Alcohol Is The World’S Fifth Leading Risk Factor For Social

Alcohol is the world’s fifth leading risk factor for social and public health problems around the world[1, 2]ï ¼â€º however, alcohol drinking has still been intensively increasing among adolescents[3, 4]. Drinking habits are highly socially modeled, while social relationships influence an individual s drinking at all ages. The social pressured by family, friends, and acquaintances can motivate either drink more or less[5]. It is worth noting that almost every event of the daily lives is marked with some kinds of festive rituals at which alcohol is served culturally and practically[6-8]. Some researchers found that children learn to drink early in Zambia by drinking small quantities when they are sent to buy alcohol; children in France, Italy,†¦show more content†¦Four motives of drinking, which are an enhancement, coping, socialization, and conformity motive, have been categorized by scholars and experts in the studies of behavioral drinking[13-15]. The enhancement m otive is a drinking to increase positive outcomes or to experience pleasant feeling[16], whereas coping motive represents a drinking to mitigate negative emotions such as to forget one’s problems[13]. Both enhancement and coping motives are associated with heavy drinking and alcohol-related problems[17]. The social motive or socialization is a drinking for the favorable social rewards such as enjoying a party, making more friends and building new relationships[17, 18]. Lastly, when ones are invited or pressured to drink by friends or social groups; it is called conformity motive or drinking to avoid social disposal[14]. Conformity motives have a strong relation to the cultural settings, particularly in some cultures such as Japan, China, and Cambodia. In these countries, the independent and interdependent cultural models have various influences on emotional, motivational, and cognitive processes[19]. In Japan, giri is a key understanding of social obligations which is defined as moral principles; the rules one has to obey to maintain social relationships and to avoidShow MoreRelatedHiv / Aids : A Growing Problem Among American Indians And Alaska1731 Words   |  7 Pagesneedles/equipments with an affected person. The risk factors are indistinguishable for everyone; some racial/ethnic groups are more affected than others, given their percentage of the populace. HIV/AIDs are a growing problem among American Indians and Alaska Natives (CDC). Some groups have higher rates of HIV in their communities, hence the rising of the new infections with each sexual or drug use encounter (CDC). Social, economic, and demographic factors including stigma, discrimination, revenue, educationRead MoreThe Emotional, Social, And Academic Effects Of Homelessness On Children1291 Words   |  6 PagesDevan Thieu HHG4M Mrs. Nystrom 01/22/2015 The emotional, social, and academic effects of homelessness on children Hardly a day in life goes by without seeing a homeless child trying to survive, especially in developing countries. Unwanted sightings of homeless children happen every day both in developed and underdeveloped countries. The increase in divorce and trend in cohabitation has led to an increasing number of children being homeless. As stated in the â€Å" Homeless Facts Children and HomelessnessRead MoreThe Effects of Homelessness on Children1654 Words   |  7 Pagesothers are suffering from chronic and acute health problems as a result of drug and alcohol abuse. According to Didenko Pankratz, 2007 â€Å"Service providers report a 40 percent substance use rate among women in their programs, with approximately one-fifth of homeless women disclosing drug and alcohol abuse during pregnancy†. Babies born to homeless mothers are more likely to have low birth rates and a greater risk of SIDs (sudden infant death). Children of homeless mothers often are unable to receiveRead More Infant Mortality Within the United States Essay3180 Words   |  13 PagesInfant Mortality Within the United States Herein I briefly overview the Infant Mortality Rate (IMR) within the United States. Initially, I discuss specific causes of infant death and then, contributing factors which put babies at risk. Next, the distribution of various IMR is surveyed on a state to state basis. States possessing the ten highest infant mortality rates are discussed, including possible reasons for higher IMR. In addition, those states with the ten lowest IMR are mentioned.Read MoreEssay on Heineken Marketing Report 20094988 Words   |  20 Pagesforces   Ã‚   3 - Demand   Ã‚         a)Total size of market   Ã‚         b)Market share   Ã‚         c)Characteristics of demand   Ã‚               1-When   Ã‚               2-where   Ã‚               3-how often costumers buy   Ã‚   4 - Competitive forces   Ã‚   5 - Technological forces   Ã‚   6 - Social/Cultural forces III - SWOT Analysis   Ã‚   A. Strengths and Weaknesses   Ã‚   B. Opportunities and Threats IV - Marketing objectives V - Marketing strategies   Ã‚     A. Target markets   Ã‚   B. Marketing Mix   Ã‚           1-Product   Ã‚           2-Pricing   Ã‚           3-Distribution Read MoreImpact of Radio and Television Advertising on Consumer Behaviour Special Referance on Consumer Durable Goods5906 Words   |  24 Pageswhite and rosà ©. Types of Fortified Wine Fortified wine is a wine that has been blended with a liquor. The liquor most often used for this is Brandy which is essentially just distilled wine. This gives fortified wines a distinct flavor and a higher alcohol content than normal wine – usually at least %15 ABV. * Port * Sherry * Madiera * Marsala * Vermouth * Bum Wine Types of Dessert Wine These are sweet wines and as the name suggests, they are generally served with dessert.Read MoreMarketing Plan for Chanel N5 Perfume3426 Words   |  14 Pagesuse products that have less damaging effect on their health and environment. Technological environment Technology plays an important role in the perfume industry. The influence of technological factors is known for the new advanced features of the products, along with a remarkable growth of social media and internet which are related to most effective marketing tools. Some buyers will buy perfume products for special occasions, like Christmas or birthdays. Product Attributes The fragranceRead MoreImportance of Surrogate Advertising in Creating Brand Identity for Liquor Industry(Final)14020 Words   |  57 PagesDelhi based liquor consumers were selected for collecting primary data. Alcohol advertising has the potential of promoting changes in attitudes and social values, including publicizing the desirability of social drinking to its viewers, which all encourage a higher consumption of alcohol. It is known that advertising can influence consumer choices, have a positive short-term impact on knowledge and awareness about alcohol, but it has proved difficult to measure the exact effects of advertising onRead MoreThe History and Future of Poverty Essay3716 Words   |  15 Pagesthat their humanity does not count. The stripping of respect and hope from the poor is well systematized. Capitalism from its start had poverty in its train. Serfs in the feudal, pre-capitalist system did often have a kind of paternalistic social security. They were part of a unit that shared the essentials out of a kind of practical necessity. With the dawn of modern capitalism, the serfs were cast out to look for work and security. Capitalism had two choices from the beginning, eitherRead MoreEssay on Heineken Business Analyses15259 Words   |  62 PagesDuPont chart. If you look at the number of employees you can see that Budweiser is the biggest in the world, second is Heineken and third is Carlsberg. The fourth chapter consists of the risk management of Heineken. We explain the sales risks, operational risks, interest risks and the total risks. The fifth chapter contains the growth management what is explained through the subjects market penetration, product diversification, market development and product development. Heineken is a company

Female Immigrant Subjectivities And The Politics Of Voice

During the decade of the eighties in El Salvador, the government would armed forces and recruit children that are approximately twelve years old out of their schools. Since Chava is only eleven years old, he still has a year of innocence, which means a year before he is conscripted to fight against the rebels of Farabundo Marà ­i National Liberation Front (FMLN). Chava’s life becomes at risk since it is a game of survival and he carries negative effects with violence. Although with the love of his mother and with a classmate, Chava finds the bravery to keep positive understandings and stay alert against time before he might get recruited. According to Yahaira Padilla, in Hermanas lejanas? Female Immigrant Subjectivities and the Politics of†¦show more content†¦This film was taken place before by Oscar Torres; the person who co-wrote the script was once situated before becoming a teenager. Torres wanted to parallel his ending when he landed to the United States at the same time when Chava left El Salvador. On the other hand, Luis Mandoki, a Mexican film director that enjoys putting real life situations in a movie. While reading â€Å"Re-membering the Nation: Gap and Reckoning within Biographical Accounts of Salvadoran Émigrà ©s† by Susan Bibler Coutin compares and contrast the narratives of after the Civil War in El Salvador. During those twelve years of war, majority of people were separated because of international emigration and violence (Coutin 2011). In contrast, Coutin argues to the audience that Central American minorities narrate their personal experience just to relink their historical events, just as Torres. There are many war films that can relate to â€Å"Voces Inocentes†, but unfortunately it is rare that a twelve-year-old kid tells the story throughout his own experience. I guarantee that most people would not want to live around a ‘barrio’ that is around with death like the one in this film. On the other hand, Mandoki prefers to show the brutal that military soldiers would do at the time to the children; death and terror. The film tends to bring different tones such like having its humor once in a while and how

Susceptibility Patterns and Genomics of Bacteria †MyAssignmenthelp

Question: Discuss about the Susceptibility Patterns and Genomics of Bacteria. Answer: Introduction To deliver the care for chronic illnesses, multiple factors have to be taken into consideration. It is important for the nurse to consider the patients and the clinical needs. Assessment of patient is an important part of the nursing as it can be life saving. It helps improve the clinical performance, by identifying the priorities of care (Viera, 2016). Primary and secondary assessments are important for the observation, and interpretation of data. It significantly influences the patients diagnosis and the prioritisation of care. Prioritisation of care will help improve the care delivery (Brown, Edwards, Seaton Buckley, 2017). The essay deals with case study of Catherine Bexley, a 77 year old woman, presented to ED with right lower lobe pneumonia. The patient also has the history of heart disease, hypertension, and hypercholesterolemia. In response to the case study the essay discusses the primary assessment using the DRSABCDE approach followed by the focused assessment for respirat ory distress. The essay then discusses the pathophysiology of the shock experienced by the patient and explains the clinical manifestations. Lastly, the essay presents the appropriated nursing interventions, based on evidence to improve Catherines health outcomes. DRSABCDE approach will be used for primary assessment. It stands for Danger, Response, Send for help, Airway, Breathing, Circulation, Disability, Exposure. According to Smith Bowden (2017) it is the systematic approach to immediate assessment and treatment. On assessment of Danger, initially the patient appeared to need HDU however, found safe to ward after oxygen and antibiotics. The DRS assessment showed that patient is conscious and responsive. She was further assessed using PPE. Immediate help required in the ED is that of physician. The patient may be at risk of shock and death due to low oxygen supply. The neurological assessment showed that the patient is complaining of pain and is confused. The airway assessment showed that the Catherine is using her upper accessory muscles. She has decreased air entry to her Right lobe to midzone. There were no noisy respirations found and no sign of cyanosis. On breathing assessment, shortness of breath was found and the patient is having increased effort evident from speaking of short sentences. He patient has pain 5/10 in her Right lower chest with deep. Immediate intervention is needed to prevent to prevent decreased GCS (15/15 in patient), life threatening conditions (Velasco Howard, 2017). The circulatory assessment revealed low BP 90/65mmHg instead of normal 120/80, HR 120 bpm instead of 96 regular, The radial pulse was very weak, with skin flushed and sweaty. The capillary refill is 3 seconds. Her ECG is NAD. Immediate intervention is required as hypovolaemia, pump failure, and vasodilatation (sepsis) causes this breathing problem. Adequate perfusion is needed (Perman, Goyal Gaieski, 2012). Further patient was assessed for disability to rule out possibility of stroke. Catherine was confused to day and place. Further, assessment includes examination of patient head to toe and front and back, showed no sign of haemorrhage but the patient was bleeding as she has removed her IV line. The patient has sign of fever and is ensured to be warm. According to Zhang, Chen Ni (2015) fever, chills, confusion, difficult breathing and significant drop in blood pressure are indicators of septic shock. Thereby, focused assessment is necessary. The relevant focused assessment required in this case is related to respiratory. The red flags for focusing on respiratory assessment are chest pain and shortness of breath. Therefore, the secondary assessment is justified (Nemer Villar, 2015). The oxygen flow rate and delivery device is assessed. It is necessary as the patient demonstrated hypoxia, tachypnoea, tachycardia, hypotension, hyperglycemia condition. The delivery device must be assed as the low flow systems do not provide the adequate ventilatory requirement. The high flow system is used only when approved but meets or exceeds their Peak Inspiratory Flow Rate. Mechanical ventilation is associated with function of lungs (Perman, Goyal Gaieski, 2012). In this case the patient may ensured of high flow system. The patient is assessed for auscultation of breath and type of breath that is cough or deep. Cough is common in pneumonia, a noscomial infection. It is necessary to identify the wheezes, crackles, adequate inspiration and expiration time. Wheeze indicates the narrowed airway and respiratory distress. Sound indicates pulmonary congestion and impaired gas exchange indicates abnormal breathing. Narrowed airway, pulmonary ventilation, perfusion, is common in septic shock (sellars et al., 2016). Further, injuries to the chest wall are observed and assessed for pain, deformities, and movement of chest wall. The rationale is to rule out any clot formation due to inflammatory process. Increased capillary permeability and Vasodilatation also hampers the bodys adequate perfusion indicating sepsis. The chest pain was found to be 5/10 and may be due to clot. Fever and increased heart rate may be due to systematic inflammatory response syndrome trigged by activated immune system (Zhang, Chen Ni, 2015). It is also evident from the high respiration rate evident from the primary assessment. According to Silversides et al. (2015), presence of sepsis leads to systematic inflammatory response syndrome. Heart rate, temperature and respiratory rate are important criteria to confirm infection in respiratory tract. Two of the above criteria is fulfilled and is confirmation for sepsis. It rules out any other major insult to the body such as myocardial infarction. Septic shock is further confirmed by the hypoxemia, hypotension, and oliguria, as they are signs of organ dysfunction (Van Vught et al., 2016). Pathophysiology of septic shock Sepsis is defined as a life threatening organ dysfunction which occurs as a result of infection. The infection may be caused from a variety of conditions such as post operative treatment procedures or due to incomplete cure from a variety of medical conditions. Under sepsis conditions the blood pressure falls below the abnormal level and sufficient oxygen are not transferred to the vital organs of the body leading to ac condition of multiple organ failure (Avni, Lador, Lev, Leibovici, Paul Grossman, 2015). The septic shock leads to tissue perforations where the capillaries start to leak resulting in organ failure. It is defined by persistent hypotension requiring vasopressin to maintain a mean arterial pressure of 65 mm hg or higher and a serum lactate level greater than 2 mmol/L. The signs and symptoms of sepsis vary within the patients such as fevers, chills, rigors, confusion, anxiety, difficult breathing, nausea, vomiting etc. As mentioned by Damiani et al. (2015), the sepsis is further triggered by a variety of clinical conditions such as the presence of chest and pulmonary infections. One of the major features of septic shock is the occurrence of peripheral vasodilatation where the normal mechanisms to vasoconstrict fail in the smooth muscles. Septic shock is further triggered by conditions such as pneumonia. It affects the blood coagulation system resulting in tissue leakage. As mentioned by Liu et al. (2014), sepsis has been mostly recently related to being immune-stimulated. Under sepsis schok cellular changes becomes activated in a deteriorating fashion leading to lymphocyte apoptosis. The systematic inflammatory response syndrome is characterised by a number of clinical conditions and symptoms such as body temperature garter than 38 degree centigrade, heart beat greater than 90 per minute, respiratory rate greater than 20 per minutes along with blood white cells count greater than 12,000 /mm3 (Singer et al., 2016). Additionally the medical professio nal worldwide have further developed another acronym for dealing with the medical condition of the patient suffering from septic shock which is known as PIRO, where P stands for pre-disposition indicating pre-existing co-morbid conditions, I refers to infection, R represents the response to the infectious challenge and O stands for organ dysfunction or organ failure. The septic infection results in disseminated intravascular coagulation (DIC) (Duan et al., 2016). This disturbs the blood coagulation homeostasis resulting in blood to clot when it should not, resulting in clogging of vessels, which further restricts the blood flow in the patient. The dysfunctional vasculature results in local bleeding. Additionally, the tissue perforations results in the contents between the cells to mix, resulting in organ failure by disrupting the normal homeostasis of the body (Semler, Andrews Bernard, 2018). The sepsis shock results in the production of high amount of interleukins which result in the development of hyper inflammatory responses. The tissue in jury also enhances the levels of endotoxin which further triggers the release of cellular cytokines. The release of cellular cytokines further induces widespread secondary infection. The excessive activation of TNF ad endokines would result in suppression of activity of neutrophils, which fail to engulf the phagocytic cells (Andrews et al., 2017). The disturbed homoeostasis also affects the normal mechanism of apoptosis by delayed removal of the neutrophils and hastened removal of the lymphocytes, which further enhances the rate of the infection resulting tissue lyses. The respiratory syndrome has been associated with decreased chemotactic responses, which could be related to disrupted homeostasis of the cell. One of the most serious concerns of the septic shock is the occurrence of multi-organ failure which could enhance the chances of mortality in the patient. The pro-inflammatory and the anti-inflammatory responses lead to mitochondrial or endothelial dysfunction (Semler, Andrews Bernard, 2018). The series of septic shock also affects the normal neurotransmission in the patient. This results in loss of sense regarding time and surroundings and result in the development of utter confusion in the patient. This situation has also been referred to as encephalopathy with sepsis. In this respect, administration of glucorticoids has been seen to relive the condition of sepsis within the patient (Gawlytta et al., 2017). However, the results are debatable as no assured benefits have been obtained for the follow up of the method. Pathophysiology of experienced clinical manifestations The clinical condition of the patient could be studied over here in order to understand the deep rooted pathophysiology of the patient. The patient here depicted a number of clinical conditions as an associated symptom of septic shock. Some of these have been studied in details in order to understand the current health scenario pertaining the patient. Catherines past medical conditions shows that she had a history of cardiac ischemia. Therefore, the disturbed homeostasis owing to sepsis could have hampered the rate of neurotransmission resulting in delayed responses across the sinoatricualr (SA) node of the heart (Toan et al., 2018). The patient recorded a respiratory rate of 36 breaths/ mins. The septic shocks lead to tissue and blood vessels blockage resulting in disrupted flow of oxygen. The patient was admitted to the hospital with decreased air entry to right lower lobe. Additionally, the sepsis shock could further aggravate the condition of the patient leading to airway block. One of the most common clinical symptoms expressed in sepsis is the lock jaw syndrome which could have fatal consequences. As mentioned by Montull et al. (2016), most of the times the lock jaw happens owing to secondary infections caused by pathogens , which gain entry into the body of the patient through catherer port channels. The doctor further examined her symptoms based upon nursing scales and standards such as PEARL which refers to Pupil equal, accommodating and reactive to light. The pupil dilations were noted around 3 mm which signifies a state of anxiety or confusion in the patients. The IDC drainage bag of the patient has 30 ml of urine output which further confirms the presence of oligourea. Additionally, the medical emergency team has suggested the administration of 500 mg of azithromycin to the patient in a 2 L of normal saline solution. The purpose for the admini stration of Azithromycin was to regulate the spread of the sepsis shock infection in the patient. As mentioned by Singer et al. (2016), the use of azithromycin has been associated with more ICU free days for sepsis with or without pneumonia. The sepsis shock and resultant tissue perforations resulted in blood coagulations s directly cutting off the oxygen supply in the patient. Therefore, the patient had been feeing breathlessness. On increasing the oxygen supply the state of panting in the patient could be reduced. Therefore, the patient was put upon increased oxygen supply in order to reduce the chances of a septic shock. As commented by Andrews et al. (2017), the restricted blood flow cuts off the required amount of glucose to the brain resulting in neural shock. Therefore, administration of glucose in standard normal solutions may prevent the chances of a severe septic shock. Therefore, the glucose control acts as substantial protection of the endothelial cells. Therefore, at any point care should be taken to avoid the administration of steroids to the patient. It has seen to produce lethal consequences in the patient resulting in high mortality rates most of the times. Nursing interventions Based on the assessment and the evaluation the prioritisation of care involves oxygen supply followed by fluid resuscitation, blood culture tests and lastly antibiotic therapy. The patient may be provided with significant respiratory support. It includes monitoring and providing adequate oxygen supply. High flow system is used only when approved but meets or exceeds their Peak Inspiratory Flow Rate. In this case the patient may be ensured of high flow system. Mechanical ventilation is associated with function of lungs. The goal would be to maintain SpO2 greater than 94% (Gaudry et al., 2018). It will help reduce the shortness of breath and maximise the oxygen level for cellular uptake. When resting the patients head on bed will be elevated and the position to be change frequently. It will help lower the diaphragm. It will promote aeration of lungs by chest expansion. It will promote the mobilization and expectoration of secretions. It will ensured by nurse that the patient is conscio us and the airway is clear by regular monitoring. Active intolerance is common in this condition due to decreased gas exchange. Therefore, the care will be clustered to conserve the patients energy. It is needed for essential task like ambulation, eating, deep breathing and coughing (Silversides et al., 2015). The patient may then be provided width N/S infusion. A massive fluid resuscitation is required in patient with sepsis. As per instructions from the medical emergency team 2L of Normal Saline 0.9% STAT will be started. A large amount of fluid may be required to maintain the tissue perfusions as the oxygen intake is already low (Silversides et al., 2015). It will help support the circulating volume and overcome hypovolemia and reduce fever diaphoresis (Rastegar, 2015). Adequate precautions will be taken to prevent fluid over resuscitation. According to Semler, Andrews Bernard (2018), sepsis is a combination of arterial dilation, venodilation, intravascular volume depletion, therefore, care will be clustered to address each problem. Prior to commencing antibiotics the blood test may be conducted, as antibiotics may alter the blood test results. For Catherine, appropriate labs shall be obtained that includes antibiotic troughs, ABGs and sputum cultures. For Catherine two sets of blood culture will be taken from separate sites. It will used to check for coagulations, blood glucose level and FBE. The next assessment will comprise of lactate (venous blood gas). The rationale is to assess CRP, LFTs and ELIC. The cultures will be taken without delaying the antibiotic administration. Senior clinician will be informed immediately if unable to access IV or obtain blood cultures. Ensure the blood cultures will be properly examined for identification of appropriate pathogen. Identification of organism is crucial to effective septic shock treatment. The timings of the collection of the lab reports are essential as related to administration of antibiotics and ensure accuracy (Urden et al, 2017). These interventions will be immediately followed by the administration of the antibiotics as the responsibility of nurse. The patient will be assessed for penicillin allergy and use of antibiotics previously that may have caused any side effects. The same will discussed with concerned physician. In case of renal impairment the dosage may be reviewed. Antibiotic therapy will also be discussed with ID service. Currently as per the Medical emergency team advice, Azithromycin- 500 mg will be administered on the right time and in right dosage to ensure efficacy. The use of azithromycin has been associated with more ICU free days for the patient affected with severe sepsis with or without pneumonia. Broad spectrum antibiotics will be used such as methicillin, but the dosage will be balanced against the renal function clearance. If MRSA is detected then vancomycin may be preferred for its efficacy (Hagen et al., 2017). Followed by the above interventions the patient and the family members will be educated on energy conservations, symptoms requiring emergency care, food and nutrition and effective airway clearance as well as coughing and breathing. It is necessary create awareness among patient on these aspects of recovery. It will ensure adherence the treatment protocol and compliance to medication (Viera, 2016). To evaluate the effectiveness of the treatment, and determine the next steps, it is imperative to draw the labs promptly. It is very sensitive in sepsis treatment. Therefore, the lab studies for the neutrophils and band counts will be monitored. Bodys response to the infection is indicated by the elevation of band cells. The room temperature may be decreased as the patient has high fever. Catherine may be provided with the antipyretics and the cooling blankets to save her from chills and shivering. The nursing interventions may further involve continuous monitoring of temperature. The patient may be assisted with tepid sponge bath. According to Zhang, Chen Ni (2015) septic patient has fluctuating temperature. It is essential to maintain the body temperature as an increase in the temperature increases metabolic oxygen demands. The patients cardiac output may be monitored as indicated. The patient will be monitored of the urinary output as the decrease in urine output indicates hypovo lemeia associated with vasodilation (Viera, 2016). Further evaluation may comprise assessment of hemodynamic status, nutritional status and fluid intake and output. The patient may evaluate the patient for hemodynamic stability. It must be evaluated if the patient can verbalise the feelings and understanding of disease process. Based on the findings appropriate discharge and home care guidelines will be provided (Urden et al., 2017). Conclusion In conclusion the essay helped understand the importance of assessment and need of early findings prevent shock. The case study analysis of Catherine has developed insights into the pathophysiology of septic shock and the cause of clinical manifestations. It helped develop the care plan based on prioritisation. It was evident from case study analysis that considering the clients personal and clinical needs is essential in prioritisation of care. A comprehensive nursing plan has been developed for Catherine. The first priority is supplying adequate oxygen followed fluid volume and then performing blood tests to determine the antibiotic therapy. Lastly the treatment is evaluated to ensure positive outcomes. References Andrews, B., Semler, M. W., Muchemwa, L., Kelly, P., Lakhi, S., Heimburger, D. C., ... Bernard, G. R. (2017). Effect of an early resuscitation protocol on in-hospital mortality among adults with sepsis and hypotension: a randomized clinical trial.Jama,318(13), 1233-1240. doi:10.1001/jama.2017.10913 Avni, T., Lador, A., Lev, S., Leibovici, L., Paul, M., Grossman, A. (2015). Vasopressors for the treatment of septic shock: systematic review and meta-analysis.PLoS One,10(8), e0129305. Retrieved from: https://doi.org/10.1371/journal.pone.0129305 Brown, D., Edwards, H., Seaton, L., Buckley, T. (2017).Lewis's Medical-Surgical Nursing: Assessment and Management of Clinical Problems. Elsevier Health Sciences. Retrieved from: https://books.google.co.in/books?hl=enlr=id=Y1QoDwAAQBAJoi=fndpg=PP1dq=importance+of+primary+assessment+in+nursingots=AE6x0dvWw6sig=Rcezf35s4ow4xfumYzdcS1WXyT4#v=onepageq=importance%20of%20primary%20assessment%20in%20nursingf=false Damiani, E., Donati, A., Serafini, G., Rinaldi, L., Adrario, E., Pelaia, P., ... Girardis, M. (2015). Effect of performance improvement programs on compliance with sepsis bundles and mortality: a systematic review and meta-analysis of observational studies.PLoS One,10(5), e0125827. https://doi.org/10.1371/journal.pone.0125827 Duan, E. H., Oczkowski, S. J., Belley-Cote, E., Whitlock, R., Lamontagne, F., Devereaux, P. J., Cook, D. J. (2016). -Blockers in sepsis: protocol for a systematic review and meta-analysis of randomised control trials.BMJ open,6(6), e012466. Retrieved from: https://bmjopen.bmj.com/content/6/6/e012466 Gaudry, S., Hajage, D., Schortgen, F., Martin-Lefevre, L., Verney, C., Pons, B., ... Carpentier, D. (2018). Timing of Renal Support and Outcome of Septic Shock and Acute Respiratory Distress Syndrome.American journal of respiratory and critical care medicine, (ja). DOI: https://doi.org/10.1164/rccm.201706-1255OC Gawlytta, R., Niemeyer, H., Bttche, M., Scherag, A., Knaevelsrud, C., Rosendahl, J. (2017). Internet-based cognitivebehavioural writing therapy for reducing post-traumatic stress after intensive care for sepsis in patients and their spouses (REPAIR): study protocol for a randomised-controlled trial.BMJ open,7(2), e014363. Retrieved from:https://bmjopen.bmj.com/content/7/2/e014363?utm_source=trendmdutm_medium=cpcutm_campaign=bmjghtrendmd-shared=1utm_content=Journalcontentutm_term=TrendMDPhase4 Hagen, T. L., Hertz, M. A., Uhrin, G. B., Dalager-Pedersen, M., Schnheyder, H. C., Nielsen, H. (2017). Adherence to local antimicrobial guidelines for initial treatment of community-acquired infections.Dan Med J,64(6), A5381. Retrieved from: https://pdfs.semanticscholar.org/ca82/7b183b689e5d4b1ca86c79b0889fdc6dab56.pdf Liu, V., Escobar, G. J., Greene, J. D., Soule, J., Whippy, A., Angus, D. C., Iwashyna, T. J. (2014). Hospital deaths in patients with sepsis from 2 independent cohorts.Jama,312(1), 90-92. doi:10.1001/jama.2014.5804 Montull, B., Menndez, R., Torres, A., Reyes, S., Mndez, R., Zalacan, R., ... Bello, S. (2016). Predictors of severe sepsis among patients hospitalized for community-acquired pneumonia.PLoS One,11(1), e0145929. Retrieved from: https://doi.org/10.1371/journal.pone.0145929 Nemer, J. A., Villar, J. (2015). Septic shock secondary to pneumonia.SimWars Simulation Case Book: Emergency Medicine, 123. Retrieved from: https://books.google.co.in/books?hl=enlr=id=vxxEBgAAQBAJoi=fndpg=PA123dq=cough+and+breath+assessment++septic+shock+ots=FPkZ0NrqZOsig=ZnrQcQ0LB8QOgs2b1IPIqnGmoJs#v=onepageqf=false Perman, S. M., Goyal, M., Gaieski, D. F. (2012). Initial emergency department diagnosis and management of adult patients with severe sepsis and septic shock.Scandinavian journal of trauma, resuscitation and emergency medicine,20(1), 41. DOI: https://doi.org/10.1186/1757-7241-20-41 Rastegar, A. (2015). Rational fluid therapy for sepsis and septic shock; what do recent studies tell us?. Retrieved from: https://pdfs.semanticscholar.org/11ad/9d45d0fc0823ad0ba282e548abc6e Sellars, J., Hernndez-Gonzlez, F., Lucena, C. M., Paradela, M., Brito-Zern, P., Prieto-Gonzlez, S., ... Snchez, M. (2016). Auscultation of velcro crackles is associated with usual interstitial pneumonia.Medicine,95(5). Semler, M. W., Andrews, B., Bernard, G. R. (2018). Early Resuscitation for Adults With Sepsis in a Low-income CountryReply.JAMA,319(6), 614-615. doi:10.1001/jama.2017.20410 Silversides, J. A., Ferguson, A. J., McAuley, D. F., Blackwood, B., Marshall, J. C., Fan, E. (2015). Fluid strategies and outcomes in patients with acute respiratory distress syndrome, systemic inflammatory response syndrome and sepsis: a protocol for a systematic review and meta-analysis.Systematic reviews,4(1), 162. Singer, M., Deutschman, C. S., Seymour, C. W., Shankar-Hari, M., Annane, D., Bauer, M., ... Hotchkiss, R. S. (2016). The third international consensus definitions for sepsis and septic shock (sepsis-3).Jama,315(8), 801-810. doi:10.1001/jama.2016.0287 Smith, D., Bowden, T. (2017). Using the ABCDE approach to assess the deteriorating patient.Nursing Standard (2014+),32(14), 51. DOI: 10.7748/ns.2017.e11030 Toan, N. D., Darton, T. C., Boinett, C. J., Campbell, J. I., Karkey, A., Kestelyn, E., ... Hung, N. T. (2018). Clinical features, antimicrobial susceptibility patterns and genomics of bacteria causing neonatal sepsis in a childrens hospital in Vietnam: protocol for a prospective observational study.BMJ open,8(1), e019611. Retrieved from:https://bmjopen.bmj.com/content/8/1/e019611?utm_source=TrendMDutm_medium=cpcutm_campaign=BMJOp_TrendMD-0 Urden, L. D., Stacy, K. M., Lough, M. E. (2017).Critical Care Nursing-E-Book: Diagnosis and Management. Elsevier Health Sciences. Retrieved from: https://books.google.co.in/books?hl=enlr=id=VIglDgAAQBAJoi=fndpg=PP1dq=nursing+interventions+for+septic+shockots=jQsaM68sQesig=Z7PrOKLXdzP0NKFBkfDnMPJVmgQ#v=onepageq=nursing%20interventions%20for%20septic%20shockf=false Van Vught, L. A., Klouwenberg, P. M. K., Spitoni, C., Scicluna, B. P., Wiewel, M. A., Horn, J., ... van der Poll, T. (2016). Incidence, risk factors, and attributable mortality of secondary infections in the intensive care unit after admission for sepsis.Jama,315(14), 1469-1479. Velasco, C. E., Howard, C. (2017). Trouble on Both Sides: Pulmonary Embolism with Pneumothorax.The American journal of medicine,130(5), 530-533. DOI: https://doi.org/10.1016/j.amjmed.2017.01.009 Viera, A. (2016). Preventive care in adults: Strategies for prioritization and delivery. Retrieved from: https://www.uptodate.com/contents/preventive-care-in-adults-strategies-for-prioritization-and-delivery Zhang, Z., Chen, L., Ni, H. (2015). Antipyretic therapy in critically ill patients with sepsis: an interaction with body temperature.PLoS One,10(3), e0121919. DOI: https://doi.org/10.1371/journal.pone.0121919

Situation Ethics as an ethical theory Essay Example

Situation Ethics as an ethical theory Paper Situation ethics is an alternative ethical theory, particularly influential in Protestant Christianity, similar to utilitarianism, in that it is a way a deciding upon the correct action that is to be taken in a given situation, but where happiness has been substituted for love. It does however take an individualistic approach, with the emphasis being upon each person, rather than on looking after the majority, as is the case in utilitarianism. The theory is based on love, and revolves around doing the most loving thing for the greatest number of people. It is teleological which means that is consequential and not based on rules. St. Augustine of Hippo Regius was one of the first to articulate this theory, love and do what you will, however it is more closely associated with Joseph Fletcher. An American professor of ethics, Fletcher developed Situation ethics as a result of his critique of Legalism and Antinomianism. Fletcher disliked like the way in which so many ethical theories, such as utilitarianism, were based upon and around a basic set of rules; that is to say, that they take a legalistic approach. He believed that this was too rigid, and that it did not allow for exceptions. He also firmly disapproved of antinomian approaches where there are not fixed moral principles and where one should act spontaneously, because it Rejects the idea that there are any authoritative laws, rules or regulations that you ought to obey in a decision-making situation. Rejecting these ethical models, he proposed a more relativist version. We will write a custom essay sample on Situation Ethics as an ethical theory specifically for you for only $16.38 $13.9/page Order now We will write a custom essay sample on Situation Ethics as an ethical theory specifically for you FOR ONLY $16.38 $13.9/page Hire Writer We will write a custom essay sample on Situation Ethics as an ethical theory specifically for you FOR ONLY $16.38 $13.9/page Hire Writer He circulated this theory in the 1960s, having used his beliefs and concerns to come up with, what he believed, was a fair way of deciding what the right action to take in a situation should be. Instead Fletcher used love as a general rule in decision making; not storge love, to love a country or place; not philia love, to love a family member or friend; and not eros love, to make love and to lust for someone; but instead agape love, unconditional and self-giving love, as is demonstrated by Jesus dying upon the cross. To Fletcher, agape love was fundamentally sacrificing, without any reward or pleasure, as the teachings of Jesus are told in the Bible, and he took a lot of his ideas from this. The quote in Matthew saying, Love your neighbour as you love yourself, epitomises what agape is all about; where agape love is the ultimate duty. He believed that something could be determined as good or evil, depending on whether or not love had been fully served. Fletcher made four presuppositions before setting out his theory: i) Pragmatisim the course of action must work towards an end, where love is that end. ii.) Relativism there are no fixed rules that must be obeyed, but all decisions must be relative to Christian love. Fletcher is quoted as saying, that Situation ethics relativises the absolute, it does not absolutize the relative. iii.) Positivism this can be divided into two categories; natural positivism, where reason deduces faith from natural phenomena or human experience, and theological positivism, where reason works within faith as opposed to being the basis for faith. Though religious knowledge or belief can be approached in either way, people must understand that love is the most important thing. iv.) Personalism situationists put people first, asking what to do to best help them, instead of putting laws first as a legalist would do. Value is only added to something when it is useful to love (working for the sake of persons). In addition to these, Fletcher proposed six fundamental principles: 1.) Only one thing is intrinsically good; namely love: nothing else at all. Love is the only thing that is good in itself, and is good in all situations. In other words, an action is good if it expresses love for others, and bad if it doesnt. 2.) The ruling norm of Christian decision is love: nothing else. You are only required to follow laws, rules and regulations if they serve love, therefore it replaces, and cannot be equalled by, any other law. Good actions should not be done for reward, but for their own sake. 3.) Love and Justice are the same, for justice is love distributed nothing else. Love and justice cannot be serperated from each other, as justice is love at work for the whole community. 4.) [L]ove wills the neighbours good, whether we like him or not. Love is not sentimental or erotic, but driven simply out of desire for the good of the other person. 5.) Only the end justifies the means, nothing else. To ensure that the end is the most loving result by weighing up the consequences of moral actions, we are sure to make the most moral decision. 6.) [L]oves decisions are made situationally, not prescriptively. If an action will bring about an end that serves love most then it is right, and this decision (of which action to take) is made depending on and relative to the situation at hand. 2.) How far does it succeed as a strong ethical theory? For some Christians, Situation ethics appears as the perfect theory, as love is at the heart of the morality, which harmonises with the teachings of Jesus. Even the idea of an act done for love rising in superiority over all rules is supported by Jesus teachings, as he taught Paul that love is the highest principle above the Law. Fletcher argues that, because Christianitys God is a personal one, its moral approach should be centred around human beings too, as opposed to focusing on a worship of laws and principles. Additionally, a key strength this theory possesses is flexibility, and many argue that it allows for pragmatic decisions to be made without having to follow rule-based ethical systems built on absolute commandments, which means that exceptions can be made. For example, Roman Catholics deduce their morality from Natural Moral Law, and believe in the sanctity of life (where life is sacred and must be preserved). Therefore if a terminally ill patient in a hospital desired to be allowed to die to end his suffering, a Roman Catholic would deem this immoral. However someone following the guidelines of Situation Ethics may be able to grant the patient their wish, if it was the most loving thing to do in that situation. However, despite its evident strengths and popularity, Situation ethics has been criticised on a number of important points. Perhaps the most damaging attack is the assessment of this theorys practicality. Fletcher argued that in order to do the most loving thing in every situation we must look at the long term consequences of the options available to us. Unfortunately, this is incredibly difficult; some claim it is impossible. As limited human beings, we are not gifted with perfect foresight. We simply cannot accurately predict the consequences of an action, as there are always a large number of factors, some of which we may even be unaware of, and the required calculations are by and large far too complicated to be done at all, let alone on the spur of the moment in a pressing situation. Some argue that this renders Situation ethics unpractical as an ethical theory. Another devastating attack on Situation ethics is the argument that love is subjective; that it means something different to every individual. What this means, is that in a given situation one person may calculate the most loving thing to do by using Situation ethics, yet another person may perform the same calculations, using exactly the same guidelines and principles, and arrive at a different result. We can also enter into this the actuality that peoples emotions and feelings change daily, so the morals that we hold one day may have changed by the next. The undeniable fact that love does not mean the same thing to everybody calls into question the supposed universality of the theory. In addition to this, Situation ethics can in theory allow acts such as murder, lying, cheating and stealing, for if they were done in the name of love and produced the most love for the community, then by Situation ethics they would be announced morally just. For example, it is generally considered wrong to steal a gun, but if by stealing that gun you prevented the murder of numerous people then your action would be justified, as you had acted in order to serve love. Your theft is non-accountable, as in fact the only accountability in Situation Ethics is whether your actions will result in the highest possible expression on love for others.