Given the projected demographic trends and the actual statistics from the surrounding hospitals considered above, it is obvious that the "business" for open heart surgery is moving into the Cabarrus Memorial Hospital area. In the interim however, the hospital administrators on the Board will have to consider possible alternative strategies before making a "go/no-go" decision on the possible addition of the open heart program. Unfortunately, a helicopter medevac average price is $7,500-$8,000. This will of course vary based upon the medications and supplies used during trip ("How much does," 2011).

First of all, in the opinion of the author, we have identified an access problem for the present CMH area residents to the existing open heart surgery facilities at the surrounding hospitals. As noted in the case study text, driving to Charlotte is a major problem. The immediate issue will be relieving this before an open heart surgery center is…

Works Cited

Heart. (2011). Retrieved from  http://www.cmc-northeast.org/body.cfm?id=51 .

How much does a ride in a medevac helicopter cost? (2011). Retrieved from  http://answers.yahoo.com/question/index?qid=20100329055051AAbYeqW .

Nilsson, J., Algotsson, L., Hoglund, P., Luhrs, C., & Brandt, J. (2006). Comparison of 19 pre-operative risk stratification. European Heart Journal, 27, 867 -- 874.

Swayne, L.E., Duncan, W.H., & Ginter, P.M. (2007). Strategic management of health c are organizations. Malden, MA: Blackwell, MA.

Does taking Metoprolol before cardiac surgery reduce the incidence of post-op atrial fibrillation
Abstract
Postoperative atrial fibrillation (POAF) remains a prevalent supraventricular arrhythmia. PoAF has associated effects such as deteriorating hemodynamic, increased risk of stroke and increased probability of death. Beta-blockers have been recommended as effective intervention mechanism of preventing PoAF. Metoprolol is one such beta-blocker that is commonly administered to prevent the incidence of PoAF. The systematic review below entails an analysis of six clinical trials that explore the effectiveness of metoprolol. The analysis identifies reduced hospitalization length, reduced mortality and reduced financial burden as the beneficial impact associated with the administration of prophylactic. The small number of studies reviewed limits the validity of the conclusion warranting future large sample size research.
Introduction
Annually, approximately 750,000 cardiac surgery are performed globally with postoperative atrial fibrillation (PoAF) being the prevalent complications (George, et al., 2018). With the increasing proportion of elderly population…

Heart Hospital: A Combined Effort between Cornell University

and the New York Presbyterian Hospital

According to the American Heart Association, approximately 2,600 Americans die each and every day from cardiovascular diseases and claim an average of one life every 33 seconds. By building on the successes of the New York Presbyterian Hospital and Cornell University NYP will leverage its cardiac resources to educate, research, treat, and prevent the nation's and New York's number one killer.

The primary driving force behind NYP Hospital's design has been its efficiency to support advanced patient care, synergy of comprehensive cardiac services, and farsighted and visionary advances in medical technology. The planned facility will be a state-of -- the art wireless (digital) environment permitting physicians, nurses and other healthcare practitioners to be significantly closer to the medical consumer's bedside and the design of inpatient surgery and medicine step-down units will improve the workflow across all…

I know whatever major I choose, my first priority is to help others and make a difference in their lives.

I feel I have a lot to offer to your university in my attitude, involvement, and dedication. I am a very sensitive person because of my sister and her condition. She has had many medical problems (including open-heart surgery, heart failure, and several battles with pneumonia). She is an inspiration to me, and my family rejoices in all of her successes. This has made me more open to others, and to understand those who are different, as well as those who fit in. I feel this will make me a better, more compassionate student and peer.

My sister has taught me more than compassion and sensitivity. Despite her health problems and situation, she still holds down a part time job at McDonald's, and is always positive and upbeat. As my…

In year 1799 anesthetic properties of Nitric Oxide were discovered by Humphery Davy (1778-1829) he advised that the by using nitric oxide, pain and shock of the surgical procedure can be negated. Third person who continue with Morton and ells philosophy was Charles T. Jackson. The Fourth man who contributed to anesthetics was Thomas Mortan (Blatner, 2009). In the year 1848 James Simpson used chloroform in obstetric surgery, he used diethyl ether to anesthetize a women with a pelvic deformity for delivery (kodali, 2009) and in year 1853 John Snow did a successful induction of chloroform to her Majesty Queen Victoria at the time of Prince Leopold's Birth and also on Fenny Longfellow who wrote to her poet brother that this use of ether is certainly the greatest blessing of this era (Longfellow, 1956). In the year 1885-illiam Halsted introduced the nerve block. In 1891 Heinrich Quincke demonstrated the process…

WORKS CITED

Bergman, Norman. History of Anesthesia. chua2.fiu.edu.  http://ahahq.org/Bulletin/AHA_GB_1991-10.pdf  .Retrieved from 14th Jan 2013.

Conquering surgical pain: Four men stake their claims. (2012). Massachusetts General

Blatner, Adam. The discovery and invention of Anesthesia. Blatner.com.  http://www.blatner.com/adam/consctransf/historyofmedicine/4-anesthesia/hxanesthes.html . Retrieved on 14th Jan 2013.

Fadden, John. Cultural, Environmental and Genetical influences on drug therapy. Jbpub.com. http://samples.jbpub.com/9780763786076/86076_CH03_FINAL.pdf . Retrieved on 14th Jan 2013.

Indeed, "time heals all wounds," even those resulting from open heart surgery, and the payoff was shown to be clearly worth the risks involved for most of the people who electively seek out the CABG procedure for their coronary heart disease.

eferences

CABG and PCI Each Have Strengths, Weaknesses Ann Intern Med. 2007 [Published online Oct.

16, 2007] cited in Latest research. (2007, November 2). Medical Economics, 84(21), 75.

Ben-Zur, H., appaport, B., Ammar, . & Uretzky, G. (2001). Coping strategies, life style changes and pessimism after open-heart surgery. Health and Social Work, 25(3), 201-

Kos-Munson, B. A, Alexander, L.D., Culbert, P.A., Hinthorn, E.L. & Goetze, C.M. (1988).

Psychosocial predictors of optimal rehabilitation post-coronary artery bypass surgery.

Scholarly Inquiry for Nursing Practice, 2(3), 171-172.

Peterson, J.C., Charleson, M.E., Williams-usso, P. & Krieger, K.H. (2002). New

postoperative depressive symptoms and long-term cardiac outcomes after coronary artery bypass surgery. The American Journal…

References

CABG and PCI Each Have Strengths, Weaknesses Ann Intern Med. 2007 [Published online Oct.

16, 2007] cited in Latest research. (2007, November 2). Medical Economics, 84(21), 75.

Ben-Zur, H., Rappaport, B., Ammar, R. & Uretzky, G. (2001). Coping strategies, life style changes and pessimism after open-heart surgery. Health and Social Work, 25(3), 201-

Kos-Munson, B. A, Alexander, L.D., Culbert, P.A., Hinthorn, E.L. & Goetze, C.M. (1988).

Cardiopulmonary bypass entails the techniques through which perfusionists replace some major functions of the lungs and heart with a mechanical system to support a patient during surgical interventions on the pulmonary or cardiovascular system (Ghosh & Cook, 2009). It involves bypass of the lungs and heart in an open-heart surgery where perfusionists redirect blood getting to the heart via a heart-lung machine before it gets into the arterial circulation. Cardiopulmonary bypass takes the role of the lungs and heart during surgery.

Reasons for Application

Cardiothoracic surgeons conduct cardiopulmonary bypass while repairing cardiac defects. he surgeons need a bloodless and motionless heart to work on, and to attain this, the surgeons stop the motion of the lungs and the heart. While the lungs and the heart remain motionless, there must be a way for blood to flow throughout the body to deliver oxygen and nutrients essential in life. Perfusionists together with…

The patient receives heparin to avoid clotting besides protamine sulfate to overturn heparin effects. In the course of the procedure, the surgeons maintain hypothermia, and body temperature remains at 8°C to 32°C (McCann, 2005). The surgeons and perfusionists cool the blood during cardiopulmonary bypass and return it to the body. The cooled blood lowers the basal metabolic rate of the body, lowering its oxygen demand. Cooled blood holds an increased viscosity, while the crystalloid solution utilized to guide the bypass tubing water-down the blood. The cardiopulmonary bypass comprises of two major elements, which include the oxygenator and the pump. The oxygenator removes deoxygenated blood from the body replacing it with oxygenated blood via numerous hoses. The elements cardiopulmonary bypass circulates and interconnect through a chain of tubes formed of PVC or silicon rubber while the pump console consists of numerous rotating motor-compelled pumps that massage tubing peristaltically.

Risk Linked to CPB

During open-heart surgery, surgeons temporarily stop the pounding of the heart and maintain life via CPB. Surgeons stop the functioning of the heart through lowering its temperature or through a preservative injection to allow CPB to pump blood throughout the patient's body. Although

Jesus' Teachings, Prayer, & Christian Life

"He (Jesus) Took the Bread. Giving Thanks Broke it. And gave it to his Disciples, saying, 'This is my Body, which is given to you.'" At Elevation time, during Catholic Mass, the priest establishes a mandate for Christian Living. Historically, at the Last Supper, Christ used bread and wine as a supreme metaphor for the rest of our lives. Jesus was in turmoil. He was aware of what was about to befall him -- namely, suffering and death. This was the last major lesson he would teach before his arrest following Judas' betrayal. Eschatologically speaking, the above set the stage for the Christian ministry of the apostles, evangelists and priests. Indeed, every Christian is called to give of him or herself for the Glory of God and the Glory of Mankind. The message at the Last Supper was powerful. People have put themselves through…

Coronary Artery Disease
Development of Coronary Artery Disease (CAD)
Coronary artery disease represents an obstruction or constricting (stenosis) of vessels and arteries which supplies the heart with oxygenated blood. The cause for CAD is atherosclerosis (arterial hardening), or a fatty plaque buildup on inner arterial linings. The resultant obstruction impedes blood flow across coronary arteries. The complete cut- off of blood flow leads to a heart attack (or myocardial infarction, in medical terms). CAD takes place when coronary arteries are partly obstructed or hindered, thus cutting off oxygen supply to heart muscles (i.e., myocardial ischemia). When the blockage is temporary or partial, angina (chest pain or pressure) may occur. The sudden, complete cut- off of blood flow due to the blockage leads to myocardial infarction (Milto, Costello, Davidson & Lerner, 2013).
CAD is a condition that sets it from a rather young age, a fact not many are aware of.…

Tribute: The Late Dr. Wilson Ko

The Late Dr. Wilson Ko: Tribute

Tribute to Dr. Wilson Ko

I feel honored to write this tribute to Dr. Wilson Ko -- a teacher, colleague, doctor, scholar, educational administrator, father, husband, son, and friend to many. From whatever vantage position we knew him, Wilson stood out as someone special.

The very first time Wilson and I met, he had just completed his cardiothoracic fellowship in Weill Cornell Presbyterian Hospital. His visionary and charismatic leadership qualities were almost immediately apparent to me, and we seemed to share the same passion and vision for the Chinese community. This very first encounter back in 1996 marked the start of our scholarly collaboration and long-standing friendship.

Wilson was passionate about improving the welfare of the Chinese community through the treatment of cardiac diseases. By then, there were only very few Chinese cardiothoracic surgeons; however, Wilson was committed…

Healthcare Administration

THE SIX STAKEHOLDES GOUPS FO IVEVIEW EGIONAL MEDICAL

The six stakeholder groups for the iverview egional Medical Center are as follows: clerical staff, medical laboratory technicians, nurses, housekeeping staff, patients, and physicians. The hospital is comprised of 700 people who all play as stakeholders for the hospital.

TAGETS MAKET OF EXISTING POGAMS AND THE GAPS IN MC MAKETING STATEGY

An addition added to the MC is the Heartburn Treatment Center. A nurse manager is utilized in the Heartburn Treatment which is similar to that of the management model used in the ED. PH monitoring, which uses the Bravo capsule, is considered one of the diagnostic procedures. This procedure is used on qualified patients, and the Nurse First program stressed the role of the hospital's commitment to the care of the patient. Usually, the nurse is the first person viewed by the patient in the ED, not individuals that…

REFERENCE

Swayne, L.E., Duncan, J., & Ginter, P.M. (2009). Strategic management of healthcare organizations (6th ed.). San Francisco: Jossey-Bass.

Cohn, K.H. & Harlow, D.C. (2009). Field-tested strategies for physician recruitment and contracting.

Routine Shaving of the Surgical Site

Select a preoperative procedure (e.g., routine shaving of the surgical site) that you would commonly find on a surgical floor.

Describe the process or procedure you have chosen and why you think it needs change.

The process which I have chosen for surgical floor is routine shaving of the surgical site and I think it needs change because patients going through surgery are required to remove hair from the site of the cut. This is considered to reduce the chance of the surgical site becoming infected (National Collaborating Centre for omen's and Children's Health, 2008). Shaving, clipping the hair and using a cream which dissolves the hair are some of the different methods available to remove hair. And these are important because clinically, care plans offer a way to plan and communicate appropriate patient care.

A2. Based on your initial investigation of the situation,…

Works Cited

Collins, A.S. (n.d.). Preventing Health Care - Associated Infections. Retrieved October 30, 2012, from National Center for Biotechnology:  http://www.ncbi.nlm.nih.gov/books/NBK2683/ 

Graham, I.D., RN, J.L., Harrison, M.B., Straus, S.E., Tetroe, J., RN, W.C., et al. (2006). Lost in knowledge translation: Time for a map? Journal of Continuing Education in the Health Professions, 13-24.

Green, L.A., & Seifert, C.M. (2005). Translation of Reserch into Practice: Why we can't "Just Do It." PubMed, 541-545.

National Collaborating Centre for Women's and Children's Health. (2008, October). Surgical Site Infection: Prevention and Treatment of Surgical Site Infection. Retrieved October 29, 2012, from Nice.org.uk:  http://www.nice.org.uk/nicemedia/pdf/CG74FullGuideline.pdf

Dangerfield and Associate Entities

Upon examining this case, it's clear that the claims made by Hartman are completely legitimate. The claims made by Mitchell are somewhat legitimate. This paper will first examine the basis of the lawsuit waged by Hartman, as the bulk of the valid accusations made are made by this particular plaintiff. The crux of Hartman's lawsuit is based on the claim that Dangerfield was liable for the negligence of its parking attendant along with independent negligence. Hartman then claims that Dangerfield and Sandman were fundamentally liable by association. While these aren't the exact details of why Hartman was suing these connected entities, it does boil down the fundamental reason. The essential element of Hartman's case boils down to primary tort's law. "A person is negligent if he fails to exercise ordinary care to avoid injury to other persons or their property. In other words, he failed to…

References

Best, A. (2007). Basic Tort Law: Cases, Statutes, and Problems. New York: Aspen Publishers.

Carper, D. (2008). Understanding the Law. Mason: Thomson West.

Cornell.edu. (2010). Responsibility in Negligence: Why the Duty of Care is not a Duty "To Try." Retrieved from Cornell.edu:  http://scholarship.law.cornell.edu/facpub/127/ 

Delpo, A. (2009). The Manager's Legal Handbook. Nolo Books.

Martin Army Medical Center, Fort Benning, Georgia and St. Francis Medical, Columbus Georgia

Because resources are by definition scarce, it is important for tertiary healthcare providers to develop healthcare delivery structures that are efficient and effective. Since every healthcare organization is unique, though, these delivery structures can vary widely in scope and purpose. To gain some fresh insights into the healthcare delivery structures that are used by civilian and military health facilities, this paper provides a comparison of Martin Army Medical Center at Fort Benning, Georgia with St. Francis Medical in Columbus, Georgia, followed by a summary of the research and important findings in the conclusion.

eview and Comparison

Martin Army Medical Center, Fort Benning, Georgia

Health care delivery structure. Opened in 1958, this is a U.S. Department of Defense facility operated by the U.S. Army that offers inpatient, outpatient and emergency services. At present, Martin Army Medical Center 250-bed,…

References

About St. Francis Hospital. (2012). St. Francis Hospital. Retrieved from http://www.

sfhga.com/about-st-francis-hospital.

About us. (2012). Martin Army Community Hospital. Retrieved from http://www.martin.

amedd.army.mil/meddepts/about.htm.

Healthcare Organization

Banner Healthcare is an American non-profit healthcare system predominantly used in Phoenix, Arizona. The healthcare organization runs twenty-three hospitals plus various other specialized units. It has about 35,000 workers in its employment and so is one of the state's biggest employers. It offers emergency care, hospital care, rehab services, outpatient surgery, pharmacies, hospice, home care and long-term care. The organization has recently begun running primary care physician clinics such as Banner Arizona Medical Clinic and the Banner Medical Group. The organization was founded when Samaritan Health System and the Lutheran Health Systems merged.

The mission statement of Banner Health is "To make a difference in people's lives through excellent patient care (Banner health, 2014). The institution is known all over the country and is well recognized. The merger that led to the formation of the institution happened over two decades ago in 1991. The resultant company launched onto…

References

Banner Healthcare. (n.d.). Retrieved from Banner Healthcare:  https://www.bannerhealth.com/ 

Bannerhealth. (2014). Our Mission. Retrieved from Bannerhealth:

Success in several high-profile areas, such as stroke prevention, acute coronary intervention, or nosocomial infection have the benefits of focusing the organization on a task which can bring tangible results, measured in clinically-relevant ways.

Specific Program for our Institution

This memo recommends that we choose five treatment areas, and implement specific quality improvement programs for each one. The focus on each should include procedures which are important to the overall quality of this institution's morbidity and mortality results. Given the hospital's focus on acute care, the following procedures might be candidates for quality improvement programs:

Ischemic stroke treatment

ACS treatment (acute coronary syndrome).

Trauma in the ER related to gunshot wounds.

Maternal ward delivery performance

Nosocomial infection reduction.

In each case, the procedures should proceed as outlined above: (1) an identification of the problem, (2) identification of best practices as demonstrated in peer-reviewed clinical trials, (3) adoption of the best…

Bibliography

CancerCenter. (2007). Cancer Treatment Centers of America. Retrieved November 23, 2007, from CCA: www.cancercenter.com

Civitarese, L.A. (1999). Congestive Heart Failure Clinical Outcomes Study in a Private Community Medical Group. Journal of American Board of Family Practice, 467-472.

Dana Farber. (2005). Dana-Farber attains nation's highest honor for nursing excellence; first cancer center in New England to earn Magnet recognition. Boston: Dana Farber Cancer Institute.

Katzan, I.L. (2003). Quality Improvement and Tissue-Type Plasminogen Activator for Acute Ischemic Stroke. JAHA, 799-800.

Doctor

The film The Doctor illustrates both sides of the doctor-patient relationship. Played by illiam Hurt, Jack McKee is a head surgeon who exudes arrogance until he is diagnosed with throat cancer. Not only does a brush with death change his outlook on life, but also his experience as a patient at his own hospital alters the way he treats his patients. hen Jack is forced to wait in lengthy lines, fill out tedious forms, and deal with impersonal physicians, he realizes how dehumanizing, humiliating, and frustrating it can be on the other end of the doctor-patient spectrum. McKee's behavior transforms considerably from the beginning of the film to the end, but he still manages to retain his witty sense of humor throughout. The Doctor provides a cinematic example of why doctors and other professionals caught up in the modern medical system need to respect their patients more, by including…

Works Cited

The Doctor. Dir. Randa Haines. Perf. William Hurt, Christine Lahti, Mandy Patinkin, Elizabeth Perkins. Touchstone, 1991.

Introduction

The health care system in the United States is often compared with that of other countries, and the one that comes up the most frequently in Canada. The Canadian system has better outcomes in general than the American system, and is completely different in terms of structure. This paper will examine the key areas where the systems differ, and seek to extrapolate what that means.

Basic Systems

At its heart, the US system relies on market forces for much of its activity. Health care is providers are usually paid by insurance companies (or the government, which will be discussed in a moment). The insurance market is generally a free market, where insurers compete for customers the same way that insurers in other fields compete for customers. Employers will often pay the cost of coverage under an employer plan for workers, but there are many types of jobs where this…

A mission is valueless if it does not truthfully motivate and guide the force of every worker in the similar course. Everyone has to consider the mission is sensible and achievable and not just unfilled speechifying (11).

usiness leaders must "outshine" by setting the model for all workers. They do not merely converse about missions, but they develop into a perfect example of the contemporary value; they should live by it day by day. A mission is vital to directing the firm in these unstable times and to establishing a competitive lead (5).

The businesses that have dedicated themselves to apply the strategic management process have accomplished considerable sensation by using the formulating missions after a careful assessment of the environment. This triumph can be calculated in terms of real evolution in concentrating on the organization's mission and of exclusive escalation in customer contentment and loyalty (5).

ibliography

1) arley,…

Bibliography

1) Barley, Stephen R., and Gideon Kunda. "Gurus, Hired Guns, and Warm Bodies: Itinerant Experts in a Knowledge Economy." Princeton, NJ: Princeton University Press, 2004.

2) Benko, Cathleen, and F. Warren McFarlan. "Connecting the Dots: Aligning Projects with Objectives in Unpredictable Times." Boston: Harvard Business School Press, 2003.

3) Black, J. Stewart and Hal B. Gregersen. "Leading Strategic Change: Breaking Through the Brain Barrier." Upper Saddle River, NJ: Prentice Hall, 2002.

4) Bossidy, Larry and Ram Charan. "Execution: The Discipline of Getting Things Done." New York: Crown Business, 2002.

United States is a country that thrives on the achievements of various people groups. The achievements of African-Americans in the United States are particularly significant. African-Americans have contributed greatly to the world of literature, medicine, and business. The purpose of this discussion is to examine the role that African-Americans have played in the formulation of American culture.

lacks in America

Although the history of blacks in America has been steeped in bigotry, hatred, and segregation, the culture has managed to face these adversities with courage and triumph. African-American's have fought for equal rights since their arrival in this country. Initially, they were forced to fight for the right to be free men and to end slavery. Eventually, African-Americans also struggled for integration during the civil rights movement. There were several individuals that were instrumental in ensuring that African-Americans were free from slavery and that they gained their civil rights. These…

Bibliography

Bennet, L. 1989. The 50 most important figures in Black American history; experts list men and women who made indispensable contributions. Ebony. Volume: 44 Issue

Department of Veterans Affairs Medical Center, Oklahoma City, Oklahoma

Today, the Department of Veterans Affairs (VA) operates the nation's largest healthcare system through the Veterans Health Administration (VHA), including 152 medical centers (VAMCs), 800 community-based outpatient clinics and numerous state-based domiciliaries and nursing home care units (About VA, 2016). As the second-largest cabinet agency in the federal government, the VA's budget exceeds the State Department, USAID, and the whole of the intelligence community combined) with more than $60 billion budgeted for VHA healthcare (Carter, 2016). One of the VHA's largest medical centers that provides tertiary healthcare services to eligible veteran patients is the Oklahoma City VA Medical Center (OKC VAMC) in Oklahoma City, Oklahoma. Like several other VAMCs, the OKC VAMC has recently been implicated in a system-wide scandal concerning inordinately lengthy patient waiting times and misdiagnoses which may have contributed to the deaths of some veteran patients and jeopardized…

References

About the Oklahoma City VA Medical Center. (2016). Oklahoma City VA Medical Center. Retrieved from  http://www.oklahoma.va.gov/about/ .

About VA. (2016). Department of Veterans Affairs. Retrieved from  http://www.va.gov  / about_va/vahistory.asp.

Breen, K. J. & Plueckhahn, V. D. (2002). Ethics, law, and medical practice. St. Leonards, NSW: Allen & Unwin.

Carter, P. (2016). How to fix the VA. Slate. Retrieved from  http://www.slate.com/blogs  / the_works/2016/03/25/slate_s_infinite_scroll_implementation_explained.html.

Rather, the reader is only exposed to the short, choppy explanations of a first person narrator. Very little explanation is given as to why the events are happening or who the characters really are underneath their outward expressions and appearances. This tends to add to the general confusion the narrator feels during the intensely scary situation. One moment the narrator was thinking about tailgating with friends, and the next he is on the floor after being hit by a bus. The level of description coincides with the overall tone of confusion. The events following the initial accident also tend to carry this sense of confusion, but the atmosphere is much faster paced. The hospital and the ensuing trouble the narrator faces is in a much more rapid and hectic atmosphere than the dull and dreary atmosphere seen in Butler's work.

Overall, it is clear that the two works may share…

Works Cited

Butler, Katy. "What Broke My Father's Heart." New York Times. 2010. Web.  http://www.nytimes.com/2010/06/20/magazine/20pacemaker-t.html?pagewanted=all 

Riederer, Rachel. "Patient." The Missouri Review, 33(1), 2010. Pp 152-166.

Hospital for Special Surgery

In America there a wide variety of healthcare organizations, that have specialized in addressing the needs of various patients. Part of the reason why this occurring, is many facilities are unable to address the challenges facing those individuals requiring some kind of specialty care. As a result, a number of hospitals have evolved to deal with these issues. One such example of this is with Massachusetts General Hospital (MGH). Even though the facility was established as a community hospital in 1811, their overall mission has evolved. What has been happening is the hospital has become more focused on: offering specialized care and innovative health solutions. This is an effort by the administration to build upon their outstanding reputation through: improving the overall quality of care that patients are receiving. ("Hospital Overview," 2011)

As a result, the facility has become known for the specialty care and the…

Bibliography

Health Care Uncovered. (2011). Connect With Partners. Retrieved from:  http://www.connectwithpartners.org/2011/04/14/%E2%80%9Chealthcare-uncovered%E2%80%9D-program-highlights-mgh%E2%80%99s-care-management-program/ 

Hospital Overview. (2011). Massachusetts General. Retrieved from:  http://www.massgeneral.org/about/overview.aspx 

Monagan, D. (2000). MGH and MGPO. Massachusetts General. Retrieved from: http://www2.massgeneral.org/pubaffairs/Issues/081100CPM.htm

Valencia, M. (2011). MGH Faces Suit. Boston. Retrieved from: http://articles.boston.com/2011-03-10/news/29339649_1_hospital-staff-hospital-report-hospital-officials

heumatic heart disease is caused by heumatic Fever or group a streptococci. It consists of "cardiac inflammation" accompanied by scarring which itself is a reaction to the autoimmune system fighting the group A streptococci. The myocardium, endocardium, and epicardium are each affected in turn. In the chronic stage, heumatic heart disease results in valvular fibrosis (Burk, 2013).

The pathophysiology of heumatic heart disease is as follows: The causative agent is group A streptococci. It develops into strep throat, which if untreated can turn into heumatic fever. At this point, the individual suffers inflammation of the layers of the heart as well as the mitral valve. Vegetation also begins to develop. This will lead to valvula regurgitation plus stenosis. The result of all of this is heart failure (Burke, 2010).

heumatic fever typically occurs in individuals between the ages of 5 and 25, so it is neither a newborn's disease nor…

References

Burke, A. (2013). Pathology of Rheumatic Heart Disease. Medscape. Retrieved from  http://emedicine.medscape.com/article/1962779-overview#a7 

Wallace, M. (2014). Rheumatic Fever Medication. Medscape. Retrieved from  http://emedicine.medscape.com/article/236582-medication

Nursing and eligion Practice

ELIGION AND NUSING PACTICE

Nursing success depends on the ability to put the patient in a state of rest and comfort as much as it is about administering the prescriptions of the doctor. To secure the rest of the patient, nurses need to understand their needs and show respect to their beliefs and values. This requires courteous and open communication with the patient and adopting a patient-centric orientation. Along with other factors, the religious background of the patient makes a lot of difference to their values and expectations. eligious doctrines and practices may differ across religions and denominations such as Jehovah's Witnesses, Muslims, Seventh Day Adventists and Scientologists and may impose restrictions on certain kinds of interaction between nurse and patient or on certain forms of treatment. Moreover, people with a different religious background are not usually aware of such differences. Therefore, it is necessary for…

References

Banja, J.D. (2010). Overriding the Jehovah's Witness patient's refusal of blood: A reply to Cahana, Weibel, and Hurst. Pain Medicine, 10(5), 878-882. doi: 10.1111/j.1526-4637.2009.00648.x.

Charles, C.E., & Daroszewski, E.B. (2012). Culturally competent nursing care of the Muslim patient, Issues in Mental Health Nursing. 33(1), 61-63. doi: 10.3109/01612840.2011.596613.

Cort, M., & Cort, D. (2008). Willingness to participate in organ donation among Black Seventh-Day Adventist college students. Journal of American College Health, 56(6), p. 691-697. Retrieved from EBSCO Academic Search Primer.

Effa-Heap, G. (2009). Blood transfusion: Implications of treating a Jehovah's Witness patient. British journal of nursing, 18(3), 174-177.

Apart from that, Chennai has become the eye specialist city and Kerala has become the ayurvedic center for healing. These facilities are being made use of by the non-Indian nations (Connell, 2011).

Huge market at hand

The population is surging, the patterns of diseases are altering, salary levels are rising, clinical needs aren't attended, health issues aren't being attended, demand for quality care is needed at moderate prices and medical tourism is all set to rise. So is the need for modern equipment. In any case, demand for modern equipment is needed in India on a basis of 12%-15% yearly. Many foreign companies commence their initial 500 surgeries in India after getting approval from FDA. Medical services are still shallow by the way. China has 106 doctors while India has 60 doctors per 1000. Australia has 247 doctors per 1000 people. The rural areas suffer a lot from this lack…

References

Connell, J. (2011). Medical Tourism. CABI - Business & Economics.

Dhawan, J (2007). The Changing Face of Indian Economy. Atlantic Publishers & Dist.

Gulati, S., & Taneja, U. (2012). Specialty Hospitals Leveraging Information Systems For Greater Success. Internet Journal of World Health & Societal Politics, 7(2).

Herzlinger, R.E. (2008). Fortis Healthcare. Harvard Business School.

Nursing Culture: Overcoming Barriers to Change

Introduction and Theoretical Framework

This program of study continues personal research and professional practice in the field of nursing within the area of public and private health systems. In an era characterized by increasing calls for more efficient approaches to healthcare delivery and accountability on the part of healthcare providers, there is a growing need for identifying opportunities to overcome organizational barriers to change that facilitate the implementation and sustainment of evidence-based practices over time. In order to accomplish this challenging enterprise, the nature of existing organizational barriers must be better understood, an issue that directly relates to the problem to be considered by the study proposed herein and which is discussed further below.

Statement of the Problem

According to Mannion, Davies and Marshall et al. (2005), the results of much of the research to date have identified a relationship between nursing culture and…

References

Banyard, V.L., & Miller, K.E. (1998). The powerful potential of qualitative research for community psychology. American Journal of Community Psychology, 26(4), 485.

Burton, S., & Steane, P. (2004). Surviving your thesis. New York: Routledge.

Dennis, C., & Harris, L. (2002). Marketing the e-business. London: Routledge.

Department of Health. (2000). The NHS plan: A plan for investment, a plan for reform. London:

Merrill, in the UK. Following his experience with heart surgery using innovating surgical techniques, the physician noted the problems he experienced in understanding all of his alternatives compared to a simpler earlier procedure, and finally trusted to the advice of his cardiologist to surgically intervene. In response to the experience, Dr. Merrill emphasized that, "As a physician talking to colleagues, I had the best information possible under the circumstances. But it wasn't the same as my hernia repair. The experience brought home to me the realization that the progress of medicine has made informed consent impossible -- even for me" (Merrill 1999: 190).

ationale of Study

Taken together, the foregoing issues indicate that there is an ongoing need for an assessment of knowledge levels of informed consent among perioperative nurses and operating department practitioners. Perioperative nurses and operating department practitioners, though, are frequently subjected to an enormous amount of stress…

References

Calloway, S.J. (2009) 'The Effect of Culture on Beliefs Related to Autonomy and Informed

Consent.' Journal of Cultural Diversity 16(2): 68-69.

Cobb, W.G. (2005) 'Defending the Informed Consent Case.' Defense Counsel Journal 72(4):

330-331.

In summary there is a complete lack of methodology to get beyond what appears to be a major opportunity in the Hanoi market for healthcare when in fact there was a very good reason that part of the market was open; no one had taken the time to define services in the high-end of medical services, and the pricing dynamics of the market would later prove to be difficult to sustain such a high-end hospital on. If the founders had done research before the actual launch of the VIH they would have known this.

If you had been acting as a pre-project marketing consultant to Mr. Lee what might you have done by way of data collection to ascertain the nature of the market? (Remember, this is a developing-world country, and oftentimes consumers have little conceptualization of the product you envision.) would have taken a very systematic approach to building…

Nursing Definitions

Autonomy

Autonomy in the nursing profession states the importance of the client's role in making decisions that reflect advocacy for the client (Wade, 1999, p.310). Ultimately, this includes taking care of the patient physically as well as mentally and emotionally, developing a relationship with the patient that is beneficial to his care and actively advocating for the patient's rights and care. This type of autonomy, it is important to note, is not the same as individual or work autonomy, yet it must be considered that empowerment in nursing autonomy will inevitably lead to better professional and personal autonomy and should also lead to increased job satisfaction (Wade, 1999, p.310).

Typical definitions of autonomy would include the idea of complete independence for the person making the decisions. However, in the case of the nursing profession, the client's needs and desires must be heavily weighed and, in fact, become central…

References Cited

Wade, G.H. (1999). Professional nurse autonomy: Concept analysis and application to nursing education. Journal of Advanced Nursing, 30(2), 310-8.

Gaylord, N. & Grace, P. (1995). Nursing advocacy: An ethic of practice. Nursing Ethics, 2(1),

11-18.

White, L. (2004). Foundations of nursing: Second edition. Clifton Park, NY: Delmar Learning.

ears are blasted daily by the drumbeat of environmental forewarnings. The seas are rising. The glaciers are melting. Don't drive -- take the bus. Recycle. Turn off the lights. Adjust that thermostat. Save the polar bears! Reduce your carbon footprint!

Nothing against carbon, or ecologists, or polar bears, but while society focuses on reducing carbon footprints, why aren't more folks out there creating footprints for God? ho is marching through the pain and the rain and the snow to rekindle faith that God will intercede in broken lives, and will help repair the world's environmental problems if we just put one foot in front of the other in a march towards Christian truth?

hy have we been waiting for inspiration as to what we should do in this troubled world? Are not seeing that global warming and rising sea levels are sending us warning that we need to trust God's…

Works Cited

Faris, Stephan. (2008). Craig Sorley. Time. Retrieved October 25, 2011, from  http://www.time.com .

Sorley, Craig. (2011). Christ, Creation Stewardship, and Missions: How Discipleship into a Biblical Worldview on Environmental Stewardship Can Transform People and Their Land.

International Bulletin of Missionary Research, 35(3), 137-143.

Srokosz, M.A. (2008). God's Story and the Earth's story: Grounding our concern for the Environment in the biblical meta-narrative. Science & Christian Belief, 20(2), 163-175.

Boston Children's Hospital has become an important location for assisting children to deal with a host of issues ranging from cancer treatment options to transplants. According to U.S. News and World Report (2013), Boston Children's Hospital is ranked as the number one facility for helping children to address a host of health issues including cardiology and neurology. he hospital is having a positive impact on the lives of children by offering them state-of-the-art treatment options in a caring environment. However, the institution faces a variety of challenges. his case study examines those challenges and how Boston Children's Hospital can meet those challenges.

Background of Boston Children's Hospital

Boston Children's Hospital first opened its doors in 1869, as a 20-bed facility in the South End. By 1891, Boston Children's had already proven itself to be a leader in health care delivery by creating the first laboratory for producing bacteria-free milk in…

To learn from Boston Children's Hospital, it is necessary to focus on the way the institution is evolving to meet health management and real life challenges. It is hypothesized that leadership and effective change management have become the core competencies of Boston Children's Hospital's management team. An examination of Boston Children's Hospital's approach to challenge and change will demonstrate how the institution can and will succeed over the long-term. This analysis will in turn help Boston Children's Hospital become a role model for other health care organizations.

Sandi Fenwick, President and COO

Fenwick has worked with Boston Children's Hospital for more than a decade. Fenwick is dedicated to promoting a health care system that is focused on the patient and not on profits. In her public statement, Fenwick states, "some healthcare discussions seem to imply that cost is the only measure of a hospital's worth. At Boston Children's value means more than just dollar and cents," (Boston Children's Hospital, 2013). Children are not to be treated as "small adults," according to Fenwick, who also acknowledges the practical and medical differences between treating children and treating adults. Boston Children's Hospital leadership is also committed to running an efficient organization, by forming strategic alliances with organizations like Blue Cross Blue Shield

Authors Communicate

There are a number of points of interest regarding "Massage therapy in post-operative rehabilitation of children and adolescents with cerebral palsy - a pilot study." On the whole this is an extremely well-organized article, which is one of its primary strengths. The different sections and phases of the research are well documented. There are a variety of tables that elucidate several components related to the literature review, the results, and the particulars of the subjects considered in the research. However, there is more than one area of the study in which the researchers could have benefited from the use of more substantial effort and a more thorough methodology, which is certainly reflected in the results and the conclusion.

The central weakness of this study is the fact that all of the results were based on research performed on just six subjects. To the credit of the researchers they…

References

O'Conner, P. (2003). Woe is I: The grammarphobe's guide to better English in plain English. New York: Riverhead Books

Sanford, J., Townsend-Rocchicciolli, J.,Horigan, A., & Hall, P. (2011). A process of decision making by caregivers of family members with heart failure. Research & Theory for Nursing Practice, 25(1), 55-70.

Describe the population for this study.

participants were recruited from cardiology offices, inpatient hospital units, or adult day care facilities. The participant had to be related to the patient with heart failure (HF), provide one activity of daily living, and/or assist the care recipient with two activities of daily living and do this voluntarily.

How was the sample selected? What are the strengths and weaknesses of this sampling strategy?

This was a convenience sample. The participants were recruited from cardiology offices, inpatient hospital units, or adult day care facilities and had to meet certain conditions. The strengths are that the researchers know and get precisely what they are looking for (in terms of qualifications of participants). The weaknesses are that…

Learning Objectives:

In support of the Terminal Objective, several key learning objectives will drive the content and curriculum for nurses undergoing the present training course. Primary among them, the training course is designed to create a standardized set of behaviors amongst nurses that conform with existing and evolving best practices in the perioperative care of CABG patients. This means that course content and design will be geared toward achieving procedural and professional consistency amongst attending nurses where preoperative, intraoperative and postoperative care are concerned.

An additional learning objective is to ensure that outgoing students are informed in the ethical and personal dimensions of the profession. Coronary surgical procedures are inherently serious in nature as are the heart and circulatory conditions that typically require such procedures. Therefore, it is of critical importance that nurses are trained in the proper bedside manner to approach patients, families and extended support systems with potentially…

Works Cited:

Aroesty, J.M. (2010). Patient information: Recovery after coronary artery bypass graft surgery (CABG). Up To Date, 19(2).

Cleveland Clinic (CC). (2011). Diseases and Conditions. my.ClevelandClinic.org.

Kulick, D. & Shiel, W.C. (2011). Coronary Artery Bypass Graft Surgery. MedicineNet.com.

National Heart Lung and Blood Institute (NHLBI). (2010). What is Coronary Artery Bypass Grafting. National Institute of Health.

To verify this diagnosis, a doctor may then order either an X-ray of the area, or more likely, an MRI, which is better at imaging tears in soft tissues. hen surgery is required, these symptoms persist for several weeks after surgery.

Surgery is a common treatment for a rupture to the Achilles tendon; and most often consists of making an incision to the back of the lower leg and stitching together the torn section of the tendon. ("Surgery for an Achilles Tendon Rupture") if the rupture is complete, then the repair may be reinforced by connecting the torn tendon to other nearby muscles. hile the surgery is often performed through an open surgery procedure, if a patient has heart, circulatory, or poor healing risk factors, a percutaneous surgery will be performed. This surgical procedure differs in that it requires a number of small incisions instead of a single large one.…

Works Cited

"Everything About Achilles Tendons." AchillesTendon.com. Web. 26 Mar. 2012.

 http://www.achillestendon.com/ 

rupture

Furthermore, one of the pillars of collaborative care that will need to be firmly established is the fostering of clear dialogue and a means for strong communication within the care management planning. For instance, there needs to be a clear decision and communication of all tests ordered and when the test results will be available. One of the most important aspects of this collaborative care will be the nursing interventions which can have significant impact on the patient's health and stabilization (Allen, 2010). In fact, strategic nursing care can even minimize readmission rates of Margaret and other patients with comparable conditions (Chen et al., 2012).

Prioritize the Nursing Care Needs of Margaret

The prioritization of nursing interventions is essential, and the way in which a nurse determines this priority is going to be something unique and distinct. "Trials reviewed demonstrated a beneficial impact of nursing interventions for secondary prevention in…

References

Adler, H.M. (n.d.). Toward a biopsychosocial understanding of the patient -- physician relationship: An emerging dialogue. (2007). J Gen Intern Med,22(2), 280 -- 285.

Afilala, J. (n.d.). Frailty in patients with cardiovascular disease: Why, when, and how to measure. (2011). Curr Cardiovasc Risk Rep, 5(5), 467 -- 472.

Allen, J.K. (2010). Randomized trials of nursing interventions for secondary prevention in patients with coronary artery disease and heart failure: Systematic review.

Journal of Cardiovascular Nursing,25(3), 207-220.

For example, in these procedures it is often difficult to open the patient's mouth wide enough for laryngoscopy and intubation, thus creating the possibility that cardiopulmonary changes may be present and the "probability o lesions in oesophagus, bowel, kindneys, skin and joints." This information would not be known if not for this study and its reported findings.

The study's conclusion is that the use of thoracic epidural anesthesia to sevoflurane based inhalation "may be a suitable technique for thoracic surgery in achalasia due to sclerodermic patients." The reason for this conclusion is that the study found that this procedure "can provide a smooth anesthesia course and a rapid recovery, with hemodynamic stability, and also having pain-free postoperatively." More so, the study found that providing anesthesia without neuromuscular blockade and non-intravenous opioids has "provided a shorter recovery time."

Clearly this specific case study has important and practical implications to the practice…

Bibliography

Erol, Demet Dogan, M.D. (2006): "Thoracic Epidural Blockade in an Elderly with Achalasia Due to Scleroderma for Thoractomy, Esophageal Myotomy and Cystotomy-Capitonnage. The Internet Journal of Anesthesiology. Vol. 11, Number 1.

References

Boulton, Martha (2005) Exploring alexithymia, depression, and binge eating in self-reported eating disorders in women. Perspectives in Psychiatric Care

Dahm, Lori (2005) Obesity update: are we getting any thinner?(Special Report)

Private Label Buyer

Merrick, Joav (2005) Psychosomatic reasons for chronic pains.(Editorial)

Southern Medical Journal

____(2006) Obese people may be more sensitive to pain.(NEWS Breaks)(Brief article) Nutrition oday

PORER, LAWRENCE C. WAMPLER, RICHARD S (2000) Adjustment to Rapid Weight Loss. Families, Systems & Health

Rubin, Jay J. (2005) Psychosomatic pain: new insights and management strategies.(CME opic: Psychosomatic Pain) Southern Medical Journal

ucker, Miriam E. (2005) Depression tied to poor adherence to cardiac Rx: results of two studies show that use of aspirin and [beta]-blockers was lower in depressed patients.(Psychosomatic Medicine) Clinical Psychiatry News

MEHODOLOGY

his study will seek to determine whether or not obese post operative patients have a higher incidence of psychosomatic disorders and illnesses than non-obese post op…

The need for this study is evident. The cost factor of psychosomatic illnesses may be reduced if it can be determined whether or not the obese patient population has a higher incidence of psychosomatic illness in post op. If it does then future steps can be taken to better prepare the obese patient population for surgery to reduce the incidence of post op psychometric illness.

REFERENCE

Tucker, Miriam E. (2005) Depression tied to poor adherence to cardiac Rx: results of two studies show that use of aspirin and [beta]-blockers was lower in depressed patients.(Psychosomatic Medicine) Clinical Psychiatry News

Pharmaceutical industries have to operate in an environment that is highly competitive and subject to a wide variety of internal and external constraints. In recent times, there has been an increasing trend to reduce the cost of operation while competing with other companies that manufacture products that treat similar afflictions and ailments. The complexities in drug research and development and regulations have created an industry that is subject to intense pressure to perform. The amount of capital investment investments required to get a drug from conception, through clinical trials and into the market is enormous. The already high-strung pharmaceutical industry is increasingly investing greater amounts of resources in search of the next "blockbuster" drug that can help them gain market position and profits. Laws, regulations and patents are important to the industry while spending billions of dollars in ensuring the copyright of their products.

It is the intention of this…

Bibliography

Ansoff, H.I. (1957). Strategies for diversification. Harvard Business Review, 35(5), 113-124.

Ansoff, H.I. (1965). Corporate Strategy. New York, NY: McGraw-Hill.

Ashour, M.F., Obeidat, O., Barakat, H., & Tamimi, A. (2004). UAE Begins Examination of Patent Applications. Tamino.com. Retrieved January 18, 2004, from the World Wide Web:  http://www.tamimi.com/lawupdate/2001-01/intprop.htm 

Bain, J.S. (1954). Economies of scale, concentration, and the condition of entry in twenty manufacturing industries. American Economic Review, 44, 15-36.

As Pressman states, "Given what has later become known about the delicacies of brain function and the complexities of psychiatric illness, it strains credulity that such a crude procedure as the original lobotomies might truly have yielded therapeutic benefits for a great many patients." (Pressman1998, 195) This also refers to the fact that some medical theories are favored at certain times and not others. This suggests the relativity rather than the certainty of the scientific -- rational worldview.

The above brings us to the views put forward by Freeman and others concerning the technological fix. This in turn relates to other questions; such as why a method like lobotomy should have been seen to be effective in the past but not today. This leads to the view that political and social factors influence medicine and especially the success once attributed to a technology like lobotomy. For example, Pressman refers to…

Bibliography

Freeman, Walter and Watts, W. 1942. Psychosurgery, Intelligence, Emotion and Social

Behavior Following Prefrontal Lobotomy for Mental Disorders. Springfield:Baltimore.

Freeman, Walter and Watts, W. 1937. "Subcortical Prefrontal Lobotomy in the Treatment

of Certain Psychoses." Archives of Neurology and Psychiatry 38: 225-229

It is also a population that often has limited resources and one that seeks to find others to help comfort and educate them. Modern technology has certainly improved both the diagnosis and treatment of the illness, but there are so many options that the patient is often left bewildered and frightened (Guadalupe).

A proactive and professional nursing approach to this illness takes Mishel's theory and uses it in four ways:

To combat ambiguity -- Patients are unaware of the progress and severity of their illness and often fill in with worst-case scenarios. Open and honest communication about that status of the illness will alleviate many concerns, or at least allow for uncoerced decision making.

To combat complexity -- Illness is complex and often based on statistical tables, not individual expressions. Using Michel, the nurse can simplify to the necessary degree both the illness and options.

To provide information -- More…

REFERENCES

Alligood, M. (2010). Nursing Theory: Utilization and Application. Denver, CO: Mosby.

Guadalupe, K. (2010, Feb.) Understanding a meningioma diagnosis using Mishel's theory of uncertainty in illness. British Journal of Neuroscience Nursing. 6 (2): 77-82.

Mishel, M. And Clayton, M. (2003). Theories of Uncertainty in Illness. In Smith, M. ed. Middle

Range Theory for Nursing. New York: Springer. Chapter 2.

Hospital Case Study

If the first requirement of any successful case study is a detailed and analytical examination of the situation, the emotional component of so called "high stakes" issues can make this requirement difficult, indeed. The simple fact, however, is in order to find good solutions and policies regarding the problem presented in the case study, one must apply the three main questions of "situation," "remedy/s," and "method/s." Although this may seem difficult in some situations, the emotional component must not be considered.

A good example of this fact occurs in the examination of an unfortunate case involving the botched heart/lung transplant of a 16-year-old girl, much like the recent incident at Duke Hospital. In this case, a young girl died as a result of receiving miss-matched organs. Unfortunately, in this case, all of the supposed safeguards of the system, imposed to assure that proper blood typing of both…

Bibliography

Chibbaro, Lou. (2004) Victory Claimed in HIV Suits. Washington Blade. Web site. Retrieved on August 8, 2004, at  http://www.washblade.com/print.cfm?content_id=2771 

Colorado State University Writing Center. "Case Studies." Retrieved from Web site on August 2, 2004  http://writing.colostate.edu/references/research/casestudy/com2a1.cfm 

CTDN. California Donors Network. (2004) Facts about organ and tissue donation. Web site. Retrieved on August 8, 2004, at http://www.ctdn.org/resources/faqs.php?id=3&NoHeader=1

Duke University. (2004). UNOS and DUH Safeguards for Organ Transplant Safety. Duke Medical News. Retrieved on August 7, 2004, at http://dukemednews.org/filebank/2003/06/28/UNOS%20and%20DUH%20Safeguards%20for%20Organ%20Transplant%20Safety.doc

Nevertheless, my passion for medicine remained which led to applying to the Technology Institute of Pharmacy at the university. Unfortunately, due to conditions beyond my control, I requested a transfer to the Nursing Institute at the university, yet because of my brother's failing health, I was forced to remain at home to care for him. Things changed in 2001, when I came to the U.S., knowing that I had a much better chance there to fulfill my dreams of becoming a medical specialist. Soon after, I registered at Northern Virginia Community College to major in science and after working full-time to pay for my studies, I am now in my last semester at NVCC, aiming for an Associate in Science which hopefully will open the door to pharmacy school. Overall, by obtaining a pharmacy degree, I could not only help people in the U.S. But also my own people in…

My initial interest in pursuing a degree in the medical field came about when my brother developed a very serious disease. This event prompted me to wonder about his medical future regarding treatment in the form of surgery or chemotherapy, and due to the fact that we were living in Addis Ababa, Ethiopia, where I was born and raised, the prospects of my brother finding adequate treatment and care for his disease were rather poor. As a result, I decided to create the foundations for a career in medical science. Part of this required that I take the Ethiopian School Living Examination. In 1994, after competing against 167,000 other high school graduates, I received a passing score which made me eligible to attend Addis Ababa University; however, since Ethiopia follows the command economy, I ended up in social sciences rather than in my chosen field of medicine.

Nevertheless, my passion for medicine remained which led to applying to the Technology Institute of Pharmacy at the university. Unfortunately, due to conditions beyond my control, I requested a transfer to the Nursing Institute at the university, yet because of my brother's failing health, I was forced to remain at home to care for him. Things changed in 2001, when I came to the U.S., knowing that I had a much better chance there to fulfill my dreams of becoming a medical specialist. Soon after, I registered at Northern Virginia Community College to major in science and after working full-time to pay for my studies, I am now in my last semester at NVCC, aiming for an Associate in Science which hopefully will open the door to pharmacy school. Overall, by obtaining a pharmacy degree, I could not only help people in the U.S. But also my own people in Ethiopia. While a student at NVCC, I served the Ethiopian Community Development Council by providing outreach services for refugees seeking health assistance.

In conclusion, my personal desire is to expand and enhance my knowledge in the pharmacy field and thus be able to provide my services to communities in the U.S. And abroad, particularly in Ethiopia. Therefore, I am looking forward with much relish to participating in GWU's Sonography Bachelor's Program.

Legal Aspects of Health Care Administration

One of the platforms upon which the law enforcement agencies and the healthcare providers interact on frequent occasions is the treatment and handling of the patients who might have been injured outside the hospital and brought in for treatment, or even sustained the injuries from within the hospital altogether in the process of general medical care, surgery or drug administration. There are OSHA regulations that guide the reporting, recording and handling of such events within the hospital settings.

The following are the injuries that hospitals are required to formally report to the local law enforcement authorities or the police department for the city within which the treatment took place (UNC School of Governance, 2011). If there are patients brought into the hospital with wounds and injuries resulting from apparent gunshots or any other type of discharge from a firearm, then these must be reported…

References

UNC School of Governance, (2011). Reporting Patient Injuries to Law Enforcement: It's Not Just Gunshot Wounds.  http://canons.sog.unc.edu/?p=5792 

U.S. Department of Labor, (2014). OSHA Forms for Recording Work Related Injuries and Illnesses. https://www.osha.gov/recordkeeping/new-osha300form1-1-04.pdf

Nurses expressed empathy when I complained of pain or discomfort and promptly advocated for me when the need arose.

While hospitalized in an acute care setting, I feel that because I am a nurse, I did not receive the same degree of scrutiny a non-clinician patients or physician may have been given.

While hospitalized in an acute care setting, I feel that because I am a nurse, I received more consideration than a non-clinician patient may have been given.

While hospitalized in an acute care setting, I feel that because I am a nurse, I received less consideration than a physician may have been given.

I feel that the type, quality, and consistency of care I received while acutely hospitalized did not differ from treatment any other person would have been given.

My experience as a patient contributed to shaping my perception as nurse of the health care environment.

I…

References

Bennett, Leeann RN. (2007). "When a Nurse Becomes a Patient." American Nurses Credentialing Center. Retrieved October 23, 2008, at  http://www.medscape.com/viewarticle/564685 

Bowers, Len RMN PhD., McFarlane, Linda BSc, Kiyimba, Frank RMN, Clark, Nicola MA MSc, Alexander, Jane. "Factors underlying and maintaining nurses' attitudes to patients with severe personality disorder." Department of Mental Health Nursing, City University' August 2000, p. 6. Retrieved October 23, 2008, at  http://www.city.ac.uk/sonm/dps/research/research_reports/bowers_l/sdp.pdf 

Growing question in hospitals: Como esta?," Post and Courier (Charleston, SC). July 24, 2006. Retrieved October 23, 2008, at  http://www.highbeam.com/doc/1G1=148588515.html 

Hample, Henry. "When Doctors and Nurses Become Patients. Inside MS, June 22, 2000. Retrieved October 23, 2008, at  http://www.highbeam.com/doc/1G163690617.html

Life and Death: The Life Support Dilemma by Kenneth E. Schemmer M.D

Kenneth Schemmer in his thorough, thought provoking book brings to life the controversial subject of the life support issue. For years, many all over the country have pondered, "What if a person were in some kind of an accident and the physicians told them that they were not going to make it?" And all that he or she could do is just lie there in extreme pain waiting for their life to the end. Or even worse case scenario what if they happened to end up completely brain dead? These debated questions are taken on by Dr. Schemmer in making his point that life support decisions may not necessarily be the decision of the family, the doctor or the patient but by a higher being that gives life and takes life. Schemmer uses these controversial questions in his…

References:

Court backs right to die | terminally ill have right to refuse medical life support. (1984, Dec 28). The San Diego Union, pp. A.1-1.

Ackerman, T. (2005, Mar 27). Life support battle shifts / A decade ago, patients families had to press for 'right to die. Houston Chronicle, pp. 1-B.1.

Allen, P. (2000, Oct 07). Right to die upheld despite new euro law, doctors can end life support rules judge. Daily Mail, pp. 33-33.

Dolan, M. (2001, Aug 10). Justices deal setback to right-to-die movement; health: State court bans removal of life support from conscious patients whose wishes are not clear. Los Angeles Times, pp. A.1-A.1.

Mitchell, Ted, Tim Church & Martin Zucker. (2008). Move yourself: The Cooper Clinic medical director's guide to all the healing benefits of exercise (Even a little!). New York: Wiley.

Much has been written about the importance of reforming the American diet. However, there is an equally important aspect of fitness and the maintenance of a healthy weight: exercise. Move yourself: The Cooper Clinic medical director's guide to all the healing benefits of exercise (Even a little!) is a positive, upbeat book that proclaims the value of even small amounts of exercise, as a way of encouraging overweight Americans to change their negative lifestyle behavioral patterns. Given the multiplicity of prescriptions to Americans about the right way to 'move more' as well as to 'eat less' as the way of addressing their weight problems, it is worth considering the question as to if it is enough to do even small amounts…

References

Cloud, John. (2009). Why exercise won't make you thin. Time Magazine.

Retrieved December 7, 2011 at  http://www.time.com /time/magazine/article/0,9171,1914974-3,00.html

Mitchell, Ted, Tim Church & Martin Zucker. (2008). Move yourself: The Cooper Clinic medical director's guide to all the healing benefits of exercise (Even a little!). New York: Wiley.

Taubes, Gary. (2007). The scientists and the Stairmaster. New York Magazine.

Nursing Assessment

Taking the history of a patient is a crucial aspect of patient assessment and treatment. A good history can mean the difference between a successful patient outcome and unsatisfactory outcomes. However, taking a complete and useful history is a skill that is developed by means of training and practice; it is not some talent that is innate (Bickley & Szilagyi, 2007; McKenna et al., 2011). According to Craig (2007) nurses are increasingly being asked to take patient histories. Given these growing responsibilities nurses need training and guidelines to taking an adequate patient history. The following is a summary and critique of Craig, L. H, (2007), A "Guide to Taking a Patient's History" in Nursing Standard, volume 22, issue 13, pages 42-48.

Craig (2007) takes a comprehensive approach to explaining the interview and history taking process. This approach is applicable for most any patient population; however, Craig does not…

References

Alarcon, R.D. (2009). Culture, cultural factors and psychiatric diagnosis: Review and projections. World Psychiatry, 8, 131 -- 139.

Bickley, L.S. & Szilagyi, P.G. (2007). Bates' Guide to Physical Examination and History

Taking. 9th ed. Hagerstown, MD: Lippincott, Williams & Wilkins.

Craig, L.H. (2007). A guide to taking a patient's history. Nursing Standard, 22 (13), 42-48.

Invention and Summarize the Significance of the Underlying Technology Innovation

The device titled the Thornton Adjustable Positioner or TAP is an oral/dental device worn in the patient's mouth during sleep to move the lower jaw slightly forward to create an open airway for proper breathing while sleeping. The device or some like them have been previously tried on minor sleep disturbances such as snoring, yet, their efficacy has been unknown for more serious problems such as mild to severe sleep apnea. Sleep apnea, a disorder that creates oxygen deprivation during sleep and can moderately to severely affect the health of the individual first by depriving the individual of restful sleep and in more severe cases by creating oxygen deprivation that can lead to other chronic diseases or even acute death from asphyxia.

Up to this point the most commonly prescribed device for sleep apnea is a device that forces oxygen…

Resources

University of Texas Health Science Center at San Antonio (2009, February 4). Small Device Helps Sleep Apnea Sufferers In A Big Way.  http://www.sciencedaily.com/releases/2009/02/090203140147.htm

limiting free speech ID: 53711

The arguments most often used for limiting freedom of speech include national security, protecting the public from disrupting influences at home, and protecting the public against such things as pornography.

Of the three most often given reasons for limiting freedom of speech, national security may well be the most used. President after president, regardless of party has used national security as a reason to not answer questions that might be embarrassing personally or would show their administration as behaving in ways that would upset the populace. Although there are many examples of government apply the "national security" label to various situations, perhaps some of the stories that are associated with the Iran-Contra issue best display what government uses limitations on free speech for. In horrific tangle of lies double and triple dealing that resulted in the deaths of many Nicaraguans, the egan administration sought to…

References

Curtis, M.K. (1995). Critics of "Free Speech" and the Uses of the Past. Constitutional Commentary, 12(1), 29-65. Retrieved August 5, 2005, from Questia database,  http://www.questia.com .

Dan, W. (1989). On Freedom of Speech of the Opposition. World Affairs, 152(3), 143-145.

Reflections and Farewell. (2002). Social Work, 47(1), 5+. Retrieved August 5, 2005, from Questia database,

This is exactly where the problem usually starts.

There are a number of reports published which revealed that even the physicians are not so keen into attending more seminars and trainings to learn the new systems (Ball, 1992). Physicians are expectedly always busy. They sometimes work from hospital to hospital. They are always on call hence they really find it hard to squeeze in their thigh schedule the time for further training and semi-are regarding the system. At some point in time, physicians will also worry about their income that will be affected if they will get a time off just to attend the training.

In the same manner, most of the administrators, who will manage the new systems for the hospitals, also show signs of hesitance regarding the training. It must be noted that the being considered as a 'wired hospital' the institution must have uniform data standards (Aspden…

Works Cited

Aspden, P., J.M. Corrigan, J. Wolcott, and S.M. Erickson. 2003. Patient Safety: Achieving a New Standard for Care. Washington, DC: National Academies Press.

Ball, M. 1992. "Computer-Based Patient Records: The Push Gains Momentum." Health Informatics 9 (1): 36-38.

Bates, D.W., J.M. Teich, J. Lee, D. Seger, G.J. Kuperman, N. Ma'Luf, D. Boyle, and L. Leape. 1999. "The Impact of Computerized Physician Order Entry on Medication Error Prevention." Journal of the American Medical Informatics Association 6 (4): 313-21.

Benefits of it to Medical Profession  http://www.cica.org.uk/bre-cica_survey/ranking_of_it_benefits.htm . September 25, 2006

Even though users of light therapy are often advised not to look directly at the light source, the mechanisms of the eye focus incoming light onto the macula, the small region of the retina where vision takes place, and where age-related macular degeneration occurs. Since blue light wavelength make up only a small percentage of the light in white light, any form of light therapy using a high proportion of blue light therefore risks subverting a variety of defensive mechanisms that protect the retina against blue light hazard. These defensive mechanisms include the anatomical positioning and structure of eye and its surrounding features, as well as human posture, which makes it awkward for humans to gaze upwards for long periods of time. Sunnex iotechnologies, 2008)

The work of David H. Sliney entitled: "Ocular Hazards of Light" presented at the International Lighting in Controlled Environments Workshop states the following risks and…

Bibliography

Figueiro, M.G., J.D. Bullough, R.H. Parsons, and M.S. Rea. Preliminary Evidence for Spectral Opponency in the Suppression of Melatonin by Light in Humans. Neuroreport, Vol. 15, 2004, pp. 313-316 in: Figueiro, Mariana, Bullough, John D. And Rea, Mark S. (2007) Light isn't just for vision anymore: implications for transportation safety. United States Department of Transportation Lighting Research Center Region 2 University Transportation Research Center Polytechnic Institute 31 Dec 2 -- "7

Figueiro, M., et al. Demonstration of additivity failure in human circadian phototransduction. Neuro Endocrinology Letters, Vol. 26, 2005, pp. 493-498.

Ingling, C.R., E. Martinez, and a.L. Lewis. Tonic-Phasic-Channel Dichotomy and Crozier's Law. Journal of the Optical Society of America, Vol. 73, 1983, pp. 183-189 in Figueiro, Mariana, Bullough, John D. And Rea, Mark S. (2007) Light isn't just for vision anymore: implications for transportation safety. United States Department of Transportation Lighting Research Center Region 2 University Transportation Research Center Polytechnic Institute 31 Dec 2 -- "7 Report

Lack, Leon, Bramwell, Toby, Wright, Helen, and Kemp, Krystyn (2007) Morning blue light can advance the melatonin rhythm in mild delayed sleep phase syndrome

Shape of Things:

Theatrical Convention from Class: Suspension of Disbelief -- the audience is made to believe that a man or any person for that matter could become so obsessed with a single person that they are willing to completely change themselves, including having plastic surgery and destroying their interpersonal relationships for a person whose only appeal to them is a sexual one.

Potential Convention: Given the subject matter of the play and the heightened emotions the ending portrays at least on the part of one character that I would try to have the actors deliver their dialogue and their attitudes as realistically as possible.

In the Blood:

Theatrical Convention from Class: Pathos -- the audience is meant to feel sympathy for the main character of this play and to understand her sense of desperation and her inability to find a way to preserve herself and her sense of dignity…

Works Cited

Albee, E. (2000). The Goat or Who is Sylvia? Overlook TP.

Edson, M. (1995). Wit. Faber & Faber.

LaBute, N. (2001). The Shape of Things.

Parks, S. (1999). In the Blood.

Essay 2: In what collegiate extracurriculars did you engage? (400 characters)
As Vice President of Phi Kappa Sigma, I co-managed the annual $30k budget, participated in 100+ hours of community service, volunteered for the Rutgers Dance Marathon, raised funds for the Embrace the Kids Foundation, and organized the annual Phi-Esta fundraiser for the Eric Legrand’s Foundation with several other fraternities. I also volunteered for the Leukemia Lymphoma Society.
Essay 3: Did you work for compensation during college during the year or the summer? (300 Word limit)
Yes, every summer I worked full-time. During the summers of my undergraduate career, I worked at Selco Associates, a distribution and warehousing company. There I coordinated with management personnel to provide high quality customer service. I also managed apparel and footwear inventory for major companies and assisted in opening new accounts. This experience helped me to develop communication, organization, and problem-solving skills that I…

Heart hospitals are foregoing the traditional systems with a model known as patient-focused care. In this model patients stay in one room throughout the entire procedure, rather than the traditional method of waiting for beds to open as they transfer from one unit to another. This one-room approach also works to reduce the time spent in the hospital. The Heart Hospital, which has 12 beds, usually sends patients home in three days, in comparison to five to seven days in a conventional hospital.

In addition, medical staff is generally paid higher salaries at specialty hospitals. Nurses can earn between $5 and $7 more per hour than their counterparts in traditional hospitals (tringer, 2001).

A study by health care research firm HCIA.com in Maryland demonstrates that the amenities of specialty hospitals are winning over more and more patients (tringer, 2001). The study revealed that two public hospitals performed between 25% and…

Stringer, Heather. (January 22, 2001). Change of Heart. Nurseweek Magazine.

Terlep, S. (September 19, 2003). Hospital waiting room or living room? The Detroit News.

Wood, Kaitlin. (October 20, 2005). Hospital aims ads to attract patients. Stanford Daily.

Direct to Consumer Advertising

HISTRY F DRUG ADVERTISING

THE DTC ADVERTISING PHENMENN

CREATING DEMAND

DECEPTIVE ADVERTISING - A WLF IN SHEEP'S CLTHING

CAUSE F DEATH

PRFIT

UTILIZATIN, PRICING, AND DEMGRAPHICS

LEGISLATIN, PLITICS AND PATENTS

LEGISLATIVE INITIATIVES REGARDING DTC

RECALLED and/or DEADLY DRUGS

In order to provide the most efficient method of evaluation, the study will utilize existing stores of qualitative and quantitative data from reliable sources, such as U.S. Government statistical references, University studies, and the studies and publications of non-profit and consumer oriented organizations. Every attempt will be made to avoid sources of information sponsored by or directly influenced by the pharmaceutical industry.

Existing data regarding the history, levels, content and growth of direct-to-consumer advertising will be examined. In addition, the industry's composition prior to and after the proliferation of direct-to-consumer advertising will be examined, with regard to market share, type of substances sold, benefits of substances sold, and…

On January 9, 2002, Dr. Darlene Jody, Vice President of Medical Marketing for Bristol-Myers Squibb, issued a manufacturer's "Important Drug Warning Including Black Box Information." The Important Drug Warning advises healthcare practitioners that "cases of life-threatening hepatic failure have been reported in patients treated with SERZONE." The manufacturer's Warning indicates that numerous persons have or will suffer liver failure, death or transplantation. The manufacturer's Warning also indicates that the current estimate of the rate of liver failure associated with Serzone use is "about 3-4 times the estimated background rate of liver failure." A new Warning is being added to the Serzone prescribing information, advising that "patients should be advised to be alert for signs and symptoms of liver dysfunction (jaundice, anorexia, gastrointestinal complaints, malaise, etc.) and to report them to their doctor immediately if they occur." According to Warnings, Serzone should be promptly discontinued if signs or symptoms suggest liver failure.

Vioxx belongs to a class of drugs known as COX-2 inhibitors. When the drugs were introduced a few years ago, COX-2 inhibitors were thought to be safer and more effective than other drugs such as Aspirin and Ibuprofen. However, several studies have questioned the cardiovascular safety of Vioxx. Studies indicate that people taking Vioxx have four times the risk of a heart attack.

In May 2002, the U.S. Food and Drug Administration (FDA) published a Talk Paper about new label warnings for the popular arthritis and pain drug know as Vioxx (rofecoxib). The new label warnings are based on the results of the Vioxx Gastrointestinal Outcomes Research (VIGOR). According to the FDA, recent studies demonstrate that Vioxx is associated with a higher rate of serious cardiovascular thromboembolic adverse events (such as heart attacks, angina pectoris, and peripheral vascular events). Based on the recent study, the FDA agreed with the Arthritis Advisory Committee recommendations February 8, 2001 that the label for Vioxx include gastrointestinal and cardiovascular warning information. Serious side effects attributed to Vioxx are heart attacks, seizures, strokes, or liver/kidney problems.  http://www.recalleddrugs.com

An adult do not need to make all decisions in advance, but educating oneself is a vital first step. (Death with Dignity: Planning Ahead for End-of-Life Care) few guidelines for signing a DN order are given here. A Do Not esuscitate Order - DN is a physician's order to not to employ cardiopulmonary resuscitation - CP in case of cardiac or pulmonary arrest. Competent adult patients may relinquish CP for medical or non-medical reasons. The patient may make such requests verbally irrespective of whether or not he/she is fatally ill. An appeal to relinquish CP may also be part of an Advance Directive. When it has been determined that the patient is short of decision-making capacity, the suitable substitute decision-maker should be recognized to make treatment decisions, including decisions to relinquish CP, if no such person has been appointed by an Advance Directive. If the patient is out of action,…

References

Care of the Sick and Dying. Roman Catholic Bishops of Maryland. Retrieved at  http://www.mdcathcon.org/Care.htm . Accessed on 17th March 2005

Collins, Tony. Dealers of Death. Retrieved at  http://www.envoymagazine.com/planetenvoy/Update-TCollins-TerriS-Jan04-Full.htm . Accessed on 17th March 2005

Dealers of Death. 30 November, 2004. Retrieved at  http://www.catholicexchange.com/vm/index.asp?vm_id=2&art_id=26177Accessed  on 17th March 2005

Do not Resuscitate- DNR Orders. 1 January, 2001. Retrieved at  http://www.healthsystem.virginia.edu/internet/housestaff/policy-manual/dnr.cfmAccessed  on 17th March 2005