Plaza Home Health Services Assignment Example | Topics and Well Written Essays - 1000 words

Plaza Home Health Services - Assignment Example The strength of Plaza Home Health Services is that it caters to elderly people. There are very few hospitals that cater to such range of people. Such individuals hence have an excellent opportunity to live a peaceful life. They have designed state of art University Plaza Rehabilitation & Nursing Centre. There they have all the amenities which senior citizens need during a rehabilitation therapy. They have launched education program in order to help the families of the patient make intelligent decisions for their loved ones. There they bring experts from the healthcare services at discussing a range of topics like Stroke, Diabetes, Pain Management, Dental Healthcare, Medicare Fraud, Skin Care, Senior Safety and Identity Theft. They have attained breakthrough in rehab therapy through new Tibion Bionic Leg. This helps the patients walk again after being in Wheel Chair after a long period of time (Niles, 2011).The weakness of Plaza Health Services is that they can’t afford many pa tients all at once. They have not opened up many such medical services across the United States. They have limited presence. They have been serving only Villa Rica and their surrounding area for 27 years. Hence they need to expand their network across the United States. Plaza Home Care provides a full range of medical equipment to their patients. According to research, the senior citizen population in the US continues to increase as the boomers reach the age of 65. Miami-Dade has largest senior citizen populations in the country.

INDIVIDUAL SOLUTION OF AN ALLOCATED SCENARIO-BIG BROTHER BART Essay

INDIVIDUAL SOLUTION OF AN ALLOCATED SCENARIO-BIG BROTHER BART - Essay Example The case brings out the work of Bart and also brings into light the software used by him to keep a tab on the employee systems to ensure that the software is working fine. Bart uses this software to keep track of people who have issues with new software and he uses this log in to simply keep an eye on the working conditions of the software. Bart’s manager requests him to use this software to keep track of two specific employees who are under the suspicion of trading in drugs using the office computers. Bart is faced with an ethical dilemma here and is unsure of whether it is a good idea to keep a tab on an employee’s computer for this reason. In this case the question is to analyse whether it is ethical for Bart to keep a tab on the employee systems or not and to analyse the theories that relate to these. The two chosen theories here are Utilitarianism and Deontology. The following section provides a brief overview of these theories and helps set the base for analysis o f the case. Utilitarianism and Kantian Deontology share one thing in common, i.e. they are both aimed to provide solutions to moral dilemmas. Utilitarianism is more of morality of justice and it focuses more on maximising the utility or ensuring that most numbers of persons are satisfied and happy with the result that is taken up (Tavani, 2004: 234 - 244). This is relatively much better than the Kantian Deontology or any other deontology approach as this takes into consideration the importance of satisfying people and tries to build a foundation with complete justice (Rachels, 1998: 226 - 240). Here in the case of Utilitarianism, the main aim is to ensure that all parties involved are benefiting from the decision made and there is a high level of success for a number of people in the case. This method (utilitarianism) takes everybody to be equal and it looks for a solution which is for the benefit of more number of people (Held, 2006:

Ferropenic Anaemias as a Problem of Public Health

Ferropenic Anaemias as a Problem of Public Health There are several levels of consideration when analysing the problem of the ferropenic anaemias. Firstly there is the overall prevalence in the population, which is quite low in the UK when compared to the developing world (see on). Secondly we need to differentiate between the physiological ferropenic anaemias such as those which occur in pregnancy, those which occur as a result of disease states such as the various forms of malabsorbtion and those which occur through neglect or malnutrition (in the widest possible sense).(Allen, L et al. 2001) The physiological anaemias are not a major public health issue as they are almost invariably screened for in the routine ante-natal clinics and when found, are generally treated on an expectant basis. Iron stores may be depleted after pregnancy and during the breast feeding period, but again, one could reasonably expect that these conditions would be detected and treated as a matter of course. (Ramakrishnan, U. 2001) The same comments generally apply, although with not quite such universal accuracy, in the malabsorbtion states. Such states are generally found as part of another (usually more clinically obvious) pathophysiological process or as part of a post-operative syndrome. (I M 2001) One would hope that, as such, they would be part of the general management of the overall condition and therefore do not pose a particular public health issue. Another area where the Public Health is a potential concern is that where the ferropenic anaemias occur as a result of malnutrition, poor diet or neglect. One way of considering these issues is to analyse the situation in circumstances where the prevalence of ferropenic anaemias is greater than in the UK (where it is comparatively unusual). (Gibson, R. S et al. 2001) In the developing world, the ferropenic anaemias are a major Public Health issue and some countries have instituted measures to directly combat them.(Yip, R. 1994) The first issue to address is to consider the notion that the commonly measured index of haemoglobin concentration is actually a good measure of iron stores. The evidence base here is quite clear that in developed countries where the level of nutrition is generally good, there is a reasonable (but not exact) correlation. In countries with less good nutritional values, there is a marked disparity between haemoglobin levels and iron levels. Haemoglobin distributions of a subset of iron deficient U.S. children (dotted line) and children who are not iron deficient (solid line). The key observation is the substantial overlap Haemoglobin distributions of Palestinian refugee children (dotted line) and U.S. children (solid line). The key observation is the relatively small overlap. (after Yip et al. 2002) Secondly we should note that as a matter of basic pathophysiology, not all anaemia is due to iron deficiency and not all iron deficiency will be reflected in anaemia. Therefore uncritical use of the haemoglobin index as a measure of the ferropenic anaemias is basically flawed. These charts suggest that the linkage between haemoglobin and serum iron is closer in developed countries than in developing ones. We can point to other indicators of iron status including transferring saturation, serum ferritin, free erythrocyte protoporphryn (FEP) or the more technologically advanced transferrin receptor levels . (Gimferrer E et al. 1997) which can be utilised to give indicators of iron levels either in a specific patient or on a population level. (Lynch, S et al. 2001). There is another consideration here and that these indicators, although probably accurate on an individual level, may not be so helpful on the population level as, particularly in the developing countries, their laboratories may not have a sufficient level of sophistication to perform the assays and also these tests are less accurate in populations where there is a high prevalence of infections One of the main areas of concern to the Public Health is that of the ferropenic anaemias in children. There is a relative period of â€Å"physiological† anaemia in the child which occurs between 6 and 18 months. The word physiological is in parenthesis because it is not strictly accurate. It is physiological insofar as this is the time when the child’s body has its highest levels of iron requirement (almost 10 times higher than in the adult in comparison to body weight) and the comparative depletion is generally rectified by dietary means once the period of high usage is over. (IM 2001). The second factor in this situation is that the typical diet of this age range tends to be low in bio available iron when compared to that of an adult. (O’Donnell, A. M et al. 1997) In the UK it is rare for a child to develop a ferropenic anaemia because those at risk (underweight and malnourished) are generally picked up by routine Health Visitor screening and also because of the better dietary quality of the average diet which is high in meat with a high iron content. Specifically designated infant food in the UK is commonly fortified with additional iron in any event. (Hall, A et al. 2001). We should not overlook that fact that breast milk has a high content of bio available iron and is a useful source of protection (although not universally effective) against the ferropenic anaemias in the young child We should note however, that in studies that have compared breast fed children, with â€Å"normal† diet children and compared them also against those with a fortified diet (defined by being primarily fed on artificial milk) there was virtually no significant incidence of ferropenic anaemias in those children who were given the fortified diet suggesting that those countries who still utilise the fortified milk system as a Public Health measure are spending their money in a cost effective way. (Walter T et al. 2001) Because of the substantial evidence base that supplementation of iron in the diet of the young child is both cost effective and demonstrably workable, (Bothwell T H et al. 1999) One should really also to consider the additional question as to whether there is a case for supplementing other micronutrients as well as iron. This is a question that is outside the strict parameters of the essay title set here so we will not consider it further except to observe that there is a substantial evidence base to support this as well. (Solomons N W et al. 1993) If we now expand the arguments to women of reproductive age, we note that the risk of developing a ferropenic anaemia during pregnancy is greater than during virtually any other stage of life. In approximate values, a pregnant woman can expect her circulating blood volume to expand by about 35% during pregnancy. She would expect to have a total pregnancy requirement of about 590 mg of elemental iron for the foetus and physiological RBC turn over. Routine prophylaxis in the UK supplies about 750 mg during a pregnancy which leaves about 160 mg for erythropoesis. Studies have suggested that the typical woman needs about 1100 mg of elemental iron throughout her pregnancy to avoid a â€Å"natural ferropenic anaemia â€Å". (Viteri F E 1999) There is considerable evidence that a pre-pregnancy ferropenic anaemia increases the risk of developing further anaemia during a first (and progressively greater in subsequent) pregnancies as it suggests that the iron stores in the body are already depleted. There is evidence to suggest that, in women in the reproductive years in the developed world, ferropenic anaemia is more likely to be associated with increased blood loss (menorrhagia or polymenorrhoea) than it is to be associated with poor diet. Lennartsson, (J et al. 1999) made a substantial study of ferropenic anaemias in women and identified a â€Å"substantial sub-set† whose menstrual loss was such that a normal diet could not keep up with their iron requirements. In the context of our essay we can state that iron deficits that are due to menstrual loss appear to have the greatest effect on women in the developing world as they tend to have diets which are already comparatively poor in both overall iron content and bioavailability. Paradoxically, women in the developed world who do develop ferropenic anaemias due to excessive blood loss, are more likely to suffer from multiple micronutrient dietary deficiencies as well, most notably zinc, copper, calcium and vitamin A, (Hall, A et al. 2001). It is also the case that in the developing world, intercurrent infections such as helminthic infestations and malaria may also result in increased levels of blood loss and therefore the underlying causes will also need to be addressed as well as simply correcting the iron deficiency. The nutritional iron requirements of the pregnant woman are typically twice that of the non-pregnant woman, who, in turn, has approximately twice the requirement of the same aged man (corrected for appropriate energy expenditure). Recent studies have shown that 50% of women in developed countries do not have sufficient iron stores for pregnancy requirements. (Kim, I et al. 1998). This fact is essentially the rationale behind the fairly routine prescription of iron tablets to pregnant women in the UK Iron requirements in relation to energy intake for infants, men, women and pregnant women. (After IM 2001) We note that different countries adopt different strategies taking account of costs and available resources. Many, including the UK and the USA, adopt a fortification strategy as a Public Health measure as not only women but men and children will also benefit. Some countries chose to adopt periodic supplementation under supervision such as in a school or the workplace. (Viteri, F. E. 1999) Many countries, including the UK, choose to fortify basic food ingredients such as wheat flour which is currently fortified to levels of 60  µg/g. Basic calculations based on an annual intake of 20 kg/yr (which is fairly low by UK standards) would suggest that this measure alone equates to 3 mg of elemental iron per day or about 25% of the recommended daily requirement. (Viteri, F.E. 1997) In terms of Public Heath costs a recent estimate suggests that it costs about 70p ($1.30) to fortify one ton of wheat flour with six micronutrients, including iron. (Lofti, M 1998). If we revert back to the 20 kg per year estimate of minimal intake, the cost is only a few pence per year ($0.025). Some sources have suggested a programme of plant development and breeding to develop strains of staples such as rice and wheat that have a intrinsically higher micronutrient content. (Gibson, R. S et al. 2001). These measures are certainly within the technological capabilities of the majority of countries and therefore make such measures a viable option. References Allen, L. Casterline-Sabel, J. (2001) Prevalence and causes of nutritional anemias. Ramakrishnan, U. eds. Nutritional Anemias 2001 : 7-22 CRC Press Boca Raton, FL Bothwell T H, Charlton R W, Cook J D, Finch C F, eds. 1999 Iron metabolism in man. Oxford, United Kingdom: Blackwell Scientific Publications, 1999 ; 21. Gibson, R. S. Hotz, C. (2001) Dietary diversification/modification strategies to enhance micronutrient content and bioavailability of diets in developing countries. Br. J. Nutr. 85 (suppl. 2) : S159-SS66. Gimferrer E, J. Ubeda, M.T. Royo, G.J. Marigà ³, N. Marco, N. Fernà ¡ndez, A. Oliver, R. Padrà ³s, and I. Gich 1997 Serum Transferrin Receptor Levels in Different Stages of Iron Deficiency Blood, Aug 1997 ; 90 : 1332 1333. Hall, A., Drake, L. Bundy, D. (2001) Public measures to control helminth infections. Ramakrishnan, U. eds. Nutritional Anemias 2001 : 215-240 CRC Press Boca Raton, FL. IM 2001 Institute of Medicine (2001) Dietary Reference Intakes. . Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, Zinc 2001 National Academy of Sciences Washington, DC. . 2001 Kim, I., Hungerford, D. W., Yip, R., Kuester, S. A., Zyrkowski, C. Trowbridge, F. L. (1998) Pregnancy nutrition surveillance system—United States, 1979–1990. CDC Surveillance Summary, Morb. Mortal. Wkly. 1998 Rep. 7 : 25-41. Lennartsson, J., Bengtsson, C., Hallberg, L. Tibblin, E. (1999) Characteristics of anaemic women. The population study of women in Goteborg 1968–1969. Scand. J. Haematol. 22 : 17-24 Lofti, M. eds. 1998 Food Fortification to End Micronutrient Malnutrition—State of the Art. Micronutrient Initiative 1998 Ottawa, Canada. . Lynch, S. Green, R. (2001) Assessment of nutritional anemias. Ramakrishnan, U. eds. Nutritional Anemias 2001 : 23-42 CRC Press Boca Raton, FL. O’Donnell, A. M., Carmuega, E. S. Duran, P. (1997) Preventing iron deficiency in infants and preschool children in Argentina. Nutr. Rev. 55 : 189-194 Ramakrishnan, U. (2001) Functional consequences of nutritional anemia during pregnancy and early childhood. Ramakrishnan, U. eds. Nutritional Anemias 2001 : 43-68 CRC Press Boca Raton, FL. . Solomons N W, Mazariegos M, Brown K H, Klasing K. 1993 The underprivileged, developing country child: environmental contamination and growth failure revisited. Nutr Rev 1993 ; 51 : 327–32. Viteri, F.E. (1997) Iron supplementation for the control of iron deficiency in populations at risk. Nutr. Rev. 55 : 195-209. Viteri, F. E. (1999) Iron supplementation as a strategy for the control of iron deficiency and ferropenic anemia. Arch. Latinoam. Nutr. 49 (suppl. 2) : 15S-22S Walter, T., Olivares, M., Pizarro, F. Hertrampf, E. (2001) Fortification. Ramakrishnan, U. eds. Nutritional Anemias 2001 : 153-184 CRC Press Boca Raton, FL. . Yip, R. (1994) Iron deficiency: contemporary scientific issues and international programmatic approaches. J. Nutr. 124 : 1479S-1490S Yip R and Usha Ramakrishnan 2002 Experiences and Challenges in Developing Countries J. Nutr., Apr 2002 ; 132 : 827 830. ################################################################ 8.11.06 Word count 2,251 PDG

Building Of Dwelling Houses In Estonia :: essays research papers

Building of Dwelling Houses in Estonia Not wanting to analyze the building of dwelling houses in Estonia inefficiently and seemingly scientifically (where would I have got competent statistics from), I simply try to express the thoughts which are connected with that topics somehow and have come into my mind. What kind of â€Å"scientific† analysis it could be or who should make it, if even the architectural critics seem not to manage with the simplest things. That reminds me an article in the EE some time ago about a Finnish lady (naturally in Finland) completing or taking her doctor's degree. She was examining Finnish post-war modern house, it's morphology, the structure of the Finnish family, the connections between them and making conclusions which extend to this day. Those observations about architecture were much more smarter than those that the most of self-confident architects could do. Unfortunately it has to be confessed that I don't remember such a research work or sentiments in Estonian science, but no doubt, they could be necessary. The typology of the houses used by most of the architects goes back to the living model of the middle class at the end of the 19th century. That model was idealized and carried on through a hundred of years up to the end of this century. No doubt that our living style is changing — repeating banalities: paradigm changes — as well as the composition and make-up of the family. There was a news in a newspaper about Estonia which declared that 50 % of the children are illegitimate (it is possible, of course, that some parents live together without getting married officially) and 12,5 % of the born children know nothing about their fathers. The living with grandparents is not so popular any more. (As to the models of living it is worth of observing what has happened in North- America — though some europercentage followers don't accept that — it may happen that we will be on the same development level soon. In that country the grown-up children don't want to live with their fathers and mothers, at least statistically). Even such an every day activity as cooking is changing essentially. An apartment or house is not a small production unit with its storages, kitchen and dining room any more. The kitchen can be as presentable as the dining room, also the furniture and the quality of the activities, they can become more melted. There are some theorists who admit that not only eating but washing procedures as well will leave the house to so-called town-social level.

Internet is the major driving force behind this growth

The UK tourism industry is the fifth largest industry and is worth 85 billion pounds and employs 2.1million people which as about 7.7% of the total workforce. (Visit Britain, press release, 11/Jan/2007)Internet is the major driving force behind this growth, which has seen the development of latest technologies that encourage browsing on personal computers.These days, people can get tourism information easily anywhere in the world if they have access to a computer. Internet usage and popularity has continued to grow at an unprecedented rate ever since its invention. Today according to Internet world state (data), 1.1 billion people are connecting to it.The Internet has generated new communication space, which is called cyberspace (Cyberspace 2 data). People can be in and out ‘virtually’ at any time in this space where a community of users is formed.Recently the Internet has become an essential factor in the cyber market and in people’s life. Because of this the tou rism industry needs to invest much of its resources towards establishing a comprehensive Internet marketing system.There are many travel agencies, hotels and airline companies opening their own web homepages and offering tourism information and related services for tourists. This makes it almost impossible today to operate without the Internet, because many organizations are selling their products on-line and covers all aspects of life service.Since the advent of Internet, electronic commerce or E-commerce as popularly known has become an important factor for revenue generation for organizations. According to the Market Report of 2005, the amount of UK e-commerce consumption is expanding annually. (Figure 1)Figure 1: The estimated total UK online market for leisure and entertainment by value (ï ¿ ¡m), 2001-2005Moreover, Internet electronic commerce revenue is predicted to increase by 177.4% between 2005 and 2009 to ï ¿ ¡236.9bn. As seen in the above chart, e-commerce in hotels has continued to increase over the time. (Keynote Ltd, 2005)However, there would not be enough levels of revenue from hotel products over the Internet, because of unfamiliarity on the Internet. Over the last few years it has had a big impact on modern life, so people would not hesitate to pay for these products online using the electronic facilities available.The Hotel on the Internet uses sophisticated technology in its business relationship-marketing program that helps to generate business-marketing leads and maintain long-term customer relationships.Hotels need to use effective reservation services for easy gathering of customer information, enhancing various services like media advertising, internal marketing programs and customer feedback platforms. Therefore, the marketer and the manager of the hotel need to pursue a systematic and organized management process for their web homepage by regularly updating their website.These study is a research on a hotel organization to see how t hey utilized their homepage in relations to their own Internet marketing and the most important factors to pay attention to. It also checks out the general performance using the Internet system. Finally, the research will suggest recommendations for future hotel Internet marketing.References[KM CHO1]1. Visit Britain, press release, www.visitbritain.com.presscentre 11/Jan/20072. World state1) http://www.internetworldstats.com/top20.htm 03/01/20083. (Cyberspace 2) http://www.atis.org/tg2k/_cyberspace.html 03/01/20084. E-commerce: The internet leisure & entertainment market, Fourth edition, p11, June 2006, Key note Ltd, Middlesex5. Internet usage in business, Eighth edition, p72, July 2005, Key note Ltd, Middlesex6. Secondary research – information sources and methods, Stewart, David W, p1, p2, 1993, SAGE Publications, LondonKjell Erik Rudestam, Ph.D. and Rae Newton, Ph D: Surviving Your Dissertation: A Comprehensive Guide to Content and Process. February 2006, p,10-77[KM CHO1]R eview the reference presentation by going to the research centre for â€Å"Reference guidelines†

Analysis of Chapters 8 and 9 in Paradise of the Blind Essay

Write an analysis of how Chapters 8 and 9 explore the connection between culture, food and community The interdependent connection between culture, food and community is pivotal in the demonstration of the importance Vietnamese tradition in Paradise of the Blind. Chapters eight and nine focus on the importance of culture through family particularly evident in the way food acts as an expression of this culture. Food is also used to establish a sense of community, which is an important aspect in the Vietnamese culture. Food is presented as a direct reflection of a person’s wealth in Vietnamese culture. Limited in other forms of power, women like Aunt Tam can rely on materialistic objects, such as food, in order to display their wealth and earn respect. This is evident as one of the guests at the feast exclaims, â€Å"What a pleasure this evening has been. A sumptuous meal followed by such spellbinding stories. This is a blessing from heaven.† The use of words with strongly positive connotations, such as â€Å"sumptuous† and â€Å"spellbinding† displays the great degree of appreciation and thus importance that food has on Vietnamese culture. This idea is further emphasised with the reference to the Gods and ancestral beings through the use of the word â€Å"heaven†. Another example of food reflecting the idea of wealth is when another guest says, â€Å"A sticky rice flavoured with rose-apple juice! Why, it’s exquisite.† Aunt Tam responds to the compliment, â€Å"Oh please, will you stop it?† The use of the word â€Å"exquisite† again highlights the importance of food and its inherent effectiveness in delivering praise. The way in which Aunt Tam replies, almost rehearsed and clichà ©d, suggests that there was an unspoken expectation of praise and therefore respect in the original intention of the feast. The undeniable connection between food and wealth reflects the material-focused culture of Vietnam. Another idea that connects food to culture is the idea of the sacrifice, particularly in relation to food. Selflessness is a major part of Vietnamese culture and a certain amount of gratification can be achieved through sacrifice, which is shown in these chapters as sacrifice of food. Hang observes that Aunt Tam â€Å"ate almost nothing as if watching me gave her greater pleasure.† Aunt Tam’s sacrifice of her own wellbeing reflects the cultural idea that the strongest link between people is in family. Aunt Tam is willing, even happy to sacrifice her own well-being in order to cater for Hang. This idea of sacrifice can also be linked to the cultural idea of worship and fate, whereby it is believed those who perform good deeds in the present will be rewarded in the future. This idea of selflessness has evidently also affected Hang as she says â€Å"I played the part of the successful niece†¦ I smile dutifully at everyone. My lips stiffened into a permanent smile.† Although Hang is obviously uncomfortable, which can be seen through the use of words such as â€Å"dutifully† and â€Å"stiffened†, she continues to put on a faà §ade of happiness to please her Aunt. This reinforces the cultural idea of the strength of familial ties as well as the importance of sacrifice in solidifying these relationships. The practice of food preparation establishes a sense of community in the chapter. Food preparation appears to have a rehearsed, methodical quality which is evident in the line â€Å"The scene was lively but well-ordered as if all the feverish activity was directed by the iron hand of some invisible conductor.† The simile of the conductor draws a comparison of food preparation to an orchestra, thereby highlighting the importance of group collaboration. Furthermore, the juxtaposition of the â€Å"feverish activity† and its â€Å"well-ordered† nature suggests the idea of controlled chaos. Thus the great amount of activity that is required in the practice of food preparation can only be completed with the cooperation of each individual party. Finally, the unchanging nature of culture is shown to cause conflict within Hang’s character as she is caught in her desire to become a modern woman and her family’s strong links to cultural traditions. Hang describes the countryside as â€Å"Everywhere, an indescribable backwardness hung in the air, immaterial yet terrifyingly present: It would be like this for eternity.† This line suggests not only in restrictive nature of culture but also shows how difficult it is to shake culture. The use of the phrase â€Å"terrifyingly present† highlights the inescapable nature of tradition and the strong bond to which each individual in the book is tied to their traditions. The ideas of food, culture and community are explore in chapters eight and nine, particularly through the ideas of family relationships and its strong links to traditional Vietnamese culture.