Prescription Obesity Drugs Essay -- Pharmaceuticals

1. Has FDA provided ‘sufficient guidance’ to guide development and registration of prescription diet medications? If you agree, provide examples of what you consider ‘sufficient advice’ (including date of publication). I believe the FDA does provide sufficient guidance on the development and registration of prescription diet medications. In 2007, FDA issued draft guidance that clearly defines their expectations to judge effectiveness (weight reduction and maintenance of weight loss after 1 year’s treatment). It also indicates an effective product should provide improvements in blood pressure, lipids, and glycaemia therefore changes in common weight-related comorbidities need factored into clinical trial to assess efficacy. FDA also states it expects to see drug-mediated weight reduction demonstrated to result from a loss of body fat verified through advance screening tools. From a safety perspective, the FDA states the drug should not adversely affect cardiovascular function particularly highlighting cardiac valvulopathy. 2. Has FDA’s grounds for rejecting the NDAs of prescription diet pills in the last 10 years been based on safety/efficacy concerns? In 2010 alone, three drugs reviewed by the Endocrinologic and Metabolic Drugs Advisory Committee (EMDAC) have failed to gain approval. EMDAC felt each drug (naltrexone/bupriopion, lorcaserin and phentermine/topiratate) had unacceptable safety issues (particularly cardiovascular risk profiles). The committee also concluded that lorcaserin did not provide enough convincing evidence of efficacy and safety to gain approval. EMDAC cite lack of diversity in the phase 3 trial population might result in efficacy of the drug being overstated while potential safety risks understated. Whi... ... FDA. (2010). FDA Briefing Document: NDA 22529 Lorqess (lorcaserin hydrochloride) Tablets, 10 mg. Sponsor: Arena Pharmaceuticals Advisory Committee. Retrieved from http://www.fda.gov/downloads/advisorycommittees/committeesmeetingmaterials/drugs/endocrinlogicalandmetabolicdrugsadvisorycommittee/ucm225631.pdf FDA. (2007). Guidance for Industry. Developing Products for Weight Management. Retrieved from http://www.fda.gov/downloads/Drugs/GuidanceComplianceRegulatoryInformation/Guidances/ucm071612.pdf FDA. (2011).Predictive Safety Testing Consortium (PSTC). Retrieved from http://www.fda.gov/AboutFDA/PartnershipsCollaborations/PublicPrivatePartnershipProgram/ucm231132.html McCallister, E. (2011). BioCentury, Obesity Reset. Retrieved from http://www.biocentury.com/promotions/obesity/next-generation-of-obesity-drugs-unlikely-to-reach-regulators-before-2014.html Prescription Obesity Drugs Essay -- Pharmaceuticals 1. Has FDA provided ‘sufficient guidance’ to guide development and registration of prescription diet medications? If you agree, provide examples of what you consider ‘sufficient advice’ (including date of publication). I believe the FDA does provide sufficient guidance on the development and registration of prescription diet medications. In 2007, FDA issued draft guidance that clearly defines their expectations to judge effectiveness (weight reduction and maintenance of weight loss after 1 year’s treatment). It also indicates an effective product should provide improvements in blood pressure, lipids, and glycaemia therefore changes in common weight-related comorbidities need factored into clinical trial to assess efficacy. FDA also states it expects to see drug-mediated weight reduction demonstrated to result from a loss of body fat verified through advance screening tools. From a safety perspective, the FDA states the drug should not adversely affect cardiovascular function particularly highlighting cardiac valvulopathy. 2. Has FDA’s grounds for rejecting the NDAs of prescription diet pills in the last 10 years been based on safety/efficacy concerns? In 2010 alone, three drugs reviewed by the Endocrinologic and Metabolic Drugs Advisory Committee (EMDAC) have failed to gain approval. EMDAC felt each drug (naltrexone/bupriopion, lorcaserin and phentermine/topiratate) had unacceptable safety issues (particularly cardiovascular risk profiles). The committee also concluded that lorcaserin did not provide enough convincing evidence of efficacy and safety to gain approval. EMDAC cite lack of diversity in the phase 3 trial population might result in efficacy of the drug being overstated while potential safety risks understated. Whi... ... FDA. (2010). FDA Briefing Document: NDA 22529 Lorqess (lorcaserin hydrochloride) Tablets, 10 mg. Sponsor: Arena Pharmaceuticals Advisory Committee. Retrieved from http://www.fda.gov/downloads/advisorycommittees/committeesmeetingmaterials/drugs/endocrinlogicalandmetabolicdrugsadvisorycommittee/ucm225631.pdf FDA. (2007). Guidance for Industry. Developing Products for Weight Management. Retrieved from http://www.fda.gov/downloads/Drugs/GuidanceComplianceRegulatoryInformation/Guidances/ucm071612.pdf FDA. (2011).Predictive Safety Testing Consortium (PSTC). Retrieved from http://www.fda.gov/AboutFDA/PartnershipsCollaborations/PublicPrivatePartnershipProgram/ucm231132.html McCallister, E. (2011). BioCentury, Obesity Reset. Retrieved from http://www.biocentury.com/promotions/obesity/next-generation-of-obesity-drugs-unlikely-to-reach-regulators-before-2014.html

Importance of Leadership

Chapter 1 The Importance of Leadership D. Quinn Mills Leadership How to Lead, How to Live  © 2005 D. Quinn Mills. All Rights Reserved. Leadership: How to Lead, How to Live Few things are more important to human activity than leadership. Effective leadership helps our nation through times of peril. It makes a business organization successful. It enables a not-for-profit organization to fulfill its mission. The effective leadership of parents enables children to grow strong and healthy and become productive adults. The absence of leadership is equally dramatic in its effects. Without leadership, organizations move too slowly, stagnate, and lose their way. Much of the literature about organizations stresses decision-making and implies that if decision-making is timely, complete, and correct, then things will go well. Yet a decision by itself changes nothing. After a decision is made, an organization faces the problem of implementation—how to get things done in a timely and effective way. Problems of implementation are really issues about how leaders influence behavior, change the course of events, and overcome resistance. Leadership is crucial in implementing decisions successfully. Each of us recognizes the importance of leadership when we vote for our political leaders. We realize that it matters who is in office, so we participate in a contest, an election, to choose the best candidate. Investors recognize the importance of business leadership when they say that a good leader can make a success of a weak business plan, but that a poor leader can ruin even the best plan. 10 The Importance of Leadership Who Will Gain from Leadership? Do you want to be a leader? Or, if you’re already a leader, do you want to improve your leadership? Do you want to affect what other people do—to help them accomplish important goals? Do you want to point the way in your organization? Do you want to climb the promotion ladder to positions of higher authority and greater pay? Leadership will make these things possible. You should read this book if: †¢ †¢ You are interested in leadership and how it affects you. You plan to lead an organization or are already in a leadership position. You are interested in developing yourself to meet the challenges you will confront in a leadership role. You wish to make a difference in the world through leadership. †¢ †¢ The Meaning of Leadership What is leadership? It is a process by which one person influences the thoughts, attitudes, and behaviors of others. Leaders set a direction for the rest of us; they help us see what lies ahead; they help us visualize what we might achieve; they encourage us and inspire us. Without leadership a group of human beings quickly degenerates into argument and conflict, because we see things in different ways and lean toward different solutions. Leadership helps to point us in the same direction and harness our efforts jointly. Leadership is the 11 Leadership: How to Lead, How to Live bility to get other people to do something significant that they might not otherwise do. It’s energizing people toward a goal. Without followers, however, a leader isn’t a leader, although followers may only come after a long wait. For example, during the 1930s Winston Churchill urged his fellow Englishmen to face the coming threat from Hitler’s Germany. But most Englishmen preferred to believe that Hitler could be appeased—so that a war could be avoided. They were engaged in wishful thinking about the future and denial that the future would be dangerous. They resented Churchill for nsisting that they must face the danger. They rejected his leadership. He had very few followers. But finally reality intruded—Germany went too far and war began. At this point Churchill was acclaimed for his foresight, and became prime minister of the United Kingdom during the Second World War. During this period almost all Englishmen accepted his leadership willingly. True leadership is sometimes hard to distinguish from false leadership, which is merely a form of pretending. Winston Churchill was a real and great leader. But there are also people who wish to appear to be leaders, but aren’t actually. They say that they are leading others; they posture as if they are setting direction and inspiring others. Yet often they are merely pretending. There’s an old saying that the way to become a leader is to find a parade and run to the front of it. We refer to a person â€Å"leading† a parade, but walking at the front isn’t really leadership unless the person in front is actually choosing the direction! If the person isn’t choosing the direction, then being at the front of the line is merely a way to pretend to be a leader. 12 The Importance of Leadership Leadership can be used for good or ill. Hitler seemed to be a leader of the German people, but he set an evil direction. He had great leadership skills, but put them to terrible uses. Sometimes people in business use leadership skills to exploit others. Sometimes people in charitable organizations use leadership skills to benefit themselves rather than the people they are supposed to help. Leadership skills can be perverted to pursue bad ends. The Importance of Ethics The danger that leadership will be perverted is why ethics are so important to good leadership. Ethics are the inner compass that directs a person toward what is right and fair. Only if a person has an inner ethical compass can he or she be sure that leadership qualities will not turn to evil ends. Learning to lead with good objectives is the only purpose of this book. So let us say that those who do harm are not leaders at all; we recognize that they may be influential and persuasive, but we will not think of them as leaders. With confidence that you, good readers of this book, will put leadership to noble ends, we go forward. The Work of the Leader Taking a leadership position means several things: A leader must have a vision of the future for the organization and its members. 3 Leadership: How to Lead, How to Live EXECUTIVE SUMMARY 1-1 TAKING A LEADERSHIP POSITION Taking a leadership position means: †¢ †¢ Having a vision about what can be accomplished. Making a commitment to the mission and to the people you lead. Taking responsibility for the accomplishment of the mission and the welfare of those you lead. Assuming risk of loss and failure. Acc epting recognition for success. †¢ †¢ †¢ A leader must be able to express his or her vision clearly and in a compelling manner so that others are engaged by it. (See Executive Summary 1-1. A leader has to make a commitment to his or her vision, to the organization, and to the members of the organization. A leader can’t be committed one day and uninterested the next. People will judge a leader by his or her commitment, and will commit themselves no more than the leader does. A leader assumes a considerable amount of responsibility— not just for the mission that he or she urges others to accept, nor just for the organization he or she heads, but for his or her followers, their lives and efforts, as well. 14 The Importance of Leadership A leader assumes risk. If there is no risk, little leadership is required. If the effort is easy and certain to succeed, anyone can, and probably will, â€Å"lead† it. But where the effort entails a risk of failure, then many people will quail before the challenge and leadership is necessary to get people to make the commitment and the effort to succeed. In most organizations, one associates high levels of leadership with high levels of authority. The chief executive of a company usually plays more of a leadership role than people at lower levels of the hierarchy in the firm. It is the same in notfor-profits and government agencies. The higher on the job ladder a person is, the more she is expected to exhibit leadership. In the military, however, the opposite holds true, and for a very good reason. In the military the greatest leadership challenge is to get other people to risk their lives in combat. Generally, the higher one goes in the chain of command, the less exposure he has to the battlefield, and the less exposure to men and women who are in combat. The officers who have responsibility for commanding soldiers in combat have the greatest leadership challenge, for they must get others to risk their lives. Michael Jordan’s brother is an army sergeant major leading a deployment in Iraq in which he is responsible for more than 2,000 soldiers. Offered an opportunity to leave his assignment in combat, he chose to stay with his unit in harm’s way. In so doing, he accepted one of the military’s most significant leadership challenges. 15 Leadership: How to Lead, How to Live The first responsibility in a position of leadership is to have a vision. (See Executive Summary 1-2. ) The visionary leader must create his or her concept of what the organization can accomplish. A business leader may be leading a few people in a department or an entire company; a military leader a small squad or an entire army. The vision may be smaller when the group of people is small; and much broader when the group of people is large, but it must be forward-looking and exciting in either case. EXECUTIVE SUMMARY 1-2 VISIONARY LEADERSHIP Visionary leadership requires: †¢ †¢ Creating a vision, a mission, and a strategy. Communicating the vision/mission/strategy and getting buy-in. Motivating action. Helping an organization grow, evolve, and adapt to changing circumstances. †¢ †¢ The leader must also provide a mission—what needs to be done—and a strategy, a path, for how to accomplish the mission and achieve the vision, a way for the group to get there. But having an exciting vision, an exciting mission, and a careful strategy is not sufficient. A leader must clearly communicate them. Only if people grasp the vision can they commit to it, and buy-in is crucial to motivating action. Finally, a vision cannot be rigid and unchanging; it must adapt 16 The Importance of Leadership to changing circumstances, growing and evolving. Otherwise it becomes outdated and obsolete, and loses its power to excite and motivate people. Leaders versus Administrators and Managers Leadership is not the same thing as being in a position of authority. It is possible to be a boss in a company without being a leader. A boss can be more of an administrator than a leader. Conversely, an administrator can be effective in his job without being a leader. The administrator is a bureaucrat— whether in government or in business—a person who keeps careful records and sees that things are done according to the rules. On the other hand, a leader can be effective without being an administrator—leaving rules, regulations, and their enforcement to others. Administration is not as exciting a topic as leadership, but it is almost as important. The success of organizations depends to a great degree on how well they are administered. A manager is often thought to be primarily an administrator. But a manager is not an administrator; management requires a special set of skills of its own. And being a manager is different from being a leader, as we shall see below. So there are three roles: administrator, manager, and leader. A manager has the broadest role, and a good manager has much of an administrator and a leader in him or her. A manager needs to set direction and inspire others to get work done (leadership functions) and he or she needs to keep records and see that rules are followed (administrative functions). 17 Leadership: How to Lead, How to Live The manager is a necessary combination of leader and administrator. (See D. Quinn Mills, Principles of Management, Waltham, MA: MindEdge Press, 2005. ) But leadership is the most important of the three roles. Administrators What does an administrator do? (See Executive Summary 13. ) An administrator applies rules and regulations generally developed by top executives of an organization. In the government, the key rules and regulations are often issued by legislative authorities like the U. S. Congress). He or she keeps records and fills out forms necessary to take administrative steps (like getting employees paid or reimbursing an employee for travel expenses). EXECUTIVE SUMMARY 1-3 ELEMENTS OF ADMINISTRATION The elements of administration are: †¢ †¢ Making rules and regulations Making decisions that apply and interpret rules and regulations Keeping records Filling out forms †¢ †¢ 18 The Importance of Leadership Managers What does a manager do? See Executive Summary 1-4. ) He or she makes plans and creates budgets that set forth in great detail how something will be accomplished and how much money and other resources (e. g. , people, office space) are necessary to accomplish those plans and budgets. He decides who is going to be assigned to the necessary tasks and how they will fit into the organization. She supervises the actions people take, ensuring that they are doing the right things, that no money is being misappropriated or wasted (we call this â€Å"controlling†), and when problems arise she helps to resolve them. Finally, by combining these tasks into a coherent whole, the manager makes the organization operate efficiently. Running an organization effectively requires administration, management, and leadership. Leadership is ordinarily in shorter supply than administrative or managerial competence. Leadership is more important and more demanding for most people. Fewer people are able or willing to be leaders, so it tends to be a higher calling than administration or management. There is a large literature discussing the differences between leaders and managers. There is also an important distinction to make between leaders and administrators. In general, a leader takes a broader view and points an organization toward necessary, even critical, change. The core of the criticism in the literature is that organizations of all sorts (corporations, government agencies, and not-for-profit organizations) tend to be over-managed (and/or over-administrated) and under-led. Because of over-management and overadministration, organizations are slow to make necessary changes and achieve less than what they could. This is a substantial criticism that points to the importance of leadership. 19 Leadership: How to Lead, How to Live EXECUTIVE SUMMARY 1-4 ELEMENTS OF MANAGEMENT The elements of management are: †¢ †¢ †¢ †¢ †¢ †¢ †¢ Planning and budgeting Setting direction Organizing and staffing Aligning the efforts of many people Controlling Decision-making and problem solving Motivating and inspiring people The Nature of Leadership True leadership is special, subtle, and complex. Too often we confuse things like personal style and a position of authority with leadership. †¢ Leadership is not primarily a particular personality trait. A trait closely linked to leadership is charisma, but many people who have charisma (for example, movie actors and sports figures) are not leaders. Leadership is not primarily a set of important objectives. It involves getting things done. †¢ 20 The Importance of Leadership †¢ Leadership is not primarily a formal position. There have been great leaders who did not hold high positions—for example, Martin Luther King, Jr. and Jeanne d’Arc—and there are people who hold high positions who are not leaders at all, but administrators who don’t want to rock the boat. Leadership is not primarily a set of behaviors. Many leadership manuals suggest that what defines leadership is things such as delegating and providing inspiration and vision; but people who are not leaders can do these things, and some effective leaders don’t do them all. †¢ Many discussions of leadership confuse any and all of the above— personality, important objectives, formal position, specific behaviors—with leadership. (See John P. Kotter, What Leaders Really Do, Boston: Harvard Business School Press, 1999. ) But leadership is more than any of the above characteristics. It’s a process by which one influences the thoughts and behaviors of others in a substantial way. It may involve charisma, important objectives, a formal position, and a particular set of behaviors, but it is not limited to any of them. Effective leaders are often very complex people. Writing about Oliver Cromwell, the Lord Protector of England during the English civil wars of the seventeenth century, a foremost historian marveled at the complexity of his personality. â€Å"There was no single Cromwell, â€Å" he wrote, â€Å"—that is, a clear-cut individual†¦Instead, there was a multiplicity of Cromwells, each linked to the other by his enormous vitality†¦Firstly, there was the very human, simple and compassionate man, a visionary and a romantic. Secondly, there was a violent, boisterous and irascible bully. Thirdly, there was the resolute and iron-willed general†¦Fourthly, the calculating politician, the man of expedients who had no guiding principles. 21 Leadership: How to Lead, How to Live And lastly, there was†¦the Cromwell†¦who, as the interpreter of God’s will, was capable of committing any atrocity. † (J. F. C. Fuller, A Military History of the Western World, Volume 2, New York: Funk & Wagnalls, 1955, p. 110. Because leaders can be so complex, we must be careful in our generalizations about leaders and their personalities. But not all leaders are such complex personalities, which is good for most of us who aspire to leadership. Examples of Leadership Leadership in Business In the 1980s Harley-Davidson was almost knocked out of business by competition from other firms. To survive, it needed to change dramatically. Rich Teerlink, the company’s leader, was able to save the firm financial ly, but with the pressure off, the challenge of continuing to improve seemed even more daunting. Could Teerlink get his managers and employees to make the significant, and to many of them inconvenient, changes necessary? He did it by building a different company, one driven from the bottom up by employees rather than from the top down by managers. It’s a story of successes and failures, advances and setbacks, dead ends and breakthroughs, ending in a much stronger company than before. (Read the inspiring story in Rich Teerlink and Lee Ozley, More Than a Motorcycle: The Leadership Journey at Harley-Davidson, Boston: Harvard Business School Press, 2000. 22 The Importance of Leadership Leadership in Government When Charles O. Rossotti became commissioner of the Internal Revenue Service (IRS) in 1997, the agency had the largest customer base—and the lowest approval rating—of any institution in America. Mired in scandal, caught in a political maelstrom, and beset by profound management and technology problems, the IRS was widely dismissed as a hopelessly flawed an d dysfunctional organization. Rossotti— the first businessperson to head the IRS—transformed the much-maligned agency. In the glare of intense public scrutiny, he effected dramatic changes in the way the IRS did business—while the agency continued to collect $2 trillion in revenue. Through heated congressional hearings, encounters with Washington bigwigs, frank exchanges with taxpayers and employees, and risky turnaround strategies, Rossotti demonstrated leadership against daunting odds. (Read this enlightening story in Charles O. Rossotti, Many Unhappy Returns: One Man's Quest to Turn Around the Most Unpopular Organization in America, Boston: Harvard Business School Press, 2005. ) 23

Oil And Natural Gas A Source Of Strategic Power - 956 Words

Oil and Democracy in Middle East Fossil energy (i.e. coal, oil and natural gas) is generally considered as a main force that drives innovation of new technology and highly developed economy around the world from industrial revolution. It is also the â€Å"lifeblood† of the global economy and takes up 80% of world’s net primary energy supply. However, due to the huge exposure of oil reserves in Persian Gulf after World War I, geopolitical struggles and potential conflicts surrounding fossil energy resources of the Middle East gradually emerge. Michael Klare, the author of Blood and Oil, ever makes an argument in his book that exemplifies the unexpected interaction between geopolitics and geoeconomics in current global economy (â€Å"Review of†¦show more content†¦In order to competing in wars, many western countries gradually expressed huge demand of oil for military use, especially those who were lack of oil. From then on, some leading countries like U.S. and Britain started to import large volumes of oil from the Middle East. To some extent, those countries regarded the Middle East as their â€Å"gas station† and they finally want to control oil wealth according to fast developed oil-based economy. At the end of WWII, President Roosevelt representing U.S. first built relationship with Saudi Arabia. â€Å"The United States will provide military protection for Saudi Arabia in exchange for privileged American access to Saudi Arabia’s vast oil reserves† (â€Å"Blood and oil,† 2008). In a way, Saudi Arabia became an ally of the U.S. The build of relationship between U.S. and Saudi Arabia actually demonstrates how U.S. foreign policy and energy policy essentially intertwined. Furthermore, U.S. also interfered in regimes change in certain Middle Eastern countries like Iraq and Iran, which aroused social controversies that claim the U.S. has destroyed national democracy in Middle Eastern countries. In 1953, U.S. over threw Mossadegh’s government in Iran since he nationalized oil fields which restricted benefits U.S. might get from Iran. As for U.S., they regarded this overthrow as an essential step to get control of oil wealth. Thus, they came up with a solution and sent the â€Å"Shah† to build a new regime which was expected to be a staunch ally

Essay on Franny and Zooey and Holden Caufield - 694 Words

Holden as a Foil ti Zooey Although they are the protagonists from two separate books, Franny Glass, a teenage girl in J.D. Salinger’s Franny and Zooey, and Holden Caufield, a young man in Salinger’s novel Catcher in the Rye, serve as foils to each other. Both suffer unnecessarily due to their interaction with those whom they are close to, due to their relationships with themselves, as well as due to their views on the world. In the end, however Franny and Holden change their values and therefore are able to begin the healing process. Throughout Franny and Zooey, Franny perceives humans to be inherently evil. As a result, she constantly feels frustrated with the egotism and self-centeredness of the world. One of Franny’s major†¦show more content†¦For this reason, she often recites â€Å"the Jesus prayer.† Like the prayer’s namesake, Franny experiences guilt for anyone who is not completely righteous. Holden too feels responsible for the prevention of corruptness. His fantasy is to stand in a field and prevent children from falling off the edge, thus saving them from society’s imperfections. In addition, a major theme common to both books is the relationship of the protagonist to a sibling, and the healing that ensues as a result. For Franny, this healing comes about through her older brother, Zooey. In his efforts to help his sister, Zooey points out the flaws in Franny’s prayers. He shows that by becoming obsessed, Franny is acting as self-centered as the people again st which she battles. For Holden, on the other hand, it is the innocence of Pheobe, contrary to the scornfulness of Zooey, which persuades Holden that there is in fact a balance between untainted aspects of society as well as less than perfect ones. In this way, Pheobe succeeds in changing Holden’s outlook. Rather than focusing solely on the negative facets of a situation, Holden learns to take all parts into account, and not to become discouraged. Lastly, Franny and Holden can be compared and contrasted through their inner thoughts. Franny often finds herself feeling remorseful for her personal trivial harms, such as when she asks her boyfriend for the olive in his martini. When she realizes that â€Å"sheShow MoreRelated The Writings of J.D. Salinger Essay1513 Words   |  7 Pagesto Columbia University where he decided to become a writer. Salinger published short story collections and one novel. His best known work, The Catcher in the Rye, was published in 1951. The short stories he wrote were Nine Stories in 1953, Franny and Zooey in 1961, Raise High the Roofbeams, Carpenters and Seymour: An Introduction in 1963, Young Folk in 1940 and A Perfect Day for Bananafish in 1948. Many critics have considered J.D. Salinger a very controversial writer because of the subject

What Can Be Done to Help the Homeless Essay - 583 Words

Did you know that there are 5 times as many vacant and empty houses than there are homeless people (Truthdig)? That’s right, homeless people are sleeping and living on the streets, unknowing of the hundreds upon thousands of empty homes they could be occupying! But alas, they sleep on the streets, beg for money, and scavenge for food in dumpsters, hoping for a way to pull through for the night. Homelessness is important because there are 3.5 million homeless people on the streets, maybe even more (National Student Campaign Against Hunger and Homelessness). They are starving on the streets, desperate for a job and a warm place to sleep. Of those 3.5 million homeless people, 1.7 million are teenagers. 75% of all homeless teens use drugs or†¦show more content†¦The U.S. can also raise the minimum wage to help end homelessness if they decide not to lessen the prices of houses (National Student Campaign Against Hunger and Homelessness). There is nowhere in the U.S. that th e minimum wage is high enough to afford a market-rate one bedroom apartment (Family Promise). They could also improve health care, not only for the homeless people, but for the people in need of health care (National Student Campaign Against Hunger and Homelessness). In 2009, Barack Obama created a program to help end homelessness (National Alliance to End Homelessness). It focused on rapid re-housing and prevention of homelessness rather than soup kitchens and shelter (National Alliance to End Homelessness). But realistically, what can we do to help end homelessness? There are many things you can do to help homelessness today. One of them is volunteering at a soup kitchen to help feed the homeless (Do Something). You could tutor homeless children at shelters (National Coalition for the Homeless). You could also donate items such as food, clothes or even survival kits (National Coalition for the Homeless). Maybe you could work at a shelter to help the people running the shelter (Nat ional Coalition for the Homeless). You could even convince friends and family to help end homelessness by having them come with you (National Coalition for the Homeless)! The next time you see a homeless family or person, don’t just ignore them as ifShow MoreRelatedAnalysis Of Jonathan Kozol s Untouchables 879 Words   |  4 Pagesthe homeless what do you think about? Do you see them and feel disgust or are you someone who wonders how and why they are where they are, or maybe, you are one of the few who want to help and who are able to. In the U.S., more than 3.5 million people experience homelessness each year and that number is growing. They are families with little children, people who are trying to escape domestic violence, people with mental illness, veterans who have served our country, and many more. From what I readRead MoreHomelessness And The United States863 Words   |  4 Pagesessay describes the hardships of homelessness and what can be done to help these peo ple. Helping the Homeless Many people have gotten to experience what life is like in big cities or small rural communities. Often times, these places have a population of wealthier people and an area of poorer families. What many do not experience is what it is like to be homeless in these places. Homeless men, women and children can be seen under bridges, on front stoops, in cars, andRead MoreCauses of Homelessness Essay1298 Words   |  6 Pagesdown upon those who are poor. Stereotypes include poor people who are viewed as lazy, jobless, criminals, or un-educated. When I think of a homeless individual, I would agree with most of the stereotypes and find within the reading and researching that there is more to just the mental perceived thoughts. I think one big cause of being in poverty or being homeless is by the choices people make. By choices I mean the way that people choose to spend their money. A budget is hard for many in this typeRead MoreThe Problem Of A Program1465 Words   |  6 Pages200 million people that are homeless, which is including the recorded 1 million children as well. This is an obvious issue because there is no need for there to be homeless when there are available resources to help them. They have programs put in place to help out the homeless, but it is not working because they do not have the resources to do everything that needs to be done.. We need to create a system or a program that receives donations that will help out the homeless individuals in China, adultsRead MoreHomelessness : Is It Difficult For People? Essay1191 Words   |  5 Pagesfood, and the government should step in to help control the growth of homelessness in America. Firstly, why is it difficult for people to escape homelessness ? â€Å"Because of our housing shortage, rents have gone up 28% since 2000. Over the same period, renters median incomes fell 8%. The result is an untenable situation: More than 250,000 households in Los Angeles pay 90% or more of their income on rent.† maybe drug test should be administered to homeless people for a house and food to maintain balanceRead MoreThe Problem Of Senior Homelessness1360 Words   |  6 Pagesreflects those born in this era. Being homeless, especially in these late years of life, causes for many problems related to health and mortality. Individuals under these circumstances lack mobility resulting in disability, lack health care and necessary resources such as food water and shelter, and are also put at risk to mental illnesses as well as substance abuse. While identifying the major risks associated with homelessness in the elderly population, a plan can be addressed and put into actio n toRead MoreThe Problem Of The Lgbt Homelessness852 Words   |  4 Pagesonly certain races are homeless but that is not true. Thirty nine percent of Non-Hispanic whites are homeless compared to seventy six of the general population. Forty two percent of African-Americans are homeless compared to eleven percent of the general population. Thirteen percent of Hispanics are homeless compared to nine percent of the general population. Four percent of homeless are Native-American compared to one percent of the general population. Two percent of homeless were Asians (â€Å"facts†)Read MoreThe Licking County Coalition For Housing870 Words   |  4 Pagesaverage of about 13,000 homeless people in Ohio and the number has continued to rise since then. Nearly 300 people are homeless in Licking County during any given night.(LCC Housing, 2011) The most outstanding statistic from the Licking County Coalition for Housing in 2011 was that the average age of a homeless person is the age o f only nine years old. That means, for every homeless man or women that is seen on the streets, there is two to three children who are also homeless. Families are the majorityRead MoreMental Illness, Drug And Alcohol Abuse1476 Words   |  6 Pagesalcohol abuse. These are considered to be some of the main problems associated with homelessness. According to Hertlein, (2010) when it comes to the homeless, they should be able to participate in â€Å"critical role of decision-making both in leading to homelessness as well as recovering from homelessness becomes apparent in the first year of being homeless. And, the major factors underlying their decision-making include â€Å"emotional reactivity, negative entitlement, emotional/relational wounded, impulsivityRead MoreThe Problem Of Homeless People1278 Words   |  6 PagesHomeless people are one of the major problems with america today, it is a very big problem that needs to be dealt with. There is more than 3.5 million homeless people in america, this includes men, women, kids, veterans, and the elderly (Home aid). 44,359 homeless people and the 26% of Angeleno residents who live in poverty -- and who are falling into homelessness at the rate of 13,000 a month† (Homeless. Hungry. Help.) ,lozz.oThis quote is important because it is true. There isn’t enough housing

Protocols for Wound Care Management-Free-Samples for Students

Question: Discuss about the Policies, procedures, and protocols for wound Care Management. Answer: Introduction According to Thomas, (1990 pp. 300-310) a wound is a break or a defect on/in the skin as a result of mechanical, physical or thermal damage. It might also develop as a result of an underlying physiological or medical disorder. Collier, (2002 pp. 55-63) it is an abnormal break in the (skin) intact and normal covering of the body. A wound is a break in the dermis or epidermis as a result of pathological changes or trauma on the skin or body, (Collins, Hampton and white 2002). Wounds can be classified according to their severity: acute, chronic, palliative, healed wounds. McCulloch, (2014) wound management involves assessing both the wound and the patient. Then planning intervention using the assessment data obtained. The third thing is regular evaluation of these interventions and lastly educating the patient and the care giver on the wound management after being discharged. The policy main aims are to guide the health care providers on having a standardized way/method/approach towards wound care which will be within the holistic framework of care. Wound healing process is one aspect of the bodys response to trauma/injury, for complete healing the whole person (holistic care) needs to be attended to not just the wound, (Dealey (2005).It was also developed so as to be of assistance to the nursing staff when managing the wounds so that they can be able to choose the appropriate dressings. The market has over 2000 types of wound dressing materials. Policies, procedures, and protocols Their purpose. All the policies formulated on wound care management have similarities. They all have similar targets. 1) Provision of a standardized approach within the holistic care framework in wound care. 2) To ensure there is the appropriate management of surgical, acute and chronic wounds. 3) To make sure that the most appropriate product for wound care is being utilized so as to achieve patient's comfort, cost effectiveness, and the most importantly optimum wound healing. 4) Its a guideline for the nurses to ensure that there are no omissions while managing the wounds that can cause lead to delayed healing or even complications (Australian Wound Management Association, 2010). 5) To help in promoting and having a coordination in systematic approaches towards wound management and ensuring that the patients quality of life is maintained while making it known to them that it is not always possible to achieve a complete healing. 5) The last common purpose of the policies and procedures towards wou nd management is to ensure that the wound care complies with all the requirements as dictated by the Health Act (2006a). It states that there should be a specific Code of professional Practice aimed at reducing the infections related/associated with healthcare (NWS Ministry of Health, Infection Control, 2007) Two different policies, procedures and protocols on Wound care management. I identified two policies on wound dressing addressing different institutions. The first one is addressing the Doncaster and Bassetlaw Hospitals. Written by Sue Johnson who is the leading nurse in wound care and Tracy Vernon who is the lead nurse tissue viability. This policy was approved on 2012 and was recently reviewed in 2015. The second policy is the wound management procedures and policy in the community setting. The target group was NHS Walsall Community Health and Allied Health Care Professionals. It was written by Elaine Westwood and directed by the lead nurse Tissue viability. Was published in 2013. As mentioned earlier policies on wound management have similar aims although they all differ. Examples of the differences between the two policies. The first policy: the one addressing Doncaster and Bassetlaw hospital is less detailed in the procedures of the wound management; assessment, intervention, evaluation and the re-evaluation (Carville, 2014) It seems like it is a summa ry of the procedures and protocols, unlike the second policy which gives detailed information on wound management. The second difference is that the first policy has given the directives of what is to be done and by who. For example to expound on that, in case of wound infection the clinician has been directed to take samples for culture and tissue viability tests. Comparison of the two policies. Assessment There should be a comprehensive assessment of the needs and in this regard the health needs of the patient in regards to wound care. Provide a continuity of care on the wound management, it has to be a collaborative care where different nurses meet the needs of this patient. Ensure standardized approaches are the only ones used when it comes to wound care management. Have utilization of the most appropriate and optimum products in wound management which provides patients comfort and are cost effective. For patients with non-healing wounds, the priority in wound care management should be geared towards patient's comfort, pain relief, get rid of malodor and prevent hemorrhage. All these policies aim at a holistic patient and wound healing. The differences between the two are the details on assessment. The second policy is more detailed giving the protocols/procedures to be used in each step for example. Assessment can be classified into four major areas, (Morison, 1992). General factors (patient assessment) that could cause a delay in the healing of the wound. The immediate cause of the wounds (the pathophysiology behind it and also the environmental events that may have led to it). The local conditions at the wound site that is the assessment of the wound. Lastly, the effects the wound will be having on the patient that is an assessment of possible outcomes. With this assessment, the health care provider is able to identify the healing capacity of the patient, come up with a treatment plan, know and eliminate factors that delay healing of the wound. The patient assessment is thorough, as they assess all the factors that can cause a delay in wound healing. For example, the nutritional status is assessed as good nutriti on provides the raw materials for healing. Gray, D et al (2011); Medline, S (2012 pp. 12-26) states that minerals for example zinc are required for wound healing. Blood circulation is also considered as good circulation in the wounded area causes fast wound healing as there is a good supply of oxygen and nutrients to wound. Smoking habits of the patient as the chemicals in the cigarettes destroy the cells responsible for the wound healing (Krueger and Rohrick 2001). The drug therapy that the patient is on is evaluated. The immunity. Age is evaluated as older people cell replication is lower than cell death. Obesity is examined as in adipose tissues there is very poor vascularity (Mulder et al., 1998; Melling et al., 2001). The psychological status is also evaluated as in stress situations a lot of stress hormones are released causing a delay in wound healing. Anderson, (2014 pp. 84-91) diabetes, low immunity, smoking, use of corticosteroids facilitates wound healing delays. The seco nd assessment is the environment or the events surrounding the wound healing. The second policy sufficiently exploits this sector unlike the first one. Further mechanical injuries that can cause more harm on the granulation of the cells for wound healing (Pulman 2004), presences of tumors and poor hygiene. The third assessment is on the wound itself. Both policies explain how it should be assessed the first policy explains more. (Watret, 2005 pg. 18-26) it explains what to look for when assessing the wound. Wound cleansing, Wound infection, Wound dressing and selection of materials, There are similarities and differences on the guideline of how to do the above. The two agree that wound cleansing is to be done so as to remove contaminants with minimal pain to the patient and also prevent trauma to the healing tissue. The second policy explains more on cleansing. Expounds on debridement both the one that can be done at the bedside and also the surgical one. Unlike the first policy, it expounds on the exudate management from the wound. On wound infection, the second policy helps the health care provider in having a distinction between wound infection and wound colonization. Wound infections are a common hospital acquired infections (Bruce et al 2001 pg. 1-194). It explains on the dressings that are ideal for use. The choices of dressings. It has more explanation on auditing and education to the health care providers. The second policy is more comprehensive compared to the first one. It digs deeper on wound care leaving nothing unexplained. It is more rigorous than the first policy. Interpretations of the results above. The second policy(NHS Walsall Community Health and Allied Health Care professionals) is superior to the first policy(Doncaster and Bassetlaw Hospitals) as it is a continuation of the first policy that was developed in 2004 later on amended on 2007 and now this is the polished policy. This policy was developed after the Walsall manor hospital merged with Walsall Community Health. This increased the size of the firm and also the size of the target group, unlike the first policy that serves only two hospitals (Doncaster and Bassetlaw hospitals). With a huge pool of patients, it means a presentation of more complex conditions. This could be the reasons as to why the policy is more expounded. It also covers all types of wounds and their specific wound care as the patient conditions/ presentation are more and more complex. It has a huge responsibility. The second reason as to why their policy is more superior is because more resources are available to the Walsall health care organization. They run a Walsall health fundraising committee which gathers funds to be used for patient care. The second policy is more rigorous than the first policy. Conclusion Wound care management requires a holistic approach. Treating not only the wounded part but also the whole body. Wounds are caused by several causes and without proper care, they can cause more harm to the body. There are policies, protocols, and procedures that have been formulated to aid the health care provider in wound care management. Doncaster and Bassetlaw Hospital policy (the first policy) and NHS Walsall Community Health and Allied Health Care professionals' policy which is the second policy. From the above, it is clear that both policies strive to achieve the same goals the differences are on the content and the explanations on the procedures, protocols, and policies. From the two policies, they address the same issues when it comes to wound care management. The second policy is more superior and more vigorous than the first policy as it addresses more wound type and their care. It also expounds more on wound care and management. References Amin, N., (2016). Diabetic Foot disease: From evaluation of the foot at risk to the novel diabetic ulcer treatment modalities. Vol 7(7) pg. 153-164 Anderson, K., (2014) Factors That Impair Wound Healing. J AM COLL CLIN WOUND SPEC. vol 4(4) pg.84-91 Benbow, M., (2010) Mixing and matching dressing products, Nursing standards. Vol 24(49) pg. 56-62 Carville K., (2012) Wound care manual 8th edition, Silver Chain Foundation, Perth. Dealey, C., (2005). The care oNursingf wounds: A guide for nurses. Oxford Blackwell science limited. Department of health (2006). The Health Act: A Code of Practice for the Reduction of health care associated infections. London. Department of health NSW patient Matters, Section 9 Gray D et. al. (2011) Consensus guide for the use of debridement techniques in the UK. Wounds UK. vol 7(1) Kingsley A., (2009). A proactive approach to wound infection. Nurse standards. 15th edition, vol 30, pg. 50-58. McCulloch J, et al., (2014). Wound healing. Alternatives in management. 2nd edition, Philadelphia F.A.Davis. Medlin, S., (2012). Nutrition for wound healing. British Journal of Nursing. Vol 21, issue12, pg. 12-26 Meggers, J., (2008) Defining infection in a chronic wound; does it matter? Journal of wound care. Vol 7(8). Pg. 389-392 Miller, M., Dyson, M., (2016). The principles of wound care. London Macmillan Magazine Ltd. NMC, (2008).codes of professional practice London NMC. NWS Ministry of Health (2007) infection control policy Silhi, N., (2008) A review of the diabetes-related factors that affect wound healing. The journal of wound care, Vol 7(1) pg. 47-51) The Australian Wound management Association Inc. (201

The Lottery A Setting Analysis Essay Example For Students

The Lottery A Setting Analysis Essay Shirley Jackson takes great care in creating a setting for the story, The Lottery. She gives the reader a sense of comfort and stability from the very beginning. It begins, â€Å"clear and sunny, with the fresh warmth of a full-summer day; the flowers were blossoming profusely and the grass was richly green.† The setting throughout The Lottery creates a sense of peacefulness and tranquility, while portraying a typical town on a normal summer day. With the very first words, Jackson begins to establish the environment for her plot. To begin, she tells the reader that the story takes place on an early summer morning. This helps in providing a focus of the typicality of this small town, a normal rural community. She also mentions that school has just recently let out for summer break, which of course allows the children to run around at that time of day. Furthermore, she describes the grass as â€Å"richly green and â€Å"the flowers were blooming profusely. These descriptions of the surroundings give the reader a serene feeling about the town. The location of the square, â€Å"between the post office and the bank, proves the smallness of this town, since everything centralizes at or near the town square and it acts as the primary location for the remaining part of the story, playing a significant role at the end setting of the story. We will write a custom essay on The Lottery A Setting Analysis specifically for you for only $16.38 $13.9/page Order now Up to this point, nothing unordinary has happened, which might later reflect an ironic ending. Eventually, small hints about the unusualness of this town are added. The author points out significant buildings that surround the town square, but fails to describe a church or a courthouse, which are common buildings to all communities. In this, there seems to be no central governing body for this town, such as a court or a police station. Also, oddly enough, these people celebrate Halloween but not Christmas, Easter or Thanksgiving, the largest holidays that normal people celebrate. However, Halloween implicates a certain proneness to defiant, evil activities. In addition, the children are building a great pile of stones in one corner of the square.† An impression of the children as normal children gathering rocks is counterbalanced by their ironical construction a massive pile of stones in one corner, as if they were punished through labor. The introduction of the black box acts as the major turning point for the setting. It symbolizes an immoral act to the villagers as â€Å"the villagers kept their distance from it. The introduction of the black box into the setting changes the mood and the atmosphere of the residents as they become uneasy around it. Furthermore, the black box changes the mood from serene and peaceful to ominous, where the moment of illumination reaches climax at the very end of the story. Through her use of subtle details in the setting, Shirley Jackson foreshadows the wicked emotional ending, which lacks official authorities, by the incoherent mentioning of stones. Indeed, the story starts to feel more and more uncomfortable, and the commonplace attitude of the townspeople remains even during the stoning of Mrs. Hutchinson. They are all unaffected by the outcome except for, obviously, the victim of their collaborate murder. Near the end, one of the women casually tells the victim to â€Å"be a goo d sport† as they slaughter her with stones. In spite of the peaceful mood created by the town setting, everyone commits a brutal act by stoning an innocent person. Throughout The Lottery, the setting plays a significant role in portraying irony in the plot. However, Shirley Jackson does not end her story with a resolution to the plot, but she illustrates the irony she sees in the world through a creative ironical setting.Indeed, the setting expresses The Lottery’s theme of a hidden reality beneath the surface of everyday lives. Bibliography: