Knowledge & Understanding questions Essay

1.1 Describe a range of causes of dementia syndrome ANSWER Neurodegenerative diseases is a common cause of dementia which mean that the brain cells known at the neurons either are degenerating therefore the neuron die off quicker which will lead to a more decline in the person mental health such as memory, language and sometimes their physical abilities all depending on which area of the brain is infected. Dementia affects the brain and the loss of function of the brain in such a way that the things we normally take for granted, for example our ability to remember things (time, date, events, to use language all of these things begin to disappear. Also there are more causes of dementia caused by depression, brain tumours, thyroid hormone, and head injuries. Some of these causes of dementia can also be dementia –like conditions which may be treatable or non-progressive. These neurodegenerative diseases are known to us as Alzheimer’s fronto temporal dementia, and Lewy bodies are where over time a build up of abnormal protein deposits in the brain cause the gradual change and damage to the neurons which will cause the shrinkage of the brain. 1.2 Describe the types of memory impairment commonly experienced by individuals with dementia ANSWER Dementia is a collection of symptoms including memory loss, personality change, and impaired intellectual functions resulting from disease or trauma to the brain. These changes are not part of normal ageing and are severe enough to impact daily living skills, independence, and relationships, while Alzheimer’s disease is the most common type of dementia, there are also many other forms, including vascular and mixed dementia. Common signs and symptoms of dementia may include: Memory loss Impaired judgement Difficulties with abstract thinking Faulty reasoning Inappropriate behaviour Loss or communication skills Disorientation to time and place Gait, motor and balance problems Neglect of personal care and safety Hallucinations, paranoia, agitation. The most common forms of mental decline associated with ageing are: Slower thinking and problem solving Decreased attention and concentration Slower recall As the dementia progresses the individual ability to look after themselves from day to day may also become affected. 1.3 Explain the way that individuals process information with reference to the abilities and limitations of individuals with dementia ANSWER The working of the brain are very complex, the human brain is made up of around 100 billion cells, main these cells are called neurons. If the neurons is switched off is resting when it is switched on it fires electrical impulses along its body known as the axon. Some people with dementia often confuse things, this may be very distressing for their family or carers, but can be called as a natural aspect of their memory loss. An individual with dementia may be trying to interpret a world that no longer makes sense to them that because them brain is processing the information incorrectly. An individual with dementia may receive care from a provider who does not maintain a good standard of continuity with their staff, for a person with dementia it is very important as they must become familiar with  the people who care for them to gain trust and familiarity with their daily routine. Communication could not be structured correctly for the person who causes confusion and lack of understanding as they are unable to comprehend what is expected of them. Infections, change of medication, change of environment, pain and stress, social skills, understanding and interaction levels may decrease or fluctuate. However an individual process the information in different ways therefore depending on their abilities will depend on their limitations as suffering with Dementia. 1.4 Explain how other factors can cause changes in an individual’s condition that may not be attributable to dementia ANSWER Change of diet, environment, and medication can cause changes in an individual condition; in spite of the fact experiencing a loss of reduction in memory does not mean always indicate a form of dementia. There are many other conditions which could affect an individual health which can be a difference between dementia, depression and confusional state. Sensory changes due to age related degeneration example macular degeneration and cataracts affecting vision, loss of hearing and increase of tinnitus affecting balance, reduced metabolism causing poor appetite. The part of the brain which was affected will determine how the person will be affected. Some condition that may affect the memory are listed below: Brain injury- which can be caused by an external trauma such as a blow to the head or internal factors such as a result of a stroke or aneurism. Brain tumour – a tumour of the brain can be benign (slow growing, non cancerous) or malignant Medication – some prescription medication can have side effects which can affect somebody’s memory. Diet – some foods can have an effect on a person’s memory. Stress –is the emotional and physical strain caused by individual’s response to pressure from the outside world. Stress can affect an individual’s health in many ways, including memory difficulties. 1.5 Explain why the abilities and needs of an individual with dementia may fluctuate ANSWER Each individual may experience dementia in different ways. There is no definitive direction or path that the condition will follow and there are no exact timescales in which the condition may progress. Somebody with dementia can have â€Å"good days† and â€Å"bad days†. Believed all depends on how we are feeling, how much sleep we have had, and what activity we are doing and how much we want to do that activity. On the other hand changes that may occur in their day to day life, changes of people (changes of carers on a regular basis), therefore not being consistent in a routine programme. 2.1 Describe the impact of early diagnosis and follow up to diagnosis ANSWER Generally speaking for most people receiving the diagnosis of dementia is very distressing, also can be very upsetting for their loves one. Many people in nowadays still, think of dementia as being a condition which causes people to go â€Å"crazy†. When supporting somebody who is exhibiting any signs or symptoms of forgetfulness, confusion or the inability to find the right words when communicating, it is important that they see their GP. In the early stages diagnosis can be difficult to make as the symptoms of dementia can develop slowly, also the symptoms can be similar to symptoms of other health condition. The early diagnosis of dementia is essential in order to: Rule out other conditions that may be treatable Access advice, information and support Allow the person with dementia and their family to plan and make arrangements for the future. Although there is not cure at the present, there are various medications available which can help improve symptoms and possibly to slow down the progression of disease. Following diagnosis, an individual may want to live as independently as they can. In order to aid a person to self look after themselves, the individual could place a list of important telephone numbers by their phone, labels also could be placed on cupboards doors to  remind them of the contents. However the quality of life, fear, feeling lack of control, loss of dignity, loss of identity, invasion of privacy, fear or losing own home, inability to communicate needs and preferences, loss of friends , increased risk of falls, nutrition, personal hygiene all of these factors are playing a huge impact in an individual life diagnosed with dementia. 2.2 Explain the importance of recording possible signs or symptoms of dementia in an individual in line with agreed ways of working ANSWER The recording signs or symptoms of dementia in an individual day by day life can be made, depends of the policies and procedures of the company such as verbal, written, electronic, accurate, timely, and confidential reporting. When monitoring somebody’s condition, it is important to record any findings in line with the organisation’s policies and procedures. The following areas area those which it is very important to monitor and record in the person, as these will show what changes have occurred and over what period: Memory Behaviour Personality Ability to cope with daily living skills Care- giving strategies Activities that person enjoys Any medication that they have taken that day Below are shown some key points in importance of recording: To obtain specific facts about health, personal matters To measure accurately the individual needs To ensure health and safety of all involved To accurately record the action agreed To ensure nutrition needs are accurately met To make sure hygiene needs are met Follow the Smart model( specific, measurable, realistic and time based) to be  sure the individuals family and carers have their needs met. 2.3 Explain the process of reporting possible signs of dementia within agreed ways of working ANSWER The diagnosis of dementia does not always occur from the first visit to GP. Generally there is a process in which the person goes through in order to receive a definitive diagnosis. National Institute for Health and Clinical Excellence has advised guidelines in supporting people with dementia, where the early diagnosis of dementia it is included. The person history A cognitive and mental state examination A physical examination A review of all medication including over the counter remedies To report a concern, the organisation’s guidelines and procedures have to be followed, usually most reports are given to a designated member of staff, this may be line manager, supervisor or manager, always try to avoid by giving the personal opinion. Also agreed ways of working may be: Medical diagnosis Referral pathway Diagnosis tests Profiling Observation Care planning Review Follow up Continuation of care 2.4 Describe the possible impact of receiving a diagnosis of dementia on: A) The individual B) Their family and friends ANSWER The impact on the person and their family receiving a diagnosis of dementia can vary, some may see it as a relief that the cause if their difficulties has been diagnosed while others may be in disbelief, preferring not to acknowledge what they have been told. Impact on the individual: Confusion Shock Frightened Denial of failings Disorientation Trying to construct sense of meaning into the situation Destruction of hope Loss of future goals May have to retire early Financial implications May need to stop driving Loss of socialisation Whatever feeling the diagnosis creates in the person, you should encourage and support them to talk about their feelings. Impact on family and friends: Loss of socialisation Increased stress levels Feeling of guilt Need to balance commitments Anger Loss of financial support/ increased financial needs Fear Feeling embarrassed The individual’s family and friends should respect the wishes of their loved one. 3.1 Compare a person-centred and a non-person-centred approach to dementia care ANSWER When an individual been diagnosed with dementia it is important to bear in mind that people with dementia are individuals first, with their condition of dementia coming second. They may also be mothers, fathers, brothers, sisters, sons or daughters. Person-centred care is a way of providing care with the person at the centre of everything you do, or another way of describing it is individualised care- care that is given to the person according their needs, wishes, beliefs and preferences. Studies have shown that a person-centred approach can help reduce agitation in the person with dementia where the agitation is often causes by the person’s frustration in not being able to express themselves . Recognising individuality Enabling choices Enabling social relationships Valuing the individual Providing the opportunity for stimulation Inclusion Looking at the person a s unified whole Once a person needs have been identified, plans should be made to draw up a support plan which will describe how those needs will be met. Nothing should be planned for the individuals for them without them. A non person-centred approach can be identify such as: Dictating form of care to be used Not recognising the individual’s uniqueness and needs Exclusion Lack of choice Not allowing participation in decision making Not allowing the individual to exercise their rights Responding to behaviour rather than looking at the unified whole Not empowering the individual 3.2 Describe a range of different techniques that can be used to meet the fluctuating abilities and needs of the individual with dementia ANSWER Many people with dementia are able to live in their own homes for most their lives with care being given to them by their families. As a carer or support for those suffering with dementia, must focus on the skills and abilities that the person has, rather those that they have lost. Ensure that they are fully aware of and respect the person’s background, their history, likes and dislikes. Be prepared for changes and adapt flexible approach. Not every day may be the same in supporting people with dementia. By learning about each individual ‘history and background, can be designed the care and the type of support provided around their specific needs. Ensure that individual’s support plan is kept as up to date as possible and shows alternative methods to use for various fluctuations in their support needs, share the information with the rest of the carers., provide a stable environment and suitable surroundings as one of the main triggers resulting in somebody with dementia becoming agitated and confused is a change in their routine. To ensure stability it is important to : Have consistent, regular staff, unfamiliar faces can cause the person great upset Maintain a familiar environment, if there some new decorations needs to be undertaken try to make the new decor similar if not the same as it was previously. Ensure that the individual is in a non stressful, constant and familiar environment Establish a regular routine regular physical activity and adequate exposure to light and improve any sleep disturbances.

Literature Search

Grap, Mary. ,Munro, Cindy. , Hummel, Russel. , Jessica. , Elswick, and Sessler Curtis. 2005. Effect of Backrest Elevation on the Development of Ventilator-Associated Pneumonia. AACN. Retrieved from ajcc. aacnjournals. org on March 3, 2012. Abstract †¢ Background Ventilator-associated pneumonia is a common complication of mechanical ventilation. Backrest position and time spent supine are critical risk factors for aspiration, increasing the risk for pneumonia. Empirical evidence of the effect of backrest positions on the incidence of ventilator-associated pneumonia, especially during mechanical ventilation over time, is limited. Objective To describe the relationship between backrest elevation and development of ventilator-associated pneumonia. †¢ Methods : It is a nonexperimental, longitudinal, descriptive design was used. The Clinical Pulmonary Infection Score was used to determine ventilator-associated pneumonia. Backrest elevation was measured continuously with a transdu cer system. Data were obtained from laboratory results and medical records from the start of mechanical ventilation up to 7 days. †¢ Results Sixty-six subjects were monitored (276 patient days).Mean backrest elevation for the entire study period was 21. 7 °. Backrest elevations were less than 30 ° 72% of the time and less than 10 ° 39% of the time. The mean Clinical Pulmonary Infection Score increased but not significantly, and backrest elevation had no direct effect on mean scores. A model for predicting the Clinical Pulmonary Infection Score at day 4 included baseline score, percentage of time spent at less than 30 ° on study day 1, and score on the Acute Physiology and Chronic Health Evaluation II, explaining 81% of the variability (F=7. 1, P=. 003). Literature Search 3 †¢ Conclusions Subjects spent the majority of the time at backrest elevations less than 30 °. Only the combination of early, low backrest elevation and severity of illness affected the incidenc e of ventilator-associated pneumonia. Amelia Ross. (2006). The impact of an evidence-based practice education program on the role of oral care in the prevention of ventilator-associated pneumonia. Retrieved from, www. elsevierhealth. com/journals/iccn. on March 2, 2012.Abstract BACKGROUND: Despite strong evidence in the literature on the role of oral care in the prevention of ventilator-associated pneumonia (VAP), nurses continue to view oral care as a comfort measure with low priority and utilize foam swabs rather than toothbrushes. Although an evidence-based oral care protocol existed and best-practice oral care tools were available, the VAP rates had not significantly decreased even though nurses reported providing oral care. OBJECTIVES:The aim of the study was to determine if an evidence-based practice (EBP) educational program would improve the quality of oral care delivered to mechanically ventilated patients; thereby, reducing the VAP rate. RESULTS: Improvement in oral health was demonstrated by a decrease in median scores on the Oral Assessment Guide (pre (11. 0), post (9. 0)). A t-test analysis revealed a statistically significant difference (p=0. 0002). The frequency of oral care documentation also improved as demonstrated by a positive shift to the more frequent timeframes. The VAP rates have decreased by 50% following the EBP education Literature Search 4 ntervention. CONCLUSIONS: The implementation of an EBP educational program focused on patient outcome rather than a task to be performed improved the quality of oral care delivered by the nursing staff. Carolyn L. , Cason, Tracy, Tyner. , Sue, Saunders, Lisa, Broom. , 2007. Nurses Implementation of Guidelines for Ventilator-Associated Pneumonia from the Centers for Disease Control and Prevention. AACN. Retrieved from ajcc. aacnjournals. org on March 1, 2012. Abstract †¢ Background Ventilator-associated pneumonia accounts for 47% of infections in patients in intensive care units.Adherence to t he best nursing practices recommended in the 2003 guidelines for the prevention of ventilator-associated pneumonia from the Centers for Disease Control and Prevention should reduce the risk of ventilator-associated pneumonia. †¢ Objective To evaluate the extent to which nurses working in intensive care units implement best practices when managing adult patients receiving mechanical ventilation. †¢ Methods Nurses attending education seminars in the United States completed a 29-item questionnaire about the type and frequency of care provided. †¢ Results Twelve hundred nurses completed the questionnaire.Most (82%) reported compliance with hand-washing guidelines, 75% reported wearing gloves, half reported elevating the head of the bed, a third reported performing subglottic suctioning, and half reported having an oral care protocol in their hospital. Nurses in hospitals with an oral care protocol reported better compliance with hand washing and maintaining head-of-bed el evation, were more likely to regularly provide oral care, and were more familiar with rates of ventilator-associated pneumonia and the organisms involved than were nurses working in hospitals without such protocols.Literature Search5 †¢ Conclusions The guidelines for the prevention of ventilator-associated pneumonia from the Centers for Disease Control and Prevention are not consistently or uniformly implemented. Practices of nurses employed in hospitals with oral care protocols are more often congruent with the guidelines than are practices of nurses employed in hospitals without such protocols. Significant reductions in rates of ventilator-associated pneumonia may be achieved by broader implementation of oral care protocols. Grap, Mary. ,Munro, Cindy. , Hummel, Russel. , Jessica. Elswick, and Sessler Curtis. 2005. Effect of Backrest Elevation on the Development of Ventilator-Associated Pneumonia. AACN. Retrieved from ajcc. aacnjournals. org on March 3, 2012. Abstract †¢ Background Ventilator-associated pneumonia is a common complication of mechanical ventilation. Backrest position and time spent supine are critical risk factors for aspiration, increasing the risk for pneumonia. Empirical evidence of the effect of backrest positions on the incidence of ventilator-associated pneumonia, especially during mechanical ventilation over time, is limited. Objective To describe the relationship between backrest elevation and development of ventilator-associated pneumonia. †¢ Methods : It is a nonexperimental, longitudinal, descriptive design was used. The Clinical Pulmonary Infection Score was used to determine ventilator-associated pneumonia. Backrest elevation was measured continuously with a transducer system. Data were obtained from laboratory results and medical records from the start of mechanical ventilation up to 7 days. †¢ Results Sixty-six subjects were monitored (276 patient days).Mean backrest elevation for the entire study period was 2 1. 7 °. Backrest elevations were less than 30 ° 72% of the time and less than 10 ° 39% of the time. The mean Clinical Pulmonary Infection Score increased but not significantly, and backrest elevation had no direct effect on mean scores. A model for predicting the Clinical Pulmonary Infection Score at day 4 included baseline score, percentage of time spent at less than 30 ° on study day 1, and score on the Acute Physiology and Chronic Health Evaluation II, explaining 81% of the variability (F=7. 1, P=. 003). Literature Search 3 †¢ Conclusions Subjects spent the majority of the time at backrest elevations less than 30 °. Only the combination of early, low backrest elevation and severity of illness affected the incidence of ventilator-associated pneumonia. Amelia Ross. (2006). The impact of an evidence-based practice education program on the role of oral care in the prevention of ventilator-associated pneumonia. Retrieved from, www. elsevierhealth. com/journals/iccn. on March 2, 2012.Abstract BACKGROUND: Despite strong evidence in the literature on the role of oral care in the prevention of ventilator-associated pneumonia (VAP), nurses continue to view oral care as a comfort measure with low priority and utilize foam swabs rather than toothbrushes. Although an evidence-based oral care protocol existed and best-practice oral care tools were available, the VAP rates had not significantly decreased even though nurses reported providing oral care. OBJECTIVES:The aim of the study was to determine if an evidence-based practice (EBP) educational program would improve the quality of oral care delivered to mechanically ventilated patients; thereby, reducing the VAP rate. RESULTS: Improvement in oral health was demonstrated by a decrease in median scores on the Oral Assessment Guide (pre (11. 0), post (9. 0)). A t-test analysis revealed a statistically significant difference (p=0. 0002). The frequency of oral care documentation also improved as demonstrated by a positive shift to the more frequent timeframes. The VAP rates have decreased by 50% following the EBP education Literature Search 4 ntervention. CONCLUSIONS: The implementation of an EBP educational program focused on patient outcome rather than a task to be performed improved the quality of oral care delivered by the nursing staff. Carolyn L. , Cason, Tracy, Tyner. , Sue, Saunders, Lisa, Broom. , 2007. Nurses Implementation of Guidelines for Ventilator-Associated Pneumonia from the Centers for Disease Control and Prevention. AACN. Retrieved from ajcc. aacnjournals. org on March 1, 2012. Abstract †¢ Background Ventilator-associated pneumonia accounts for 47% of infections in patients in intensive care units.Adherence to the best nursing practices recommended in the 2003 guidelines for the prevention of ventilator-associated pneumonia from the Centers for Disease Control and Prevention should reduce the risk of ventilator-associated pneumonia. †¢ Objective To evaluate the extent to which nurses working in intensive care units implement best practices when managing adult patients receiving mechanical ventilation. †¢ Methods Nurses attending education seminars in the United States completed a 29-item questionnaire about the type and frequency of care provided. †¢ Results Twelve hundred nurses completed the questionnaire.Most (82%) reported compliance with hand-washing guidelines, 75% reported wearing gloves, half reported elevating the head of the bed, a third reported performing subglottic suctioning, and half reported having an oral care protocol in their hospital. Nurses in hospitals with an oral care protocol reported better compliance with hand washing and maintaining head-of-bed elevation, were more likely to regularly provide oral care, and were more familiar with rates of ventilator-associated pneumonia and the organisms involved than were nurses working in hospitals without such protocols.Literature Search5 †¢ Conclusions Th e guidelines for the prevention of ventilator-associated pneumonia from the Centers for Disease Control and Prevention are not consistently or uniformly implemented. Practices of nurses employed in hospitals with oral care protocols are more often congruent with the guidelines than are practices of nurses employed in hospitals without such protocols. Significant reductions in rates of ventilator-associated pneumonia may be achieved by broader implementation of oral care protocols.

Review of Tom Englehardt’s The End of Victory Culture Essay

Like many young men of his generation Tom Englehardt is the son of a World War II veteran and was raised in the shadow of Allied victory over Japan and Germany. It was an era of clearly evil enemies and clearly honorable victors. America was a â€Å"winner†, but according to Englehardt â€Å"between 1945 and 1975 victory culture ended in America† and he â€Å"traces its decomposition through those years of generational loss and societal disillusionment to Vietnam, which was its graveyard for all to see† (10). According to Englehardt’s cover-jacket promotion, â€Å"this remarkable and unexpected history of our time†¦reconstructs a half-century of the crumbling borderlands of American consciousness†¦a nation living an afterlife amid the ruins of its national narrative† (cover-jacket). Further, he presents the question of whether there is â€Å"an imaginable America without enemies and without the story of their slaughter and our triumph? † (Cover-jacket). Perhaps since its publication in 1995 Englehardt has had a chance to reflect on his version of American history and consider how it is that America has lived through its â€Å"afterlife† and despite incredible adversity continues to not just survive, but thrive. Englehardt begins his version of post-war American history with what can only be described as the academically-required survey of All That Was Wrong With America. There is a great value in discovering and analyzing policies and actions in a postmortem sense, for the obvious reason of improving what worked and reworking what failed. There is a great disservice in reviewing history within the context and framework of contemporary thought and morality. The reader gets Englehardt’s version of the European White Man’s conquest of indigenous Americans, the depredations of slavery and lynching, and the unworldly horror of American atomic destruction of Hiroshima and Nagasaki. There is little, if any doubt in any rational person’s mind these were not exactly shining examples of Americana. But his recounting of these events raises questions he is unable to answer. First, and truly not callously, how long should America apologize, if that is what Englehardt demands? Second, with American â€Å"manifest destiny† and the bombing of Japan, just exactly what were the alternatives at the time? Finally, with slavery and the civil rights movement, where is the relevance to Englehardt’s central thesis? At some point realizations are made that we cannot undo historical fact, no matter how unsavory the events were, and ultimately, as a person and as a nation we must move on. Throughout his book Englehardt exhibits a not-so-subtle bias, evident from the onset and which must be taken into account. One need look no closer than the jacket promotion: Englehardt is careful to use the word â€Å"slaughter† in reference to America’s enemies, not â€Å"defeat†. Englehardt traces the â€Å"victory culture† through the media, beginning with the World War II era â€Å"Why We Fight† documentaries and Hollywood’s active war-time production of â€Å"hero† movies (51). In the post-war era â€Å"pride in on-screen westerns and war culture was any boy’s inheritance† (52). Englehardt believes the culture was based â€Å"on an ambush that could touch all but the imagination in only the most limited ways. Now for the first time since the earliest days of the European invasion of North America, the ambush (by nuclear weapons) threatened actual extermination† (52). Again, Englehardt is careful to use the word â€Å"invasion† instead of â€Å"migration† or colonization† preferring to impart a negative connotation whenever possible. For him â€Å"the military-industrial complex grew to monstrous proportions† leading to the first real nuclear standoff in the Cuban Missile Crisis (52-3). Englehardt does not supply any reference to support his claim that â€Å"nothing could rally Americans for such a war† (53). Englehardt writes in a very disjointed manner, alternately discussing the bombing of Japan, the Korean War, communism and McCarthyism, and his father (73). He devotes chapters to children’s toys and his own collection of war figurines (85). He discusses the impact of television, and declares that by the end of the sixties â€Å"war as myth and play seemed to have been swept clean out of American culture† (89). In the span of less than thirty pages Englehardt manages to discuss, and apparently relate, Malcolm X, George Kennan, the Cold War, vampires, Broken Arrow, UFO’s and The Incredible Shrinking Man (90-112). Apparently these all relate to the pronouncements of Malcolm X and Kennan, respectively: â€Å"the whole world knows that the white man cannot survive another war† and Kennan â€Å"marking the spot where his own society threatened to leap of some cliff† (111-112). Englehardt continues his review of the media culture of the late fifties and sixties, once again in a very haphazard and distracting style. It seems he is bent on throwing in every facet of American culture as if to miss any one item would spoil his entire recipe. The reader is left to his discussions of anti-communism and Cuba, juvenile delinquency, civil rights, Dobie Gillis, Mad Magazine, Bill Haley and the Comets, television advertising, Rebel Without a Cause and Happy Days. His chapters read more like the answers to a huge game of Trivia Pursuit than any historical reflection of substance. All he is missing is the game cards: question: who played Josh Randall in Wanted: Dead or Alive? answer: Steve McQueen (152). Somehow, according to Englehardt, it is all related to the demise of victory culture. When after approximately two hundred pages Englehardt finally decides to discuss Vietnam he does so with an expected emphasis on horrors and atrocities. But first he must take the reader through GI Joe (Englehardt takes pains to describe Hasbro’s late entry with â€Å"Negro Joe† and â€Å"She-Joe†), Sergeant Roc, Kennedy assassination conspiracy theory, and Fail Safe (175-187). Any review of substance of the war in Vietnam will by necessity be a huge undertaking, and Englehardt is not to be criticized for discussing what amounts to a â€Å"worst of† list of horrors that faced the Vietnamese, the American soldiers, and the American public. Unfortunately for Englehardt â€Å"the mineshaft has been thoroughly mined† and he brings no new information or analysis to the table. Vietnam was a tremendous â€Å"media war† in terms of coverage and indelible images. A few images, such as the young naked napalmed girl running in fright or the point-blank assassination of a captured Viet Cong soldier, seem to crystallize all of the horror and insanity of that war. Englehardt decides to provide the literary simile, with quotations from veterans describing the horrors and atrocities of My Lai and other villages. It is in a sense gratuitous and repetitious, and serves little purpose other than to reinforce the general negativity of the entire book. Before Englehardt turns his attention to the Desert Storm/Desert Shield operations he first makes the point that previous military operations in Panama and Grenada were unnecessary exhibits of force and quickly dismisses them as â€Å"exaggerated, over referential event(s)† (281). He prefaces his discussion of the Gulf War as â€Å"(in) the new version of victory culture, the military spent no less time planning to control the screen than the battlefield, and the neutralization of a potentially oppositional media became a war goal† (290). It is always remarkable that reporters and journalists who steadfastly claim they have either been manipulated or denied access manage to produce analytical and critical volumes assessing what they allegedly were not allowed to witness. Englehardt reaches the conclusion that in a sense â€Å"the Gulf War was a response to the Japanese and European economic challenges in that it emphasized the leading-edge aspects of the country’s two foremost exports: arms and entertainment† (295). Englehardt finishes his book by revisiting his friend GI Joe, who has â€Å"been running hard to survive in a confused world† (302). In closing he states â€Å"what path out of the ruins may be neither Joe nor we understand† (303). It is doubtful Englehardt is on anyone’s â€Å"short list† of consultants to contact regarding the contemporary framework of war. His work is well-researched and thoroughly documented with page upon page of footnotes and references. However what is telling is what is absent from his index. It reads like an encapsulation of American pop culture, as would be expected, with countless references to movies, television, and American icons. It reflects an insulated viewpoint of American â€Å"culture of victory† as seen only through American media. There is a much greater awareness of the geopolitical effects of any conflict, and it is difficult if not impossible to simply pigeon-hole war in outdated terms of American cultural â€Å"heroes† or â€Å"victory†. Ultimately he can take credit with the foresight to see the end of a culture of victory, but events since publication have drastically changed the meaning of â€Å"victory† in war, and unfortunately decrease the relevance of his work. Today’s battlefields in Iraq and Afghanistan reflect America’s greater engagement in a global War on Terror. There is little, if any similarity in the dangers faced today compared to previous military engagements or World Wars. Global terrorism brings a previously unknown dimension to military theorists and analysts. Certainly there is a popular swell of support for the defeat, if not â€Å"slaughter† of Osama bin Laden and the terrorists responsible for the death of civilian non-combatants. But there is less a sense of a desire for a â€Å"victory culture† as there is for a â€Å"survival culture†. Without saying as much Englehardt could stand for the premise, as any wise man would, that pacifism is preferred to war, and in war the victors are often vanquished as well. That takes a world far different from the one that exists today. There is no doubt America is the superpower but it does not operate in a vacuum; today there is a broader and stronger global mandate for peace than any American desire for victory in war. At the time of publication The End of Victory Culture may have reflected â€Å"a confused world† with â€Å"paths not understood†. Since September 11, 2001 events have given clarity to any confusion, and the path to safety and survival must be followed.

Business Assignment 6 Essay Example | Topics and Well Written Essays - 750 words

Business Assignment 6 - Essay Example Teams are formed with organizations to address specific issues, challenges, or problems. Members of a team should therefore be individuals who are aware of the problems or the needs of the group and are as well willing to contribute in finding the solution as well as making the situation better than it already is. If an organization has a financial crisis, for instance, accountants, economists, financial analysts and others who understand the organization’s financial trends should form the core of the team. Knowledgeable people enhance understanding of the team and hence smooth meetings (Dyer & Dyer, 2013). The most important aspect of a team meeting should be what the members are supposed to discuss in those meetings, the agenda. Agenda setting is the second step for team meeting management. With an agenda well set, team meetings are half on course of delivering their mandates. Team meetings should have agendas that are specific, measurable, attainable, realistic and time bound to deliver instantly (Dyer & Dyer, 2013). A team should comprise of individuals who are ready to work both for themselves and for the other members of the team. Team members, therefore should bear tasks and responsibilities that aid in the accomplishment of the objectives of the team (Kayser, 2011). Not all the activities of the team can be left to specific individuals, but each team member should at least contribute to those activities. Either, communications and contributions in meetings should allow for the participation of at least the interest of every member. In the formulation of the agenda for any committee meeting, time should be a factor worth a critical consideration. Too long meetings or too short meetings barely deliver amicable solutions to organizations. In addition, the best times for meetings are when the members are fresh in mind and ready to contribute. Time management contributes to the quality of the meeting

Epistemology and the Legend of the Sphinx in Oedipus Rex Research Paper

Epistemology and the Legend of the Sphinx in Oedipus Rex - Research Paper Example The idea of pharmakos in Oedipus Rex is embodied in the interaction between the sphinx and Oedipus and how the sphinx guards and reveals knowledge. Pharmakos is the idea that there is a duality to things; that an item can be both a cure and a poison. The sphinx is used as a pharmakos in Oedipus Rex because not only does her physical appearance portray a duality, but also her riddles conceal knowledge in their ambiguity, but also in a sense, reveal truth concerning Oedipus and the Greek society. Epistemology Epistemology can be defined as the branch of philosophy that looks at the nature, origin, methods, as well as limits of human knowledge. It seeks to answer the question of how to distinguish true knowledge from false knowledge. One of the outstanding epistemological problems in Oedipus Rex is the ambiguity presented in terms of the nature and extents of Oedipus’ knowledge about his true origins (Carel 103). Many philosophers have argued that Oedipus may have been too ignora nt to figure out facts about his past. However, at the beginning of the play, his intelligence is well portrayed when he is the only man who has the ability to solve the riddle of the sphinx. This ambiguity brings forth the vagueness of the extent to which Oedipus can and should be held responsible for his actions, which are: killing his biological father and marrying his own mother. Sophocles tells the story of Oedipus in reverse: he starts with the ending and goes to explain how it happened. According to the oracle, the plague that has befallen Thebes will find no cure until the person responsible for the murder of King Laius is found and expelled from the city. Oedipus starts an investigation to reveal the murderer, but this investigation quickly turns into an investigation of Oedipus’ real identity. Initially the epistemology lies around finding an answer to the question â€Å"who did it†, but this changes course to the question â€Å"who am I?† (Foster 22)T he psychological journey of discovery takes up much of this story. Knowledge is supposed to end with gratification and satisfaction. However, in this story, epistemology led to a discovery that was more tragic than the events that led to the discovery itself. The Sphinx The word sphinx comes form the Greek verb which when translated means â€Å"to squeeze† or to tighten (Gosse 65). Some historians however argue that the word is a corruption of the Egyptian word â€Å"shesepankh† which translates to â€Å"living image† (Zivie-Coche and Lorton 9). In Greek mythology the Sphinx is represented as having a serpent’s tail, a lion’s hunches, a large bird’s wings and a woman’s breast and face. This malevolent creature is normally characterized as being merciless and treacherous. She is the demon of bad luck and destruction and kills and mauls those who fail to correctly answer her riddle. According to myths, the sphinx was the guardian of the gates into the City of Thebes. To be allowed entry, one had to correctly answer her riddle. The riddle is â€Å"which creature has four legs in the morning, two at midday and three in the evening, and the more legs it has, the weaker it is? It is said that no man had ever been able to give a correct answer to the riddle (10). Oedipus was the only one who gave the correct answer which was ‘man’. After Oedipus gave the correct answer, the sphinx is said to have been infuriated and she killed herself. The original purpose of the sphinx

Legal Foundations of Health Care Essay Example | Topics and Well Written Essays - 500 words - 1

Legal Foundations of Health Care - Essay Example One of the department’s roles, through â€Å"Administration on Aging,† is provision of social services to the elderly population. It ensures the citizens’ interests in â€Å"income, housing, health, employment, retirement, and community services† by developing and implementing relevant programs (p. 25). The department’s role also includes administration of Medicare and Medicaid programs that offer health care services to the elderly, people with special disabilities, and needy populations. The Department of Health and Human Services, through the Agency for Healthcare Research and Quality, also ensures affordable cost of care through initiating research on factors affecting cost of care and making appropriate decisions for regulating costs. The agency also regulates clinical activities with the aim of influencing cost and quality of offered services in care facilities. Similarly, the department plays a significant role initiating and promoting resear ch initiatives towards affordable care and development of information for evidence based practice and clinical decisions (Pozgar, 2012, p. 25-27). Other roles of the department are illustrated through its associated agencies such as â€Å"Centers for Disease Control and Prevention,† â€Å"Food and Drug Administration,† and â€Å"National Institute of Health† (Pozgar, 2012, p. 27-28). The Centers for Disease Control and Prevention identifies the department’s role to reduce and possibly mitigate diseases. The department also ensures, through the Food and Drug Administration, that developed medicines, food products, other health consumables, and medical equipments are safe for human use (Pozgar, 2012, p. 28). It further formulates and facilitates implementation of measures for preventing and managing drug abuse. Its partnership with other stakeholders also plays a role in identifying dangerous drugs and it offers directives against consumption of such drugs besides offering

Important Sex Linked Disorder That Affects Humans Assignment

Important Sex Linked Disorder That Affects Humans - Assignment Example Crossing a female with the disease with a male that doesn’t have it will result in all male offspring having the disease and all females being carriers. Finally, crossing a female and a male both that have the disease will result in all offspring having it. Many genetic disorders are inherited recessively. As such the child must have two copies of the allele for it to show phenotypically. One such disorder is cystic fibrosis. This condition results in the excess build up of mucus in many organs including the lungs and liver, as well as increased susceptibility to developing infections. Without treatment, the disease often results in death at early childhood. A cross between a female carrier (Cc) and a male with the disease (CC) would result in 50% of the offspring having the disease, and the other 50% being carriers. A cross between two carriers (Cc) would result in a quarter of the offspring having the disease, half being carriers and the final quarter not inheriting the alle le. Lastly, a cross between two individuals with the disease would result in all of the offspring having the disease. ... Thus, a cross between two carriers (heterozygotes) would result in three-quarters of the offspring having the disease and one not. A cross between a female that did not have the disease and a male carrier (heterozygote) would result in half of the offspring having the disease and the other half not. Finally, a cross between two individuals with the disease depends on the genotypes of each. If both have only one copy of the disease allele, the one-quarterer of their offspring will not have the disease. However, if even one of them is homozygous, then all offspring will have the disease.