Company law Reform Bill Essay Example | Topics and Well Written Essays - 2500 words

Company law Reform Bill - Essay Example These directors together are called the Board of Directors. Since all the directors cannot execute individually they elect one among them as a Managing Director. The board of Directors will take all policy decisions in the Board meeting and the Managing Director executes the decision taken by the board. The proviso 741(1) deals with the definition of directors, this proviso is an inclusive provision which says the directors include properly appointed directors, "de jure" directors like "governor", not properly appointed directors such as "de facto directors" and "shadow" directors. [Charlesworth & Morse, Company Law (1999)] a De facto Directors: De facto Directors are those who act openly as directors and they claim to be directors on they being performed the functions of the directors, though they are not properly appointed. These directors are recognized as de facto directors for only that period during which they acted so. [Charlesworth & Morse, Company Law(1999)] b It is a decided law that person who claims to be director by de facto has to make a plea and establish that he has undertaken such function of the company which would have been undertaken by the director only, but not simply to show that he has under taken the and discharged the functions which the management below the directors could not be under taken and discharged. Re Richborough Furniture Ltd 2 In this case it was held that De facto director should satisfy either of two tests such as (a) he is sole person directing the affairs of the company or (b) he was acting on par with other directors in directing the affairs of the company, if there are other properly appointed directors. Secretary of State for Trade and Industry v. Lating 3 In this case while approving the two tests it was held that by simply satisfying either of the two test is not sufficient to claim as de fact director, but he should be still acting as such, which means that the de facto director is recognized as director only during the period in which he is acting as per the two tests. Once he ceased to be acting as such he would be ceasing to be de facto director. The court in another case Secretary of State for Trade and Industry v. Hickling 4 approved this Shadow Directors: Section 741(2) of the companies act 1985 defines shadow director as 'a person in accordance with whose directions or instructions the directors of a company are accustomed to act'. Professional persons on whose, advise the directors act are excluded from this definition. Shadow directors are vicariously liable for the action of the directors whom they appoint or control. This provision aims at preventing the persons escaping from the liability under the shelter of a board of marionette. The directors of a subsidiary who are working under the directions of the directors of the parent company then the directors of the parent company are called the shadow directors. (LS Sealy, Cases and Materials in Company Law) c Re Hydrodam(Corby)ltd 1 The court held in this case that one has to satisfy the four conditions for adjudicating a person as shadow director such as (i) he is properly appointed or de facto director (ii) the director directs the other directors in which manner they have to function in relation to the company (iii) the other directo

Dance Paper Essay Example for Free

Dance Paper Essay This dance is danced to live music with traditional Cambodian instruments. There is also singing done by the musicians. It is performed on an indoor stage. The dancers are very graceful and move slowly. The focus a lot on head movements even though there is a slight tilt from side to side. The dancers are carrying a goblet. They wear costumes with headpieces. The hands and wrist move and the focus is on the upper body because the long skirts cover up the legs. This dance looks like it may symbolize something that has to do with the goblet prop. Royal Ballet of Cambodia. This dance is danced on stage and with live music and traditional singing. The dancers are very graceful and the women play both the male and female part. There are dancers in the background sitting. The dancers use their hands and do not travel very much. The costumes are elaborate and the headpieces are very large. The facial expressions are subtle and not dramatic. The torso remains upright. The dance is performed indoors on a stage with lighting. This dance may symbolize a love story because there are both male and female roles. Tahiti Group Dance Performance This dance is performed on an outdoor stage with live music. The male dancers wear grass skirts just as the female dancers. The dance is very fast and upbeat. The female dancers move their hips while the male dancers move their legs in a scissor motion. Like the Cambodian dances, the facial expressions are not dramatic- they are very subtle. Male Tahitian Dance This is performed outdoors on grass to live music. The audience is not shown in this video but it seems like the audience is very casual. The dancers are scream and chant with passion. The male dancers wear garlands around their arms and ankles. They are in very short grass skirts. The dancers move very quickly using their legs and arms. They travel as a group and do the same movements as a group. Fiji Dance This dance is performed outdoors to live music and live singing. This dance is about the Fiji ancestors. The dancers wearing grass garlands around their arms and grass skirts. The singing is very beautiful and the dancers are fluid in their movements. This seems to be a production because there are many dancers. It seems like a very large ceremony. There are different parts to this dance and it goes from smooth and fluid to a part that is more warrior-like. The males march and carry props like they are in battle. In the battle scene, they have their face painted to create a bigger effect of battle. The scene after the battle has the female dancers who are wearing dresses. They dance very fluidly with the paddle prop. It seems like the male dancers bring the strength to the dance and the female dancers bring the grace. Maori- Dances of Life excerpt The dancers provide their own music using their voices and slaps. This seems like it is a warrior dance because the male dancers are very intense. They have painted faces and their faces are dramatic. The dance is about frightening the enemy and getting ready for war. They are dressed in loin cloths and use a spear prop. They dance outdoors in front of an audience. The dance itself has a lot of stomping and moving of the arms. New Zealand- Haka They are dressed in military outfits on the streets. It looks a lot like the Maori dance because they are chanting and using their legs in a squatting motion. They mostly dance with their upper body by moving their arms. It is very dramatic because of the chanting. They are honoring a member of the military who has passed away.

US national security New Development Essay -- US Politics, Bush Doctri

The first period of the Bush administration revolution in concepts and ideas with us national security, had an impact in various business systems and institutions of America on national security. The US Administration has taken from the events of 11 September 2001 essential impetus to develop those concepts. One of my central points of controversy "Bush doctrine" or "Bush Principal", which was in essence the concept of "pre-emptive war". This was followed by such developments increase the relative importance of the role of the Department of Defense at the expense of the State Department, and armed force, diplomacy is reflected in the declining role icon at that stage (Colin Powell) for a Ministry of Defense (Donald Rumsfeld) and the growing influence of neocons from civilian defense vs. undue influence moderates within the State Department But the Bush Administration's first year saw a second relatively momentum in applying policies (war pre-emptive, unilateral action), which leads to the question of the continuing national security policies that characterized the first administration, and the impact of those policies on US national security concepts after second administration, and perpetuated in this context two basic views: (1) See a real change in national security policies during the second phase of the management and Administration (2) Moves pragmatically less ideologically, but that is talked about death "Bush doctrine". The second point of view either, it rejects fundamental changes, and see what is happening is slight movements and switches to file locations under the strategy, adopted in the context of a unique moment in American history and open world, a strategy, in which the heating of some files at some point, ... ... wars based; won committed long about Iraq military ability of enterprise Military moving on other fronts, and is one of the factors constraining national security policies of the Bush administration. vement, but AKP with realistic movement and began to raise demands and conditions, which could open the door to political dialogue with the movement. Another example is the United States dealing with Iran, and is treated fully recognized, and the dramatic revelations British Foreign Secretary Jack Straw recently that rice would be transferred to the Iranians in Geneva meeting in May 2005-two: I attach the United States cessation opposed Iran's accession to the WTO, and its readiness to resume the sale of aircraft parts Tehran (50). Thus, regional and international reality generates new convictions and gaps occur in gaps closed strategy launched in the first period.

Care Plan

Palliative care would allow the client to receive a combined and holistic approach for medications, equipment, unseeing, and symptom treatment all fascinated through one program. The community health nurse needs to be careful not to impose ones own perception about quality of life upon the client. With the experience of having helped both of my parents through the dying process, I know that it is important to separate my own experience and perceptions from those of my client. Just as each person takes on life with a different philosophy, so it goes with the dying process.The nurse must not assume that the patient's priorities are the same as his or hers. Open communication regarding the patient's wants and needs must be initiated. Though not all patients have had the time or skills to know how to deal with a terminal illness, one of the most important Jobs of the nurse is to connect the patient to the proper resources needed for navigating through the various aspects and stages of th eir disease process, and to do so without Judgment or bias. B. Many terminally ill patients begin to navigate through the stages of grief as outlined by Elisabeth Kibble-Ross.While caring for this client with a lingering terminal illness such as cancer, my first strategy would be to keep the lines of communication open, managing the patient's emotional and spiritual needs and outlining the stages of grief as the client progresses through them. By initiating a good line of communication, one can recognize and guide both Mr.. And Mrs.. Thomas through denial, anger, bargaining, depression and acceptance (Kibble-Ross). It will be easier to better manage Mrs.. Thomas' physical needs if her psychological social needs have been addressed.My second strategy in helping to improve the quality of life for Mrs.. Thomas and her husband would be to manage Mrs.; Thomas' comfort. Working carefully with a palliative or hospice team to manage the physical discomforts of the tangent's illness, can gre atly increase quality of life. This is often a critical area of educating the patient on pain control. Patients are often afraid to take pain medications, and therapeutic communication is likely to be necessary. Monsoon). My third strategy would be to set up an interdisciplinary palliative care team to to manage the health of Mrs..Thomas. Terminal illness can be overwhelming for a family, where likely there are other factors – be it financial, familial, psychological, and no one person can manage it all. By working with the family to institute a good team or care, the burden can be lifted off the family and this will ideally allow them to care for their loved one without becoming burdened or overwhelmed. It is important to consult the family regarding any spiritual support that they would feel comforting. Is there a minister or spiritual guide currently in their life?If not, would they be open too visit from someone that is akin to their spiritual values? These are questions that should be carefully addressed. C. Nursing Care Plan for Mrs.. Thomas Assessment: Mrs.. Thomas is a 56 year-old female with a history of breast cancer. Mrs.. Thomas is aired with two grown sons, aged 28 and 30 both of which live out of state. Mrs.. Thomas has a strong familial history of braes cancer and one year ago, was treated for a malignant mass in her right breast.After a right mastectomy, chemotherapy and radiation six months ago, the cancer has now returned with subsequent right sided mastectomy, chemotherapy and radiation. The cancer has now metastasis's to the lungs and the prognosis is now deemed to be â€Å"poor† with â€Å"palliative care now being recommended†. (Task 2). Diagnosis Number One: Acute Pain related to incision secondary to surgical intervention as evidenced by tangent's visible discomfort/crying in bed, pallor, respirations, blood pressure and a report of 8/10 pain. Goal 1.Patient will verbalize a pain rating of 4 or less on a scale of 10 with each assessment. 2. Pain control as evidenced by patient demonstrating ability to use analgesics appropriately, use alternative non-analgesic relief, reported pain to be mild, relaxed body language, vital signs returning to normal Plan 1. Analgesic pain medication as prescribed by physician (Swearing) 2. Use of diversionary and or strategies to assist with pain (SHE Nursing Care Plan Guide) 3. Assist patient with positioning for comfort Implement .Evaluated effect of medication, utilize pain scale 2. Assessed effectiveness of diversionary strategies (SHE Nursing Care Plan Guide) 3. Assisted with position changes Diagnosis Number Two: Activity Intolerance related to generalized weakness as evidenced by increasing fatigue Goal 1. The nurse will help fascinate a physical therapist to help with mobility 2.. Will ambulate IX around block daily Patient 3.. Patient will fully participate in Tall's within physical limitations without dizziness or change in vital signs by 8/1/14 1 .Ass ess patient's level of mobility, educate within patient's capability 2. Assess nutritional status. Adequate energy reserves are required for activity. (Swearing) 3. Ambulate patient XX a day 1. Educated patient on benefits of mobility and the proper body mechanics for mobility 2. Encourage nutrition prior to activity and the proper body mechanics for mobility Monsoon) 3. Ambulated patient XX daily Diagnosis Number 3: Ineffective Coping related to financial burden and emotional impact of diagnosis on family as evidenced by patient's increasing isolation 1.Set up a quality interdisciplinary team incorporating counseling services for the family 2. Patient will demonstrate problem solving techniques Monsoon) 3. Patient ill verbalize acceptance of diagnosis 1. Patient will utilize available support systems and work with counselor for socio psych issues 2. Assist client to identify priorities and attainable goals as he/she starts to plan for necessary lifestyle and role changes 3. Perform actions to facilitate the grieving process (Elsevier) 1. Patient met with counseling services 2. Patient identified priorities and set goals 3.Patient demonstrated knowledge of the 5 stages of grief and how to work through them In order to optimize Mrs.. Thomas functional ability, the care team should strive for all three of the goals in her plan of care to be met. First of all, her pain needs to be managed so that manipulation can be successful, without discomfort. It is quite common for patients to be concerned about becoming addicted to pain medication as in the case of Mrs.. Thomas. Addiction is â€Å"psychological dependence† on a drug and is not the same as tolerance or physical dependence, according to Oncologist, DRP.Gary Johansson who states that â€Å"In fact, addiction is rare when avoids are used for pain relief†. With proper education and regularly scheduled pain medication, Mrs.. Thomas should be much more comfortable and able to manage other areas of he r life more successfully. Once Mrs.. Thomas' pain is under control, she will be able to work through many of the stresses that have mounted since her diagnosis. As Mrs.. Thomas disease progresses, there will come a time when she will no longer be able to care for herself. A new Plan of Care should be created and ready to transition to at that time.At this time the interdisciplinary team should consist of a hospice care which is generally implemented when a patient has less than 6 months to live. When hospice is begun, all care is transferred to the hospice team. New orders for care, medication, equipment will be set up and time is given to the family or supporting both the patient and their loved ones. Care will focus on making the most out of the time they have left, â€Å"without some of the negative side-effects that life prolonging treatments can have†. Monsoon).Most hospice patients can attain a level of comfort that allows them to â€Å"concentrate on the emotional and practical issues of dying†. Willet-Legislations). Mr.. Thomas is carrying a big physical and emotional burden during his wife's terminal illness. The Thomas family's case is complicated by Mr.. Thomas' chronic depression and high stress occupation. As Mrs.. Thomas' needs escalate and change, so do the needs of the Mr.. Thomas. By facilitating psychological help for Mr.. Thomas, the care team is in turn helping Mrs.. Thomas by easing her worries about her spouse.Patients and families need support, guidance, and encouragement to begin planning for many decisions. Many spouses are weighted with concern about the patients' comfort and impending death as well as every day problems. â€Å"This is an emotionally intense, exhausting, and singular experience, set in a world apart from everyday life patterns†. (Siegel). Mr.. Thomas needs to be reminded that in order to help care and be emotionally supportive to his wife, he needs to take care of himself. Medication reminders and grief support should be set up for Mr.. Thomas.Therapeutic conversation and guidance can make all the difference for the significant other off terminal patient. In addition, Mr.. Thomas needs respite care so that he can be fully present while caring for his wife. Mr.. Thomas should be encouraged to take a walk, a nap, or a restorative A care plan for Mr.. Thomas could be initiated with a nursing diagnosis of: Risk for Caregiver Role Strain. (SHE). Goal: Spouse will report low or no feelings of burden or distress by 8/01/14, measured by relief stated by spouse. Plan: Encourage the caregiver to talk about feelings, concerns, uncertainties, and fears. Care Plan Transition Nursing Process Discussion Group 3 Case Study Michael Martinez Is a 24-year-old Marine who was Involved In a motor vehicle accident (MBA) while on leave. His face hit the dashboard, resulting in a fracture of the mandible. Yesterday, he underwent a surgical incommensurable fixation, (wiring of the Jaw) for stabilization of the fracture. As a result of this surgery, he is unable to open his mouth and is limited to a liquid diet. The restricted diet will be necessary for 4 to 5 weeks until the fracture heals. One day post pop, his vital signs are 120/76, T-99. 2, P-82, and R- 20.After medication, is pain level is 3/10. With the exception of facial bruising, his appearance is within normal Limits, Steps of the Nursing Process Patient Information Assessment Objective and subjective data will be entered here. The database presented In the case study will be used. Data is collected and verified from the primary (apt. ) and the secondary (family, friends, health professionals, an d medical record). Analysis of this data provides the basis for development of the remaining steps in the nursing process. Subjective: Patient expresses disinterest in a liquid only diet Objective: wired Jaw Liquid diet Nursing DiagnosisAfter analyzing the assessment data, formulate a priority nursing diagnosis. Remember, a nursing diagnosis is a statement describing the patient's actual or potential response to a health problem that the nurse Is licensed and competent to treat. An actual diagnosis Is written In three parts: diagnostic label (problem) related to_ as evidenced/exhibited by_. A risk diagnosis is written in two parts: Risk for (diagnostic label) _ related to Nutrition: less than body requirements related to Inability to eat solid foods as evidenced by liquid diet post-surgery Planning Goals: Now is the time set patient centered goals.Here you will develop expected selection of interventions based on six important factors outlined in your text. Please write the interven tions you select below in implementation. Patient will be free of signs of malnutrition post dinner time each shift Implementation Here is where the nurse will carry out the plan of care. Then continue data collection and modify the plan of care as needed and document care provided. What nursing interventions will you provide to enhance patient outcomes? Assess patient's weight every shift Calculate bowel sounds Evaluate total daily food intake Provide high calorie, nutrient-rich dietary supplementsEvaluation The purpose of evaluation is to support the effectiveness of nursing practice which is patient-centered and patient-driven. This phase measures the patient's response to nursing interventions and progress towards achieving goals using five elements listed in the text. Did you achieve the goal for this nursing diagnosis? Will you continue the plan of care, revise the plan of care, or discontinue? Reassess patient's lab value daily for signs of malnutrition. If malnourished call health care provider for further orders Patient will weight within 10% of normal body weight every morning Care Plan A. Our client, Mrs.. Thomas has been given the unfortunate diagnosis of metastasis breast cancer. When considering the current and future needs of this client, significant thought and planning must be directed toward the client's level of well being. In the case off terminally ill patient, it is important to help facilitate a high quality of life that encompasses both physical and psychological health. I would recommend initiating palliative care for Mrs.. Thomas.Palliative care would allow the client to receive a combined and holistic approach for medications, equipment, unseeing, and symptom treatment all fascinated through one program. The community health nurse needs to be careful not to impose ones own perception about quality of life upon the client. With the experience of having helped both of my parents through the dying process, I know that it is important to separate my own experience and perceptions from those of my client. Just as each person takes on life with a differen t philosophy, so it goes with the dying process.The nurse must not assume that the patient's priorities are the same as his or hers. Open communication regarding the patient's wants and needs must be initiated. Though not all patients have had the time or skills to know how to deal with a terminal illness, one of the most important Jobs of the nurse is to connect the patient to the proper resources needed for navigating through the various aspects and stages of their disease process, and to do so without Judgment or bias. B. Many terminally ill patients begin to navigate through the stages of grief as outlined by Elisabeth Kibble-Ross.While caring for this client with a lingering terminal illness such as cancer, my first strategy would be to keep the lines of communication open, managing the patient's emotional and spiritual needs and outlining the stages of grief as the client progresses through them. By initiating a good line of communication, one can recognize and guide both Mr.. And Mrs.. Thomas through denial, anger, bargaining, depression and acceptance (Kibble-Ross). It will be easier to better manage Mrs.. Thomas' physical needs if her psychological social needs have been addressed.My second strategy in helping to improve the quality of life for Mrs.. Thomas and her husband would be to manage Mrs.; Thomas' comfort. Working carefully with a palliative or hospice team to manage the physical discomforts of the tangent's illness, can greatly increase quality of life. This is often a critical area of educating the patient on pain control. Patients are often afraid to take pain medications, and therapeutic communication is likely to be necessary. Monsoon). My third strategy would be to set up an interdisciplinary palliative care team to to manage the health of Mrs..Thomas. Terminal illness can be overwhelming for a family, where likely there are other factors – be it financial, familial, psychological, and no one person can manage it all. By working w ith the family to institute a good team or care, the burden can be lifted off the family and this will ideally allow them to care for their loved one without becoming burdened or overwhelmed. It is important to consult the family regarding any spiritual support that they would feel comforting. Is there a minister or spiritual guide currently in their life?If not, would they be open too visit from someone that is akin to their spiritual values? These are questions that should be carefully addressed. C. Nursing Care Plan for Mrs.. Thomas Assessment: Mrs.. Thomas is a 56 year-old female with a history of breast cancer. Mrs.. Thomas is aired with two grown sons, aged 28 and 30 both of which live out of state. Mrs.. Thomas has a strong familial history of braes cancer and one year ago, was treated for a malignant mass in her right breast.After a right mastectomy, chemotherapy and radiation six months ago, the cancer has now returned with subsequent right sided mastectomy, chemotherapy an d radiation. The cancer has now metastasis's to the lungs and the prognosis is now deemed to be â€Å"poor† with â€Å"palliative care now being recommended†. (Task 2). Diagnosis Number One: Acute Pain related to incision secondary to surgical intervention as evidenced by tangent's visible discomfort/crying in bed, pallor, respirations, blood pressure and a report of 8/10 pain. Goal 1.Patient will verbalize a pain rating of 4 or less on a scale of 10 with each assessment. 2. Pain control as evidenced by patient demonstrating ability to use analgesics appropriately, use alternative non-analgesic relief, reported pain to be mild, relaxed body language, vital signs returning to normal Plan 1. Analgesic pain medication as prescribed by physician (Swearing) 2. Use of diversionary and or strategies to assist with pain (SHE Nursing Care Plan Guide) 3. Assist patient with positioning for comfort Implement .Evaluated effect of medication, utilize pain scale 2. Assessed effectiv eness of diversionary strategies (SHE Nursing Care Plan Guide) 3. Assisted with position changes Diagnosis Number Two: Activity Intolerance related to generalized weakness as evidenced by increasing fatigue Goal 1. The nurse will help fascinate a physical therapist to help with mobility 2.. Will ambulate IX around block daily Patient 3.. Patient will fully participate in Tall's within physical limitations without dizziness or change in vital signs by 8/1/14 1 .Assess patient's level of mobility, educate within patient's capability 2. Assess nutritional status. Adequate energy reserves are required for activity. (Swearing) 3. Ambulate patient XX a day 1. Educated patient on benefits of mobility and the proper body mechanics for mobility 2. Encourage nutrition prior to activity and the proper body mechanics for mobility Monsoon) 3. Ambulated patient XX daily Diagnosis Number 3: Ineffective Coping related to financial burden and emotional impact of diagnosis on family as evidenced by p atient's increasing isolation 1.Set up a quality interdisciplinary team incorporating counseling services for the family 2. Patient will demonstrate problem solving techniques Monsoon) 3. Patient ill verbalize acceptance of diagnosis 1. Patient will utilize available support systems and work with counselor for socio psych issues 2. Assist client to identify priorities and attainable goals as he/she starts to plan for necessary lifestyle and role changes 3. Perform actions to facilitate the grieving process (Elsevier) 1. Patient met with counseling services 2. Patient identified priorities and set goals 3.Patient demonstrated knowledge of the 5 stages of grief and how to work through them In order to optimize Mrs.. Thomas functional ability, the care team should strive for all three of the goals in her plan of care to be met. First of all, her pain needs to be managed so that manipulation can be successful, without discomfort. It is quite common for patients to be concerned about bec oming addicted to pain medication as in the case of Mrs.. Thomas. Addiction is â€Å"psychological dependence† on a drug and is not the same as tolerance or physical dependence, according to Oncologist, Dry.Gary Johansson who states that â€Å"In fact, addiction is rare when avoids are used for pain relief†. With proper education and regularly scheduled pain medication, Mrs.. Thomas should be much more comfortable and able to manage other areas of her life more successfully. Once Mrs.. Thomas' pain is under control, she will be able to work through many of the stresses that have mounted since her diagnosis. As Mrs.. Thomas disease progresses, there will come a time when she will no longer be able to care for herself. A new Plan of Care should be created and ready to transition to at that time.At this time the interdisciplinary team should consist of a hospice care which is generally implemented when a patient has less than 6 months to live. When hospice is begun, all c are is transferred to the hospice team. New orders for care, medication, equipment will be set up and time is given to the family or supporting both the patient and their loved ones. Care will focus on making the most out of the time they have left, â€Å"without some of the negative side-effects that life prolonging treatments can have†. Monsoon).Most hospice patients can attain a level of comfort that allows them to â€Å"concentrate on the emotional and practical issues of dying†. Willet-Legislations). Mr.. Thomas is carrying a big physical and emotional burden during his wife's terminal illness. The Thomas family's case is complicated by Mr.. Thomas' chronic depression and high stress occupation. As Mrs.. Thomas' needs escalate and change, so do the needs of the Mr.. Thomas. By facilitating psychological help for Mr.. Thomas, the care team is in turn helping Mrs.. Thomas by easing her worries about her spouse.Patients and families need support, guidance, and encour agement to begin planning for many decisions. Many spouses are weighted with concern about the patients' comfort and impending death as well as every day problems. â€Å"This is an emotionally intense, exhausting, and singular experience, set in a world apart from everyday life patterns†. (Siegel). Mr.. Thomas needs to be reminded that in order to help care and be emotionally supportive to his wife, he needs to take care of himself. Medication reminders and grief support should be set up for Mr.. Thomas.Therapeutic conversation and guidance can make all the difference for the significant other off terminal patient. In addition, Mr.. Thomas needs respite care so that he can be fully present while caring for his wife. Mr.. Thomas should be encouraged to take a walk, a nap, or a restorative A care plan for Mr.. Thomas could be initiated with a nursing diagnosis of: Risk for Caregiver Role Strain. (SHE). Goal: Spouse will report low or no feelings of burden or distress by 8/01/14 , measured by relief stated by spouse. Plan: Encourage the caregiver to talk about feelings, concerns, uncertainties, and fears.Acknowledge the frustration associated with caregiver responsibilities. Initiate counseling. 2. Help the caregiver problem solve to meet his needs. 3. Set up medication reminders for psychological medications. Implement: 1. Patient openly discusses concerns, uncertainties and fears (SHE). Patient acknowledges frustrations associated with his caregiver responsibilities. Patient attends counseling. 2. Patient participates in problem solving to meet his needs. 3. Patient follows medication reminders and takes medications for his depression. Care Plan A. Our client, Mrs.. Thomas has been given the unfortunate diagnosis of metastasis breast cancer. When considering the current and future needs of this client, significant thought and planning must be directed toward the client's level of well being. In the case off terminally ill patient, it is important to help facilitate a high quality of life that encompasses both physical and psychological health. I would recommend initiating palliative care for Mrs.. Thomas.Palliative care would allow the client to receive a combined and holistic approach for medications, equipment, unseeing, and symptom treatment all fascinated through one program. The community health nurse needs to be careful not to impose ones own perception about quality of life upon the client. With the experience of having helped both of my parents through the dying process, I know that it is important to separate my own experience and perceptions from those of my client. Just as each person takes on life with a differen t philosophy, so it goes with the dying process.The nurse must not assume that the patient's priorities are the same as his or hers. Open communication regarding the patient's wants and needs must be initiated. Though not all patients have had the time or skills to know how to deal with a terminal illness, one of the most important Jobs of the nurse is to connect the patient to the proper resources needed for navigating through the various aspects and stages of their disease process, and to do so without Judgment or bias. B. Many terminally ill patients begin to navigate through the stages of grief as outlined by Elisabeth Kibble-Ross.While caring for this client with a lingering terminal illness such as cancer, my first strategy would be to keep the lines of communication open, managing the patient's emotional and spiritual needs and outlining the stages of grief as the client progresses through them. By initiating a good line of communication, one can recognize and guide both Mr.. And Mrs.. Thomas through denial, anger, bargaining, depression and acceptance (Kibble-Ross). It will be easier to better manage Mrs.. Thomas' physical needs if her psychological social needs have been addressed.My second strategy in helping to improve the quality of life for Mrs.. Thomas and her husband would be to manage Mrs.; Thomas' comfort. Working carefully with a palliative or hospice team to manage the physical discomforts of the tangent's illness, can greatly increase quality of life. This is often a critical area of educating the patient on pain control. Patients are often afraid to take pain medications, and therapeutic communication is likely to be necessary. Monsoon). My third strategy would be to set up an interdisciplinary palliative care team to to manage the health of Mrs..Thomas. Terminal illness can be overwhelming for a family, where likely there are other factors – be it financial, familial, psychological, and no one person can manage it all. By working w ith the family to institute a good team or care, the burden can be lifted off the family and this will ideally allow them to care for their loved one without becoming burdened or overwhelmed. It is important to consult the family regarding any spiritual support that they would feel comforting. Is there a minister or spiritual guide currently in their life?If not, would they be open too visit from someone that is akin to their spiritual values? These are questions that should be carefully addressed. C. Nursing Care Plan for Mrs.. Thomas Assessment: Mrs.. Thomas is a 56 year-old female with a history of breast cancer. Mrs.. Thomas is aired with two grown sons, aged 28 and 30 both of which live out of state. Mrs.. Thomas has a strong familial history of braes cancer and one year ago, was treated for a malignant mass in her right breast.After a right mastectomy, chemotherapy and radiation six months ago, the cancer has now returned with subsequent right sided mastectomy, chemotherapy an d radiation. The cancer has now metastasis's to the lungs and the prognosis is now deemed to be â€Å"poor† with â€Å"palliative care now being recommended†. (Task 2). Diagnosis Number One: Acute Pain related to incision secondary to surgical intervention as evidenced by tangent's visible discomfort/crying in bed, pallor, respirations, blood pressure and a report of 8/10 pain. Goal 1.Patient will verbalize a pain rating of 4 or less on a scale of 10 with each assessment. 2. Pain control as evidenced by patient demonstrating ability to use analgesics appropriately, use alternative non-analgesic relief, reported pain to be mild, relaxed body language, vital signs returning to normal Plan 1. Analgesic pain medication as prescribed by physician (Swearing) 2. Use of diversionary and or strategies to assist with pain (SHE Nursing Care Plan Guide) 3. Assist patient with positioning for comfort Implement .Evaluated effect of medication, utilize pain scale 2. Assessed effectiv eness of diversionary strategies (SHE Nursing Care Plan Guide) 3. Assisted with position changes Diagnosis Number Two: Activity Intolerance related to generalized weakness as evidenced by increasing fatigue Goal 1. The nurse will help fascinate a physical therapist to help with mobility 2.. Will ambulate IX around block daily Patient 3.. Patient will fully participate in Tall's within physical limitations without dizziness or change in vital signs by 8/1/14 1 .Assess patient's level of mobility, educate within patient's capability 2. Assess nutritional status. Adequate energy reserves are required for activity. (Swearing) 3. Ambulate patient XX a day 1. Educated patient on benefits of mobility and the proper body mechanics for mobility 2. Encourage nutrition prior to activity and the proper body mechanics for mobility Monsoon) 3. Ambulated patient XX daily Diagnosis Number 3: Ineffective Coping related to financial burden and emotional impact of diagnosis on family as evidenced by p atient's increasing isolation 1.Set up a quality interdisciplinary team incorporating counseling services for the family 2. Patient will demonstrate problem solving techniques Monsoon) 3. Patient ill verbalize acceptance of diagnosis 1. Patient will utilize available support systems and work with counselor for socio psych issues 2. Assist client to identify priorities and attainable goals as he/she starts to plan for necessary lifestyle and role changes 3. Perform actions to facilitate the grieving process (Elsevier) 1. Patient met with counseling services 2. Patient identified priorities and set goals 3.Patient demonstrated knowledge of the 5 stages of grief and how to work through them In order to optimize Mrs.. Thomas functional ability, the care team should strive for all three of the goals in her plan of care to be met. First of all, her pain needs to be managed so that manipulation can be successful, without discomfort. It is quite common for patients to be concerned about bec oming addicted to pain medication as in the case of Mrs.. Thomas. Addiction is â€Å"psychological dependence† on a drug and is not the same as tolerance or physical dependence, according to Oncologist, Dry.Gary Johansson who states that â€Å"In fact, addiction is rare when avoids are used for pain relief†. With proper education and regularly scheduled pain medication, Mrs.. Thomas should be much more comfortable and able to manage other areas of her life more successfully. Once Mrs.. Thomas' pain is under control, she will be able to work through many of the stresses that have mounted since her diagnosis. As Mrs.. Thomas disease progresses, there will come a time when she will no longer be able to care for herself. A new Plan of Care should be created and ready to transition to at that time.At this time the interdisciplinary team should consist of a hospice care which is generally implemented when a patient has less than 6 months to live. When hospice is begun, all c are is transferred to the hospice team. New orders for care, medication, equipment will be set up and time is given to the family or supporting both the patient and their loved ones. Care will focus on making the most out of the time they have left, â€Å"without some of the negative side-effects that life prolonging treatments can have†. Monsoon).Most hospice patients can attain a level of comfort that allows them to â€Å"concentrate on the emotional and practical issues of dying†. Willet-Legislations). Mr.. Thomas is carrying a big physical and emotional burden during his wife's terminal illness. The Thomas family's case is complicated by Mr.. Thomas' chronic depression and high stress occupation. As Mrs.. Thomas' needs escalate and change, so do the needs of the Mr.. Thomas. By facilitating psychological help for Mr.. Thomas, the care team is in turn helping Mrs.. Thomas by easing her worries about her spouse.Patients and families need support, guidance, and encour agement to begin planning for many decisions. Many spouses are weighted with concern about the patients' comfort and impending death as well as every day problems. â€Å"This is an emotionally intense, exhausting, and singular experience, set in a world apart from everyday life patterns†. (Siegel). Mr.. Thomas needs to be reminded that in order to help care and be emotionally supportive to his wife, he needs to take care of himself. Medication reminders and grief support should be set up for Mr.. Thomas.Therapeutic conversation and guidance can make all the difference for the significant other off terminal patient. In addition, Mr.. Thomas needs respite care so that he can be fully present while caring for his wife. Mr.. Thomas should be encouraged to take a walk, a nap, or a restorative A care plan for Mr.. Thomas could be initiated with a nursing diagnosis of: Risk for Caregiver Role Strain. (SHE). Goal: Spouse will report low or no feelings of burden or distress by 8/01/14 , measured by relief stated by spouse. Plan: Encourage the caregiver to talk about feelings, concerns, uncertainties, and fears.Acknowledge the frustration associated with caregiver responsibilities. Initiate counseling. 2. Help the caregiver problem solve to meet his needs. 3. Set up medication reminders for psychological medications. Implement: 1. Patient openly discusses concerns, uncertainties and fears (SHE). Patient acknowledges frustrations associated with his caregiver responsibilities. Patient attends counseling. 2. Patient participates in problem solving to meet his needs. 3. Patient follows medication reminders and takes medications for his depression.

Aspirin-its preparation, history and applications Essay

How drugs are discovered and developed Pharmacologist along with chemist focus on a specific disease and unmet patient needs in order to discover new drugs. They search for biological targets within the body that play a role in a given disease. Unique molecules are found or created that some day might be medicines. Lead Compound Selection, is the testing of compounds that might undergo the long expensive drug develop process. Random Screening- uses existing ‘library’ of chemical agents. This is the simplest method but the odds are low and patience is needed. Combinational Chemistry Screening- uses a compound (from existing library) as a base, then randomly adding amino acids or molecule segments of other agents to the base compound in order to enhance the base compounds activity and disease fighting potential. The enhanced compounds are then tested in rapid screening test. However this method is complex and costly but it improves the odds. Target Synthesis- targets the disease for drug intervention. For example High Blood Pressure would be studied in detail. Consequently this method still requires screening of hundreds of compounds and extensive amount of research to understand a particular disease process. Drug Modeling- uses more high technology. This method manipulates chemical structures by computers so that they can attach to, activate or deactivate proteins that interfere with or maintain the body’s normal functioning. The model is used to enhance the properties of the other methods but the cost for designer compounds are significant because of the huge amount of research that is needed to identify biochemical target and establish their molecular structure. How safety of drugs is checked before being used on the public A drug undergoes 3 clinical phases before being used on the public. PHASE 1 This is designed to determine the safety of the new drug, how best to administer it and the correct dosage- (one that will minimize desirable side effects). 20-30 patients (volunteers) are used to find out how the drug behaves in their body, so their blood and urine will be frequently monitored. Even though drugs in this will have been already tested in a laboratory. PHASE 2 After the correct dosage has been determined in phase1 clinical trial, it can enter phase2. This trial consists of determining the drug’s effectiveness in treating a specific disease. Phase2 involves more patients (volunteers) and they are tested for the number of platelets in their blood and take frequent blood samples. If the drug being tested brings a positive change in at least 1/5 of the patients then it can be tested in phase3. However if the drug shows very positive effects in-patients, the Food and Drug Administration also have the option of approving the drug for general use at this point. PHASE 3 This trial involves hundreds of patients and is divided into two groups. The control group receives a standard treatment (placebo) and the treatment groups are given the new drug. Results are then compared from the two groups. Blinded studies are used to prevent biased study results. If the new successfully passes a phase3 trial the FDA will approve the drug for marketing to the general public. . Purification -The acetylsalicylic acid is washed with distilled water until all the acetic acid is removed. -It is pressed to be as dry as possible and then dried more by a current of warm air at 60-70 degrees Celsius. The yield of pure acetylsalicylic acid is between 1780-1795kg per batch using this reaction process. * History of Aspirin and its modern development * How aspirin is prepared on the large scale Main reactor for the process- a glass lined 1500 gallon fitted with a water-cooled reflux condenser, thermometers with automatic temperature register and an efficient agitator. The Mother Liquor- 1532kg of acetic anhydride in 1200kg of toluene (this does not get used up. ). The reactor is charged up with the mother liquor. 1382kg of salicylic acid is added to the mother liquor. The reaction mixture is heated to between 85-92 degrees Celsius and kept at this temperature for 20 hours. The reaction mixture is transferred into an aluminum-cooling tank and is allowed to cool for 3-4 days. By the end the cool mixture will have reached room temperature 15-25 degrees Celsius. At this point the acetylsalicylic acid has precipitated as large regular crystals. Mother liquor is removed by filtration or centrifuging. Filtrate solution- 180-270kg of UN-precipitated acetyl acid, 510kg of acetic anhydride, 600kg of acetic acid and 1200kg of toluene. The acetic acid is obtained as a by-product of the acetylation step of the process. An well-agitated reactor using a diffusion plate will introduce Ketene gas, to be passed through the recycled filtrate at a temperature between 15-25 degrees Celsius. When a weight increase of 420. 5kg of the Ketene gas is observed, the mother liquor contains 180-270kg of UN-precipitated acetyl acid and 1532kg of acetic anhydride in 1200kg of toluene. The Mother liquor is recycled and 1382kg of Salicylic acid is added to continue the reaction cycle. BC- the first and most influential physician wrote about the bitter powder extracted from the willow bark that could ease aches and pains and reduce fever. 1700- The scientist Reverend Edmund Stone found out that the part of the willow tree bark that was bitter and good for fever and pain is a chemical known as Salicin. This converts into another chemical called Salicylic acid when eaten. 1829- A pharmacist known as Leroux showed that Salicin is the active willow ingredient and for the first time an Italian chemist Piria used Salicylic acid to treat pain and swelling in diseases such as Arthritis and to treat fever in illnesses like Influenza. The problem was that these chemicals was causing the users upset stomachs. Some people had bleeding in their digestive tracts from high doses needed to control swelling and pain. It was thought that the reason of stomach upsets were because of the acid in the chemical, therefore the compound Salicylic acid went through a couple of chemical reactions that covered up one of the acidic parts with an ACETYL group, converting it to ACETYLSALICYLIC ACID (ASA). It was found that ASA reduced fever and relieve of pain and swelling but also it was much better for the stomach and worked better than Salicylic Acid. 1899- ASA was given the name ASPIRIN- that comes from the plant relative of a rose that makes SALICYLIC ACID (several plants makes this compound not just willow). Â  How drugs such as aspirin work Prostaglandin is a chemical that is released to make the nerve ending register an even stronger pain to the brain. It is made in working cells of the damaged tissues by using an enzyme called CYCLOOXYGENASE 2 (COX-2). Prostaglandin makes you feel the pain of the damaged area and causes it to swell up (inflammation), to bathe the tissues in fluid from the blood so that it will protect it and help it heal. Pain serves the purpose here to remind you that the damaged area cannot be used, as it is not healed. However sometimes we endure pain when there is no real reason to. For example Period Pains and Arthritis. It can make people feel really uncomfortable and arthritis can damage joints permanently. ASPIRIN works by locking itself to the enzyme that makes the chemical Prostaglandin. The enzyme C0X-2 that is found in normal tissues but mostly in tissues that have been damaged in some way, can no longer convert floating chemicals into Prostaglandin because they are unable to move with the aspirin lock on. Aspirin does not treat the cause of the pain; it just lowers the pain signals getting through your nerves to the brain. How effective aspirin is New researches suggest that an aspirin a day is a preventive measure against Heart Attacks. However the effectiveness of aspirin has differential effects depending on genetics.

Assume vs. Presume

Assume vs. Presume Assume vs. Presume Assume vs. Presume By Maeve Maddox Both words have numerous definitions in the OED, but in ordinary usage, both assume and presume mean suppose. I suppose you are going to the beach this summer. I assume you are going to the beach this summer I presume you are going to the beach this summer. H.W. Fowlers opinion was that in using presume, the speaker believes the supposition is true and will believe it until he learns otherwise. In using assume, the speaker feels no certainty that his supposition is true or not. In a legal context, presume means to take as proved until contrary evidence is presented. Ex. The defendant is presumed innocent. Because of the association of the word presume with legal contexts, it carries a connotation of formality. For the fiction writer, presume would be the preferable choice in the speech of a remote or officious character. Here are some quotations from newspapers: cant even agree on why we disagree about President Trump, a USA TODAY/Suffolk Poll finds, but we assume the worst about the other side. Republicans described Trump’s opponents as lazy, narrow-minded  and mired in (www.usatoday.com) Even the most secure corporate networks tend not to take that sort of approach: once you’re in the secure zone, they assume you’re one of the good guys.† The future won’t be a hack-free heaven. Software is complex, mistakes (www.theguardian.com) As the heirs to those brave patriots who fought the American Revolution, we must not retreat from the ramparts they built. Due process was costly to achieve in battle and ought not to be conveniently ignored. When someone raises an allegation that the law has been violated, we must presume that the claim lacks merit until evidence is tested in a court of law and a judge or jury makes a ruling. Want to improve your English in five minutes a day? Get a subscription and start receiving our writing tips and exercises daily! Keep learning! Browse the Vocabulary category, check our popular posts, or choose a related post below:When to Capitalize Animal and Plant Names50 Synonyms for â€Å"Idea†10 Tips to Improve Your Writing Skills

Spanish Loan Words

Spanish Loan Words Spanish Loan Words Spanish Loan Words By Sharon The English language is a thief. What we call English isnt really English at all. Instead, its a collection of borrowings from other languages. Latin is the main one, but theres also a good bit of French and a healthy serving of Spanish. There are thousands of Spanish loan words in English some claim as many as 10,000 and they all entered the language from three main sources. Trade in the Caribbean region brought a number of local Spanish words into the language: barbecue cannibal llama hammock hurricane potato tobacco yucca Many words were brought into English by cowboys working in the Southwest USA, such as: bronco buckaroo (from vaquero, Spanish for cowboy) desperado rodeo vigilante Then there are several words for food and drink that you just cant describe in English: avocado banana burrito chili dorado guacamole maize margarita paella papaya pimento tequila tortilla vanilla yam And then there are others, where we know the Spanish words, but were just not sure exactly how they got here. adobe albino alcove alfalfa algebra alligator (from the Spanish for lizard el lagarto) armadillo barracuda cafeteria canyon chihuahua cigar/cigarette cockroach embargo guerilla guitar iguana incommunicado jaguar macho mosquito renegade savvy siesta tornado This is just a selection of the Spanish loan words we use in English. Have you got any favorite ones to add to the list? Want to improve your English in five minutes a day? Get a subscription and start receiving our writing tips and exercises daily! Keep learning! Browse the General category, check our popular posts, or choose a related post below:Passed vs PastThe Writing ProcessTreatment of Words That Include â€Å"Self†