Disease

We are living in a generation that we can’t complete our day without using technology, A generation of the beginning of the new world order, That have started to become a major problem in our society and effects the way we live.

On the one hand, It makes as unsociable in the real life; Since the beginning of technology, When Computers and video games consoles were invented people started to spent more time in their houses playing virtual games and virtual activities that has started to make them unsociable in the real life and isolated from the outside activities, And that creates new diseases and disorder such as laziness and a loss of personality. Second of all, People Started using technology to chat with their friends and beloved once instead of talking to them personally, and that has started to affect our way to communicate with each other’s.

Furthermore, People has started to use technology for online shopping, Paying the bills, and its good it saves time and effort but there is disadvantages of it, people used to go shopping and meet new people why doing it and now the technology Is taking over. On the second hand, People started to lose their Jobs to machines that will do the work for them; nowadays people have been replaced by machines to the Job for example; the train ticket guy has been replaced for a machine to do the Job, tell then unemployment rate has Increased.

Second of all, based on the American police department, machine robbery has been Increased since 1990 till now, because It Is easy to rob. On the other hand, technology has made as over dependent on our gadgets; technology had made as over dependent on our gadgets that we cannot not to check on our smartness every minute, we depend on It In everything for example; Navigation, Alarm, Calculator, Calendar. It Is good to have this technologies but what if the battery died? Or the phone got stolen?

People will get lost In their life and will face hard time managing It. Second of all, the more people begin to depend on computers and other forms of technology for everyday existence. This means that when a machine breaks or a computer crashes, humans become almost disabled until the problem Is resolved. This kind of dependency on technology puts people at a distinct disadvantage, because they become less self-reliant. In conclusion, as we have seen above, nothing Is perfect. Everything can be dark or right; positive or negative.

It depends on the way we deal with It, depending and using technology every day In our lives can cause a lot of problems as mentioned above, we Just have to find a way to use It less than before and not to depend on It. Technology is a major problem in society By Weeks-Shabby people why doing it and now the technology is taking over. Unemployment rate has increased. Second of all, based on the American police department, machine robbery has been increased since 1990 till now, because it is on our smartness every minute, we depend on it in everything for example; Navigation, Alarm, Calculator, Calendar.

It is good to have this technologies but what if the battery died? Or the phone got stolen? People will get lost in their life and will face hard time managing it. Second of all, the more people begin to depend on until the problem is resolved. This kind of dependency on technology puts people at In conclusion, as we have seen above, nothing is perfect. Everything can be dark or bright; positive or negative. It depends on the way we deal with it, depending and using technology every day in our lives can cause a lot of problems as mentioned above, we Just have to find a way to use it less than before and not to depend on it.

We are aware that official practice is to use the terms “service users” or “people using this service” to describe those receiving care. We prefer the term “client’ and use it throughout our training package. The principles for the safe handling of medicines do not vary depending on hype of care offered, people cared for or size of business. Your home, and you, have a duty of care to properly handle medication and to support your clients to take their medicines safely The majority of people living in care homes take some kind of medicine. Some will be administering their own medication; others may take medicines that can only be administered by trained doctors and nurses. As a care worker you will need to be familiar with the medicines taken by your clients and you may even be trained to administer a number of them; you should be aware of issues concerning their control and must have knowledge of your home’s own policies and procedures.

As a career you are most likely to be administering medicines that are taken by mouth, inhaled or applied to the skin; you may also receive specific training to use suppositories and to carry out certain types of injection. Clients requiring medicines that cannot be administered by you should, unless they are clandestineness be treated by doctors and / or nurses. This course is designed as an introduction to the care and administration of medicines. It will make you think about the type of destined used in your Care home and the reasons for their use; it will also look at how they need to be controlled and administered.

Medicines can be highly dangerous substances and as such must be carefully controlled. It is essential that only competent staff administer medications and that there are suitable in-house policies and procedures for the safe storage and use of all medicines in the home. Staff administering medications must have received appropriate training that must include: Basic knowledge of how medicines are used and how to recognize and deal with problems in use

The principles behind all aspects of the homes policy on medicine handling and records Administration of medication must be carried out by a designated, appropriately trained member of staff and should be witnessed by a second designated, appropriately trained member of staff.  In essence the members Of staff responsible for the administration Of medication should have enough knowledge and experience to carry out the task safely and efficiently. All staff must receive in-house training on policies and procedures relevant to their workplace. This may form part of the induction programmer and must be updated regularly.

 ‘The registered person must protect service users against the risks associated with the unsafe use and management of medicines, by means of the making of appropriate arrangements for the obtaining, recording handling, using, safekeeping, dispensing, safe administration and disposal of medicines used for the purposes of the regulated activity. ‘ Managers must: Make sure a person-centered approach is taken regarding medication Manage risk

Follow relevant guidelines Promote rights and choices Us port clients appropriately Ensure staff are competent Health and Safety at Work Act 1974 Appropriate measures must be taken to ensure the safety of all staff and anyone who may be affected by work practices. Medications are hazardous substances therefore their use must be risk assessed and safe procedures should be implemented. Adequate training must also be available. Control of Substances Hazardous to Health 2002 Medicines can cause ill health if they are given in incorrect amounts, administered by the wrong method or given to the wrong person.

Clients, staff and even visitors may be at risk.  Employers must:

• Ensure correct storage of medicines
• Provide information sheets about the hazards associated with each type of medicine
• Provide appropriate personal protective equipment

Gloves Employees must:

• Handle medicines according to in-house policies
• Make themselves aware of associated hazards use personal protective equipment where provided
• Safe administration of medicines is a vital part of care homes’ responsibilities for their clients’ welfare.

Both over and under medication can be signs of career abuse and willful or accidental neglect. Clients should receive appropriate medication whether they are self-administering or dependent on staff; you must also be able to account for all medication received in the home. You must be able to demonstrate that all medications have been stored, used and disposed of appropriately, failure to do so could result in investigation and, where necessary, prosecution. Medicines are hazardous substances and may have a high value, in-house policies and procedures must protect against misuse, abuse, theft and accidental harm.

As it is important for you to encourage your clients’ independence efforts would be made to support them in controlling their own medication. Decisions as to who is able to do this will be made jointly between the client, their family, doctors and care staff; there should be ongoing monitoring of the situation to prevent clients suffering if they become more forgetful or fail to recognize the importance of taking their medication. It may be considered an invasion of privacy to check up on clients each time they are supposed to have taken medication. Monitoring should be discreet and appropriate.

Clients who are able to self-administer must be provided with a lockable rawer or cupboard for safe storage of their medicines; in case of problems occurring there must be a fall back policy to allow care staff to access this drawer or cupboard with the client’s permission. Any clients who are mentally able to choose are free to buy their own remedies for minor ailments, they should be supported to do this and encouraged to discuss options with the pharmacist. It is important that staff take care of the needs of other, less independent, clients when they suffer from complaints such as coughs, colds and headaches.

The home may keep a tock of over the counter treatments from a list that has been compiled with the assistance of clients’ Gap’s and the pharmacist, policies must exist for their safe administration and there should be procedures in place for recording their receipt, storage and use. Complementary or alternative treatments may only be used with the informed consent of the client or a person authorized to speak on their behalf. Advice should be sought from the pharmacist regarding the possibility Of reactions between these remedies and any prescription medicines being taken.

Some personal control over medication is better than none at all, so for example if a client suffering from arthritis is unable to open containers staff should be able to provide help but medicines may still be retained in the client’s own room. A client may be able to apply creams but decide to let staff administer tablets etc. Clients who become forgetful or lack understanding may be given 24 hours medication in a compliance aid. Give two examples of hazards associated with medicines.  If you are going to administer medication what training should you have received?  What does self-administration mean? In your opinion why is it important to encourage and support solidification’s?  Who is responsible for the administration of medication in your workplace?  What are Medicines?

Dictionary Definitions: Medicine

.Any substance used to treat or prevent disease or illness, esp.. Taken internally. The science or practice of treating or preventing illness esp. Using prepared substances rather than surgery.  Any substance used in the treatment of disease . Any substance taken (esp.. Illegally) for its affect on the mind . Anything craved for There are ore than 5,000 substances that can be classed as medicines; the definition of medicine as something that can treat or prevent disease may be applied to prescription drugs, over the counter remedies, herbal preparations, vitamin and mineral supplements and even foods. Think about the sort footings that you use for medicinal purposes; how do you deal with headaches, what if you’re feeling a bit down? Do you take anything to keep you healthy? Do you use anything that might be considered ‘alternative’ such as herbal remedies? How do you know that the medicines which you use are safe?

Development of Medicines

Originally all medicines came from natural, mainly plant, sources; today with advances in science and technology conventional medicines are a mixture of refined plant sources and chemical compounds. Chemists are constantly trying to create new substances that will be more effective in treating and preventing illness. Below are some examples of medicines derived from natural sources with comments concerning their use and potential problems : 8 Aspirin made from willow bark and used for pain relief, as an nondiscriminatory, to reduce temperature and to lower blood pressure.

Aspirin thins the blood and an cause stomach ulcers. Morphine made from poppies it is used for pain relief and sleep induction. Morphine is highly addictive and may cause serious breathing problems. SST John’s Worth used for a variety of reasons including as an anti-depressant it can cause diarrhea, may turn skin yellow and has been suspected Of increasing depression in certain individuals. Attainment a cancer treatment made from yew tree clippings. Penicillin a type of mould used as an antibiotic that can cause serious allergic reactions.

As the above list shows ‘natural’ remedies are no less effective than chemical impounds nor are they any safer. As new medicines are developed they are rigorously tested often over a period of six to ten years, if shown to be medically effective and safe to use the Committee on Safety of Medicines (SCM) will approve them for marketing. Classes of Medicine While some medicines can only be obtained from a pharmacist, others are more readily available. Care must be taken with all medicines but some are more strictly controlled than others.

General Sales List

These medicines can be purchased in all kinds of places including grocery stores and garages. These products are unlikely to cause harm if taken according to instructions but their quantity may be limited as, for example, happens with painkillers (e. G. Paramedical) which are sold in boxes of 12 with restrictions on the number of boxes that can be bought. Pharmacy medicines – also known as over the counter (ETC); these may only be sold in a pharmacy under the supervision of a pharmacist.

The pharmacist, or staff, will check the suitability of the medication by asking questions about the patient, their health problem and any Other medicines they may be taking. POMP – Prescription Only Medicines – medicines that are expensed by a pharmacy in accordance with a prescription written by a doctor, dentist or specially qualified nurse. CDC – Controlled Drugs – prescription only medicines which have certain properties, such as addictiveness, which mean that stricter controls are necessary.

How do Medicines Work

Even with today’s increased knowledge scientists are still unable to say exactly how all drugs work, however, loosely speaking effects can be split into three main categories; those that replace chemical deficiencies, those that interfere with cell function and others that act against invading organisms and abnormal cells.  Replacement of chemical deficiencies .Examples: vitamin injections insulin hormone replacement When the body cannot properly produce its own chemical requirements they may be given artificially.

The downside of this approach is that artificial supplements may reduce the body chances of producing its own in the future and in cases such as the use of vitamin tablets and injections the effects may not be as beneficial as if they were achieved through a healthy diet. Interfering with cell function painkillers These types of medication either block the action of hormones or slow them r, alternatively, they block the transmission of messages through the nervous system.

Introduction The primary purpose of this essay is to understand various models of organization diagnosis and their differences also well as their similarities, and also evaluate their strength and weakness. In order to understand these OD models we will need to know what is organizational diagnosis. What is Organizational Diagnosis? This is a strategy implemented by organizations to increase its effectiveness. This involves assessing an organization’s existing levels of performance, to design a suitable change that will achieve the expected performance.

In organizational diagnosis, diagnostic activities should centre its focus on 2 main areas: – Subsystem areas (management, group, individual unit) – Organization processes (decision-making process, communication model, relationships between groups and the setting of goals. Organizational diagnostician carries out this process of diagnosis considering the whole organization as a total system. They use data form internal and external sources for this purpose. The organizational diagnosticians direct their focus on the activities they think are the vital for the existence of the organization.

When performing the diagnosis whole organization is put into focus when drastic changes are needed (French & Bell, 1995). Lastly in the organizational diagnosis process, all the data collected are communicated back to the organization’s management in order to begin the organizational change phase (Harrison 1987). Uses of Organizational Diagnosis Models Organizational diagnosis models help to clearly understand inefficiencies and diversions from organizational goals and targets.

Organizational diagnosis models also provide a systematic way together, categorize and understand data. Models identify crucial organizational variables which are theorized to exist according to previous research. Models also reflect the nature of relationship between important variable. Without such models it would be hard to collect and interpret data. Here I will analyse three such organizational diagnosis model, – Weisbord’s Six Box Model – Sharp-image Diagnosis model – The Congruence Model Weisbord’s Six Box Model

This model of organizational diagnosis consist six elements which are purpose, structure, relationship, rewards, leadership and helpful mechanism. The model focuses on the areas of dissatisfaction as a starting point. The areas of dissatisfactions considered are from the customer point (external), internal point of view (management and employees). The main advantages of this organizational diagnosis model have been its easy to understand and adopt. The model draws from a number of management theory schools -organisation design, behavioural, psychology and organisational learning.

Due to its very simplistic approach it has a lack of theoretically basis to determine the actual gaps, degree of change and inefficiencies in an organization. Weisbord’s model also fails to provide the actions needed to close gaps, degree of change and inefficiencies of organization structure. Harrison and Shirom (1999) says that Weisbord’s model, on identification of gaps, “for each of these elements, consultants has to diagnosis the gaps and degree of changes. – Gap between what exists now and ought to be – Gaps between what are actually done and what the mangers say is done.

The Congruence Model The Congruence model considers data from internal and external of the organization, strategies employed, product and services (output) and how the people of the organization are organised to convert the inputs into outputs. In order to understand the organization system and also how these factors influence in achieving intended results. The Congruence model’s most important element is the concept of fit. Organization success depends on the alignment of each factor (people, work, structure and culture) to one another.

The tighter they fit the greater congruence and higher performance is achieved. Sharp-image Diagnosis model This model is a combination of open system and political frame, which aims at a border view of the organization initially but later focus on core problems and challenges (Harrison and Shirom 1999). Sharp-image diagnosis model uses 3 steps to evaluate: 1. Gather data to identify problems 2. Uses theoretical models targeted to specific problems 3. Development of a diagnostic model to identify the root causes of problems Weakness of this model has been The lack of predetermined tools to carry out the organizational diagnosis – Need for highly experienced practitioners to develop customised diagnosis models The strengths of this model has been – The customised diagnosis models targeted at specific problems – Deals with high levels of feedback to managers to understand the diagnostic results. Main Similarities All three, the six box model, sharp-image diagnosis and the congruence model are based on action research models. Action research involves data collection, feedback of data to management and planing for change based of data.

These models focus on inefficiencies to bring about change in those areas, will bring benefits the organization. Apply Weisbord’s Six Box Model to “Lentil as Anything” Marvin Weisbord identified a process with six steps to assist business to diagnosis its business operations. These steps identified by him are purpose, leadership, reward, structure, relationships and helpful mechanisms. These steps were introduced to assist organizations to improve their internal processes. “Lentil as Anything” and ordinary business with an extraordinary mission, which as has been giving a new meaning to pricing of meals.

The concept that Lentils as Anything functions under is “No Pricing”, here customers can decide what they think their meals valve or how much they can afford to pay. “Lentil as Anything” first started with two employees and in one location but now after 8 years it has over 100 staff and operates in 4 locations in Melbourne. Its purpose being to serve its customers with food wether they can afford or not as become a reality. The next step in the model is structure. Structure is where an organization splits workloads between staff members, as every member cannot do all types of work.

Everyone in the organization has to know and understand what there are required to do and what they are suppose to do. If staff does not know what is expected form them, there would chose and no work would be done efficiently. “Lentil as Anything” has mainly 3 departments, which administration dept, front of house and back of house. All of them have specific jobs at Lentils. Admin dept coordinates the purchases, supervision and other admin duties. While the back of house is responsible for preparing quality meals and the front of house is responsible for delivering quality customer service and maintaining the restaurant floor.

Another step in this model is rewards. Rewards systems include bonuses, vacation time, awards, promotions and recognition. According to Michael le Boeuf, “you get more of the Behaviour you reward’. If business wants to achieve success and have satisfied employees there should be a reward system in place. In “Lentils and Anything” the reward system as been in the way of promotions to employees. Which as kept most of the staff happy and content with the recognition give to their hard work? The next step in the model is leadership.

According to Weisbord, Leadership’s tasks are to set goals, scan the environments for opportunities and keep performance to defined objectives. Lentil as Anything has a laid back leadership style. This fits this environment as there are no rule and special guide line that staff as to follow at Lentils. Shanaka Fernando has being able to get his staff to carry out his vision successfully. The former Secretary of State, Colin Powell once said, “…the essence of leadership is the willingness to make the tough, unambiguous choices that will have an impact of the fate of the organization. Another step of the model is relationships. This one of the important factor in an organization, this allows management to solve conflicts between top management and staff. At Lentil, even though the relationship between the managers and other staff is good there are some thinks that need to improve. That is from the side of the founder Shanaka, who does not like to take others opinion and advice when making decisions. This has lead to managers leaving the organization. The last element of this model is helpful mechanisms.

Helpful mechanisms refer to the policies, programs, meetings, systems, and committees. Those facilitate concerted efforts to meet goals. They include budget systems and planning and control mechanisms. At Lentil as Anything management meeting are rare and there has not been any staff meeting held to discuss any sought of issues. And also there are no mechanisms for employee feedback but there is strong informal grapevine is used to communicate issues. Lentils do not provide any training for its employees, it basically fits in the staff where work need to be done. Conclusion

While six box model uses a simple and straightforward method and predefined models look at the organizational strategy, structure, rewards, leadership, relationships and helpful mechanisms. The sharp-image diagnosis model uses customised model to depending on the problem. While the congruence model considers data from internal and external of the organization, strategies employed product and services (output) and how the people of the organization are organised to convert the inputs into outputs. Despite their differences these models derive from action research.

When applying the organizational diagnosis model to Lentil as Anything, the best and easy model was Weisbord’s Six Box theory. This model allowed to see the inefficiencies that were at every level of the organization. Now it’s up to the Lentil as Anything management to implement the necessary changes where the inefficiencies were highlighted. References: Kotelnikov,V. (2001), “Effective Reward Systems. ” E-coach. 19 December 2010 Powell, C. (2001) “18 Lessons for Leaders. ” 1000 advices. 19 December 2010 Weisbord, M. (2005-2008) “Six Boxes. Proven Models. 19 December 2010. Harrison, M. I. (1987). Diagnosing organizations: Methods, models, and processes. Newbury Park, CA: Sage Nadler, D. A. & Tushman, M. L. (1980). A model for diagnosing organizational behavior. Organizational Dynamics, French, W. , & Bell, C. (1999). Organization development: Behavioural science interventions for organization improvement. Upper Saddle River, NJ: Prentice-Hall. Harrison, M. I. & Shirom, A. (1998) Organizational Diagnosis and Assessment: Bridging Theory and Practice, Thousand Oaks, CA: Sage Publications.

Running head: PREVALENCE AND ASSOCIATED FACTORS OF SPIRITUAL Prevalence and Associated Factors of Spiritual Needs Among Patients With Cancer and Family Caregivers Prevalence and Associated Factors of Spiritual Needs Among Patients With Cancer and Family Caregiver Problem Statement Identify cancer patients and their caregivers spiritual needs and measure the prevalence of these spiritual needs. The patients and their caregivers can have similar spiritual needs that may require care. However, a nurse’s help with these spiritual needs, may not always be wanted.

So how does the nurse identify the spiritual needs? If and when these needs are identified, how is the nurse to approach these needs? Study Purpose This study is significant to nursing because it reveals “nurses must be educated to recognize and nurture various spiritual needs” (Johnston Taylor, 2006, p. 734). Research Questions 1. ) How prevalent are the spiritual needs of patients with cancer and family caregivers, from their perspective? 2. ) What demographic and illness-related factors are associated with type and frequency of perceived spiritual needs? . ) What are the patients’ and family caregivers’ expectations regarding nurses addressing their spiritual needs? ((Johnston Taylor, 2006, p. 730) Hypothesis/Hypotheses The study hypothesis is all people have spiritual needs, but the importance varies as do their beliefs. The desire for nurses to assist in these spiritual needs vary according to what is the patient’s religion, are they an inpatient, and perception of an incurable disease. Study Variables The independent variable is the questionnaire. The dependent variables are the research participants.

Conceptual Model/Theoretical Framework A theoretical framework was used to guide this study by examining peoples definition of spiritual needs, surveying oncology nurses, and looking at studies done measuring spiritual needs of cancer patients. The Institute of Medicine defined spiritual needs as “the needs and expectations that humans have to find meaning, purpose and value in their life” ((Murray, Kendall, Boyd, Worth, & Benton, 2004, p. 730). Whether religious or not, all people have various ways of believing to give their life purpose and meaning.

Some may connect spiritually with what they call a higher power, nature, or other human beings. A survey was done in 1995 with 181 oncology nurses and their perception of patients spiritual needs. They identified factors as patients talking about God or faith, meaning of life, or hopelessness or guilt. But “also identified more subtle expressions of spiritual need (e. g. , anxiety, anger, restlessness, sadness, withdrawal, difficulty coping)” ((Johnston Taylor, Amenta, & Highfield, 1995, p. 730).

There have been many studies done measuring spiritual well-being and quality of life, but there has been only one that focused on the spiritual needs of those with cancer. ((Moadel et al. , 1999, p. 730) Review of Related Literature The literature supports the need for this study because all people believe in spirituality in some form and have needs. Cancer patients in previous studies have discussed their spiritual well-being and quality of life, but only one study focused on their spiritual needs. As healthcare providers we need to become educated to these spiritual needs and how to address them.

Study Design This study is a descriptive design because of the need to gain more information about spiritual needs in cancer patients and their family caregivers. And also if patients require or request a nurse’s care regarding their spiritual needs. At least 2 threats to the internal validity of this design would be selection due to inadequate number of non-Euro-Americans in the study and mortality due to the small number of research participants at 156 cancer patients and 68 family caregivers. There were no threats found to the external validity of this study design.

Sample and Setting The sample included 156 cancer patients and 68 family caregivers. This sample of research participants represented the target population for this study by focusing on individuals and their family affected by cancer and their spiritual needs. The setting was appropriate because each individual was given the option to speak face to face with a research team member or take home the Spiritual Interests Related to Illness Tool (SpIRIT) questionnaire. They all chose the questionnaire that was developed specifically for this study.

Each participant completed the questionnaire without help from the research team and then returned to a neutral party that was not a member of the research team and chosen by the institutional research board. Identification and Control of Extraneous Variables The one extraneous variable noted was the SpIRIT questionnaire had not be offered prior to this study. By using a neutral party to receive the completed questionnaires helped alleviate potential problems. Study Instruments/Tools Used the Spiritual Interests Related to Illness Tool (SpIRIT) questionnaire Data Collection/Methods

The data collection methods were appropriate for this study because of offering this study without pressure to participate and to remain anonymous. Data Analysis Procedures The data analysis procedure was appropriate for this type of data collected because they measured the central tendency (average) from the SpIRIT and the Information About You form; checked all SpIRIT items and removed one item that correlated poorly; and performed a factor analysis to determine SpIRIT validity. Then computed coefficient alphas. Strengths

The 2 major strengths of the scientific merit of this study were: * “Those that who perceive more spiritual needs may be most receptive to nurses’ spiritual caregiving ((Johnston Taylor, 2006, p. 733) * “Religious people (as indicated by frequency of attendance at religious services) not only are more apt to consider spiritual needs important but also have more * Desire for nurses’ assistance with such needs ((Johnston Taylor, 2006, p. 733) Limitations The 2 major limitations of the scientific merit of this study were: * Samples of patients and family caregivers were from cancer patients that were not life threatening. SpIRIT was a new test performed. Extent that study findings are valid are evidenced by the spiritual needs cancer patients and their family caregivers do have. The study findings are practical for nursing practice and education because the analysis suggest cancer patients that may be a higher risk for spiritual distress and would benefit from a more-focused spiritual assessment. Implications Implications for practice would be to include admission questions related to the patients spiritual beliefs and/or values; any special needs related to religion or spirituality.

And follow-up to have their needs met, record on patient electronic medical record for all involved in care to continue same care throughout patient stay. Implications for education would be attend classes related to cultural and religious differences, meanings and needs. Implications for research would be to extend this study to a larger group and different cultures, religions, and terminally ill. References Johnston Taylor, E. (2006). Prevalence and Associated Factors of Spiritual Needs Among Patients With Cancer and Family Caregivers. Oncology Nursing Forum, 33 (4), 729-735. Johnston Taylor, E. , Amenta, M. & Highfield, M. (1995). Spiritual care practices of oncology nurses. Oncology Nursing Forum, 22(), 31-39. Moadel, A. , Morgan, C. , Fatone, A. , Grennan, J. , Carter, J. , & Laruffa, G. et al. (1999). Seeking meaning and hope: Self-reported spiritual and existential needs among an ethnically diverse cancer patient population. Psycho-Oncology, 8, 378-385. Murray, S. , Kendall, M. , Boyd, K. , Worth, A. , & Benton, T. (2004). Exploring the spiritual needs of people dying of lung cancer or heart failure: A prospective qualitative interview study of patients and their carers. Palliative Medicine, 18(), 39-45.

COPD which is Chronic Obstructive Pulmonary Disease is known as a condition that progressively makes it harder to breathe because the airflow into and out of the lungs is reduced. This usually occurs because the airways and air sacs lose their elastic quality, the walls between the air sacs are destroyed, the walls of the airways become swollen, or if the airways are clogged because they made more mucus than usual. Three main conditions of this disease are emphysema, chronic obstructive bronchitis, and asthma. Most patients who suffer from COPD also suffer from emphysema and chronic bronchitis as to why they are commonly just defined as COPD.

The patients who experience one or more of these conditions usually find it even more difficult to breathe. It is known to be a major cause of disability, and the fourth leading cause of death in the United States. It is said that approximately 12 million people have been diagnosed with COPD while another 12 million may have it and don’t even know it. COPD is mostly caused by cigarette smoke; however, pipe, cigar, and other types of tobacco smoke, as well as, second-hand smoke can contribute to this disease. This disease can also be caused by inhalation of air pollution, chemical fumes or dust either in the workplace or from the environment.

COPD is usually found in patients of at least 40 years of age; however, it may affect a patient younger if they happen to have the genetic condition, which is alpha-1 antitrypsin deficiency. Alpha-1 antitrypsin is a protein made in the liver. This is an inherited deficiency that puts patients at a high-risk for lung disease. This deficiency occurs when the AAT proteins are not the right shape, which means they get trapped in the liver cells and cannot get into the bloodstream to travel to the lungs in order to protect them.

Signs and symptoms of COPD are chest tightness, wheezing, shortness of breath, and also the “smoker’s cough. ” The “smoker’s cough” is defined as an ongoing cough in which the patient produces large amounts of mucus. Severe COPD can cause symptoms such as weight loss and lower muscle endurance. If a patient is having a hard time catching their breath or talking, their not mentally alert, their heartbeat is very fast, their lips or fingernails turn gray, or blue or their recommended treatment which usually works isn’t work emergency treatment should be sought.

If a doctor is attempting to diagnose COPD, he will first determine whether or not the patient is a smoker, then look into the patient’s family and medical history as well as their signs and symptoms. The doctor will also perform an auscultation using a stethoscope to listen for any wheezing or abnormal chest sounds. If the diagnosis process isn’t completed at that point, the doctor may then perform lung function tests. There are many different lung function tests; those are a spirometry, a peak flow meter, a lung volume measurement, a lung diffusion capacity, pulse oximetry, or an arterial blood gas test.

A spirometry is a test to measure how much air you breathe in and out and how fast you blow it out. A peak flow meter is a small, hand-held device that shows how well air moves out of your lungs. A lung volume measurement like a spirometry measures how much air you can breathe in and out, however, it also measures the size of your lungs. A lung diffusion capacity determines how well oxygen passes through your lungs to your bloodstream. Last, are a pulse oximetry and an arterial blood gas test, both of these tests are used to see how much oxygen is in your blood.

The arterial blood gas test is usually what is used to determine how severe your COPD condition is. After COPD is diagnosed, different treatments may be advised. There is no cure for this condition, but certain treatments may help a patient to feel better, remain more active and also keep their condition from progressing so fast. First, the doctor will tell you if you are a smoker the best thing to do is to quit. And, depending on the severity of your COPD your doctor may advise you to see a pulminologist, who is a doctor who treats patients with lung problems.

Then, different medications may be prescribed such as bronchodilators, short-acting or long-acting again depending on the severity of the disease. Both are used to relax the muscles around your airways to help make breathing easier; however, short-acting is said to only last four to six hours, whereas, long-acting is said to last twelve hours or more. Most bronchodilators are used through metered-dose inhalers. Also, inhaled steroids may be prescribed to reduce the airways from swelling. Doctors will usually prescribe the steroid for a trial period of six weeks to three months.

Other treatments to help this disease from progressing may be pulmonary rehabilitation, oxygen therapy, and vaccines to prevent the patient from the pneumonia or the flu. Rarely, a patient may be advised to have surgery such as a bullectomy, which is a removal of one or more very large bullae of the lungs, a lung volume reduction surgery, which is used to removed damaged tissue from the lungs, or a lung transplant may also benefit patients who suffer from COPD. Although emphysema, chronic bronchitis, and asthma are all conditions of this disease COPD, each condition affects the lungs slightly different.

Emphysema is the condition that affects the lungs almost the same way because just like COPD it involves damage to the air sacs within the lungs; however, chronic bronchitis and asthma are different. Chronic bronchitis is known as a long-term inflammation of the bronchi, which causes increased mucus and other changes. Asthma occurs when the muscles in the bronchial tubes tighten and the airways become blocked by the extra mucus the airways are producing. Emphysema just like COPD is more progressive than chronic bronchitis or asthma.

Patients with emphysema usually have shortness of breath and within later stages of the illness develop a chronic cough or sputum, whereas, patients with chronic bronchitis usually have a cough and develop sputum for many years before suffering from shortness of breath. And, for patients with asthma if proper treatments are followed then symptoms can be controlled. Causes of these conditions are also very similar. The most common cause for all of these conditions is smoking. The AAt deficiency can also play a role on patients who suffer from emphysema like COPD.

Other causes for emphysema are known to be the HIV infection, as well as, connective tissue disorders. Other causes for chronic bronchitis can be from bacterial or viral infections. And, many different causes for asthma are airborne allergens, like pollen, mold, animal dander, dust mites, etc. , exercise-induced asthma, cold air, and certain medications, like beta-blockers, aspirin and other NSAID’s. It is said that the menstrual cycle in some women, as well as, the gastroesophageal reflux disease, which causes stomach acids to back up into the throat can lead to an asthma attack.

And, allergic reactions to foods, like peanuts or shellfish can also cause an asthma attack. Symptoms of emphysema are known as a mild or chronic cough, loss of appetite and weight loss, and muscle fatigue. Symptoms for chronic bronchitis are known as a cough, spitting out of excess mucus, lips and skin may appear blue, abnormal lung signs, swelling of the feet, and heart failure. And, symptoms of asthma are chest tightness or pain, shortness of breath, a whistling or wheezing sound when exhaling, and trouble sleeping because of the shortness of breath, coughing, or wheezing.

The diagnosis and treatments for both emphysema and chronic bronchitis are very similar as COPD, where pulmonary function tests, x-rays, and/or CAT scans may be performed to diagnose the condition. And different treatments may include bronchodilators, oxygen therapy, steroidal medications, and even possible lung surgery. Different procedures that may be used to diagnose the condition known as asthma are a methacholine bronchial challenge, where the patient inhales an asthma trigger called methacholine to mildly constrict the airways and a positive methacholine test will support the diagnosis.

Another test is known as the nitric oxide test, which is used to measure the amount of nitric oxide you have in your breath. If your airways are inflamed, that is a sign of asthma. Medications that may be prescribed to treat asthma symptoms are inhaled corticosteroids, like Flovent Diskus, Pulmicort, Azmacort, Aerobid; Long-acting beta-2 agonists, which are long-acting bronchodilators; Leukotrine modifiers, theophylline. Also, short-acting bronchodilators may also be prescribed such as albuterol, atrovent, and oral and intravenous corticosteroids.

“The process of growing up is when you discover the strength within you survives all the hurt”. It was that last hot summer day of sixth grade, walking home from school as usual being so excited to finally move on and become a seventh grader. While walking home I still remember I had that feeling of joy and happiness to think wow moving up to seventh grade next school year and the enjoyment of growing up a little bit more. Seeing how it was going to be summer break. It was a normal and more than perfect day to actually go home from school without a care in the world.

When walking up to my house, I saw the green Ford truck all packed up with our belongings; I thought well, “when we decided to move”? I was analyzing and questioning all the possibilities of why that truck was loaded up with things that both belonged to my mom and stepdad. As soon as I stepped in the house I knew there was something terribly wrong. I walked throughout my house seeing everything turned upside down, smashed, thrown around everywhere and destroyed all to pieces.

As a sixth grade little girl I didn’t know how to react or even know what to think. All I really knew was someone obviously wasn’t happy and that same person was moving out. At this point my mom was basically the “house wife” that cooked, cleaned and did all the motherly things. While my stepdad worked and made the money. They both had their hands full with four kids and still being able to maintain their marriage and relationship. But as you can see their marriage wasn’t at all perfect, everything down fell from there.

My stepdad left us with nothing; took just about everything that was in our house. The only thing we had left was our toys and rooms. Coming home and seeing my house destroyed in every way is when I knew at that point nothing is going to be the same and knowing my stepdad was moving out was not one of the best things for any of my family’s lives. Since my mom didn’t work she had to get a job in order to support four kids including a roof over our heads, food and clothing on our backs.

This was the turning point of many emotions, anger, disgust and hatred but at the same time this one thing helped me grow in strength, maturity and even responsibility towards myself, making me who I am today. Devastated as I was, my mom had to work nights as a bartender meaning she was never home with me at night and me being the oldest resulted in me having to watch my brothers and sister. Emotions were running high in my family, but from then on watching my little brothers and sister was my job, didn’t really have a huge social life, I found my world spiraling.

All of these effects that took place when my stepdad decided to move out really had this huge impact on my life. While trying to take care of my brother and sister, I found myself having to grow up more and more every day. The responsibilities that were involved were more than I could ever handle at that time. Working hard to help out my mom and getting through the emotions of my stepdad leaving was the most life learned experience I’ve ever had to go through. The hardest time in my life by far.

As a result of that time, I can say now it really made me a better person in every way imaginable. As time went on it eventually resolved itself, making me more responsible than ever; my maturity enlarged immensely and just that experience alone makes me a grateful person now. Seeing how people can destruct something they once loved including their family really made me realize how lucky our family was without him. Although this experience was at rock bottom at the beginning it ended up working out for the better.

In a way that I got a chance to realize something’s on my own and not to only depend on my parents. Just of the simple fact that I learned to have responsibilities. Which in the end really helps me now and for in my future. Having to grow up too fast was the most challenging thing in my life. My family and I survived all the heartbreak that came from my stepdad leaving but now actually being eighteen, I can say it was really worth him leaving. With that being said; “The process of growing up is when you discover the strength within you survives all the hurt”.

The Supply and Demand for Immigration Laws! One of the most controversial political and economical issues facing the United States today is immigration. The rules against illegal immigrants coming into the United States should be stricter along with the number of legal immigrants we allow into the United States lowered. The reason for these stricter laws and smaller amount of foreigners is due to the drastic increase violence due to immigrants, they also bring in a plethora of diseases while increases the cost of health care and degrading health care service.

Immigrants whether legal or illegal should be under harsher rules and should be constantly observed. Sister Helen Chaska was walking around in her hometown of Oregon doing missionary work when Maximiliano Esparza—illegal immigrant for Mexico—raped her and then strangled her with her rosary beads (Crime Victims). In another cases three young boy s, two of age 9 and the other age 10, were brutally killed by two illegal immigrants. One of the young boys was beheaded while the other two almost beheaded; the children also suffered from blunt force trauma and asphyxiation (Crime Victims).

Immigrants such as Esparaza and the killers of the 3 young boys have no compassion or care for Americans i. e. 9/11. A majority of the violence that occurs in cities is committed by immigrants but once they are caught they are deported back to their country of origin. Once legal immigrants are able to receive their green cards they must be immunized and screen to assure the American government and citizens that they are not bring any diseases over to the USA.

Chagas Disease, Tuberculosis, Hepatitis, Swine flu, Leprosy, and Dengue are example of diseases that began in other countries and were bought over to the United States by Immigrants (Engler). In the past 40 years the United States only had 900 cases of Leprosy but it was reported in 2003 that 7,000 people were infected with the disease. Leprosy was first bought over to the United States by illegal from Brazil, Mexico, India and the Caribbean.

We also cannot forget the Hepatitis outbreak in Pittsburgh; the outbreak was caused by a Mexican restaurant shipping food from Mexico to United States (Engler). When illegal immigrants come over to the United States they do not care about what type of sickness they could be bringing over to the United States. A majority of Immigrants whom come over are uninsured. Forty-three percent of immigrants that come to the United States under the age of 65 have no health insurance. That equals out to 9. million uninsured immigrants and not including the illegal ones whom are unaccounted for. The cost of medical care for the uninsured immigrants is passed over to taxpaying citizens. Immigrants also use hospitals, clinics and emergency services twice the rate of U. S. born citizens. This causes long lines and over capacity health care faculties which results in the patients being rushed in and out. A California study showed that U. S. tax payer dollars continuously goes to the delivery of babies from illegal alien mothers.

In one year 74,987 babies were delivered and it cost the taxpayers around 215 million dollars (Illegal Immigration). We have neglected areas in our economy where taxpayers’ dollars should be spent rather paying for illegal immigrants. The statue of liberty was not built to welcome and greet the worlds’ tired and huddled masses. The actually purpose of the Statue of Liberty was to symbolize the French-American friendship and the underlying political message of America supporting and helping Third Republic of France.

Furthermore, the statue of liberty has nothing to do with freely allowing immigrants into the United States (The History). The French initial intent of Lady Liberty is to inspire many culture and countries around the world to emulate the enlightened United States such as the Sculptor of Lady Liberty, Frederic-Auguste Bartholdi, hoped to glorify the United States in the republic of French (The History). The message of the Frederic Bartholdi was not intended to be a welcome mat as many immigrants argue but encourage citizen other countries to admire America.

Illegal immigrants are a burden to our country. They blatantly bring in foreign diseases, which could kill of half of our population. When the Immigrants come over here they also commit horrid crimes that are unthinkable in America but are common in their countries. Most of the crime that is actually reported here in the United States is committed by Immigrants. Due to the abundance of immigrants the cost of health care is increasing drastically and the quality of health care is decreasing. Therefore, the U. S. overnment should implement stricter rules and enforcement around our borders and we should decrease the amount of immigrants we allow in the states. Works Cited “Crime Victims of Illegal Immigrants. ” Immigration Human Cost. Web. 14 Nov. 2009. Engler, Robert. “Immigration And Disease: It’s Enough to Make You Sick. ” American Daily. 21 Nov. 2003. Web. 14 Nov. 2009. “Illegal Immigration and Public Health. ” Federation For American Immigration Reform. Web. 15 Nov. 2009. “The History of the Statue of Liberty. ” The Statue of Liberty- Ellis Island Foundation, Inc. Web. 13 Nov. 2009.