How Child Labor Affects a Child in the Philippines Essay

According to NSO Survey, in the year 2011 the population of child labor grew up to 3 million compared in the year 2001 that has 2.4 million population of child labor. 25% of the population are doing hazardous jobs that can harm them. Many laws had been passed but the population of child labor still increases. Child labor refers to the employment of children in any work that deprives children of their childhood, their ability to attend regular classes, and totally dangerous for them. In the developing countries like in the Philippines with high poverty and poor schooling opportunities, child labor is still present. Vast majority of child labor is found in the rural places and an unreached help of the government. Poverty and lack of schools are considered as the primary cause of child labor. For better information, the researcher includes the history and the effects of the topic. Its history can be traced in some dark realms of industrialization but in a more detailed study, the practice can reveal that child labor was present, much before industrialization spread out. Unfortunately, they work at a lower pay. The effects of child labor are definitely unimaginable for such a young age. Child labor deprives the child’s proper childhood. Their time of childhood days was now taken by their jobs. It also suffers their physical and mental mind that makes them tortured. They are forced to feed their family and it gives them such a hard responsibility to handle out. This leads to another new generation because of adult modeling. The parents must be aware of the rights of their children to be dresses, to be fed, and to attend in school to have a better future.

Pet food recall Essay

A recent recall across the United States and Canada has pet owners in frenzy. More than 60 million cans and pouches of pet food have been recalled as they have been linked to 10 cat and 6 dog deaths recently. The manufacturer sells food under 95 different brands, including Wal-Mart, Iams, and Safeway. As of yet the specific ingredient linked to the pet deaths has not been determined. Speculation links the liver failure of the cats to a wheat gluten ingredient. The FDA said that wheat gluten itself would not cause liver failure, but if it was contaminated with metal or mold toxins it could cause liver damage. The chief executive of menu foods, Paul Henderson issued a statement saying, â€Å"Our hearts go out to all of the pet owners across Canada, the United States and Mexico for any losses they experience and certainly for the worry this incident may be causing† (â€Å"Company behind pet†, 2007). Pet owner’s expectations when buying pet food are to keep their pets happy, healthy, and well fed. Many of the products recalled were manufactured under the best pet food names in the industry. Pet owner Chris Wood says â€Å"We love our pets just like children. They are not careful enough with the ingredients they put in pet food. That’s scary† (Molina, 2007). Pet’s are companions that owner’s have a deep responsibility to care for. Implications caused by this recall include worry for one’s pet, having to find a new brand of food not manufactured by menu foods, and in the worse case scenario losing one’s pet to liver failure. The worry alone is taking time and energy from pet owners across the United States, Canada, and Mexico. Pet owners are not only returning the recalled food but are taken precautions that cost a lot of money to ensure the safety and well-being of their pets. A veterinarian at the Animal Medical Center on the East Side of Manhattan, Dr. Ann Hohenhaus, said one cat died there over the weekend of kidney failure linked to the recalled food. Hohenhaus said the Animal Medical Center has tested 143 animals for renal failure since worried pet owners started taking their cats and dogs in for blood and urine tests on Saturday (March 18th, 2007)†(Mathews , 2007). Retailers are taking all measures to reassure pet owners. After the recall â€Å"PetSmart general manager Gary Brown said, ‘Everything on our shelves is 100 percent safe for your pet’†(Molina, 2007). Petsmart is offering a full refund on all food purchased between December 3-March 6. A Long Island family whose two year old bull mastiff, Princess, died as a result of the recall are suing Menu Foods. Princess ate nothing but Nutro Foods all of her life and passed away from liver failure. The family is absolutely devastated by their loss. The family filed a lawsuit â€Å"Wednesday against Nutro and manufacturer Menu Foods. The lawsuit, filed in state Supreme Court in Nassau County, seeks unspecified compensatory and punitive damages, said Bobb’s attorney, Kenneth Mollins†(Mathews, 2007). Quite often consumers put much research and time into products they purchase. When a consumer makes a purchase they assumed the manufacturer is offering a product that will be satisfactory and meet standards. Menu foods did switch to a new supplier for wheat gluten. As of the March 6, 2007 issued recall Mend Foods has once again changed its wheat gluten supply and is once again stocking shelves with premium pet food. Menu Foods expects losses of 24-60 million dollars for this recall and lawsuits that will prevail as a result of the contaminated pet food.

Chemistry Today Article Example | Topics and Well Written Essays - 250 words

Chemistry Today - Article Example As a result, the article further highlights that the unusual gel ageing experience is achieved from the polymer’s flexibility degree, which is equivalent to the natural body tissue. The watery substance in the hydrogel helps with the repairs of tissues and cells of the ageing persons to restore wrinkled skin units (Draper, McDonald and Adams 2015, n.p). The article is educative since the authors give instances where the characteristics of hydrogel are important considerations when producing gel ageing. The authors also offer other essential applications of the hydrogel such as the absorption and removal of harmful necrotic and fibrotic tissue (Draper, McDonald and Adams 2015, n.p). This implies that the weight and absorbent properties enable the gel to function properly with the ageing skin particles through the removal of the fibrotic tissues. Another vital concept of the article is the author’s articulation of the formation of the hydrogel compound by analyzing the different elements of water and gel. This brings about the absorbent and low molecular nature that provides the unusual gel ageing property unlike the other

Criminal Profiling Coursework Example | Topics and Well Written Essays - 750 words

Criminal Profiling - Coursework Example Investigators often employ the use of geographical profiling in deducing the most probable location of a given offender through investigation of various connected series of crimes. In accordance to Holmes (2009), geographical analysis can provide useful information plus strategies in the investigation of crime series. Geographical profiling often gets applied in cases like serial rape, arson, murder, bombings and robbery (Holmes, 2009). Through geographical profiling, linkage between a series of crimes could help pin point specific suspects records with similar past offences, identify similar crime scenes plus also provide substantial information regarding geographical and psychological profiling efforts (Rossmo, 1999). There are various elements that often become put in place when conducting geographical profiling. Some of them include crime location type, land use, arterial roads and highways, neighborhood demographics, physical and psychological boundaries plus displacement and ro utine activities of victims (Holmes, 2009). In relation to crime location type, one often considers encounter sites, crime site, attack site, vehicle dump site and victim disposal site (Rossmo, 1999). In regard to arterial roads and highways, most people have preferences on which roads and pathways that they take, hence perpetrators in serial crimes have certain routes which they follow to get in contact with their victims or dispose bodies (Rossmo, 1999). Displacement is also another factor crucial in geographic profiling since a given offender in this case changes his or her crime location due to some external factors like police patrol, etcetera. Some hunting patterns of certain investigators can be limited by certain physical and psychological boundaries. Example of physical boundaries involves rivers, lakes, while examples of psychological boundaries entail a different neighborhood, etcetera (Rossmo, 1999). Land use remains also beneficial in profiling criminals geographically through identifying the zones most affected, for instance, industrial, commercial, residential areas, etcetera (Holmes, 2009). One should always keep in mind the characteristics of the given neighborhood located around the crime site in terms of demographic and census data. The habits, travels and behaviors of the perpetrators also provide a critical element in geographical profiling (Rossmo, 1999). 2. Analyze and discuss the role of victimology in criminal profiling? According to Ann (2011), victimology implies the study of given victims involved in crimes. Victimology will try to identify similarities that exist between the victims involved in the given crimes so as the given profiler can identify a certain pattern used by the criminal in committing the given crimes (Turvey, 2011). In victimology, more emphasis is placed on the victim’s side in order to identify distinctive characteristics that attracted the perpetrator and try to draw a relation with the crimes on other vi ctims. Often, victimology tries to examine age, similarities in hair colour, eye colour, lifestyle, whether the victims ever met or even worked together or if shared common interests. In summing up all these information, victimologists often try to build a clear picture of the given offender (Turvey, 2011). Usually, serial crimes committed by certain given criminals often provide clues in relation to the victims affected regarding the criminals choice of victims. Hence in victimology, criminal profiling can be established via looking at the victims (Turvey, 2011). According to Turvey (2011), victimology often proves useful in criminal profiling through establishing the relationship between the victims and perpetrators. One could ask questions whether the two initially were family

Consequences and Implications of Afghanistan Assisting Baluch Research Paper

Consequences and Implications of Afghanistan Assisting Baluch Seperatists - Research Paper Example Still, there are multiple issues between the two countries, like Durand Line, the present war in Afghanistan, Taliban, the legacy of Soviet invasions and the issues pertaining to Baluchistan and Pashtunistan, which are impacting the relationships between the two nations. Pakistan has time and again objected to assistance being extended by Afghanistan to the Baluch separatists. It goes without saying that if the perception regarding the Afghan assistance to Baluch separatists continues to exist; this could have multiple consequences for the already unstable state of Afghanistan. Afghanistan shares multiple historical and economic continuities and discontinuities with Pakistan in a long term perspective. Existing Issues between Pakistan and Afghanistan The Durand Line established in 1893 as per an agreement between the British India and Amir Abdur Rahman Khan is a bone of contention between Pakistan and Afghanistan (Banuazizi & Weiner 6). Pakistan inherited the demarcation of the spher e of influence by the Durand Line, after its partition from India in 1947. As per the Afghan government, it still refuses to accept the Durand Line as a true arbitrator of the sphere of influence between the two nations (Roberts 168). ... There does not lay any formal agreement for the ratification of the Durand Line between the two countries (Burki 198). The relations between the two Islamic nations continue to be strained because it is a firm belief of the Afghan authorities that Pakistan tends to exert a negative influence on Afghanistan (Campbell 65). Afghanistan has time and again blamed the Pakistani intelligence agency Inter-Services Intelligence (ISI) of meddling in the internal affairs of Afghanistan by supporting and arming the Taliban and other militant groups (Crews & Tarzi 69). Pakistan has continually denied these allegations by offering the excuse that the Pak military and intelligence has never tried to destabilize Afghanistan and it is primarily the non-state actors in Pakistan that support and arm the militant groups operating in Afghanistan. With the augmenting support of the United States regarding an Afghan led invasion of the militant tribes on the Pak-Afghan borders, the relationships between th e two nations have further got strained. Afghanistan plays an important strategic role as far as the Pakistani strategy in response to any future conflict with India is concerned (Baxter & Kennedy 54). It is a firm belief of the Pakistani strategists that in the event of a war with India, it would be pragmatic to shift the Pakistani supply lines in Afghanistan, so as to prepare for a counter offensive against India. Many Pakistanis support these envisaged strategic ties considering the religious, cultural, historical, linguistic and ethnic bonds between Pakistan and Afghanistan. Pakistan has continued to exercise an important role in the regime shifts in Afghanistan in the past. Pakistan supported the Mujahedeen offensive against the Russians, the internal

Creating the Decision Environment Essay Example | Topics and Well Written Essays - 750 words

Creating the Decision Environment - Essay Example This is happens because the group welcome outside opinions, so there is no objectivity. This can be prevented by always having a neutral party that hasn’t been part of the group. This brings insight to it, and also leaves room for questioning of that decision and with this, a better decision is made. (Virtualsoft, 2009) Belief in Inherent Morality of the Group: The group has a mindset that the decision they have made is moral and ethical, this is because the group assume that they have done right. To prevent this kind of problem. The group should give the same scenario to an anonymous group of different people and gauge their responses to tell whether their decision is right (Janis, 2009). Collective Rationalization: This happens when the group makes a decision and they believe it rational. This happens when the collection of material is highly selective and biased. This tends to leave out some information that does not fit into the groups’ decision and reason for the s ame. This can cause a big problem because when a decision is made without all the relevant information regarding is examined (Marlene & Antony, 1998). This is mostly because of the close mindedness in the group. This is can be avoided by bringing in experts to examine the problem and advise the group before a group decision can be made. With the inclusion of an expert, critical information is less likely to be omitted. Illusion of unanimity: When the group look to each other to confirm their theories without consulting or involving an outside source (Janis, 2009). This close-mindedness can cause problems during the decision making process. To avoid this, the leaders should not state preference initially. This influences the group and affects the decisions made. Self-Appointed mind guards: this is also as a result of close mindedness, and the avoidance of troublesome ideas, these mind guards are usually to protect the leader. To prevent this symptom, a devil’s advocate should be appointed within the group and the sole purpose should be to critique every decision and look for flaws in it. This individual should ensure that alternatives are explored extensively. Stereotyping: Excessive stereotyping is a major symptom of groupthink; this happens when the group members start forming and constructing negative stereotypes of other rival groups (Janis, 2009). This happens especially if the other group’s opinions or ideas are not the same as theirs. This leads to the group shunning any external input leading to a decision that is a result of close mindedness. This can be prevented in decision making environments by always discussing what is happening with others outside the group (Marlene & Antony, 1998). With this, diversity is brought into the group and the decision in question will have been vetted by different individuals not just the group members, this makes the decision so much better. Pressure for conformity: Another symptom of groupthink is the m embers pressure anyone in the group that expresses an opinion or argument that is against their beliefs or ideas. They make this member or members feel that they have to conform. They make them feel that expressing an idea different from theirs is a sign of disloyalty. So in situation where a member might have a differing opinion they do not express it because they want to

Danger from Terrorism Essay Example | Topics and Well Written Essays - 1000 words

Danger from Terrorism - Essay Example Invoking national security, the government is supposed to have taken advantage of 9/11 and the generally negative perception of terrorism to invest some righteousness and enlist popular support for its anti-terrorist war that often run roughshod over individual human rights and civil liberties. Richard Posner of the Atlantic Monthly affirms that officials tend to exaggerate the dangers to national security. When surprised and hurt, we tend to overreact. "The greater the threat that an activity poses to national safety, the stronger will the grounds seem for seeking to repress that activity, even at some cost to liberty Legality must sometimes be sacrificed for other values (p. 2)." American history itself is replete with examples of such overreaction to security threats. There was Lincoln who faced the threat of secession by suspending the writ of habeas corpus. This triggered the Civil War. Officials in the modern era have learned their lessons from the past when their counterparts in the old days ignored the storm clouds in the horizon and paid dearly for it. The Japanese early posturing, for example, was glossed over and led to the Pearl Harbor disaster that triggered World War II.When Soviet missiles were installed in Cuba, the US shrugged its shoulder and regretted it when theit later grappled with the Cuban missile crisis. As for terrorism as it is known today, Posner notes that 9/11 indeed showed the US as 'in much greater jeopardy from international terrorism than was previously believed." However, the government must exercise some discretion and sensitivity in running after terrorists. There have been a good number of men who were labeled "terrorists" by the western media when they engaged in a struggle to liberate their countries, among them Nelson Mandela and Menachem Begin. Later, the same media called them "statesmen" when they assumed leadership of their liberated nations. Thus, "one man's terrorist may be another man's freedom fighter (Posner, 2001, ch. 2). Process of Terror Wikipedia says "Terrorism" comes from the French word terrorisme which is based on the Latin verb terrere (to frighten). It was first used by French officials to describe themselves as members of the Jacobin Club which ruled post-Revolution under a "Reign of Terror (1793-94)." The terrorist acts consisted mainly of illegal arrest and execution of dissidents as a means of coercing compliance. Before this, terrorist acts under different labels were carried out by the 1st century Zealots against the Roman occupiers of eastern Mediterranean, by the Islamic sect Hash-Ishiim (which became the root word for "assassin") against people who opposed their beliefs, and by the IRA precursor Irish Republican Brotherhood against the British to demand independence. (p.1) Terrorism in the modern sense is commonly described as an "immoral, wanton and unjustified political violence characterized as indiscriminate, targeting civilians and executing them with disregard for human life (Wikipedia, p. 2). On the other hand, those accused of such acts call themselves by other names, among them, freedom fighter, separatist, liberator, revolutionary, vigilante, militant, paramilitary, guerrilla, rebel, and in the Muslim world, jihadi and mujaheddin (engaged in a holy war) or fedayeen (prepared for martyrdom). For

Promotion - Introduction to Integrated Marketing Communications Essay

Promotion - Introduction to Integrated Marketing Communications - Essay Example To me, the introduction of the white, brown and chocolate-sandwiched bread gave me the knowledge about their efficiency in reaching the customers in time with information on the loss, existence or price increase or fall of these products. The company makes sure that the public, customers or audience in the communication field are reached in the most amicable and plausible way. The company sets information through the points of purchase, the supermarkets within the region. This perfectly reaches the customers as these are the points where they continuously get into contact with the company. The company does this through the use of banners. The company also gets into contact with the customers through the internet and at this point the Andronico’s Company passes information to the customers through the social interactive network platforms, like the tweeter, facebook and other social platforms (Lee & Park, 2007, p 235). To effectively pass the information to the customers about t he products, the company uses direct mail in the case where they have the contact mails of the esteem customers. This will get the customers with notification and beware of the situation in the markets (Lee & Park, 2007, p 228). This will reduce the wasting of time to go to the markets to buy a product not in the market. The company also uses the print media to communicate to the customers about the product that they are interested in. with line this, the company also uses the broadcast media which reaches most of its customers as the broadcast media is widely spread throughout the country. The company organizes events and through which all the relevant information is provided to the customers of specific goods. This will be followed by new information on counter products in place for the lost products in the market at the moment. Andronico’s communicates to the customers through the processes of sales

British Airways and its predecessor companies Essay

British Airways and its predecessor companies - Essay Example Two other airlines, Handley page, and Instone, were established using modified bombers. The three companies underwent a period of great difficulty, especially competition from French airlines, which were cheaper. To solve these problems, they merged to be joined later by British Marine Air Navigation, forming Imperial Airways. Imperial Airways began local and overseas flights immediately, flying as far as Egypt and India with a crew of 250 and a fleet of 18 crafts (Gaskell, 2010). This paper is an essay on British Airways. Later, Imperial Airways was a Brisbane, Australia route, whose duration would take grueling 12 days. The new airline added new planes such as the short S.23 C-class model, which signified that the airline was growing, as was a new carrier British Airways limited (Gaskell, 2010). After the start of the 1st World War, these two merged to form British Overseas Airways Corporation, which re-started its transatlantic flights after the war ended. In addition, they create d the BEA, a new airline to handle the European flights. At this point, the carriers needed to order new and more efficient aircraft. BOAC consequently ordered the Boeing Strato-cruiser, the Lockheed Constellation, and a Rolls-Royce engine equipped version of the DC-4. It did not take long before they ordered a jet plane, the De Havilland Comet, which dramatically reduced the length of trans-Atlantic flights (Marriott, 2010). The early 60’s saw BOAC order the Rolls-Royce Conway engine driven 707-436 to tide over until the VC-10s were ready. By 1970, with the first 747 and rapid growth, BOAC and BAL were ready to merge and work as one, establishing British Airways in 1976. BA’s most crucial year was 1976; it had a partnership with Concorde, coupled with big fleets of Lockheed TriStar and Boeing 747.

The writer & impressio Essay Example for Free

The writer impressio Essay My impression of Robert Cohn is that he is insecure and self-conscious. This is because it is mentioned in the passage that he took up boxing to counteract the feeling of inferiority and shyness that he felt on being treated as a Jew at Princeton. He became very good at it as it suited him. He also felt an inner comfort in knowing he could knock down anybody who was snooty to him. It also gave him a certain satisfaction of some sorts even though he had a permanently flattened nose as a result of it. He was also good at boxing. Boxing suited him and he became good at it. Also, Spider Kelly, his teacher, not only remembered him but also wondered what had happened to him. However, he is a gentle person. Even though he was able to knock down people, he never fought except in gym. Also, by his last year of Princeton, no one remembered that he was middleweight boxing champion. He is also a coward. He did not dare to stand up to people when he was in Princeton. He also did not dare to stand up to his wife until he became an unattractive mould under domestic unhappiness with a rich wife. He did not divorce his wife earlier because he felt that it would be too cruel to deprive herself of him. Later in his life, he was also taken in hand by a lady who was very forceful. He did not have a chance of not being taken in hand. He is also a literary person. This can be seen as in his final year, he read so much that he had to wear glasses. He also did not look like a middleweight boxing champion and the author suspected that his flattened nose was a result of something else besides a boxing accident. Also, after his divorce, he fell among literary people and backed a review of the Arts. His name also appeared as a member of the editorial board until he became the sole editor. He also liked the feel of power. When he was the sole editor of the magazine, it could be seen that he liked the authority of editing and was sorry when the magazine became too expensive. Robert Cohn is also not assertive. He did not express any discontent but instead allowed his wife to harden him into an unattractive mould under domestic unhappiness. He also did not divorce her even though he was not happy throughout their whole marriage. He is also not suited to control finances. Even though he was from a rich family, he lost most of the fifty thousand that his father left him and the remainder went to his mother. He is also sensitive to discrimination. This can be seen when he was treated as a Jew in Princeton, he took up boxing to counteract the inferiority and shyness that he felt. It also made him feel different and he was thus very bitter about it. The prejudice that he suffered while he was in Princeton and his disastrous marriage probably affected his later behavior in life. This is the opening of the novel. Has it successfully captured your attention? Justify your answer with close reference to the passage. This opening has successfully captured my attention. This is because there is a feeling of suspense ion the story. It makes the reader want to find out about the discrimination that Robert Cohn had suffered during his stay in Princeton and also about the time he spent boxing. It also makes the reader want to know how he had managed to overcome his insecurities through boxing. It also makes the reader want to know about his disastrous marriage to his wife and why it was disastrous. It also makes the reader wonder why they wanted to divorce when they had three children as children usually signify a happy marriage. The reader would also be naturally interested in his literary pursuits before, during and after his marriage. They would also be interested in why he gave up boxing to read. They would also want to know about the things that he did while among the literary people and why he joined the advisory board and later became editor. The reader also would want to know why he later had to give it up. The writer creates a feeling of suspense by first giving a summary of Robert Cohns life. The reader would then be curious to read more to find out more.

Advancing Nursing Practice Current Role and Personal Learning

Advancing Nursing Practice Current Role and Personal Learning The idea of Advanced Nursing Practice (ANP) is reported to have commenced in the USA in the early parts of the 20th century (Mantzoukas, 2006) and its development has been well recorded in the literature (Ketefian, Redman, Hanucharurnkul, Masterson Neves, 2001; Furlong Smith, 2005). But lack of clear definitions for the concept, its scope of practice and standards has resulted in a great diversity in practice (Woods, 1999; Pearson Peels, 2002; Daly and Carnwell, 2003). Furlong and Smith (2005) identifies that several attempts have been made to conceptualise advanced nursing practice. This has resulted in some consensus on the core concepts that underpin ANP such as clinical autonomy, professional and clinical leadership, research capabilities, application of theory and research to practice and graduate level education requirement (Ketefian et al., 2001; Furlong Smith, 2005; Mantzoukas, 2006). Knowledge level, skill level and population of response model developed by Calkin (1984) and from novice to expert model by Benner (1984) are some of the models that were developed but none of these analysed contextual influences on advanced nursing practice. Manley (1997) developed a conceptual framework that describes four integrated sub roles (expert practitioner, educator, researcher and consultant); necessary skills and processes as well as contextual prerequisites for the advanced nurse practitioner to achieve outcomes strove for. This framework was developed from a model by Hamric (1989) and shares similarities in the four sub roles, some skills and processes. However, the framework by Manley (1997) establishes a relationship between the ANP role, its context and its outcomes, giving it an advantage over the models of Calkin, Benner and Hamric. It is worth stating, at this point, that the term ANP is not for a single role but for different advanced nursing roles such as nurse practitioners, certified nurse midwives, nurse anaesthetists and clinical nurse specialists (Ketefian et al., 2001) I have worked for one year as a general nurse (Nursing Officer rank) after completing my four-year nursing training in Ghana. My responsibilities include ensuring adequate nutrition and elimination, administering medication and reporting on patients response, allocating task based on skill of staff, supervising staff and students in the ward, and participating in ward rounds (GHS, 2005). Henry (2007) states that Ghanaian nurses have automatic promotion after every five years of service until they reach the rank of Principal Nursing Officer. It seems that this is changing. My experience is that, recently, higher education certificate as well as evidence of continuous professional and personal development is a requirement for certain roles in the nursing profession. Moreover, research, leadership and application of theory to practice are some of the advanced nursing skills that are not well developed in my current role. I have, therefore, enrolled in the MSc. Advanced Nursing course to develop these skills to advance my nursing practice. It appears that the four advanced nursing roles described by Ketefian et al. (2001) are present in Ghana, although the term ANP is not used. East and Arudo (2009) identifies that due to shortage of health personnel, nurses in sub-Saharan Africa perform certain roles and tasks that would be classified, in other countries, as advanced practice. Ghanaian nurses in these roles have some degree of clinical autonomy, especially in the district hospitals, but not necessarily a graduate level education. Instead, a post-basic diploma is required for some of them (nurse anaesthetist and clinical nurse specialist roles). Until recently, post-basic diploma was the qualification for medical assistants (similar to nurse practitioner role). Thus, ANP roles in Ghana developed as a result of shortage of health personnel and the health needs of the population. However, the roles are different from those in the UK and USA in areas such as research, professional and clinical leadership, academic qualifi cation, and clinical autonomy. Therefore, with the ANP conceptual framework of Manley (1997) as the focus, I hope to achieve the following objectives in advancing my practice: Develop a teaching package to slow progression of chronic kidney disease (CKD) among patients with diabetes Advance myself as a nurse educator and the other sub roles identified by Manley (1997) Develop leadership and effective change management skills Contribute to the professional development of my colleagues. The Project: Introduction and Rationale for Selection In advancing my nursing practice, my focus for this project is to develop a teaching package to slow progression of chronic kidney disease among patients with diabetes. Other patients at risk of developing kidney failure, including those with hypertension would also benefit from this project. The package would, also, be used among patients with stages 1 4 chronic kidney disease. In the final year of my nursing training, I had to submit a care study to the Nursing and Midwifery Council of Ghana. The patient I worked with had been diagnosed with type II diabetes. The care study required that I participate in the active management of the patient and present a report on that, as well as a literature review on the condition. I reflect on the entire process now and I realise that complications of diabetes were just mentioned to the patient, with no adequate information on how they can be prevented. This project is, therefore, anticipated to create awareness of chronic kidney disease as a major complication among patients with diabetes in Ghana and how to delay its progression, if not avoid it. My primary focus would be to develop a strategy that would reach out to all patients, including those with low literacy skills. This would advance the nursing care and health education given to such patients, thereby, delaying the need for dialysis (Thomas et al., 2008). Literature Review WHO (2002:11) defines chronic conditions as health problems that require ongoing management over a period of years or decades and has labelled them as the biggest challenge faced by the health sector in the 21st century. While the economic cost of managing chronic diseases is high, Suhrcke, Fahey McKee (2008) identify some strong economic arguments that may be made in support of the need for societies to invest in their (chronic diseases) management. They identify some primary benefits such as improved health (in terms of patients quantity and quality of life in years), long-term cost savings from complications avoided and workplace productivity experienced by patients and their employers. Nevertheless, preventing their occurrence is central in the general management of chronic conditions (Nolte McKee, 2008) and this is a responsibility for all, including governments, private sectors, healthcare systems and individuals (Novotny, 2008). Chronic Kidney Disease (CKD) is becoming a global pandemic (Mahon, 2006; Chen, Scott, Mattern, Mohini Nissenson, 2006; Clements Ashurst, 2006). The disease causes gradual decline in kidney function (Silvestri, 2002). It has been categorised into 5 stages according to the glomerular filtration rates (Johnson Usherwood, 2005) and the progression through these stages is influenced by several processes, mostly lifestyle-related (Riegersperger Sunder-Plassmann, 2007). Management of stage 5 (end stage) is either by dialysis or kidney transplant (Johnson Usherwood, 2005, Chen et al., 2006). Patients with CKD stages 4 and 5 experience other complications such as anaemia and metabolic acidosis that must, also, be managed efficiently (Silvestri, 2002; Murphy, Jenkins, McCann Sedgewick, 2008). This, in addition to dialysis, accounts for the reported higher costs of managing CKD (Gonzalez-Perez, Vale, Stearns, Wordsworth, 2005; Kaitelidou, Ziroyanis, Maniadakis, Liaropoulos, 2005). Presently, more than 23,000 adults in the UK undergo dialysis treatment as a result of kidney failure and this number is expected to increase yearly (World Kidney Day, 2009). Korle-Bu Teaching Hospital (Ghana) recorded 558 cases of CKD between January 2006 and July 2008 in the country (All Africa, 2009) and this may represent less than 30% of the total disease burden as the hospital serves a few regions in the country. Several studies have identified diabetes mellitus and hypertension as the major causes of CKD (Clements Ashurst, 2006; Rosenberg, Kalda, KasiuleviÄ ius Lember, 2008; Marchant, 2008; Stropp, 2008; Thomas, Bryar, Mankanjuola, 2008; Ulrich, 2009). Amoah, Owusu and Adjei (2002) report of little, but outdated, statistics on the prevalence of diabetes in Ghana. Another report is on the assumption that diabetes is uncommon in Ghana (ibid.). However, it appears that my clinical experience at KATH alone suggests otherwise to the latter. Amoah et al. (2002), again, report that data on diabetes in Ghana is unreliable and this is confirmed by incongruent data observed in the literature. For example, Abubakari and Bhopal (2008) report that prevalence of diabetes in Ghanaian adults (25years and above) was 6.3% in 1998 while the Ministry of Health, Ghana (2001 cited by Aikins, 2004) estimates diabetes in 4% of Ghanaians between 15 to 70 years. Notwithstanding, Aikins (2004) reports of incr ease in the prevalence rates of chronic illnesses in the country, and diabetes is no exception. Primary care management delays nephropathy and other complications of diabetes (Thomas et al., 2008). They add that there could be a lot of potential savings if the need for dialysis can be delayed, even if for a short period for a few patients. Since prevention reduces healthcare costs (Booth, Gordon, Carlson Hamilton, 2000), Ghana, not being a rich country (CIA, 2008) stands to benefit from such an approach. Chen et al. (2006), also, identify that delaying the progression of CKD improves clinical outcomes and moderates costs. Strategies to delay progression include good glycaemic control, blood pressure control, smoking cessation and other lifestyle modification (Nicholls, 2005; Clements Ashurst, 2006; Rosenberg et al., 2008). Patients knowledge on these factors may lead to a change in behaviour which, in turn, would yield positive outcomes in the management of their conditions. Health education is one of such strategies to achieve positive outcomes and prevent complications, especially if the method used is appropriate for the age group as well as their cultural background (Funnell et al., 2008). It is often used interchangeably with health promotion in the nursing literature and criticisms have been made on that (Whitehead). The argument has been that health promotion has shifted from preventing specific diseases or detecting risk groups towards health and well being of whole populations (Naidoo Will, 2000). Hitherto, health education remains central to health promotion (Whitehead, 2), and, because of the dominance of the medical model, health promotion is mostly equated to prevention of disease, through primary, secondary or tertiary prevention in clinical settings (Naidoo Wills, 2000). Secondary and tertiary prevention interventions prevent complications such as chronic nephropathy development in patients with diabetes and health education is one of such interventions (Rosenberg et al., 2008; Naidoo Wills, 2008). Diabetes is, predominantly, self-managed (Collins et al., 1994; Funnell Anderson, 2002), making education very necessary as it empowers the patients to take charge of their health behaviour and other factors that influence their health status (Piper, 2009). Whitehead (1) adds that health education focuses on lifestyle-related and behavioural change processes, making it an integral part of comprehensive diabetes care (type II education). The above implies that when patients with diabetes receive health education, it enhances their ability to collaborate with the effective management of the disease and, consequently, avoid its complications. However, very little knowledge on CKD as well as misunderstandings of illness and treatment has been reported (Jain, 2008; Holstrà ¶m Rosenqvist, 2005). Patients may not appreciate the role that lifestyle modification, in addition to pharmacological interventions, can play in effective management of diabetes. Since diabetes, usually, do not present any physical symptoms, patients tend to distance themselves from it and, as a result, ignore the education being provided because they do not feel ill (Holstrà ¶m Rosenqvist, 2005). Complexity of self-management of diabetes may also be a major contributor to the reported misunderstandings (Szromba, 2009). The primary concern then becomes who should educate these patients and what strategies should be used to achieve positive outcome s? Making time to educate patients and their families on everything that they need to know is seldom easy because of the busy schedules of nurses in the ward (Rankin Stallings, 2001). Yet, Hamric (1989) and Manley (1997) have documented the integration of health education into the roles of advanced nurse practitioners and Rankin Stallings (2001) have attested to this. Advanced nurse practitioners are able to draw on their knowledge and skills related to higher education as well as their expertise from practice to achieve positive outcomes in the clinical settings (Manley, 1997). Szromba (2009) suggests that alternative methods to the traditional lecture method of health education should be utilized to enhance self-care. Babcock and Miller (1994) suggest that discussion, demonstration, modelling, group activities and role playing are other teaching strategies that the health educator can employ. However, they add that consideration should be given to the strategy that best fits the obj ectives, content, the clients, the health educator and the reality of the learning situation. This underscores the importance of client needs assessment in health education. Literacy skills of the clients should, also, be taken into consideration during health education. This project is to be implemented in Ghana and WHO (2009) estimates an adult illiteracy rate of about 35% of the total population. The use of written materials may be a difficulty in such settings, especially as the literates may not understand the jargons used in health very well. Therefore, the health educator should ensure that materials are simplified so readers do not have difficulties in understanding the content. Rankin Stallings (2001) suggest that health educators should, therefore, focus information on the core of knowledge and skills that clients need to survive and cope with problems, teach the smallest amount possible, make points vivid, present information sequentially and allow patients to restate and demonstrate what has been learnt. They also suggest the strategic use of educational media such as flipcharts, photographs, drawings and videotapes to enhance understanding. Aims and Anticipated Outcome The primary focus of this project is to develop a teaching strategy to slow the progression of chronic kidney disease among patients with diabetes in Ghana. Consideration would be given to strategies that would reach out to and promote understanding among patients with low literacy skills. It is anticipated that when patients have enough information on their disease condition, they would collaborate with the healthcare team in the management of the condition. I hope to enhance my knowledge on the management of chronic kidney disease and my role as a nurse educator. This experience would, also, be transferred to my colleagues in Ghana and lead to general improvement in the management of chronic kidney disease in the hospital. This collaboration would, therefore, reduce complications of the disease and enhance patients quality of life. As has been identified by Thomas et al. (2008), when complications such as kidney failure and the need for dialysis is delayed for a short period among few patients, a lot of financial savings is made. Therefore, in addition to providing quality care for patients and enhancing their quality of life, this project would reduce the cost of managing complications of diabetes and chronic kidney disease in Ghana. The Professional and Organizational Context Komfo Anokye Teaching Hospital (KATH) is the second largest teaching hospital in Ghana, training many doctors, nurses and other paramedics in the Ashanti Region of Ghana. It is an autonomous service delivery agent under the Ministry of Health of Ghana (MOH, 2009a). In addition to training many of the health personnel in the Ashanti Region at KATH, many people within and outside the Ashanti Region seek healthcare there. As a result, provision of quality healthcare has always been the focus. An organisation that recognises the need for change, weighs costs and benefits, and plans for the change when the benefits outweigh the costs is ready for a change (Dalton Gottlieb, 2003). KATH is, therefore, ready for change because some of its employees are sent overseas or to other parts of the country, whenever there is the need for a new skill or knowledge to be gained, to bring about a positive change within the institution. This may be a factor that would facilitate my agenda to implement s ome changes within the institution upon my return to Ghana. However, Ghana, as a country is underdeveloped (CIA, 2008). Therefore, financial support, many a time, becomes a difficulty. Another challenge may be the fewer nursing staff. The Ministry of Health (2009b) estimates that there was a nurse-to-population ratio of 1:2024 in Ashanti Region and 1:1451 for the entire country in year 2007 while the WHO estimates that there are 9 nurses/midwives per 10,000 of the Ghanaian population (WHO, 2009xxxxx). Nevertheless, the desire to provide quality patient care and reduce healthcare costs, and dedication from the health personnel are factors that would supersede the anticipated obstacles to the implementation of this project.

Blindness and Sight - Sight Versus Insight in Oedipus the King (Oedipus

Sight Versus Insight in Oedipus the King      Ã‚  Ã‚   "Anyone who has common sense will remember that the bewilderments of the eye are of two kinds, and arise from two causes, either from coming out of the light or from going into the light,which is true of the mind's eye, quite as much as the bodily eye; and he who remembers this when he sees anyone whose vision is perplexed and weak, will not be too ready to laugh; he will ask whether that soul of man has come out of the brighter life, and is unable to see because unaccustomed to the dark, or having turned from darkness to the day is dazzled by excess light. And he will count the other one happy in his condition and state of being, and he will pity the other" (Plato, The Republic)    The paradoxical coexistence of blindness and insight is portrayed in Sophocles' Oedipus the King, in which Oedipus experiences a devastating yet redeeming realization that the "vision" he possesses is nothing but false pride and blindness. Suffering a complete reversal, Oedipus nevertheless maintains the fortitude to actively develop and endure intense suffering in order to attain extraordinary insight; deliberately grasping the kairos, Oedipus experiences a double bewilderment of the eye - both a physical blindness and, more ignificantly, a spiritual enlightenment, resulting from his "[h]aving turned from darkness to the day [to be] dazzled by excess light (Plato, The Republic).    "The eye is the lamp of the body. If your eyes are good, your whole body will be full of light. But if your eyes are bad, your whole body will be full of darkness. If then the light within you is darkness, how great is that darkness!" (Matthew 6:22-23).    Oedipus' "eyes are bad" and the dayli... ...ham: University Press of America, Inc: 1996. Hamilton,   Edith "The Collected Dialogues of Plato"   , Eds. Edith Hamilton and Huntington Cairns, 526-574. New York: Pantheon Books, 1961. Ignatius Holy Bible. Revised Standard Version, Catholic Edition. San Francisco: Ignatius Press, 1966. Knox, Bernard. Sophocles. The Three Theban Plays. Trans. Robert Fagles. New York: Penguin, 1984. Regal, Charles. Oedipus Tyrannus: Tragic Heroism and the Limits of Knowledge. New York: Twayne, 1993. Sophocles. "Oedipus the King" Classics in World Literature. Ed by Wood, Kerry et. Al. Glenview, IL: Scott-Foresman, 1989. Marra, James L., Zelnick, Stephen C., and Mattson, Mark T.  Ã‚   IH 51 Source Book: Plato,   The Republic, pp. 77-106. Kendall/Hunt Publishing Company, Dubuque, Iowa, 1998. Plato. The Republic. Trans. Desmond Lee. 1955. 2nd ed. London: Penguin, 1987.

Circumstances that Justify the Use of Physician-Assisted Suicide and Euthanasia :: Free Euthanasia Essay

Circumstances that Justify the Use of Euthanasia "...the elderly patients...are comatose. They weigh practically nothing. Their skin hangs in heavy folds on their skeletons. 'These patients must be fed through gastric tubes pushed down their throats,' Dr. Peter Haemmerli explains, and that can make even comatose patients retch and vomit." (Culliton 1273). Thus, according to Barbara J. Culliton, many severely ill patients must endure much pain. Not a very pretty scene, is it? Is it right to keep them living in this pain? Wouldn't it be more humane to give them a painless release from their agony? For this irreversibly comatose patient euthanasia would be justified. Now consider the patient suffering from malignant cancer or some other terminal disease. How "right" is it to keep injecting drugs and performing small operations to keep the patient alive, only to lengthen his suffering? As in the case of the irreversibly comatose patient, euthanasia is not only morally justified, it is the only alternative for those truly concerned with the patient's welfare. Euthanasis is clinically defined as an "act or practice of painlessly putting to death persons suffering from incurable conditions or diseases" (Bok 1). The word "euthanasia" is generally also applied to cases in which the doctor withdraws the machines or drugs which are keeping the patient alive and thus allows the patient to die naturally. Euthanasia ends pain mercifully and easily. It is used when the pain of degradation of life or the pain of a terminal disease is greater than the pain of death (Heifetz 5). In these cases death is not the nightmare experienced in war, but rather an alternative to endless pain. "At times we must look at death as a welcome release from an untenable life. Death need not be a source of horror. It can be freedom, a release from agony" (Heifetz 5). This observation by Dr. Milton D. Heifetz encompasses the purpose of euthanasia: to provide "a welcome release from an untenable life" (5). One such "untenable life" would be that of the irreversibly comatose patient. The most widely accepted definition of an irreversible coma states that the patient displays total "unreceptivity and unresponsivity. Circumstances that Justify the Use of Physician-Assisted Suicide and Euthanasia :: Free Euthanasia Essay Circumstances that Justify the Use of Euthanasia "...the elderly patients...are comatose. They weigh practically nothing. Their skin hangs in heavy folds on their skeletons. 'These patients must be fed through gastric tubes pushed down their throats,' Dr. Peter Haemmerli explains, and that can make even comatose patients retch and vomit." (Culliton 1273). Thus, according to Barbara J. Culliton, many severely ill patients must endure much pain. Not a very pretty scene, is it? Is it right to keep them living in this pain? Wouldn't it be more humane to give them a painless release from their agony? For this irreversibly comatose patient euthanasia would be justified. Now consider the patient suffering from malignant cancer or some other terminal disease. How "right" is it to keep injecting drugs and performing small operations to keep the patient alive, only to lengthen his suffering? As in the case of the irreversibly comatose patient, euthanasia is not only morally justified, it is the only alternative for those truly concerned with the patient's welfare. Euthanasis is clinically defined as an "act or practice of painlessly putting to death persons suffering from incurable conditions or diseases" (Bok 1). The word "euthanasia" is generally also applied to cases in which the doctor withdraws the machines or drugs which are keeping the patient alive and thus allows the patient to die naturally. Euthanasia ends pain mercifully and easily. It is used when the pain of degradation of life or the pain of a terminal disease is greater than the pain of death (Heifetz 5). In these cases death is not the nightmare experienced in war, but rather an alternative to endless pain. "At times we must look at death as a welcome release from an untenable life. Death need not be a source of horror. It can be freedom, a release from agony" (Heifetz 5). This observation by Dr. Milton D. Heifetz encompasses the purpose of euthanasia: to provide "a welcome release from an untenable life" (5). One such "untenable life" would be that of the irreversibly comatose patient. The most widely accepted definition of an irreversible coma states that the patient displays total "unreceptivity and unresponsivity.

Hartshorne and Nishida Re-envisioning the Absolute :: Philosophy Philosophical Papers

Hartshorne and Nishida Re-envisioning the Absolute ABSTRACT: This paper is a comparative study of Hartshorne's neoclassical reconsideration of the notion of the Absolute based on his Whiteheadian vision of the divine relativity, and Nishida's attempt at redefining the same notion against the background of what he calls the philosophy of "place" (Jpn., basho) of absolute Nothingness or Buddhist Emptiness. By reconsidering the notion of the Absolute, Hartshorne has come up with the standpoint of "Surrelativism," and Nishida's attempt has resulted in the standpoint of "absolute dialectic as guided by the principle of the self-identity of absolute contradictions." What I intend to do in this paper is study comparatively Charles Hartshorne's neo-classical re-consideration of the notion of the Absolute based upon his Whiteheadian vision of the "divine relativity" and Nishida Kitaro's attempt at re-defining the same notion against the background of what he calls the philosophy of the "place" (Jpn., basho) of absolute Nothingness or Buddhist Emptiness. By reconsidering the notion of the Absolute Hartshorne has come up with the standpoint of "Surrelativism" in his Divine Relativity (1948). And Nishida's attempt at redefining the same notion has resulted in the standpoint of "absolute dialectic as guided by the principle of the self-identity of absolute contradictories" in his "The Logic of Place and the Religious Worldview" (written in 1945; published posthumously in 1946). Hartshorne belongs, as leader, to the second generation of Whiteheadian process-relational thought in North America. By contrast, Nishida is the founder of what is usually called the Kyoto School of philosophy in Japan; deeply inspired by Zen, Nishida vigorously engaged in a wholehearted, laborious encounter with the West philosophically throughout his career. But what I can commonly perceive in the two philosophers is a noticeable philosophical phenomenon: namely, the notion of the Absolute has undergone a profoundly significant process of self-transcendence/self-transformation in either of the two philosophical systems in such a way that one now begins to identify one's own position as "panentheism." Hartshorne and Nishida both negate and transcend the traditional notion of the Absolute as "transcendence"; in this sense, they both tend to be radically affirmative of the "immanence of the Absolute." And yet at this very juncture they both decidedly deny the linkage of their respective standpoints with that of Spinoza's "pantheism." Hence, panentheism. But how so? In what follows let me try to answer and elucidate this question as much as I can. For I perceive

Constraints Facing The African Stock Market Economics Essay

The African stock market is going progressively sophisticated in pricing, insulating and reassigning hazard. Tools such as derived functions and securitization contribute to this procedure but pose their ain hazard. The failure of accounting and ordinance to maintain abreast of development introduces more hazard with on occasion dramatic effects.Macroeconomic FactorsMacroeconomic hazards include rising prices hazard, involvement rate hazard, low modesty and thin fiscal market which all together affect the public presentation of a stock market. Macroeconomic policy has a great impact on the public presentation of the stock market. In 1996, the Zimbabwe stock market which accounted for an overall public presentation of 86.5 % . However, in 1997 its public presentation decreased by more than 50 % in the aftermath of dramatic authorities farm and to pay $ 240 million in pensions to veterans of Zimbabwe independency war. For the last two decennaries, the growing rate of existent per capita end product for Africa has been negative, while other parts have been demoing strong positive growing rates. For illustration, while between the 1970s and 1990s East Asia and South Asia moved from an mean growing rate of 4.6 per centum and 0.7 per centum to 6.4 per centum and 3.3 per centum, severally, Sub-Saharan Africa ‘s growing rate declined from 0.5 per centum in the 1970s to -0.4 per centum in the 1990s.Corporate AdministrationCoup vitamin D ‘ & amp ; eacute ; cheapnesss is rather celebrated in African history. It appears that constitutional regulation are present at that place and politicians are pull stringsing fundamental laws to either seek thirster footings in office or perpetuate their stay. Therefore, there is a deficiency of good corporate administration in the states. In the absence of corporate administration, there is inappropriate policy taken by the authorities and regulative models. Furthermore, there is no control of corruptness, capacity edifice, and there is an uneffective, inefficient, no transparent and accountable system for mobilising and apportioning public every bit good as private resources.High unemploymentIn Africa, there is copiousness of unskilled labour and this may take to worsen of the on the job category. The growing in demand for skilled labour does non fit the diminution of unskilled and semi-skilled occupations. The labour market is switching towards more skilled workers, professionals and directors. A labour study in South Africa found that there is more demand for directors in the populace sector, particularly local authorities and peculiar services sectors Unemployment is pig-headedly high and edging upward. In South Africa the expanded unemployment rate is estimated to be every bit high as 40 % with the official rate at about 29 % . The fact that the labour market is biased against those with less accomplishment is reflected in the higher mean wage additions for skilled individuals.Trade DevelopmentMany African states are faced with a multiplicity of challenges that prevent them from take parting in the planetary economic system and harvesting the benefits of increased globalisation. Africa is the most disconnected continent. Fourteen states are landlocked, accounting for 30 % of Africa ‘s population. The roots of the job prevarication in chronic restraints to competitiveness including, hapless substructure, little and disconnected markets, undeveloped fiscal markets, weak systems to ease trade, weaknesses in cardinal establishments, and the deficiency of equal human resources.Political HazardPolitical instability, institutional incapacity and societal unrest inhibit foreign capital influxs. These in bend lower investing appetencies and have a negative impact for economic chances and investing clime. Percepts of political hazard originating from peculiar events, such as those related to the recent elections in Kenya which generate market volatility and discourage investing. Africa is seen as a part of high political hazard, and important hazard premium are demanded by equity investors, loaners and insurance companies.Currency fluctuation hazardThe planetary economic lag in universe growing may impact African exports of agricultural merchandises, minerals and hydrocarbons. Africa ‘s dependance on natural resource exports has made many states vulnerable to trade good monetary value dazes that are outside their control. Sudden additions in export grosss or import costs can do currency instability and budget uncertainness. Furthermore, there is strong grounds that currency depreciation has negative consequence on the public presentation of the African stock market.Crisis of International ConfidenceMany states in sub-Saharan Africa enjoyed robust economic growing in recent old a ges. However, the nutrient and fuel monetary value dazes of 2007-08 that preceded the current planetary fiscal crisis weakened the external place of net importers of nutrient and fuel, caused rising prices to speed up, and dampened growing chances. A research done by IMF shows that in the yesteryear a 1 per centum point lag in planetary growing has led to an estimated ? per centum point lag in sub-Saharan African states. But the effects may be more marked this clip because the tightening of planetary recognition compounds the impact of the lag, worsening hazards for trade finance and other capital flows.Recommendations.The stock market needs specific attending when it comes to the menaces and challenges predominating. Normally, there are several ways which can take to the development of the stock market. Automation can be of great aid as it reduces costs every bit good as inefficiencies. It operates faster than the manual system which besides increases trading activities and liquidness. We besides have demutualization which is a procedure that involves a alteration in ownership construction and a alteration in legal and organisation signifier. Factors such as competition among exchanges, demand for increased capital, demand for good corporate administration in exchanges and the impulse to open up ownership of exchanges to public investors help demutualization addition popularity. Demutualization is expected to work out common construction jobs by opening up merchandising rights, acknowledging new trading spouses, and broadening ownership such that the populace can put in exchanges. It besides increases entree to services of the exchange and removes inordinate investing costs for fund holders. Another cardinal solution can be to beef up Financial Regulation and Supervision. Such a step will hike the assurance of investors every bit good as protects their rights and hence besides encourages them to put more in the stock market. The development of good quality establishments can besides impact the attraction of equity investing and lead to stock market development. Good quality establishments such as jurisprudence and order, democratic answerability, bureaucratic quality are of import determiners of stock market development in Africa because they cut down political hazard and heighten the viability of external finance. The increased engagement of investors on the stock market will besides assist advancing efficient market patterns and fiscal invention. They typically favor greater transparence and market unity in both primary and secondary markets, seek lower dealing cost, and promote efficient trading and colony installations. Enhancing surveillance of the OTC forex derivative markets by systematic processing and analysis of information on offshore activity will besides be of great aid. Another proposed solution to jobs faced by African stock markets is to incorporate stock exchanges. Unifying African stock markets into a individual regional exchange instantly is no uncertainty an ambitious and dashing undertaking, given the associated institutional and fiscal cost complexnesss. Advocates of this proposition argue that a good incorporate regional stock exchange in Africa will be a powerful beginning and driver of capital flows to Africa. Such an exchange will besides, if good structured, work out the current jobs of illiquidity, little size, and atomization.

Eastern foods assigment Essay

Background: As the building work is going to be complete in July 1st and therefore there is a plan to start the business early in May 1st. To develop the business the Eastern Foods is facing the following challenges with regards to HRM, Accounting, Marketing and Operations Management. (a) Overview of Challenges Facing Eastern foods: Human resource Management (HRM) Human resource management is also identified as â€Å"personnel management†. There will be in detail study required of whole business for the recruitment of the new staff. There should be study of hierarchy of the management level that will be necessary to manage the operations of business. And what skills will be obligatory for conducting the operations of business. The workers that will be recruited must have the knowledge and experience relevant to the operations of East Foods Company’s business. Such as in production there must be those people who have best knowledge of production. The diversity on workplace will have to be considered like the marital status, sexual orientations, ethnicity etc. These all criteria must be set in consideration of requirement of work for example if work required at plant needs the male man power then the women cannot be recruited there. Similarly there will be requirement of special team for marketing of the new project from the marketing backgrounds like peoples who have studied in Business Marketing and have good previous experience in marketing. The human resource should be managed in following way Digram1 (Process of Human Resource Management) Finance: Finance is the most important part of any kind of business. Through accounting the transactions are recorded and summarized and the results are generated also the figures of profits are determined. For the complex and frequent transactions the accounting software and staff who know how to operate that software are required as will. The team should study that  weather the software are required for accounting for Eastern Foods business and if it is required then which software will be suitable and whether it should be bespoke software. Then the cost of purchasing and its annual subscription will be an issue. Marketing Marketing is also essential for the success Eastern foods. In marketing the need of the consumer are known and then make research on that specific need to produce it and after production that product is advertised for sale also Eastern Foods must develop the marketing mix (4 p’s): price, product, place and promotion. Therefore the project team has to pay special attention on marketing, there should be staff for the research to invent new products and produce it to meet the customer need and take the competitive advantage if you are the first one to invent that product. Then there should be selling team who must advertise it in market to make sale. (Diagram2) (Marketing Mix 4P’s of Target Market) Operations Management Operations management is section of business management which is concerned with supervision operations for example asset management , cost management ,designing, and calculating the process of production and redesigning business operations in the production of goods or services. It involves the responsibility of ensuring that business operations are efficient in terms of using as few resources as needed, and effective in terms of meeting customer supplies. It is concerned with managing the process that converts inputs (in the forms of raw materials, labor, and energy) into outputs (in the form of goods and services). For the success of Eastern Foods it is very necessary to run the operations in sequences and in smooth manner therefore project team has to focus on the planning of management of operation and designing of operation for new business is great task. For example after estimating the future sale the project team has to focus on required production. How the things will be produced, preserve and sold everything needs planning. Different models must be designed for operation management and the best one which is most efficient and cost-effective must be chosen. The HRM and operation management are the key issue and should be addressed in effective way to run the business in smooth manner. (b) Two key issues key issues and how they can be addressed: Operational Management To address the issue of operational management the management team which is responsible for the business activities that is going to be start on May 1st must be response in following manner (Diagram 3) Service management functions 1. Optimizing Before start of the business the following level of management must be optimized. I. Service level management There is monitoring and management of the quality of services and entity’s key performance in Service-level management. The key performance indicators range from coarse-grained availability and usage statistics to fine-grained entity-contained per-interaction indicators. There is comparison of actual performance with pre-defined expectations and determine suitable actions and producing meaningful reports in Service level management. II. Financial management In financial management there is effective and efficient management of money which accomplish the goals of organization. It is the specialized functions directly associated with the top management. The significance of this function is not only seen in the ‘Line’ but also in the capacity of ‘Staff’ in overall administration of a company. The financial management is defined differently in different fields. III. Capacity management Capacity management is a procedure used to manage information technology (IT). Its primary objective is to ensure that IT capacity meets current and future business needs in a cost-effective way. One common analysis of  capacity management is described in the ITIL framework. ITIL version 3 views capacity management as comprising three sub-processes: business capacity management, service capacity management, and component capacity management (known as resource capacity management in ITIL version 2). As the usage of IT services change and functionality evolves, the amount of processing power, memory etc. also changes. If it is possible to understand the demands being made currently, and how they will change over time, this approach proposes that planning for IT service growth becomes easier and less reactive. If there are spikes in, for example, processing power at a particular time of the day, it proposes analyzing what is happening at that time and make changes to maximize the existing infrastructure, for example, tune the application, or move a batch cycle to a quieter period. IV. Availability management Availability Management aims to define, analyze, plan, measure and improve all aspects of the availability of services. Availability Management is responsible for ensuring that all infrastructure, processes, tools, roles etc are appropriate for the agreed availability targets. V. IT service consulting management The practice of helping organizations to improve their performance, operates primarily through the analysis of existing organizational problems and the development of plans for improvement. Organizations may draw upon the services of management consultants for a number of reasons, including gaining external (and presumably objective) advice and access to the consultants’ specialized expertise. VI. Work force management Encompasses all the activities needed to maintain a productive workforce. Under the umbrella of human resource management, WFM is sometimes referred to as HRMS systems, or even part of ERP systems. Recently, the concept of workforce management has begun to evolve into optimization. One main player in WFM Optimization and WFM BPO is Workforce Insight (WFI). VII. Infrastructure engineering Infrastructure is basic physical and organizational structures needed for the operation of a society or enterprise or reproductive system ,[1] or the services and facilities necessary for an economy to function.[2] It can be generally defined as the set of interconnected structural elements that provide framework supporting an entire structure of development. It is an important term for judging a country or region’s development. VIII. Security management Security management is the identification of an organization’s assets (including information assets), followed by the development, documentation, and implementation of policies and procedures for protecting these assets. After the step of optimizing there is step of changing of management according to business need. 2. Changing The changing process are consists of three steps. I. Change management The management is changed as per current requirement of business activities it may be shuffle in different departments or may be fired and recruited new one. II. Configure Management After deployment of new management the staff is configured in right way to do effective work to generate the results which is goal congruence. III. Release management After training of management it is released to do work. 3. Operating I. System administration When the management is trained and deployed and functions have been started then there is need of administration on all system of business like procurement, production, storage and sales. II. Security Administration The operations of security must be administered by admin department because for safeguarding of assets the security is very important. With the help of effective security the accidents can be avoided. III. Service monitoring and control To maintain the quality there must be effective control on all services like the procedures of procurement and production must be monitor to maintain the quality. IV. Directory monitoring administration Directory monitoring administration play important role in smoothness of operations. V. Network Administration For the fast communication there is highly need of suitable network. Therefore the networks like internet, mobiles and telephone exchange must be properly hold by company. VI. Storage management The stock must be preserved in effective way to avoid the loss and to maintain the quality of products. VII. Job Scheduling The staff must be available every time to continue the operations therefore the roster must be maintained and monitor. 4. Supporting I. Service Desk A Service Desk is a primary IT service for in IT service management (ITSM) as defined by the Information Technology Infrastructure Library (ITIL). It is intended to provide a Single Point of Contact (â€Å"SPOC†) to meet the communication needs of both Users and IT employees. II. Incident Management Incident management is a term describing the activities of an organization to identify, analyze, and correct hazards to prevent a future re-occurrence. These incidents within a structured organization are normally dealt with by either an Incident Response Team (IRT), or an Incident Management Team (IMT). These are often designated before hand, or during the event and are placed in control of the organization whilst the incident is dealt with, to restore normal functions. III. Problem Management Problem management is the process responsible for managing the lifecycle of all problems. The primary objectives of problem management are to prevent problems and resulting incidents from happening, to eliminate recurring incidents, and to minimize the impact of incidents that cannot be prevented. The Information Technology Infrastructure Library defines a problem as the cause of one or more incidents. HUMAN RESOURCE MANGEMENT: Human resource management (HRM) is the management process of an organization’s workforce, or human resources also the main foundation in management activity of any Business is the HRM. It is responsible for the attraction, selection, training, assessment, and rewarding of employees, while also overseeing organizational leadership and culture and ensuring compliance with employment and labor laws. In circumstances where the employees’ desire and they are legally authorized to hold a collective bargaining agreement, HR will also serve as the company’s primary link with the employees’ representatives. HR is a product of the human relations movement of the early 20th century, when researchers began documenting ways of creating business value through the strategic management of the workforce. The function was initially dominated by transactional work, such as payroll and benefits administration, but due to globalization, company consolidation, technological adv ancement, and further research, HR now focuses on strategic initiatives like mergers and acquisitions, talent management, succession planning, industrial and labor relations, and diversity and inclusion. In startup companies, HR’s duties may be performed by trained professionals. In larger companies, an entire functional group is typically dedicated to the discipline, with staff specializing in various HR tasks and functional leadership engaging in strategic decision making across the business. To train practitioners for the profession, institutions of higher education, professional associations, and companies themselves have created programs of study dedicated explicitly to the duties of the function. Academic and practitioner organizations likewise seek to engage and further the field of HR, as evidenced by several field-specific publications. HR is also a field of research study that is popular within the fields of management and industrial/organizational psychology, with research articles appearing in a number of academic journals, including those mentioned later in this article. In the current global work environment, all global companies are focused on retaining the talent and knowledge held by the workforce. All companies are focused on lowering the employee turnover and preserving knowledge. New hiring not only entails a high cost but also increases the risk of the newcomer not being able to replace the person who was working in that position before. HR departments  also strive to offer benefits that will appeal to workers, thus reducing the risk of losing knowledge. 1. Recruitment Management The recruitment is most important step in human resource management. It must be consider that the staff recruited by the management should be suitable to run the operation of business. For this purpose different techniques of recruitment can be obtained like written test, aptitude test and interviews. And different task base test this step must be done to identify the candidates and to have the decision which candidate to accept it. 2. Employee Management Once the employees are recruited they should be trained and then deployed in their relevant roles and their performance should be evaluated. 3. Shift Management The roster of employees must be scheduled and their shift should be managed in a manner that there should not be any discontinuity in operation of business. 4. Attendance Management The attendance register of employees must be regularly maintained and monitored by authoritative person. 5. Leave Management The annual leave days allowed must be decided and employees should be given holidays according leave rules. 6. Payroll Management The remuneration or salary must be decided according to the ranks and work of employees. And remuneration must be performance oriented to motivate the employees. Conclusion: Plan for Organization In conclusion to run the organization successfully we need to set up all the four key functions Accounts, HRM, Operation Management also marketing on similar basis. There should be finance for running the operations therefore we have to arrange the investors. Then we have to implement the designed operations like procurement (must be different department) and the production unit must be installed and relevant recruited staff will be deployed in unit. Likewise the warehouse to store the products and there should be selling and delivering man force to make sales. And the skilled  man force is needed for marketing to enhance the sale. And there will be accounting software and professional staff to record the transaction and generating results. The managing of operations will be required on ongoing basis in other words the operation must be monitors and results must be match with targeted performance. References: http://www.teamquest.com/resources/ www.ca.com/us/products/detail/ca-capacity-manager.aspx‎ www.workforce.com/‎ Alexander Bickerton lecture PowerPoint www.businessballs.com/changemanagement.htm www.servicenow.com/products/it-service†¦/incident-management.html‎ neoenglish.wordpress.com/†¦/what-is-hrm-–-human-resource-management http://hrm2013.blogspot.co.uk/ http://www.quadrasystems.net/serv_ourapproach.htm https://www.smartdraw.com/examples/view/4ps+marketing+mix/ http://shal2788.hubpages.com/hub/Role-of-Human-Resource-Management-HRM

Maslow’s Hierarchy of Needs Essay

Abstract This paper will explain Maslow’s triangle and its application to interpersonal communications. An explanation will be given how the interpersonal communications, based off of Maslow’s triangle, can be used as an interview and interrogation tool. Examples will be provided of a personal experience that directly relates to the vertical progression through Maslow’s triangle. When Maslow’s hierarchy of needs (Maslow’s triangle) is understood, it is easier to understand another person and have better more effective interpersonal communication. Maslow’s triangle is a set of needs that must be met and people are self-motivated to fulfil the needs. Maslow’s triangle can be used during interrogation and interview as a means to build trust a rapport. Maslow’s hierarchy of needs can be divided into two parts, basic needs and growth needs (McLeod, 2014). To elevate to a higher need, the needs at the current level must be satisfied. The basic needs are believed to be self-motivating and the longer they go unmet the greater the desire for them becomes. For instance the longer one goes without sleep then the more tired they become and soon the body will breakdown. The bottom of the triangle is physiological needs. These are the most basic needs for survival such as food, water, breathing, sex, sleep, homeostasis, and excretion. The next level is safety needs which consists of protection from elements, security, order, law, stability, and freedom from fear. Love and belongingness needs is the third rung and is comprised of friendship, intimacy, affection and love, from work group, family, friends, and romantic relationships. The final basic need is esteem needs which includes achievement, mastery, independence, status, dominance, prestige, self-respect, and respect from  others. The top of the triangle, and the growth need, is self-actualization needs, made up of realizing personal potential, self-fulfillment, and seeking personal growth and peak experiences. Maslow believed that people have an inborn desire to be self-actualized (Cherry, n.d.). Self-actualization is when a person reaches their full potential. Understanding human needs can be a used persuade people as they are already self-motivated to fulfil their needs. This can be used by both preventing the obtainment of a current need or by providing a current need. In the later one can build rapport with the subject by providing the needs. This can further lead into security or love and belongingness where you as an interrogator or interviewer can be the stability or friendship need that is missing. By filling in the need you can passively be purvey to more information or even take a more aggressive quid pro quo stance. Furthermore you may even give an ultimatum that if the information you seek is not provided then the fulfilled need will be taken back leaving a deficiency. As this relates to my personal experiences and my progression through the hierarchy of needs, I am no different than anyone else and I must have fulfillment of one level before ascending to the next. I have been fortunate enough that air and water have always been present in my life. Sleep is sometimes lacking and can affect my health but on the whole a sufficient amount of sleep is met. Being that the lowest level needs have been generally fulfilled the next level is considered. Safety needs have generally been provided given that safety of employment was sufficient. While employed in the active duty military I had job security providing money that provided safety in resources. Safety in employment allowed the lower level item such as food to always be fulfilled as well as safety of property a need of the second tier. Employment allowed advancement into both the third and fourth levels as I was part of a family both in occupation and able to provide for one at home. I also had friendship within the employment and much respect both from self and others as well as a sense of achievement. This had much to do with the type of occupation being what it was (military). This all fed into a greater self-esteem and then into the top tier of the triangle, growth and self-actualization. The other side to  this is that when I was no longer in the active duty military and I lost the fulfilment of safety of employment I much of the fulfilment of other needs. I lost the steady monetary income and in direct correlation I lost safety of property as I was never sure if I would be able to make my house payment. Being able to provide for my family was always a question and this greatly reduced my self-respect and respect from family and relationship within the family dynamics. I was not sure if I would be able to always meet to need of food. My focus was fulfilling that unmet need, the need for safety of employment. At no time after I had a deficiency in level two of the triangle was I ever considering my self-actualization or full potential let alone even confidence or achievement from the level below that. When Maslow’s hierarchy of needs is understood, it is easier to understand another person and have better more effective interpersonal communication. The needs laid out in Maslow’s triangle can be used during interrogation and interview. They can be used as a means to build trust a rapport and or persuasion and coercion. References (n.d.). Retrieved from wikimedia,org: http://upload.wikimedia.org/wikipedia/commons/5/58/Maslow’s_hierarchy_of_needs.svg Cherry, K. (n.d.). Hierarchy of Needs. Retrieved from About Education: http://psychology.about.com/od/theoriesofpersonality/a/hierarchyneeds.htm McLeod, S. (2014). Maslow’s Hierarchy of Needs. Retrieved from Simply Psychology: http://www.simplypsychology.org/maslow.html Tay, L., & Diener, E. (2011). Maslow’s Hierarchy. Retrieved from Changing Minds: http://changingminds.org/explanations/needs/maslow.htm

Case Study on Calculous Cholecystitis Essay

I.Introduction A. Concepts in nutrition, medical nutrition therapy, and organ systems concerned Nutrition is the study of food in relation to health. The Food and Nutrition Council of the American Medical Association defined nutrition as the â€Å"science of food, the nutrients and other substances therein, their action, interaction and balance in relation to health and disease, and the processes by which the organism ingests, digests, absorbs, transports, utilizes and excrete food substances.† Nutrition is also concerned with the physiologic needs of the body in terms of specific nutrients, the means of supplying these nutrients through adequate diets, and the effects of failure to meet nutrient needs. In this similar viewpoint, nutrition is also concerned with the social, economic, cultural, and psychological implications of food and eating. Nutrition follows the four basics concepts, namely: 1.) Adequate nutrition is essential for health. 2.) Food items are classified according to content in terms of majority of nutrients, broadly classified as carbohydrates, proteins, fats, minerals, vitamins and water and are needed daily in the diet of humans. 3.) An adequate diet is the foundation of good nutrition, and it should consist of a wide variety of natural foods. 4.) Nutrients should be provided preformed in food, whereas a few may be synthesized within the body. 5.) Nutrients are interrelated and there should be metabolic balance in the body. 6.) The body constituents are in a dynamic state of equilibrium. 7.) Human requirements for certain nutrients are known quantitatively within certain limits. 8.) The effects of nutritional inadequacy are more than physical; behavioral patterns and mental performance are also compromised, and; 10.) Proper education, technical expertise in addition to the use of all resources available in the practice of nutrition will help upgrade the nutritional status of people. (Lagua, Claudio and Ruiz, 2004) Race has been a predisposing factor in developing gallstones. Westerners usually develop cholesterol stones, while Asians tend to have pigment or mixed stones. There has been an increasing prevalence of calculous cholecystitis in the Philippines. Whatever the type, size or origin of these stones, they can present with a variety of signs and symptoms. Stones develop in a sluggish, diseased gallbladder. Formation of stones may be due to infection, stagnation of the bile or changes in the chemical composition of the bile, overeating or poor eating habits. Obesity is highly associated with prevalence of gallstones. Prevalence increases with age, history of diabetes mellitus and elevated serum triglycerides ( Lagua, Claudio, 2011) The gallbladder may contain one large stone or many small ones. Infection accompanied by formation of gallstones is referred as calculous cholecystitis. Often times, people with gallstones must have their gallbladder removed through a process called cholecystectomy. Transition diets are given accordingly after surgery and if the patient advances to an oral diet post-surgery, intake of fat is allowed as tolerated. As an accessory organ, the gallbladder is fairly easy to live without. Once it is removed, bile travels from the liver directly into the small intestine. B. IMPORTANCE/ SIGNIFICANCE OF THE STUDY Disorder of the accessory organs present a significant impact on the absorption and nutritional status of an individual. Failure to give immediate treatment could bring about complications which are more difficult to manage. These complications may or may not possibly lead to death of an individual. This study was conducted to enable the students to practice his/ her skills on Diet Therapy I. It may help the students to understand better the disease condition, the actions and interactions of food and medications to the body and the rationale for the diet prescription for the case patient. Moreover, it would help the students, as well as the readers to draft a nutritional care plan for patients with calculous cholecystitis upon acquiring information about the disease through data collection. C. Objectives (General and Specific) The study generally aims to analyze, assess and give proper recommendations to a patient diagnosed with calculous cholecystitis. This study was also conducted to allow students to apply the knowledge gained in the lecture and laboratory class of Diet Therapy I. The study specifically aims to: 1) Gather all the necessary information from the patient’s medical records and the interview 2) Assess the patient’s nutritional status and disease condition base from the information obtained 3) Know the causes, signs and symptoms of the disease condition and its complications 4) Determine and relate the factors and causality for the formation of the patient’s disease 5) Interpret and relate the findings to the patient’s disease condition 6) Formulate a nutritional care plan for the patient 7) Provide a diet prescription appropriate for the condition of the patient 8) Provide short and long term intervention for the patient and other recommendation that could help the prevent disease condition of the patient. D. Limitations of the Study The case study is only limited to the disease condition of the patient with calculous cholecystitis and its possible complications if not given immediate intervention. Due to time constraints, the attending physician and nurse were not interviewed for further understanding of the disease. There was also no diet prescription written on the patient’s medical chart, thus, the hospital’s cycle menu was used as a basis for some computations and analysis. II. Methodology Students of Diet Therapy I were grouped into pairs and were asked to get a patient for the case study. Approved letters provided by instructors of Diet Therapy II, requesting for a case patient with infections, burns, surgery, allergies and diseases of the gastro-intestinal tract were personally submitted to different hospitals in Laguna. Laguna Provincial Hospital in Sta. Cruz Laguna accommodated the request, with the approval of the medical director and assistance of the attending physician, nurse and head nutritionist-dietitian. In the nurses’ station, the necessary information was gathered on the selected case patient and the medical records were copied as data for the study. An interview with the case patient followed afterwards. The patient, together with her aunt, was interviewed to collect necessary data such as personal information, nutritional and dietary history and the 24hr. food recall. Before the said interview, a questionnaire was formulated to systematically and completely obtain all the essential information for a better further analysis. Questions include the 24-hour food recall of the patient food intake (prior to admission and during confinement), personal data, signs and symptoms experienced, patient’s tolerance and acceptance to the food given in the hospital, and some other information that would be beneficial to the study. After data gathering, the case was analyzed and a case study was then formulated. This was done through evaluation of the disease condition of the patient and correlating the symptoms experienced by the patient with the clinical manifestation of the disease. The dietary and the medical intervention given to the patient were also analyzed. This included correlating the principle and rationale of the diet with the patients’ actual illness. The possible nutrient-drug interaction that can happen due to the prescribed medication to the patient was also analyzed. The result of the laboratory and biochemical findings of the patient was also interpreted. After this, the diet of the patient PTA and DC were analyzed quantitatively and qualitatively. The diet was evaluated quantitatively by computing the CPF of the patient’s food intake and computing the adequacy of that diet. Qualitative evaluation, on the other hand, was used using RDA. After analyzing the recommendations given to the patient, short-term and long-term diet plan was prepared for the patient. In computing the desirable body weight (DBW), the Tanhausser’s Method. The WHO standards for body mass index served as the basis in determining whether the client’s nutritional status. Method I was used to determine the patient’s total energy requirement (TER) for long term intervention and the carbohydrates-protein-fat distribution was distributed using the non-protein calorie method. III. Theoretical Considerations A. Disease Condition Calculous cholecystitis or cholecystolithiasis, is caused by the precipitation of the substances contained in the bile, mainly cholesterol and bilirubin with accompanying inflammation. The bile is consisted of bile salts, cholesterol, bilirubin, lecithin, fatty acids, electrolytes and water usually found in the plasma. The cholesterol formed in the bile has no function; it is only a by-product of bile salt formation and the presence is only linked in the excretion of bile. Cholesterol is normally insoluble in water and this is where lecithin and bile salts combine with it to form micelles. Inside the gallbladder, water and electrolytes are absorbed in the liver bile, causing it to be more concentrated. Lecithin and bile salts are not absorbed in the gallbladder, their concentrations increases alongside cholesterol’s. This is the mechanism of maintaining the solubility of cholesterol. B. Definitions and Classifications Cholecystitis – inflammation of the gallbladder. There has been an association of cholecystitis with cholelithiasis. There is almost always a close association with complete or partial obstruction of the stones formed inside the gallbladder. Cholelithiasis – gallstones that precipitated from bile, cholesterol or bilirubin due to impaired gallbladder function or excessive production of by-products from fat digestion. C. Etiology Gallstone formation is due to bile salt, pigments and cholesterol salt accumulation. The stones rub off on the walls of the gallbladder, causing pain and inflammation in the subsequent internal structures. There is also a link between elevated or abnormal estrogen levels with gallstone formation. D. Incidence/ Prevalence There is a 10% incidence of adults getting gallstones. Approximately, there are twice as many women who develop this disease and it increases with age: after 60 years old, there is a 10-15% prevalence in men while a 20-40% prevalence in women was noted. E. Pathology Gallstones obstruct bile flow and causes reflux and subsequent inflammation in the gallbladder. The inflammation is caused by chemical irritation from the concentrated bile, along with the swelling of the mucosal area and ischemia from venous congestion and stasis. Bacterial infections may be a complication and this could account for the infection and could reach the adjacent gallbladder through the circulation. Staphylococci and enterococci are the most common pathogens. Perforation of the gallbladder could lead to gangrene. F. Clinical Manifestations and Underlying Mechanisms Pain is evident in early cholecystolithiasis. There is similarity in the pain experienced with biliary colic and is usually felt after a fatty meal. Pain is experienced in the right upper quadrant and there is spasm in the right, subcostal region. There is elevation in total serum bilirubin, amino transferase and alkaline phosphatase. G. Prognosis After cholecystectomy, patients can return to work in a span of 1-6 weeks. IV. The Patient A. Personal Data The patient is Chastine Salazar, 28 years old, female admitted on January 3, 2013 at Laguna Provincial Hospital in Sta Cruz, Laguna. Her physician is Dr. Flores. B. Socio-Economic History The patient works as a registrar in the Head Office of AMA in Quezon City, Philippines. Due to her sedentary lifestyle, she and her husband jogs for 2 hours every weekend. Her middle-class income allows her to select food items of higher market value, thus chocolate is always present after every meal. The patient does not smoke nor drink but based on the interview, it was found out that she uses laxatives due to constipation problems. C. Present illness and chief complaint Patient has cholecystolithiasis with cholecystectomy as the surgical procedure of which 8 marble-sized gallstones were removed. Pain and vomiting was experienced by the patient and was immediately rushed to the hospital on January 3, 2013. D. Past Illnesses and surgery, allergies, hospitalization There were no family history of predisposing risk factors to cholecystolithiasis but it was found out from the interview that the patient has allergic reaction to sea foods and patient has allergic rhinitis of which she has treated before with steroids. E. Physical State of Health Patient has allergy to sea foods and has allergic rhinitis. Patient also has constipation of which she self-medicates with laxatives. G. Nutritional and Dietary History It was observed from the 24-hr food recall that the patient has frequent consumption of chocolates and carbonated beverages. There was also a high intake of fatty and fried food and dishes every day. Snacking patterns are also noted as the patient tends to overeat every 3 hours.