NIDDK National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/kidney-disease/glomerular-diseases/goodpasture-syndrome (accessed March 1, 2017). Phelps RG, Turner AN. Anti-glomerular basement membrane disease and Goodpasture disease. In: Johnson RJ, Feehally J, Floege J, eds. Comprehensive Clinical Nephrology. 5th ed. Philadelphia, PA: Elsevier Saunders; 2015: chap 24. Lahmer T, Heemann U. Anti-glomerular basement membrane antibody disease: a rare autoimmune disorder affecting the kidney and the lung. Autoimmun Rev 2012;12:169-73. Pedchenko V, Bondar O, Fogo AB, Vanacore R, Voziyan P, Kitching AR, et al. Molecular architecture of the Goodpasture autoantigen in anti-GBM nephritis. N Engl J Med2010;363:343-54. Salant David J. Goodpastures disease new secrets revealed. N Engl J Med 2010; 363:388-91. Dammacco F, Battaglia S, Gesualdo L, Racanelli V. Goodpastures disease: a report of ten cases and a review of the literature. Autoimmun Rev 2013;12:1101-8. Jones, Joanne L., Sara AJ Thompson, Priscilla Loh, Jessica L. Davies, Orla C. Tuohy, Allison J. Curry, Laura Azzopardi et al. Human autoimmunity after lymphocyte depletion is caused by homeostatic T-cell proliferation. Proceedings of the National Academy of Sciences 110, no. 50 (2013): 20200-20205. MD, Edward. Renal Pathology http://library.med.utah.edu/WebPath/RENAHTML/RENAL093.html (accessed March 1, 2017). Greco, Antonio, Maria Ida Rizzo, Armando De Virgilio, Andrea Gallo, Massimo Fusconi, Giulio Pagliuca, Salvatore Martellucci, Rosaria Turchetta, Lucia Longo, and Marco De Vincentiis. Goodpastures syndrome: a clinical update. Autoimmunity reviews 14, no. 3 (2015): 246-253. Bolton, W. Kline. Goodpastures syndrome. Kidney international 50, no. 5 (1996): 1753-1766. Johnson, John P., Walter Whitman, William A. Briggs, and Curtis B. Wilson. Plasmapheresis and immunosuppressive agents in anti-basement25] membrane antibody-induced Goodpastures syndrome. The American journal of medicine 64, no. 2 (1978): 354-359. Rutgers A, Meyers KEC, Canziani G, Kalluri R, Lin J, Madaio MP. High affinity of anti-GBM antibodies from Goodpasture and transplanted Alport patients to 3 (IV) NC1 collagen. Kidney Int. 2000;58:115-122. Kelly, Patrick T., and Edward F. Haponik. Goodpasture syndrome: molecular and clinical advances. Medicine 73, no. 4 (1994): 171-185. Zhao J, Cui Z, Yang R, et al. Anti-glomerular basement membrane autoantibodies against different target antigens are associated with disease severity. Kidney Int 2009; 76:1108. Borza, Dorin-Bogdan, Eric G. Neilson, and Billy G. Hudson. Pathogenesis of Goodpasture syndrome: a molecular perspective. In Seminars in nephrology, vol. 23, no. 6, pp. 522-531. WB Saunders, 2003. Morita, Takashi, Yasunosuke Suzuki, and Jacob Churg. Structure and development of the glomerular crescent. The American journal of pathology 72, no. 3 (1973): 349. Phelps, Richard G., and Andrew J. Rees. The HLA complex in Goodpastures disease: a model for analyzing susceptibility to autoimmunity. Kidney international 56, no. 5 (1999): 1638-1653. Phelps, Richard G., Victoria Jones, A. Neil Turner, and Andrew J. Rees. Properties of HLA class II molecules divergently associated with Goodpastures disease. International immunology 12, no. 8 (2000): 1135-1143. Turner AN, Rees AJ. Anti-glomerular basement membrane disease (Chapter 3.11). In: Cameron SDAM, Grunfeld JP, Kerr DNS, Ritz E, eds Oxford Textbook of Nephrology, 2nd edn. Oxford University Press, Oxford, 1997 Shah MK, Hugghins SY. Characteristics and outcomes of patients with Goodpastures syndrome. South Med J 2002;95:1411-8. Van Zandt, Michael, Adam Golebiowski, Min Koo Ji, Darren Whitehouse, Todd Ryder, and Raymond Paul Beckett. Inhibitors of arginase and their therapeutic applications. U.S. Patent 9,266,908, issued February 23, 2016. Marshall, Diane, and Stevan Shaw. Method for the treatment of glomerulonephritis by administering an IL-6 antibody. U.S. Patent 9,321,837, issued April 26, 2016.

The Musical Influence of Johann Sebastian Bach Essay -- Composers Musi

The Musical Influence of Johann Sebastian Bach   Ã‚  Ã‚  Ã‚  Ã‚  Among the influential composers of baroque music, there have been few who have contributed so much in talent, creativity, and style as Johann Sebastian Bach. Bach was a German organist and composer of the baroque era. Bach was born on March 21, 1685 in Eisenach, Thuringia and died July 28,1750. Bach revealed his feelings and his insights in his pieces. Bach’s mastery of all the major forms of baroque music (except opera) resulted not only from his genius talent, but also from his life long quest for knowledge. In some parts of Germany, the name, â€Å"Bach† became a synonym with the word, â€Å"musician.† Extremely talented in the art of baroque composition, Bach placed his heart, soul, and ingenuity in his music as it is clearly illustrated in his childhood, throughout his career, and of course through his musical works.   Ã‚  Ã‚  Ã‚  Ã‚  Bach’s connection to music is already evident through his childhood. Bach was born into a musical family in Eisenach. His father, before dying, taught him the basic skills of strings and an organist at a church taught him how to play the organ. When both of his parents died, he continued to devote his early life to music. His brother Johann Christoph continued to teach him how to play the organ. Furthermore, he won a scholarship and became part of the school choir of poor boys in Luneburg. Already seen was his sheer genius and talent that he possessed for music. Clearly, his childhood played a big factor...

Prostitution Essay -- essays research papers

  Ã‚  Ã‚  Ã‚  Ã‚  I’ve often wondered what drives women into prostitution? Is it always by choice or are they forced into it? The whole idea of paying for sex seems so undignified. Something so intimate, in my opinion, should not be up for sale.   Ã‚  Ã‚  Ã‚  Ã‚  It is thought that those who are prostitutes are driven to do so because of their childhoods. Recent research does support this idea. Dr. Melissa Farley and Dr. Howard Barkin reported that out of 130 prostitutes surveyed fifty-five percent reported that they had been sexually abused as a child by three perpetrators or more. Ninety-four percent reported that a caregiver had physically abused them until they were bruised or injured. This gives us a good idea that most prostitutes have had an unstable childhood. Their childhoods have caused them to enter a profession where they repeat the abuse from the childhood in their adult lives. Of those interviewed eighty-two percent said they had been physically assaulted since they entered prostitution and sixty-eight percent had been raped. Which makes you wonder why they would stay in the profession if it causes them so much pain.   Ã‚  Ã‚  Ã‚  Ã‚  Eighty-eight percent expressed a desire to leave the profession, but complained they need help. They needed training and education. They also needed medical attention because most of them had health problems from prostitution. When you face so many problems it sometimes seems easier just to s...

Community teaching work plan proposal Essay

Lorenz et al. (2005) define end- of –life as a chronologically indefinite part of life when patients and their caregivers are struggling with the implications of an advance chronic illness. Every person’s end- of – life trajectory is different and the need for quality healthcare services, hospital or homecare interventions, family and patient legal rights, government policies and regulations pose some challenges to some patients at the end of their life. Therefore, the provision of good end- of- life care should be driven mainly by the concern to enhance life at end- of – life. The important issues for policy makers and healthcare services planners and providers are to find a lasting solution that required client’s autonomy in decision making, excellent healthcare management, love and family support throughout the end- of-life period. Moreover, the healthcare industries should understand that the altitude toward the process of dying is a reflection of the social values the society placed on how its members are supported and cared for at the end-of their lives by nurses, caregivers, social worker, and counselor’s and doctors. Furthermore, the reason majority of our elderly people die outside their own home are due to the nature of the illness and the varying stages and changing needs of the patients, which required certain hospital setting or services that most home caregivers or family members are not trained for or capable to handle. Even with the emergent of palliative care programs and hospice programs, the majority of elderly people do not die in their home because of their preference to seek better care outside the home in order prolong their lives. Although, family members, friends, partners and neighbors commonly assist with the care of older relatives, but when the patient become chronically ill or disable and not responding to treatment, the better option is to transfer the patient to the hospital or home care placement. Before making these decisions most families or caregivers factors in other problems such as patients lack of financial support, patient condition becoming burdensome to the care givers both financially and times spent in taking care of the patient. Furthermore, family members knowing that the patient is at the point of dying at any moment, the best option would be to place the patient in the hospital or homecare setting where the illness would be managed with special care and less painful services and with dignity before they die. As a nurse, I would consider first the well- being  of my patient, treat all my patients with compassion and respect, respect patient’s right and confidentiality, maintain accurate patient clinical records and refrain from denying treatment to patients. On the issue of deciding how I would help my clients at the end –of- life care stage, would be based on the guidelines of the official positions taken by the American Medical Association on end- of- life- actions. AMA’s Code of medical Ethics ( AMA,2012-2013) which provides health care physicians with a guidelines on how to deal with issues regarding end- of- life, likewise the nurses ANA;s Code of Ethics (2001) also have a guide line on what is expected from nurses when confronted with end of life issues. However, these actions should be based on clients wishes, such as Do- Not- Resuscitate Orders, Futile Care process, Quality of Life, Withholding or withdrawing life – sustaining medical treatment, Optimal Use of Order- not to intervene and Advance Directives in clients living will, health care treatment plan, health care power of attorney and do not resuscitate at home. Furthermore, we all know that some people are contented to leave decisions regarding their death in the hands of the others. By doing so, they expose themselves to the unnecessary treatments and restrictions. Family members are often forced to make decisions about life- support and treatment without knowing whether their loved one would have wanted these interventions. I would help the patient and the family plan and make the appropriate ethnical choices in accordance with the Hospice and palliative Nursing Association directives. Also, knowing the end – of –life often involves risks and ethical dilemmas such as in withdrawal of life- sustaining treatment like dialysis or feeding tube and the large need of doses of opioids, I would address the patients need based on ANA guidelines, which stated in the case of administering opioids on end-of- life patient, nurses must use effective doses of medications prescribed for symptom control and nurses have a moral obligation to advocate on behalf of the patient when prescribed medication is insufficiently managing pain and other distressing symptom. The Agency for Healthcare Research and Quality (AHRQ) 2011 CQG series between elderly patients under the palliative care and family evaluation of Hospice care patients who have died, shows the extensive evidence and numerous interventions available for patients in palliative care, such as  applying many types of medications and other interventions to treat pain are supported by strong evidence of reductions in pain severity and helps to prolong patients life. On the other hand, patients who are in Hospice care before death has a lot of complaint from the family members and noted that 18.2 percent of the family members stated inattention to the needs of their love ones and support from hospital among hospices varies from 12.6% to 21.4%, and 9 percent of family members reported that their need for emotional support was not met. References AMA’S Code of Medical Ethics-American Medical Association. www.ama-assn.org/go/codeofmedicalethics. Code of Nurses Ethics for Nurses-American Nurses Association. www.nursingworld.org/codeofethics.