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Eight-year-old Jim Morris, wading in the warm current off Florida’s Gulf Coast, swam easily toward his sister Amy and his uncle Robert. But the kids’ fun in the shoulder-deep water was cut short by Jim’s shouts of “Get it off me! Get it off me! ” Amy’s screams sliced through the peacefully rolling breakers like a knife, “Help! A shark has bitten off my brother’s arm! Call 911! ” Nearby swimmers heard the cries as Uncle Robert yelled, “Help us get the shark. It swallowed the arm! ” The swimmers converged on the spot, grabbing the six-and-a-half-foot bull shark by the tail and holding on for dear life.
The twitching shark was hauled ashore barehanded by the group of men and shot. They pried open the shark’s mouth while Robert pulled Jim’s right arm out from between its jaws. As the boy’s blood soaked into the white sand, lifeguards began CPR and applied a tourniquet. Paramedics arrived to stabilize Jim for transport to nearby Coastal Hospital. His arm was packed in ice and taken along. In the emergency room, Dr. Elaine Rogers, the physician on duty, quickly ordered multiple transfusions to restore the boy’s blood supply as the ER team began stabilizing his vital signs. Dr. Rogers began assembling the operating room team that would attempt to reattach Jim’s arm. She called Ronan McBane, a microvascular surgeon, at his home. “Ronan, we have a cleanly severed arm due to a shark bite.
It looks like it was just chopped off, with not much shredding of the tissue. The sharp-edged teeth of the shark bit through the boy’s arm so cleanly it almost seems to have been severed by a cleaver. The boy is eight years old and, although he is still in pretty bad shape, we think that since the arm was recovered and is in reasonably good condition, we have a good chance at success. Further conversation convinced Ronan that reattachment was possible. By the time Dr. McBane arrived, the other members of his medical team had started scrubbing for the 12 hours of surgery that would be needed to reconnect Jim’s muscles, bone, and nerves. Dr. McBane announced to the watching interns: “This arm was severed about four inches above the elbow. I want first to identify the muscles, blood vessels, and nerves in both the arm and the stump. We’ll mark each of these with sutures so that once Dr. Ramos has trimmed the wound and put in the supporting plate, we’ll be able to come back and hook everything up. ” Once the sutures were in place, orthopedic surgeon Juliet Ramos explained her role: “I’m going to trim bone on each side of the cut so that we can put in a plate that will keep the two parts of his arm together. This procedure will make the right arm a little shorter than the left one, but the one-inch difference shouldn’t be too noticeable. ” After the plate was screwed in, Dr. Ronan said: “Jim’s arm is now intact from the shoulder to the hand, but the hard part is just beginning.

We must now reattach each of the muscles and nerves on either side of this gap between the shoulder portion and the severed arm. We will also need to harvest the saphenous vein in order to reconnect some of these vessels. ” Several hours later all of the blood vessels and nerves were connected. Dr. Ronan removed the clamps from the brachial and other arteries and blood started flowing once more through Jim’s arm, bringing it to life again. As Jim was sent into the recovery room, Dr. Ramos and Dr. McBane looked at each other with relief.
The two surgeons then left the operating room to explain the operation to Jim’s parents. Although the prognosis for their son’s recovery was good, one sentence spoken by Dr. Ramos stood out to Mr. and Mrs. Morris: “It is unlikely Jim will ever regain complete use of his arm and hand. ” Note: These events are based on the real-life case of Jessie Arbogast, whose arm was bitten off by a bull shark near Pensacola, Florida, on July 6, 2001. Study Questions Look up information in your notes, text, atlas, the library, and the web about the arm and reattachment.
List the additional resources you use to answer the following questions: 1. Identify at least five organ systems in this region of the arm that the surgeon would have marked for reattachment. 2. List the names of the specific structures that had to be reattached. 3. What organ system was most likely not reattached? Write my Essay Online Writing Service with Professional Essay Writers – Explain. 4. Why was a clean bite so important? 5. Why was the bone shortened? 6. Identify the movements associated with the arm, forearm, wrist, and fingers. 7. Write my Essay Online Writing Service with Professional Essay Writers – Explain how the movements of the reattached arm might be altered after the reattachment. 8. Define collateral circulation and identify the regions of collateral circulation that would be found in the upper extremity. 9. Identify the specific vessels that provide the collateral circulation to the elbow.
10. Identify specific types of activities that might cause Jim problems after recovery. 11. Why would full use of his arm be unlikely? 12. Assume the role of the surgeons as they explain the procedure to Jim’s parents. Write a one- to two-page explanation about the surgery, paying particular attention to what you would say about regaining use of his arm, forearm, and hand. 13. Assume the surgery to reconnect blood vessels was successful and blood flow was re-established immediately throughout the arm. Would the nerves of the arm recover as quickly and completely as the muscles? Write my Essay Online Writing Service with Professional Essay Writers – Explain why or why not. 14. How might this situation have been different if Jim had been 80 instead of 8 years old? Image Credit: Photograph of bull shark by John Bantin. Copyright 2000. Used with permission. Date Posted: 05/24/02 nas. Revised 08/20/02. Copyright © 2003 by the National Center for Case Study Teaching in Science. Please see our usage guidelines, which outline our policy concerning permissible reproduction of this work.

Melisa A. Smith Dr. Kathryn Skulley Eng 122-500 22 November 2011 Crisis in America Back in the late 1930’s, American men were drafted to go off and fight in World War II while women at home had to learn a new way of life to support their families and support the soldiers. A woman named Florence Nightingale who was recognized as one of the first nurses to care for the wounded soldiers during the Crimean war helped to influence other women to learn how to become nurses and care for the sick and wounded.
After the war ended in the mid 1940’s, thousands of soldiers returned home to begin the next chapter in their lives by starting a family while women returned to homemaking. In fact, due to the major population shift after the war, thousands and thousands of babies were born in which it would be named the Baby-Boomer generation. Now fast forward to the year 2010, several decades later, the baby-boomer generation is aging and approaching there sixties and beyond at a time when healthcare is beginning to be used more frequently by many others.
Now that America is beginning a new era of healthcare with the creation of healthcare reform that soon will create access for the uninsured and underinsured to gain access to healthcare treatments. On March 23, 2010, “The Affordable Care Act” was signed into law by President Obama that would create healthcare access for millions of Americans. This is turn would create a huge strain on the American healthcare system at a time when concerns are rising due to the increased need of services for the baby-boomer generation and the current nursing population to care for them.

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If Americans already planned on facing a nursing shortage with the baby-boomer generation, then how would the shortage affect everyone else when healthcare reform becomes active in the year two-thousand-fourteen? This paper will discuss some individual points more in detail and evaluate the nursing shortage situation from the beginning of nursing history to present day that could affect all healthcare workers now and in the future. The nursing shortage topic in America has always been a debatable question where it will be analyzed further in detail starting with some statistical data.
Looking at the national level for current nursing employment, the U. S. Bureau of Labor and Statistics stated that, “2,655,020 registered nurses were currently employed as of May two-thousand and ten” (U. S. Bureau of Labor and Statistics: Occupation section). The information presented here did not account for self-employed nurses or one’s that currently work multiple jobs. Now on a smaller scale looking at the State of Colorado’s population and registered “nurses per 1000 rate is 7. 98 as compared with a national average of 8. 6 with an additional need of 1,780 nurses to meet the national average” (The Demographic Challenges Facing Colorado’s Health Care Workforce 15). The information noted here did not account for rural areas and small towns where the population is considerably lower. Next, the discussion will continue on about nursing school factors affecting the nursing shortage. Additionally when someone is attracted by the potential for a nursing career and advancement, they must look at all avenues first before deciding and making a commitment to nursing school.
However, when someone has made the decision to enroll they must take several prerequisite classes and take a nursing entrance exam before being accepted into a nursing program. Furthermore, after students have taken the required prerequisites, they may not easily be accepted into a nursing program because of limited number of slots available and teaching constraints. In fact, it has been well observed by many schools that the major factor in the nursing shortage is due to the lack of qualified nursing instructors.
In the United States, “nursing schools turned away 67,583 qualified applicants from baccalaureate and graduate programs in 2010 due to insufficient number of faculty, clinical sites, classroom space, clinical preceptors and budget constraints” (2010-2011 Enrollment and Graduations in Baccalaureate and Graduate Programs in Nursing 2). Another factor that contributes to the nursing shortage is that nursing faculty members and educators are being lured away from colleges by higher compensation, which in turn reduces the number of potential educators to meet the demands needed.
Consequently, most educators are generally older with a limited number of years of teaching left before retirement which in turn could also leave more potential nurses waiting on a list that could reduce the national shortage. Furthermore, the United States started facing some major healthcare challenges with the baby-boomer generation beginning to impact the healthcare system in two-thousand ten. Now that this generation is in their sixties many of them will be facing increased health problems due to aging thus putting a greater demand on the healthcare system for treatment and prevention.
Consequently, this generation will begin turning sixty-five at a rate of approximately ten thousand baby-boomers per day for the next nineteen years starting in the year two-thousand eleven. This in turn will create a huge stressor to the already problematic nursing shortage. In addition to the baby-boomer generation, America will soon be forced to provide healthcare to millions of individuals who previously did not have insurance starting in two-thousand fourteen when the Affordable Care Act goes into full force.
Furthermore, “healthcare reform will soon provide subsidies for thirty-two million citizens to more fully utilize the healthcare system” (Joint Statement from the Tri-Council for Nursing on Recent Registered Nurse Supply and Demand Projections 2). This in turn will create a huge stress on the medical profession especially the nursing sector, as the healthcare system is grappling in the shortage of nurses to care for the baby-boomers. Emergency rooms and physicians’ offices will soon be faced with a massive influx of patients to provide care for, which would cause an increased demand for more medical staff including nurses and physicians.
Patients then would be going to local hospitals for elective surgeries and diagnostic testing which would cause a surge and a need for more hospital beds to accommodate the needs of patients. When the demand exceeds the amount of resources available people could be facing other challenges such as emergencies or disasters of magnitude. With the introduction of the healthcare reform and the baby-boomer generation, the healthcare system could also be facing emergency preparedness scenarios that have not been attempted before with the combination of emergency disaster plans currently available.
Some may remember the hundreds killed and injured from the two-thousand eleven tornado outbreak or the terrorist attacks on the twin towers that caused mass casualties and injured numerous people on September 11, 2001. This is just to name a few disasters that America was impacted by with the need for emergent healthcare services. Additionally in the United States, “there is little flexibility for unanticipated fluctuations in patient acuity and demand on a daily basis, and an absence of standby capacity for large-scale emergencies” (McHugh 442).
Consequently, if the United States doesn’t come up with a large scale disaster plan that has been attempted before, then many will be faced with total destruction and demise. Nurses have gone through the grueling process to begin and succeed in their careers from the dedication of going to school to meet entry level standards, as well as taking the national licensure examination prior to practicing. Some nurses graduate with the expectation that the wages and demands of the job will be satisfying to keep them in their current role.
But some people may know very little about the profession until they are faced with the reality of the job demands versus the salary. A new graduate nurse just beginning his/her career maybe making less than the more experienced nurses, but still held to the standard of providing the same type of care to all patients. According to the U. S. Bureau of Labor and Statistics, the national median wage for registered nurses as of May two-thousand ten was “$67,720 annually” (U. S. Bureau of Labor and Statistics, Occupational Employment and Wages).
However this statistic did not report the level of education held other than the title of registered nurse. Furthermore, nurses are held to a high standard to uphold to their duties and continue to give accurate, compassionate and safe care to all patients. Nevertheless, nurses play many roles other than a care-taker or pill pusher, they are expected to know about possible medication interactions that could harm a patient since they are the last line of protection for patient. Nurses have also been trained to think critically in times of crisis and to intervene with life-saving interventions without the supervision of a physician.
Many of the “hazards on the job, include blood and body fluid exposure as well as musculoskeletal injuries related to ergonomic hazard from lifting and repetitive tasks” (Stone et al. 1984). During times of busy patient demands, nurses may also run the risk of harm to themselves, especially during the administration of an injection that could cause a needle puncture that may potentially be from an infected needle, or come in contact with the splashing of body fluids on exposed skin.
However, many hospitals have currently up-graded equipment to help prevent unwanted needle stick exposures through the use of needle free systems, but there is still work to be done to keep nurses and patients safe. Furthermore, nurses may also be exposed to occupational injuries while lifting a patient in bed, or when a patient falls on a staff member and injures them in the same turn as well. Obviously some hospitals have improved the safety for staff, and patients with the use of lifts or ssistive devices, but time maybe of essence. With this in mind, the physical and mental demands of the nursing profession may take a toll on a person’s body, or it may potentially provoke thoughts of a career change from the risks involved. However, since nurses are also held accountable for mistakes made even when times are proven difficult, in hind sight turn this could potentially create a stressful environment full of expectations without satisfaction.
Furthermore, “nurses’ working conditions have been associated with medication errors and falls, increased deaths, and spread of infection, but nurses report making more errors when working shifts greater than twelve hours, working overtime, or working more than forty hours per week” (Stone et al. 1984). In some hospitals nurses are given an assigned number of patients to care for, but patients are coming into the hospitals’ sicker than in previous years which can create a dilemma when assigning patient care.
Some hospitals’ have been designated as a Magnet hospital where the maximum ratio is one nurse to five patients which could help ease some demands to be able to provide better care to patients, but this trend is still new to some healthcare systems. On a typical working shift nurses are responsible for medication administration, physical assessments and general care of the patient, but during times of staffing shortage nurses may have to provide all the care for all assigned patients.
Generally speaking, nurses care for four to eight patients per shift while “an additional patient within this range was associated with a seven percent increase in the odds of dying within thirty days of admission and a seven percent increase in the odds of death following complications such as shock or pneumonia” (Keenen 1). In addition patients have a greater risk of infection due to lack of adequate infection control from proper hand washing by healthcare staff when staffing shortages occur.
When nurses are held accountable for a certain number of patients, and one person falls out of bed down the hall while they were getting another patient up to the bathroom can create an unsafe and unsatisfactory environment for all involved parties that in turn can cause higher morbidity in patients. With a stressful environment and combined fear of making a mistake which would result in punitive action against them, “the U. S. healthcare system contains a safety climate which blames individuals for errors instead of the system or organizational failures that may really be at fault” (Fox and Abrahamson 235).
With that said, more nurses feel pressured to not make any mistakes instead of being human. However, when hospitals’ are dealing with staffing issues and nurses are not able to give proper attention to their patients this in turn could create a dangerous situation for patients that have an increased mortality risk due to complications or co morbidities. Studies have shown that staffing insufficiencies increase the mortality risk in patients due to the inability to adequately care and educate patients on complications such as pneumonia or bloods clots which can be proven fatal.
Nurses are also expected to perform many tasks that include life saving techniques in critical situations, but in order to keep these individuals with these skills employed by a specific facility it takes a clever approach to nursing retention. However, “research shows that nurses contribute heavily to the quality of patient care, reimbursement based upon performance outcomes would likely increase the economic value of nurses, thus improving wages, work environment and recruitment and retention” (Fox and Abrahamson 235).
In the past, when hospitals were dealing with nursing shortages some would offer a sign-on bonus or a contract to pay for a portion of education expenses as an incentive to attract employees for difficult to recruit positions such as night shifts. Due to cost constraints some facilities were beginning to do away with sign-on bonuses and offer other assistance after a specific time period of employment. On the contrary, most facilities do not recognize nurses with compensation based on performance other than an increase in cost of living wages, but could benefit further through increased recognition programs.
Since World War II the nursing profession had always been a female dominant profession until now, with the addition and encouragement of male nurses in the profession. Most patients saw nursing as a female dominant profession due the delicate nature of caring for sick patients and the need for gentle interactions and nurturing. Furthermore, working conditions were often poorer in nursing with a predominately female occupation.
During times of economic recession more nurses were choosing to work, or continue employment to help meet the financial expectations of their households especially in times when other family members are facing a layoff or furlough. Although when the economy improves the shift of nurses actively working may change and create an even bigger nursing shortage while some may change careers or retire all together. Furthermore, with the introduction of men in nursing things have begun to change and more and more men were joining the nursing profession for career stability and advancement opportunities in an already female dominant profession.
A man named James Derham “in 1783 who was a slave earned money to buy his freedom by working as a nurse” making him the first male nurse (Bonair and Philipsen 19). Nursing schools began offering scholarships to male nursing students as a way to attract more people to the nursing profession. With men in a female dominant profession they were making up “five to ten percent of the workforce in the UK, USA and Write my essay for me – CA Essay writer Canada” while in the nursing profession they were more likely to be promoted into leadership roles (Brown 120).
Male nurses generally started a nursing career at a younger age compared to their female counter parts. As working nurses were getting older many of them were planning for retirement at a time when a majority of people were retiring with the baby-boomer generation. More and more people began to choose a nursing career later in life, so consequently most nurses ended up retiring earlier due to the strains of the job or age factors. Consequently, the average age of nursing students graduating was thirty-one, while the average age of the working nurse is forty-six years old.
Due to the popularity of nursing for some it is becoming a second career for individuals after many years of employment in other fields such as business, or computer industries that have had many changes and layoffs that contributed to the employment shift. With this new employment shift new nurses that began a nursing career as older adults are not working in the field as long and retiring sooner. Furthermore with the short periods of nursing employment, this again creates problems with fixing the nursing shortage across the country.
Now that the factors of the nursing shortage have been described in detail, the next discussion will be about ways to fix the nursing shortage problem in America from the faculty shortage to loan forgiveness programs. If America is going to get out of the nursing shortage crisis the first step is to address the shortage of educators, and nursing faculty that teach and train the future nursing students. In order to create an interest in teaching there needs to be some changes with regards to income levels, and more education assistance to give nurses the ability to increase their knowledge. Some hospitals ffer opportunities to take a leave of absence from their jobs to pursue further education options without the fear of job loss. However, this in turn would not only be an asset to the individual but the facility as well that encouraged their employees to seek more education. Another factor in the nursing shortage is the number of clinical sites needed to give adequate clinical experiences for nurses to learn in. In hospitals today nursing schools generally have clinical experiences five days a week instead of an additional two days on the weekend to meet more needs of clinical experience time.
By offering the additional two days per week, nursing students would meet their clinical expectations ahead of schedule therefore they could graduate earlier and begin nursing practice sooner. This in turn would help to ease the shortage of trained nurses sooner and decrease the waitlist time for entrance into nursing school. In order to attract more nurses to continue advancing their education there needs to be more monetary compensation to pay for the cost of education in order to encourage more nurses to advance into teaching.
Furthermore in order for the healthcare system and colleges to meet the recruitment demands and the shortage requirements there needs to be some collaboration between facilities for education and tuition assistance. Consequently to address the aging of the nursing faculty, more people need to be encouraged to continue their education without any lapse of time after graduation. Nevertheless, since most nurses cannot afford to pay for the higher expenses of college and continue to work then only a selected few would advance their education.
However, some nurses may choose not to continue their education due to conflicts with work schedules and family, unless there was some loan assistance or forgiveness program widely used. The United States currently has loan forgiveness programs that pay the entire amount of the loan after requirements are met. Furthermore, after a nurse has completed two years of service in a hospital then they can apply for the loan forgiveness program that may take up to six months before a decision is made, and only a limited number of individuals are selected.
In addition, if the United States invested in more healthcare facilities and offered more loan assistance and scholarships then people would be more attracted to the nursing profession and possibly reduce the nursing shortage. In conclusion, after discussing the many challenges that the nursing profession faces, it is still considered a highly respected field by many but may not be the choice for everyone. However, until the United States aggressively pursues a solution to the nursing shortage, better wages, and working conditions, then healthcare reform will define the critical needs of nurses that may end up costing more lives than money.
In the end, if the nursing shortage continues, it could be catastrophic to American society at a time when healthcare has made so many advances to increase the life expectancy rate. Works Cited “2010-2011 Enrollment and Graduations in Baccalaureate and Graduate Programs in Nursing. ” Fact Sheet-Nursing Shortage (2011). <http://www. aacn. nche. edu/Media/Factsheets/NursingShortage. htm>. Bonair, Jennifer, and Nayna Philipsen. “Men in Nursing: Addressing the Nursing Workforce Shortage and Our History. ” Maryland Nurse.
CINAHL Plus with Full Text. EBSCO, 10. 3 (May-July 2009): 19. Web. 29 Oct. 2011. Brown, Brian. “Men in nursing: Re-evaluating masculinities, re-evaluation gender. ” Contemporary Nurse: A Journal for the Australian Nursing Profession. CINAHL Plus with Full Text. EBSCO, 33. 2 (2009): 129. Web. 29 Oct. 2011 Fox, Rebekah L. , and Kathleen Abrahamson. “A Critical Examination of the U. S. Nursing Shortage: Contributing Factors, Public Policy Implications. ” Nursing Forum. CINAHL Plus with Full Text. EBSCO, 44. 4 (Oct-Dec. 2009): 244. Web. Sept. 2011.
Joint Statement from the Tri-Council for Nursing on Recent Registered Nurse Supply and Demand Projections. AACC, n. d. Web. 4 Sept. 2011. <http://www. aacn. nche. edu/Media/NewsReleases/21/tricouncil. html>. Keenen, Patricia. “The Nursing Workforce Shortage: Causes, Consequences, Proposed Solutions. ” Issue Brief. CINHL Plus with Full Text. EBSCO, (2003): 6. Web. 31 Oct. 2011. McHugh, Matthew D. “Hospital Nurse Staffing and Public Health Emergency Preparedness: Implications for Policy. ” Public Health Nursing. 27. 5 (Sept/Oct 2010): 449.
CINAHL Plus with Full Text. EBSCO. Web. 29 Oct. 2011. Stone, Patricia w. , et al. “Nurses’ Working Conditions: Implications for Infectious Disease. ” Emerging Infectious Diseases 10. 11 (2004): 1989. Web. 28 Sept. 2011. <http://www. cdc. gov/eid>. The Demographic Challenges Facing Colorado’s Health Care Workforce. Colorado Center for Nursing Excellence, n. d. Web. 4 Sept. 2011. <http://www. coloradonursingcenter. org/colorado>. U. S. Bureau of Labor and Statistics. Occupation: Registered Nurses. http://data. bls. gov, May 2010. Web. 1 Nov. 2011.

Major Research Areas of Bioinformatics Engineering is a diverse discipline, which includes several different fields and different branches. One important branch of engineering is biomedical engineering that consists of the study and design of new technologies related to biology and medicine. The field of biomedical engineering is further divided into additional areas, one being bioinformatics.
Bioinformatics is a special part of biomedical engineering that focuses mainly on the development and enhancement of approaches for the purpose of storing, retrieval, organization and analysis of different forms of biological data. The field includes the development of different software tools that provide biological knowledge and advancements. One major part of bioinformatics is research and thus we would discuss some of the major research areas of bioinformatics. Sequence analysis is a new and one of the most important research areas of bioinformatics.
It is nothing but the study of the DNA and genome sequences of different organisms. The study of such sequences help in the comparison of genes and thus leads to the development of new approaches and new technologies for the development and use of genome sequences for different purposes and for the development of new species. These studies can even be used for the identification of causes and treatment options for genetic disorders. Evolutionary biology is another major research area that makes use of bioinformatics for further developments.

Biology is no longer limited to theories and theoretical models and studies. Bioinformatics is used in different ways for calculating different aspects of biology, whether it is DNA sequencing or some other numbering. The research in computational evolutionary biology helps in examining the information related to different species and organisms that can be further used for the enhancement of the field into future developments. The study of protein expression is also a major research area for bioinformatics.
The working of the human body or any other organism on earth is highly dependent on the way the proteins in their bodies work and function. Thus, an analysis of proteins present in the bodies of different organisms helps in better statistical and theoretical analysis. Cancer mutations are difficult to analyze and study but not for bioinformatics. The examination of the cancer mutations is one of the major research areas of bioinformatics and thus can slowly and steadily helps in the treatment of he currently incurable disease of cancer. This research area includes several things, starting from the study of tumor lesions to the mutants that can help in curing the disease. The research areas of bioinformatics are vast and include several different areas and fields. Comparative genomics, network and systems biology and high-throughput image analysis are some of the other research areas and these areas would continue to multiply in number with time. Reference link: http://classof1. com/homework-help/engineering-homework-help

Micro-environment is preferred as the operating system’ which includes the forces that has significant impacts on and can affect the organization’s ability to operate and serve its customer (Chaffed et al, 2009). This is influenced by the need of customers and how services are provided to them through the competitors, marketing intermediaries, and suppliers within the marketplace (Chaffed et al, 2009). 1 .
Customer Eurasia provides to its customers the basic flight carrier service and carry the customer ‘s purpose of traveling between different destinations, but at a lowest fare mongo other airlines. (Eurasia Annual Report, 2010) The customers of Eurasia are mostly from low and middle class people in society. The customers choose the company not only for the purpose of traveling but also for cheaper price. Eurasia airline is well known as a low cost leader in Asia.
However, Airs is currently more focusing on short haul flights and less operating for long haul flights, as the company is not yet ready because long haul flight would be costly and less effective business model for now when the economy is still not stable 0. Thus, almost all the customers f Eurasia are those who are looking for short flights in the region. Today’s, Internet is very familiar with everyone and it initially becomes a common place for searching and buying products online.

This has greatly increased the power of customers, since they have widely gain the use of internet to evaluate products and compare prices (Chaffed et al, 2009). Understands that Eurasia has mainly operate its business online and improve all the functions of website and a friendly interface which attracts many internet users to book their flights online. 2. Competitors The main competitors of Eurasia are low cost airlines such as Strata, Tiger, Virgin and other regional airlines such as Vietnam airline, Malaysia airline, Indonesia airlines and Singapore airline.
Although, the competitions are identified from three main approaches which are the competition within business desire, the competition in low cost format, and the competition between low cost carriers (Airline Industry Report, 2011). First, Eurasia is currently facing fierce competition from the full service airlines on common routes. All the airlines have used price measures to combat Eurasia, using innovative yield management system which is allowed up to 30 days for advance purchase and enhancing frequencies on the loyalty campaigns by giving discount and added benefits.
Example, Thai airline keep the price unchanged for long advanced purchase. Second, Full service airlines can compete by establishing their Microeconomic By dangling 29 instance, Quanta’s has established Strata to compete with other low cost airlines. Third, with the successful run of low cost carriers like Eurasia and unlimited frills operations in Asia region skies, it is likely that more players will enter the market and urging this business design will inevitably be intense. 3.
Intermediaries Eurasia is offering a wide and innovative range of distribution channels to make booking and traveling easier (Eurasia. Com). Creating the partnership with other service providers such as hotels and hostels, car rental firms, hospitals (medical tourism), Citibank (Eurasia Citibank card) has helped the customer to obtain the low full service fare from simple booking to hotel reservation and car rent. Furthermore, Eurasia allows travel agent to from around the world to connect with Eurasia for heckling flight details and make bookings in regard of customers requests.
Besides, The links with Manchester United which one of the world’s most famous football teams and AT&T Williams Formula One team can help to expand the company brand to further geographic destination. (Eurasia. Com) II. Macro-environment Macro-environment is the societal forces that affect the whole micromanagement, which include demographic, geographic, economic, natural, technological, political and cultural (Kettle et al, 2010). 1 . Demographic force Job catalogue and income aspects are the key focuses of Eurasia for targeting the segmentation(Kettle et al, 2010).
Most the customers of Eurasia are students and low or middle class income people. Students and low incomes people are likely to concern more about fare price, while middle income people want a balance between price and quality. Eventually, Asia is becoming the potential market of the world and this creates more opportunities for traveling and carrier services especially in Asia Pacific region. 2. Geographic force Choosing and activating flight destinations of an airline is critically important, as it will affect the productive of market scale and business expanding trend (Kettle et al, 010).
For Eurasia, the current cities and countries that it is mostly operating are the big cities in Asia and no local flight in one destination country. This tactic can achieve the faster expanding market goal (Eurasia Annual Report, 2010). The customers’ consumption propensities are differential as national differences Cones ; Misspell, 2007) which mean of differences in culture. However, Asia has tried to build up a mixture of cultures and to give different experiences to its customers.
In general, Asia cultures prefers to spend less money and save more, thus spending too expensive flight ticket for traveling is still not an absolute choice for all the Asia customers and because of the slowdown of world economy, choosing a good and adequate price for the flight is becoming more optimal. Ill. SOOT ANALYSIS 1. 0 Strengths Air Asia has a very strong management team with strong links with governments and airline industry leaders. Building these powerful relationships have brought to Eurasia many guarantees from the governments as well as supports from other big companies such airplane producers.
For example, Shin Corp. (formerly wend by the family of former Thai Prime Minister – Taking Sinatra) holds a 50% stake in Thai Eurasia. This has helped Eurasia to capture the market in Thailand easily (. Besides, Eurasia has also known how to manage good relationship with Airbus, Which bring big discounts for Airplane purchase and the airplane is also more fuel efficient compared to Boeing 737 planes which is being used by many other airlines . Eurasia is also very good in strategy formulation and execution.
Their strategy formulated at the beginnings was a clever combination of proven strategies by other owe cost airlines in US and Europe. They are Ryan’s operational strategy (no frills, landing in secondary airport), Southwest’s people strategy (employee comes first) and Asset’s branding strategy (linking with other service providers like hotels, car rental). Raisin’s brand name is well established in Asia Pacific. To obtain the strong brand equity and well known brand name, Eurasia has being focused on its media advertising ; promotions.
Additionally, The partnership with other service providers such as hotels and hostels, car rental firms, hospitals (medical tourism), Citibank Eurasia Citibank card) has substantially created a very unique image among travelers. Furthermore, Using GAS system (Global Distribution System) that enables travel agents from around the world to check flight details and make bookings to Eurasia have also contributed to their brand name. Air Sais’s local presence in few become a regional brand.
Moreover, The links with Manchester United which one of the world’s most famous football teams and AT Williams Formula One team have further boosted their image to a greater extend beyond Asia regions. Eurasia is the low cost leader in Asia. Eurasia has successfully created a “low- cost airline mentality’ among their workforce and their customers. The workforce is very flexible, high committed and very critical in making Eurasia the lowest cost airline in Asia. Besides, Eurasia keeps the cost low by enabling direct purchase of tickets for consumer, thus saving from airline agent fees. . 0 Weaknesses Air Asia does not have its own maintenance, repair and overhaul (MR.) facility. With few hubs (Malaysia, Thailand and Indonesia) and over 100 planes currently owned and about another 100 planes to be operated in the next few years, Eurasia eave to ensure proper and continuous maintenance of the planes, otherwise it would not keep the overall costs low. Eurasia receives large number of complaints from the service. Examples of complaints are about flight delays, being charged for a lot of things and not able to change flight or get a refund if customers could not make it. . 0 Opportunities There are 2 major events that will effect the airline industry which are taking place now or going to take place in less than 6 months from now. First, it is the increasing oil price and the second event is the “SEAN Open Skies” agreement. The increasing oil price at the first glance may appear like a threat for Eurasia. However being a low cost leader, Eurasia has an upper hand because its cost will be still the lowest among all the regional airlines if it can manage not to increase the cost over other regional airlines.
Thus, Eurasia has a great opportunity to capture some of the existing customers from other low cost airline’s customers. Besides, The “SEAN Open Skies” allows unlimited flights among Jean’s regional air carriers beginning December 2008. This will definitely increase the competition among the regional airlines. However, with the “first mover” advantage as well as its strengths in management, strategy formulation, strategy execution, strong brand and low fare full service, this agreement can be seen as more of an opportunity. Ewe routes and airport deals. The population of Asian middle class has being increasing significant. The diversity of global wealthy has been shifted to new Asia which increase the wants for traveling in Asia. This creates a larger market and a huge opportunity for all low cost airlines in this region including Eurasia. 4. 0 Threats Certain rates like airport departure, security charges and landing charges are ended the control of airline operators and this is a threat to all low cost airlines which destroys the sustaining effort of low fare price.
For example, Changing airport in Singapore charges SEDGE for every person who departs from Singapore. Raisin’s profit margin is about 30% and this has already attracted many competitors. Most of the full service airlines have or planning to create a low cost subsidiary to compete directly with Eurasia. For example, Singapore Airlines has created a low cost carrier Tiger Airways. Besides, These airlines have also introduced and applied full service in order to cut cost to compete.

In Taylor ‘s article… .. , cited in Orme, 2003, Taylor emphasises on the significance of the populace in issues refering their wellness. The laterality of the biomedical position in the construct of wellness and healing where professionals are viewed as holding the cognition has had a batch of impact on public wellness globally. Harmonizing to Taylor, 2003, the populace, “ the ballad people ” have a important function in the procedure of wellness betterments. She emphasises on the importance of listen to, and understanding ballad people ‘s experiences of their sick wellness and how it is affected by their day-to-day lives. This can assist us to understand why people behave the manner they do in order for us to be able to happen them the best possible intervention, by working in partnership with them and utilizing available resources. Taylor relates to this partnership in two key footings, the public wellness resources and the public wellness action. The former refers to a scope of services aimed at advancing wellness including disease surveillance and the latter refers to a broad scope of activities of groups, administration, communities and persons that can advance wellness, ( Taylor, 2003, cited in Orme, 2003 ) . Using Deems taylors, partnership of the ballad position and public wellness resources as a construct of wellness and healing, this paper shall research its significance to wellness and healing in relation to the HIV/AIDS stigma. The paper will get down by specifying HIV stigma and place its causes. It will besides foreground how stigma affects people populating with HIV/AIDS. The paper will so consistently reexamine literature on HIV stigma from different surveies that have been conducted and discourse the issues highlighted on them. The paper will complete by doing some recommendations on how to turn to some of the jobs of the HIV stigma.
Goffman ‘s theory of stigma in relation to HIV/AIDS is farther complimented by Parker and Aggleton, 2003, who interpret stigma as a tool of continuing or sabotaging societal constructions. They view stigma and favoritism as functional systems which maintain boundaries between those in power and those without. Through such power, societal inequalities are developed therefore the favoritism of people harmonizing to gender, socio-economic position, age, gender, disablement and unwellness. Parker and Aggleton farther argue that from societal inequalities, societal norms are derived and this is when stigmatisation formulates as these norms govern persons ” manners of behavior and reinforce power constructions that are transformed through discriminatory patterns that serve to insulate those that are regarded as foreigners. In most of the research examined in this reappraisal both Goffman ‘s model and Parker and Aggleton ‘s reading of stigma confirm the demand for public wellness and public wellness action to work manus in battling HIV/AIDS related stigma.
A batch of surveies have been conducted globally on the impact of HIV related stigma. Due to the wideness of the topic, this paper shall reexamine literature refering HIV/AIDS stigma in relation to public wellness resources and public wellness action, those underpinned by Goffman ‘s theory of stigma. To increase the cogency and dependability of this reappraisal, a figure of web sites of different publishing houses and administrations such as Assia, through the Nottingham University library portal, PubMed, Sage, British Medical Journal, British Nursing Index, Cochrane and Eco host were visited for published articles on HIV/ AIDS stigma. The term HIV/AIDS stigma was used so that the hunt is non merely limited to stigma, HIV/AIDS or a peculiar geographical country. Abstractions from 20 surveies were reviewed for the survey aims, methodological analysis and cardinal findings. Out of the 20 surveies, twelve surveies that met the standards were chosen. Articles that did non measure up for the standards were excluded. From the bibliographies of the selected articles, relevant paperss from other administrations such as the WHO and UNAIDS were besides reviewed.

Research has highlighted a scope of features that confirm the demand for the ballad people ‘s beliefs to be taken into serious consideration in the combat against HIV/AIDS stigma for the bar and intervention of the epidemic to be effectual. In Tanzania, the survey unveiled some discriminatory and stigmatised patterns such as dish the dirting about the patients ‘ HIV ‘s position, disregard, verbal maltreatment, proving and unwraping HIV ‘s position without consent, Tanzania ‘s stigma-indicators field trial group, 2005. Similarly in India, wellness workers were unwraping the patients ‘ HIV position to their household members without seeking consent from the patient. The wellness workers even went to the extent of have oning baseball mitts even if there had been no physical contact during the interaction, Journal of Social Aspects, of HIV/AIDS, 2007. In other surveies, stigma and favoritism has a contributed a great trade in maintaining people off from accessing HIV/AIDS intervention and attention thereby compromising their wellness and good being. The fright of being identified as infected with HIV was one of the grounds why some people prolonged proving for HIV even if they had the symptoms until their unwellness was at an advanced phase. This was chiefly due to the society ‘s perceptual experience on how HIV is contracted. Research has proven that both experient and sensed stigma and favoritism have a terrible impact on both the persons and the public wellness, Bond V, Chase E, Aggleton P, 2002, Human resources of wellness, 2007, Varga C, Sherman G, Jones S, 2006, Kalichman SC, SImbayi L, 2003.
Research has besides unveiled a really interesting point on the wellness workers stigmatizing patients to cover up for their ain frights of their HIV position. They stigmatise and discriminate in order to keep their societal position as professionals for the fright of losing their power over the laic people who would them see them as portion of their community… … … … .
While most of the literature on HIV related stigma is negative, research has besides highlighted increasing grounds of the value of supportive and de- stigmatising HIV services in some parts of the Earth. 论文帮助/论文写作服务/负担得起我及时提交我最好的质量 – China, Brazil… … … ..
Recommendations, single degree, environment, policy, degree, preparation, usage of participatory methods, affecting ballad people, monitoring of stigma, address the demands of wellness workers
Research has highlighted the significance of cut downing HIV/AIDS stigma as it poses deductions in preventing, attention and intervention of HIV/AIDS. There is demand for HIV programmes to underscore on the deductions of the stigma as one of its precedences. Service suppliers should supply support services to dispute pattern that promotes HIV- stigma by professionals, within communities and globally. HIV/AIDS has claimed a batch of lives and still continues to claim more, the consequence of stigma on both the person ‘s wellness and well-being and public wellness results calls for all of us to fall in custodies in battling the spread of this deathly epidemic. By merely altering our attitudes towards people populating HIV/AIDS we will hold made our part towards public wellness for all.

DRUG ADDICTION AND DRUG ABUSE A Research Paper presented to the faculty of Cabalum Western College Iloilo City In partial fulfillment In English II by: What is drug addiction? Drug addiction is a complex brain disease. It is characterized by compulsive, at times uncontrollable, drug craving, seeking, and use that persist even in the face of extremely negative consequences. What Is Drug Abuse? Dennie Ho I am an independent freelance writer and editor with both a Bachelor’s and Master’s degree. I have worked professionally as an analyst in the government, higher education, and public relations industries.
I have been freelance writing for over eight years, including two with Demand Studios. The effects derived from abusing drugs will differ depending on the type of drug, but the basic pattern of drug abuse is the same: a compelling urgency to acquire and use the desired chemical substance. With drug abuse comes drug addiction and, as the addiction grows stronger over time, the impulse to use the drug grows more powerful: powerful enough to alter relationships, destroy health, interfere with work schedules and disrupt normal activities. 1. Definition Drug abuse entails the excessive and/or repeated use of chemical substances (in any form) in order to achieve certain biochemical effects. Significance * The abuse of drugs is coupled with addiction, and obtaining and using the drug becomes increasingly more important than any other thing in life: friends, family, employment or even children. Types * Drug abuse involves chemical substances known as street- or illicit-drugs (illegal due to their potential for addiction), as well as prescription drugs that are acquired for pleasurable use rather than medical necessity.
Consequences * The consequences of abusing drugs can be both physical and emotional, confounding the body’s normal biochemical processes, making normal functions difficult to perform and impairing cognitive abilities–like judgment–to dangerous levels. Effects * As described by the Mayo Clinic, stimulants increase blood pressure and metabolism resulting in powerful rushes of energy and difficulty sleeping. Depressants and barbiturates produce calming sensations and excessive relaxation by reducing blood pressure, heart rate and breathing to dangerously low levels. Potential Drug abuse over time chemically alters the brain’s neurological functions, causing extreme discomfort and pain when it is deprived of the drug. The Difference Between Drug Addiction and Drug Abuse Dr. Howard Samuels The terms “drug abuse” and “drug addiction” are sometimes used interchangeably and incorrectly. Although drug abuse may lead to drug addiction, they are two completely different terms. Drug Abuse Drug abuse is the misuse of any substance, legal or illicit. Some drugs, such as prescription medications and alcohol, may be used in an appropriate way and not be considered abused.

Taking prescription pills precisely how prescribed or having a single glass of wine with dinner are examples of not abusive drugs. Drug abuse occurs with these substances when they are taken in excess. Also, use of any illegal drug may be considered drug abuse, as it is not supposed to be used at all. Many illicit drugs are vulnerable to be abused because of their psychologically and physically addictive properties. Drug Addiction Drug addiction develops from repeated drug abuse, and also is believed to have genetic factors.
Addiction can be characterized by a complete overhaul of one’s motivational factors, in which the individual strives only to get high. Generally, other motivational factors such as school, work, family life, daily activities, and self-care lose their importance, as the drug becomes the only way the addict can find any happiness or relief. Addiction is always psychologically based with some causing physical addiction as well by changing the chemistry of the brain. Although an addict may find temporary relief from using, their life usually is not pleasant around them.
Although one who is abusing drugs may intentionally do so, an addict never wants to be an addict. As the drug is their only motivational factor, they cannot quit easily as nothing else gives them the same feeling they seek. Some form of treatment is often required to help addicts, whereas one abusing drugs may simply quit with their own willpower. All Addiction Articles * Drug Addiction * Meth * Methadone * Alcoholism * Ketamine * Cough Syrup * Valium * Dilaudid * Xanax * Suboxone * Sex * Drug Addiction Help * Oxycontin Statistics * How Drugs Can Become Addictive * Stages Intervention for Opiate Addiction * Drug Use in Prison * Athletes and Drug Abuse * Crystal Meth Rehab and Detox * Prescription Meds Post Surgery * Dangers of IV Drug Use * Heroin * Hydrocodone * Cocaine * Ecstacy * GHB * Inhalants * Demerol * Codeine * Ritalin * Adderall * Gambling * Drug Addiction Treatment * Drug Addiction vs. Drug Abuse * Drug Addiction Within the Family * Kids and Drugs * Vicodin * Defining Addiction * Olympic Doping * Current Events in War on Drugs * Alcohol Abuse Statistics * Love Addiction * Marijuana * Percocet * Substance * LSD * PCP * Spice Soma * Ambien * Morphine * Percodan * Nicotine * Cocaine Length in System * Drug Addiction Recovery Options * Genetic Aspect of Drug Addiction * Fact Sheet on Painkillers * Stigma * Malnutrition and Drug Use * Abstral: New Painkiller on the Market * Rich Kids Drug Use on the Rise * Agassi Crystal Meth Drug Admission * Bath Salt Addiction Causes of Drug Abuse Many people wonder about the causes of drug abuse. An underlying cause is the escape from emotional pain. Some people are physically predisposed to drug addition, whether emotional pain is present. 1. Emotional Issues The most prevalent cause of drug abuse stems from the addict’s need to escape from emotional pain. Any sort of trauma can lead to drug abuse. Job Loss * An unexpected disruption, such as job loss, can create a feeling of inadequacy and undermine a person’s confidence, leading him to flee the pain through drug abuse. Marital Difficulty * Arguments and discord in the marriage can lead to drug abuse. Drugs can provide a release from tension in the family. Genetics * A drug abuser can be susceptible to addiction because of her genetic makeup. Once the drug abuser experiments with a substance, the body will crave more.
Self-Medication * Self-medication can encompass all of the above issues for the drug abuser. He feels that he must relax, escape or mentally shut down through drug abuse. ————————————————- Causes of Drug Addiction Recognizing the causes of drug addiction can help prevent a person from becoming an addict. The motivators behind initial drug use or experimentation can lead to long-term use and becoming an addiction over time. ————————————————- Possible Causes of Drug Addiction Drug addiction can be found in many forms.
A person can be addicted to alcohol, prescription drugs, inhalants or other street drugs (cocaine, heroin, methamphetamines, etc. ). Understanding the reasons people are initially attracted to drug use can help stop future users from becoming addicts. Experimentation and curiosity are the first factors that draw many people into trying drugs. They want to feel that “high”, the sense of euphoria that comes with drug use. While this may lead to recreational use of drugs (using only in certain situations), it rarely leads to actual addiction unless other factors are present.
However, some drugs (like heroin) have are more likely to cause addiction than others resulting in an addiction from simple experimentation alone. Prescription drugs can turn people into addicts because they have conditions in which they need to take drugs in order to get relief. People become hooked on prescription drugs when they take more than the recommended dosage, take it more frequently than recommended and continue using the drug after their initial medical condition clears up. Elite athletes are susceptible to using drugs. They use them for performance enhancing abilities.
Steroids can make muscles bigger, while amphetamines help reduce or numb pain and allow people to play injured. Recently, major league baseball has come under fire for drug abuse. Although not as prominent, high school and college athletes have also been known to use drugs to enhance their performance. Others turn to drug use to cope with problems in their real lives. Whether it is past abuse (physical or sexual), school problems, work problems or relationship issues, drug use can help a person temporarily escape the realities of his/her life.
Being around drugs and being exposed to addicts can also lead to drug addiction. If a family member or close friend uses or is addicted to drugs, it seems more acceptable for other members to engage in similar behavior. It becomes a tolerated activity. Peer pressure is also a factor in turning people into drug addicts. Contrary to popular belief, peer pressure can happen at any age. Adults fall prey to peer pressure to fit into new social classes, new workplaces and new neighborhoods. Teenagers fight peer pressure on everything from looks to alcohol to sex to drugs.
In fact, using crystal meth is becoming a way for many teenage girls to fight the pressure that comes with needing to be thin and attractive. Teenagers can also fall prey to the rebellious attitude that they need to do anything their parents or those in authority say is bad. Easy accessibility to drugs and new, lower prices can also lead to drug addiction. Drugs can be found anywhere if a person simply asks. Street corners and alleyways are no longer the only place to find drugs. Schools, workplaces and even the family next door might be new places to find drugs.
With more drugs being produced, the price has also been driven down. Drug addiction can also be caused by using drugs to mask other mental problems. For example, depressed people frequently use drugs to escape their sad feelings. Schizophrenics find that some street drugs can control their hallucinations. Denial and hiding the problem just lead to more problems in the long run. Four Stages of Drug Abuse Regina Paul Regina Paul has been a full-time freelance writer and author for three years. She has published over 500 articles online and 10 books. Her articles are published at Associated Content, e-How. om, and The Fun Times Guide. Her books are published with Amira Press, Eternal Press, and Leap of Faith Publishing. Introduction * Drug abuse is now seen as a disease, rather than just a moral problem as it was in the past. These days psychiatric professionals have identified four stages of drug abuse, enabling them to help individuals regardless of what stage they may be in. First Stage: Experimentation * The first stage of drug abuse can start out with using a drug voluntarily with the intent to erase a personal problem, or out of curiosity or because of peer pressure.
For example, in the case of a personal problem, perhaps a man discovers his wife is cheating on him, and so he turns to drugs. When they appear to make him feel better, he moves from the first stage to the second stage of regular use. Second Stage: Regular Use * Someone that starts out experimenting with a drug and who likes the effects will often move on to regular use of the drug. In some cases, people will stop on their own even after they have begun regular use and they don’t move beyond stage two, but others move to stage three and begin exhibiting risky behaviors. Third Stage: Risky Behavior The transition from stage two to stage three of drug abuse varies from person to person, and it can sometimes be difficult to determine if the behavior a person is exhibiting is risky. In spite of this, if you believe the behavior of a loved one is risky, then you should tell your loved one. It is very easy to slip from stage three to stage four, which is dependence. A few examples of risky behavior are driving while high on drugs, doing target practice with a gun while high on drugs or jumping out of a second-story window under the influence of drugs. Fourth Stage: Dependence ; Addiction The characteristics of stage four are consistent drug abuse, always being high, not being able to function at work or at home, picking fights with loved ones, being incapable of rational thinking, engaging in risky behaviors such as taking drugs and driving or operating dangerous machinery while high, and legal problems that include receiving tickets for driving under the influence of drugs. If a person is in stage four they are addicted, and the problems mentioned above will continue to grow as the person’s psyche is affected for the worse by continual drug use.
Symptoms of Drug Abuse Drug, or substance, abuse is the habitual and exorbitant use of chemicals in order to produce a specific result or “high. ” Abuse can involve illegal drugs or prescription drugs. Continued use can result in an addiction that ultimately affects addicts’ work and home life as well as their health. 1. Physical Symptoms * Individuals may exhibit cycles of high energy or excessive sleep. Confusion or disorientation may be evident, along with slower speech, movement and reaction time.
Changes in appetite with a sudden weight gain or weight loss may be an indicator of drug abuse. You may notice changes in the type of clothing worn, such as long-sleeved shirts to hide needle marks, or you may find paraphernalia, such as syringes, roach clips (used to hold a small marijuana cigarette) and pipes. Other physical signs include red and watery eyes, runny nose, chronic sinus problems or nosebleeds, persistent coughing, trembling, irregular heartbeat and serious dental troubles. 2. Mental and Emotional Symptoms *
Drugs are abused for the purpose of achieving a “good” feeling. Signs of drug abuse can include cycles of unresponsiveness or being overly energetic and cheerful. Mood may change with heightened anger and irritability, and a lower threshold to become violent. Addicts may exhibit depression and apathy or paranoia and delusions. Other symptoms include hallucinations and silliness. 3. Behavioral Symptoms * You may notice a change in personality and attitude with drug abuse. Addicts may begin to socialize with different groups of friends and in different places.
Hobbies, interests and activities may change, and family becomes less important. They may exhibit suspicious or secretive behavior, lack of motivation and decreased ability to pay attention. They may begin to steal money or objects that can be sold. 4. Specific Symptoms * Marijuana produces red or glassy eyes, unsuitable laughter and talking with subsequent sleepiness, loss of motivation and interest, and weight loss or gain. Depressants result in clumsiness, concentration difficulties, slurred speech, poor judgment, contracted pupils and sleepiness.
The use of stimulants is evident by symptoms of euphoria, hyperactivity, anxiety, irritability, dilated pupils, dry mouth and nose, weight loss and excessive talking with subsequent depression or sleeping. Inhalants cause impaired vision and memory, watery eyes, nose or mouth rashes, nausea, headaches, drowsiness, appetite changes, irritability, anxiety and poor muscle control. The use of hallucinogens is exhibited by mood swings, paranoia, aggression, slurred speech, hallucinations, confusion and dilated pupils.
Heroin may be suspected due to needle marks, sweating, coughing and sniffling, vomiting, twitching, contracted pupils, loss of appetite and sleeping at odd times. 5. Support * If you believe someone you know is abusing drugs, it is important to understand that the decision to stop is entirely up to him. You can offer him support, but he must have the desire to quit. You can find a treatment facility or support group to help him get started. It may also help to involve your minister or rabbi, your family physician or a therapist.
The recovery is an ongoing process and an addict must work to overcome the withdrawal and to resist the drug cravings. What Are the Different Kinds of Drug Abuse? Someone with a drug abuse problem often displays general symptoms, regardless of the type of drug being abused: paranoia, confusion, overall attitude or mood adjustment, withdrawal from relationships or activities, abrupt changes in quality of work or school attendance. The specific signs of drug abuse, however, will differ, depending on the nature of the chemical. 1. Acute Alcohol Abuse The Handbook of Diseases describes the immediate signs of alcohol abuse as intoxication, loss of motor control (including walking and speech), alcoholic odor on breath or clothing, loss of memory and blackouts. Chronic Alcohol Abuse * The chronic signs of alcohol abuse are more subtle. This abuse can be seen in someone who has including difficulty focusing, uncharacteristic behavior (passive or argumentative), dysfunctional interpersonal relationships, declining school or job performance, and fixated attention on alcohol, according to the Handbook of Diseases.
Depressant Abuse * According to the American Council for Drug Education (ACDE), signs of the abuse of depressants (barbiturates—Amytal, Seconal; benzodiazepines—tranquilizers Xanax and Valium) include an intoxicated appearance (like alcohol, but without the noticeable smell). Signs of depressant abuse also include a lack of facial expressions or emotional responses, flaccid appearance, deflated or flat personality, and slurred or distorted speech. Stimulant Abuse The ACDE identifies the signs of stimulant abuse (amphetamine, methamphetamine, cocaine, Ritalin) as hyperactivity, extreme energy, fidgeting, twitching, nervousness, irritable or argumentative, lack of appetite and sleep deprivation. Physiological signs include dilated pupils, dry mouth and lips, runny nose or nose bleeds, and sinus problems. Hallucinogen Abuse * The ACDE describes the abuse of hallucinogenic drugs (PCP, LSD, Ketamine or Special K) as including distortion (self, others, time, the senses), hallucinations, confusion, altered mood or behavior and slurred or incoherent speech.
Signs of hallucinogenic abuse also include physiological indications, such as extreme dilation of the pupils, warm skin, heavy perspiration and body odor. Narcotic Drug Abuse * Abuse of narcotics (opiate-containing drugs such as heroine, methadone, codeine, oxycontin and morphine) can be identified by lethargy, drowsiness, pupil constriction and slurred speech. Other clues include increased amount or frequency in taking pain medication and frequent trips to doctors and clinics for pain medication.

 
Instructions
This assignment presents a difficult and painful medical dilemma, with you in an imagined professional role. Go through the You Decide scenario and make the decision it calls for. Then, compose an official memorandum that will be kept for the record and could potentially be read not only by your Peer Review Committee but also by those involved in charitable fundraising, which supports hospital development, as well as by others with financial interests in the decision.

In the memo (use the Memo Template), explain your decision and your reasoning for it. Include the following:

1. Who benefits from what you decided? Write my Essay Online Writing Service with Professional Essay Writers – Explain why.
2. Who gets denied a needed benefit? Write my Essay Online Writing Service with Professional Essay Writers – Explain why.

You will see notice that there is time pressure in the simulated situation, so remember that you would not have the luxury to dawdle in the decision-making process, and as the decision maker, you would not have the luxury of consulting a broad spectrum of advisors. It falls on you to decide!

Include in the memo the utilitarian ethical philosophy of John Stuart Mill (from the lesson last week) and one other ethical philosopher of your choosing that we have studied to date. Use both of those philosophies to bolster your decision.
You can use—- .Mill, J. S. (1991). Utilitarianism. Oxford: Oxford University  Press. 
                         .Kant, I. (2008). Grounding for the metaphysics of morals. Brantford, Ont.: W. Ross MacDonald School Resource Services Library.

 — Length: 2-3 pages (not including title page or references page)

SCENARIO
 Okay, Lead Surgeon, it is time to do what you do best! There is a lot at stake. The decision must be made almost immediately. Like all actions, you will need to write your decision into medical documentation before you begin. Yes, that means YOU! In the limited time before you would begin surgery, you need to consider the cases; the technical issues involved also, and write a Memorandum for the Record to document what decision you made and what considerations you included in your process. This will be on the record, so it needs to be thorough in case it needs to justify your actions at a later date. 

ROLE.
 You are the Lead Surgeon in a major hospital, and by virtue of your seniority you are also the key decision maker for transplant cases. Right now you have three people who are waiting and hoping for a suitable heart to become available. Your cell phone rings suddenly, and you are notified that a heart has become available-meaning that you need to make a quick yet sound decision about which patient will receive the heart and then schedule surgery for today.

PLAYERS 

 JERRY: (Male, 55 year old family man, mid-level manage)
 Jerry, a father of 3 children and at the age of 55, is in the Ward awaiting a suitable heart for transplanting. His wife Joanie is a stay at home mother with no education beyond high school and no career. Jerry is the middle level manager at a carpet distributing business and 5 year short of his retirement eligibility. Jerry and Joanie have three teenage children aged 14, 16, and 19. The 19 year old is a sophomore at college; the 14 year old is mildly autistic, and the 16 year old is an astronaut wannabe. If Jerry gets the heart, his chances of living another 10-15 years are very high. His heart is damaged due to the use of steroids in his early 20s when he was involved with bodybuilding before the dangers of steroid use were fully known. 

LISA: (Female, 12 year old lifelong health issues) 
 Lisa is one of those precocious girls – a doll-like girl at the edge of becoming a teenager. She reads voraciously and yet likes the activities of a younger girl playing with her Barbie Doll. She has suffered health issues all her life due to various viral infections and a lupus-like immune deficiency. Her heart was damaged during a nasty bout with pneumonia last year and actually stopped for a brief period. Her mother knew to begin CPR on her or she would have died there. Even with a transplant, her chances of surviving into her 20s are not good. She is the only child in the family, and they cannot bear more children. Her parents will do anything for her, and they have offered to donate $2 million to the hospital’s construction of specialized facilities if she can get a heart soon enough. Her father is also a noted oncologist working in the same hospital but in a different department. 

OZZY:  (Male, 38 year old homeless drug abuser)
 Lisa is one of those precocious girls – a doll-like girl at the edge of becoming a teenager. She reads voraciously and yet likes the activities of a younger girl playing with her Barbie Doll. She has suffered health issues all her life due to various viral infections and a lupus-like immune deficiency. Her heart was damaged during a nasty bout with pneumonia last year and actually stopped for a brief period. Her mother knew to begin CPR on her or she would have died there. Even with a transplant, her chances of surviving into her 20s are not good. She is the only child in the family, and they cannot bear more children. Her parents will do anything for her, and they have offered to donate $2 million to the hospital’s construction of specialized facilities if she can get a heart soon enough. Her father is also a noted oncologist working in the same hospital but in a different department. 

Dr Doe: ( Male, 35 year old Lisa’s Dad, the oncologist)
 Dr. Jonathan Doe is Lisa’s father. He has offered the hospital $2 Million Dollars in exchange that his daughter gets the heart transplant. He is an up-and-coming oncologist in the same hospital. He is loyal and totally committed to Lisa; while not obnoxious and pushy, his presence is keenly felt around the professional community in the Hospital and there is a need for his $2 Million. 

 
One of the great ongoing situations that calls for ethical decision making is the reality that there is almost always a greater need for something than there is a supply to meet the need.
For this assignment and scenario, the demand is the life-and-death situation of the need for transplantable organs and the rather small and transitory supply. Hard decisions need to be made, and there is little time to think things through. These are emergency situations.
Transplantable organs become available on short notice–usually because a donor has died for reasons unrelated to the organ. They need to be removed and transplanted very quickly because they only remain fresh for a limited period. Then there is the whole complicated issue of tissue type matching. There is also an ongoing concern about how long recipients can wait.

 Next, after you have reviewed this material, please address the following question in your initial post of 250+ words, including at least 2 additional academic resources.

How can artists use their creations to promote engagement in social justice/citizenship in their society and community?
Should the fine/performing arts (music, dance, painting, sculpture, architecture, etc.) focus on entertaining, enlivening, and decorating our world? Is that enough, or must an artist also help us to embrace the things we fear, loathe, or ignore in order to be considered a “true artist”? Why/why not?Notes:  It seems pretty easy to think of an ethical dilemma related to the sciences, and this week you are finishing the first essay that tackles one of these. But the sciences are only one piece of “liberal arts and sciences.” We will now look at how artists function relative to dilemmas and controversies.Begin by reviewing the following resources:

The Module Notes, “Thinking Critically about Ethical Dilemmas in the Natural Sciences”
Rolling, JR., J.H. (2013) Art as social responsibility: Reframing critical thinking in art education as a basis for altruistic intent (Links to an external site.)Links to an external site..
Lewis, Sarah E. (2017) Creativity and social justice (Links to an external site.)Links to an external site.Links to an external site.. [Video, File 31:33 mins] Retrieved from https://www.youtube.com/watch?v+FEu9Circ95g 

 
Science, especially the natural sciences, such as biology, chemistry, physics, and geology, cannot exist in a theoretical vacuum. This means that what a scientist learns through her/his research must have some link to the natural world. The research that scientists conduct can be very far removed from theory and more heavily focused on the practical application of knowledge (for example, in aerobiology, scientists may be providing pollen and mold counts to medical personnel and the media rather than engaging in theoretical research). Regardless of the “extent of abstractness” of the scientific research, all studies can or will eventually impact the world in which we live. How do scientists manage ethical issues they confront in their work? All scientific professional organizations support ethical behavior in their disciplines. Please be sure to review the Universal Ethical Code for Scientists, which is a statement of “the values and responsibilities of scientists,” (Gov.UK, 2007) as directed in this week’s reading.  
As we discussed in Module 1, ethical dilemmas reside in the “gray areas” where the answers are not clear cut and simple but involve a compromise to achieve what society deems is the greater good for the most at any given time. Scientists need to use their expertise to inform the public discussion about these issues. They also may need to take a personal stand in their work. One of the commonalities we may locate in scientific research that entails ethical decisions is:
The need to balance economic benefits for a given group of humans with the need to maintain or protect the fragile ecology and biodiversity of a particular area.
The world’s population is growing rapidly. In 2011, we reached 7 billion and the need for adequate food, water, and energy resources for everyone is becoming a major concern for governments around the globe. We should all be aware of the inequities in distribution and usage of these limited resources between developed and developing countries. Science has an important role to play in determining the choices and options that can be considered to alleviate these global concerns. The scientist needs to be informed and sensitive to the possible consequences of her/his research.

   
Instructions: 
The Excel file for this assignment contains a database with information about the tax assessment value assigned to medical office buildings in a city. The following is a list of the variables in the database:
· FloorArea: square feet of floor space
· Offices: number of offices in the building
· Entrances: number of customer entrances
· Age: age of the building (years)
· AssessedValue: tax assessment value (thousands of dollars)
Use the data to construct a model that predicts the tax assessment value assigned to medical office buildings with specific characteristics.
· Construct a scatter plot in Excel with FloorArea as the independent variable and AssessmentValue as the dependent variable. Insert the bivariate linear regression equation and r^2 in your graph. Do you observe a linear relationship between the 2 variables?
· Use Excel’s Analysis ToolPak to conduct a regression analysis of FloorArea and AssessmentValue. Is FloorArea a significant predictor of AssessmentValue?
· Construct a scatter plot in Excel with Age as the independent variable and AssessmentValue as the dependent variable. Insert the bivariate linear regression equation and r^2 in your graph. Do you observe a linear relationship between the 2 variables?
· Use Excel’s Analysis ToolPak to conduct a regression analysis of Age and Assessment Value. Is Age a significant predictor of AssessmentValue?
Construct a multiple regression model.
· Use Excel’s Analysis ToolPak to conduct a regression analysis with AssessmentValue as the dependent variable and FloorArea, Offices, Entrances, and Age as independent variables. What is the overall fit r^2? What is the adjusted r^2?
· Which predictors are considered significant if we work with α=0.05? Which predictors can be eliminated?
· What is the final model if we only use Floor Area and Offices as predictors?
· Suppose our final model is:
· Assessed Value = 115.9 + 0.26 x Floor Area + 78.34 x Offices
· What would be the assessed value of a medical office building with a floor area of 3500 sq. ft., 2 offices, that was built 15 years ago? Is this assessed value consistent with what appears in the database?
Regression Modeling

The public and professional images of nursing and the portrayal of nurses in the media have a great impact on several work-related issues – how health care as a collaborative enterprise is provided to patients, the extent that nurses’ work is valued, the participation of the nurse in healthcare team decision-making, the visibility of nurses in shaping national health care and the effect of these images on nurses’ job performance (Fletcher, 2007.

Most researchers agree that although there have been improvements in the image of nursing, the portrayal today is still largely negative – an issue that has been raised by nurses for the past century. Gender issues seem to be at the core of this situation.

Other disciplines, specifically the medical profession, view nurses based on certain qualities. In a study by Weinberg, Miner and Rivlin (2009) on the perspectives of medical residents on working with nurses, nurses were trusted and regarded as colleagues depending on how competent, congenial and hardworking the residents perceived them to be (p.37).
This implies that the collaborative approach does not always permeate the nurse-medical resident relationship despite nursing practice being elevated into a profession that is equal to other health disciplines. To be respected as a colleague requires a condition – nurses must first have to prove that they possess the qualities expected of them.
Meanwhile, the media reinforces the image of nurses as a health worker that is lower in status than physicians or as other concepts other than being a professional. In a literature review conducted by Fletcher (2007) concerning the media portrayal of nurses, the author found that television shows, novels, films and advertisements then and now mainly portray nurses in four categories, namely “as ministering angel, battleaxe, physician handmaiden and naughty nurse” – negative images because these do not capture the reality of nursing (p.208).
As an acute nursing shortage looms ahead, the campaign to improve the image of nursing, in order to attract more students into the profession, yielded a positive outcome. A recent Gallup survey on professional ethics and honesty found that 84% of Americans agreed that nurses are the most trusted professionals (Singleton, 2009). The Gallup survey image of nurses represents a positive development because nurses were viewed as professionals who are bound by a code of ethics and who adhered to such a code.
Both the positive and negative images of nursing seem to reflect the unequal power relationship between men and women in society where women are viewed as either sex objects or as domestic partners. The end product is a stereotypical view of women’s roles as subservient to men.
Along with this role are the associated feminine traits ranging from obedience, hard work, compassion and congeniality to promiscuity. The physician-nurse relationship reflects these stereotypes as physicians are disproportionately male and while nurses are disproportionately female. As a male-dominated profession, the physician’s work is highly recognized and valued while the nurse’s work is undervalued and unrecognized.
Because of the stereotypes reinforced by media, the public largely identifies nurses only with bedside care and with carrying out physician’s orders. Most would think that since the work involved seems trivial, nurses do not need to obtain a 4-year BSN degree. They do not see the complex daily responsibilities of the nurse that requires education, training and autonomy or the current scope of nursing practice. As such, they fail to appreciate the significant impact of nurses’ work on patient health and outcomes.
Although men have enrolled in nursing, it is still mainly a women’s profession and as Lavinia Dock (cited in Fletcher) aptly put it, “the status of nursing in all countries and at all times depends on the status of women” (2007, p.210). Because the nurse is a woman in a caring profession, expectations of her relate to female gender roles as well. Hence, further improvements in the status of women will similarly uplift the status of nursing.