On February 25, 1990, a Florida woman named Terri Schiavo went into cardiac arrest, apparently triggered by a bulimic episode. She was eventually revived, but her brain had been deprived of oxygen for a long time. Brain scans indicated that there was no activity in her cerebral cortex, and she suffered from severe and permanent cerebral atrophy. Basically, Schiavo was in a vegetative state. Medical professionals determined that she would never again be able to move, talk, or respond in any way. To remain alive, she required a feeding tube, and there was no chance that her situation would ever improve.

On occasion, Schiavo’s eyes would move, and sometimes she would groan. Despite the doctors’ insistence to the contrary, her parents believed that these were signs that she was trying to communicate with them.

After 12 years, Schiavo’s husband argued that his wife would not have wanted to be kept alive with no feelings, sensations, or brain activity. Her parents, however, were very much against removing her feeding tube. Eventually, the case made its way to the courts, both in the state of Florida and at the federal level. By 2005, the courts found in favor of Schiavo’s husband, and the feeding tube was removed on March 18, 2005. Schiavo died 13 days later.

Why did Schiavo’s eyes sometimes move, and why did she groan? Although the parts of her brain that control thought, voluntary movement, and feeling were completely damaged, her brainstem was still intact. Her medulla and pons maintained her breathing and caused involuntary movements of her eyes and the occasional groans. Over the 15-year period that she was on a feeding tube, Schiavo’s medical costs may have topped $7 million (Arnst, 2003).

These questions were brought to popular conscience 25 years ago in the case of Terri Schiavo, and they persist today. In 2013, a 13-year-old girl who suffered complications after tonsil surgery was declared brain dead. There was a battle between her family, who wanted her to remain on life support, and the hospital’s policies regarding persons declared brain dead. In another complicated 2013–14 case in Texas, a pregnant EMT professional declared brain dead was kept alive for weeks, despite her spouse’s directives, which were based on her wishes should this situation arise. In this case, state laws designed to protect an unborn fetus came into consideration until doctors determined the fetus unviable.

What do you think? Choose ONE of the following question prompts for your INITIAL discussion post:

Decisions surrounding the medical response to patients declared brain dead are complex. What do you think about these issues?
What would you do if your spouse or loved one was declared brain dead but his or her body was being kept alive by medical equipment?
Whose decision should it be to remove a feeding tube?
Should medical care costs be a factor?

please read and follow all the information that is listed below correctly.

Learning outcomes assessed:
1. Identify the different petroleum products, their markets and any seasonality of demand.

2. Differentiate between the characteristics of National Oil Companies, International Oil Companies and Government-Sponsored Enterprises.

3. Explain the structure of the Oil & Gas industry.

4. Explain the fundamental differences in the supply chain for petroleum
products from that for natural gas and an appreciation of fossil fuel’s share of
the global energy market, the historical trends and the broad outlook for the
future.

Assignment Question
Write a 1500 word report on the following topic:
Describe the journey of one petroleum product and one natural gas product of
your choice and compare and contrast the differences in their journeys from the
start to finish through the supply chain:
The supply chains of the Oil and Gas (with use of diagram)
• Upstream
• Midstream
• Downstream
Describe the following:
• The history and the structure of the Oil & Gas industry
• The origin and formation of Oil & Gas
Explain the different roles of the followings:
• International Oil Companies
• National Oil Companies
• Government Sponsored Enterprises
Discuss the demand and seasonality of the chosen product
• Discuss how the chosen products are demanded in the markets

Introduction (about 10% of word count)
Include some brief background information on the oil and gas industry and the products you will discuss.
Explain the steps you will take to address the question.

Main Body (about 80% of word count)
Include separate sections for the different tasks listed above and use subheadings as appropriate.

Conclusion (about 10% of word count)
Do not introduce any NEW material here. Summarise your findings, including
any key similarities and differences. Comment briefly on possible future developments in relation to the industry or products discussed.

Reference List
An alphabetically ordered list of the references cited in your report, in Harvard
style.

Mrs Kapoor is a 67-year-old British Asian lady who was diagnosed with colorectal cancer 2 years ago, and has undergone surgery (with stoma formation) followed by chemotherapy, which has helped to control the disease. Her most recent scans indicate that the cancer has recurred, and has spread. The treatment options have been discussed with her and her family, and she has decided that due to the extent of the disease, and the likely benefit of the treatment she would prefer to have a more palliative approach in managing the disease. Mrs Kapoor and her family are aware that she is nearing the end of her life.

Mrs Kapoor lives with her husband, daughter and mother at home. She also has a married son who lives nearby and a grandaughter.
Mrs Kapoor has family in India, and her Hindu faith is important to her.

You are part of the inter-discilplinary team caring for Mrs Kapoor, and it is your role to ensure her nursing needs are met.

Information Systems to Support Population Health Management

Research a minimum of four articles on big data, its usefulness in healthcare, and achieving the goal of improving patient outcomes. Do a SWOT (strengths, weaknesses, opportunities, and threats) analysis on the use of health data and the potential to improve patient outcomes based on these articles. Summarize the benefits to the patients, healthcare organizations, and providers.

Your paper should include the following:

3 pages in length, not including the title and reference pages.
3 references cited in the assignment. Remember, you must support your thinking/opinions and prior knowledge with references; all facts must be supported; and in-text references used throughout the assignment must be included in an APA-formatted reference list.
Review the grading rubric, which can be accessed from the module folder.

What is the most important health intervention in East London in 2018?

1. Please describe the health intervention and identify what issue it would address.
2. Explain the reasons why you think is important- draw upon evidence to support your argument.
3. Ensure that you identify key national and international public health policies and drivers.
4. Who will benefit most from this intervention ( age, gender, for example)?
5. Conclusion.

Word count is 2000 words.

Reference in Harvard.

For each question or set of questions, students must respond with an answer of no less than 400-500 words, and must reference at least 2 of the required texts from the Unit. Students are also encouraged to think about each question in relation to their own life experience, and to think about the connections between the ideas contained in each Unit.

Thinking critically about the social determinants of health, how do you see them as related to the concept of reproductive freedom?
Thinking critically about the social determinants of health, how do you see them as related to the so called “obesity epidemic”?

comment on the 2 post below

The social determinants of health have a very direct and clear relationship to the concept of reproductive freedom. First of all, reproductive freedom is most available to women who are affluent, educated and independent. These factors are most likely to guarantee a women access to appropriate health care in any and all scenarios. These factors determine the quality of and access to all that is necessary to ensure reproductive freedom. Educated women know of and have access to the information required, money ensures accessibility to required services and options, whether locally or abroad and independence ensures there are no suppressors denying her decisions.

“Poverty, social exclusion, poor housing and poor health systems are among the main social causes of ill health” (Hobbs & Rice, p. 456). Overpopulation, poverty and unemployment are factors that have led to enforced sterilization in countries like India, and Latin America (p. 475 – 477). Women’s reproductive freedom in India, for example, is a far off dream for many. Since the 70’s Indian governments have been concerned with population control and their main way of addressing it was enforced sterilization (p. 478). In South Africa, the Aids epidemic has given women no path to reproductive freedom.

Economics, social ills, racism are all part of the social determinants of health and they all play a role in the suppression of reproductive freedom for women. Even in developed communities like North America, women who are white, wealthy, educated and independent are the most likely to achieve reproductive freedom. They can afford the care they need and the choices available are all open to them. Women on low incomes have more limited choices. They may not have money to purchase contraception. Even access to a family doctor in some areas is limited or not there. Uneducated women may not know enough about women’s health to avail of opportunities that may exist, and limited child care options may cut down on her time and options. Poverty is a difficult life circumstance, but when coupled with limited education, perhaps immigrant status, maybe a disability, then a woman has little to no reproductive freedom.

Reproductive freedom is perhaps more ensured in the concept of reproductive justice. “Reproductive justice is the complete physical, mental, spiritual, political, social, and economic well-being of women and girls, based on the full achievement and protection of women’s human rights” (Ross, p. 489) I don’t think this has yet been achieved, and though Canada may be moving closer, the United States, appears to be moving further away from it.

2.

The obesity epidemic is complicated by a number of influences: the medical community and its theories, and the fashion community and its fads. The radio documentary, The Fat Wars, explains the history of what society considers attractive and desirable in terms of women’s bodies. It started with plump and went to thin in the Flapper era of the early 1900’s, then to more plump in the 1950’s, and then fashion dictated ultra-thin from the 60’s to current times. Unfortunately, it is not so easy to manipulate your body weight to conform to this, and in so doing or trying to do this, women may have put their health at risk.

It is obvious that women who may be more in a position to address such health related issues are those who are more educated, more wealthy and more independent. Obesity, many doctors assume, can be addressed with access to medical and dietary help. However, as outlined in The Fat Wars, there is a strong belief among some in the field that dieting and lowering calories will not address obesity, but perhaps make it worse. Women, unfortunately, are at a disadvantage here, particularly if they do not have access to information, education and credible support. Of course, there is a social and psychological aspect to obesity as well. Obese women encounter discrimination in many areas of their lives as many people link their weight to overeating and a lack of discipline. This can then create a nasty spiral adding depression and low feelings of self- worth to an obesity issue. If you throw in other social determinants such as race, poverty, etc, you have a hugely suppressive environment for women.

Obese women, however, may be doing better than they think health-wise. It is only society in general, manipulated by doctors who presume ill health will result from obesity, that think obese people are heading for early death. There are those in the medical profession who do not hold that idea at all. They say that fat may be, in fact, good for the body. There are fat people who do not suffer from hypertension, diabetes and such. If a person eats healthy, does not overeat and remains active, though they are fat, they may continue to live healthy lives for a long time. Trying to manipulate weight with diets and calorie restrictions may create unnecessary tension and stress for women.

We rely on the medical profession to lead us in a good direction, but we must sometimes be prepared to do our own research, to know whose advice to follow. Meantime, access to that knowledge and the health and information facilities needed is an important advantage. The economic and social conditions of the country are important to the provision of these services and the further accessibility to them is insured by a person’s individual resources (p. 457)

References:

Eisen, Jill. (1990). The Fat Wars. (Radio Broadcast) CBC: Toronto

Hobbs, Margaret & Rice, Carla. (2013). Part 4 (b) pp. 355 – 389. Gender and Women’s Studies

in Canada Critical Terrain. Women’s Press. Toronto.

post 2
i will post it tomorrow

Write a comprehensive waste recycling business plan and answer the following five questions.

1. What waste materials would you recycle? Consider which recyclable materials have the highest demand and are easily available in volume (i.e. cardboard, plastic, metal, textile, etc.).

Recycling symbol for #2 plastics2. How would you collect the waste material? A steady supply of the recyclables in signifiagant volumes over a long period is ideal. Proximity of your sources is important, also, as you evaluate transportation costs.

3. Who would be the buyers of the final product? Which industries have a market demand for your reusable materials? Consider how much your buyers will pay for recyclables in bale form.

4. How will you finance your business? Consider grants or special loans that may be available from the government or other environmental programs. Costs would include your facility, equipment, staff, and electricity, in addition to the transportation, storage, and handling of the waste and recycling materials.

5. How will you make your operation efficient and profitable? Identify what equipment will be needed to efficiently process the recyclables. Processes such as sorting, baling, storage, and delivering the recyclables for easier transport and reuse should be evaluated. Baling equipment will help automate the processes and are designed for various facility needs.

Finally suggest the best recycling and waste management equipment for the business or facility, the ideal equipment must suit the type of materials, volume, and facility.

A newborn girl is brought into the genetics department for a karyotype study. She was born of a 50y/o mother who feels that her child is developmentally retarded with characteristics “mongoloiddge” facial features; her pregnancy was uneventful.

On physical examination, the child presents with generalized hypotonia; flattened face and low set ears; macroglossia; flattened nasal bridge and epicanthal folds;; single transverse palmar crease with widely split fixed S2 (due to an atrial septal defect).

Karyotype reveals 47, XX; trisomy 21

On gross pathology, the child has brachycephalic head; small brain with shallow sulci; hypoplasia of frontal sinuses; endocardial cushion defect.

Imaging: double bubble (dilated stomach and proximal duodenum) due to duodenal atresia.

X-ray is unsignificant (plain); hypoplastic middle and terminal phalanges of fifth digits (Acromicria).

1) Please provide four (4) nursing differential diagnoses for this case

2) Please design a short term nursing management for the patient

3) Please provide a long term management for the patient.

2. For question #2 you will need to review and reference the reading. Select one of the sections from chapters 12 or 13 with the heading “Biocultural Connection.” Provide a summary of the major points with a focus on the culture of the people studied, the findings/contributions from anthropology, and how this relates to the key concepts from the reading/chapter. Respond to the “Biocultural Question” at the end of the section. Be sure to cite the page number and topic that you selected.

3. Apply anthropological concepts of marriage and family to a fictional family from a popular television show, movie, or book. Provide a general background on the family such as listing the individual members and their relations to one another.

A) Discuss whether or not the marriage present in the family is best described by endogamy and/or exogamy, while referencing these terms.

B) Describe the conjugal and/or consanguineal ties in the family while, while referencing these terms.

C) In terms of primary residence, is the family best described as nuclear, extended or “nontraditional?” Does the family live in a patrilocal, matrilocal, or neolocal residence?

D) Discuss how at least one or more of the members of the family associate with others outside of the family by gender, age set, and/or common interest.

4. For question #4 you will need to review and reference the YouTube video “Shadows and Reflections: Florida’s Lost People by FAS.” Shadows and Reflections: Florida’s Lost People by FAS

A) Summarize the key cultural features of the following indigenous groups of prehistoric Florida: Paleoindians, Calusa, Apalachee, Timucua, and Tequesta while considering geography, subsistence, social status, identity, bodily adornment, and sex roles (where relevant to each group).

B) What are the major sources of data (such as archaeological remains, ethnohistoric documents, landscape, etc.) that provides us with a picture of Florida’s lost people? How can anthropology, archaeology, history, and art all complement each other towards this end?

Neurological or Musculoskeletal
What part of the neurological or musculoskeletal exam in the pediatric population, challenges you the most, and how do you plan on embracing it?

I want to define in the first paragrah what is a neurological and muculoskeletal exam
the most challenging situation its when i perform the
funduscopic exam to evaluate the appearance of the optic disk, macula,retina including to evaluate the pupillary size and reaction to light, when its a infant its not so difficult but when its a toddler its a challenge due to the fact the child get irritable and anxious during the procedure,
I plan to have some toys to start play with them and capture the attention of the child in other to perform the exam and during the process explain to them the different procedures are going to perform in order to reduce the stress and anxiety.