Monetary Policy (Macroeconomics) Research Paper Example | Topics and Well Written Essays - 250 words

Monetary Policy (Macroeconomics) - Research Paper Example One of the impacts could result from a spike in Treasury yield, creating a need to raise government spending. This has a direct impact on social development as it involves spending more tax-payer’s money (http://www.ny.frb.org, n.p). In relation to societal issues impacted by the policy, the article indicates that such changes could spike up credit excesses leading to a scenario of financial instability as witnessed during the period of the Great Recession (http://www.ny.frb.org, n.p). The financial instability could be as a result of jeopardized debt ratios as well as increased amount of internal debts. On the other hand, scaling back the Federal Reserve’s Economic value has a great impact on Emerging Market Economies (EME’s). To begin with, it would lead to the reduction of the Federal Reserve’s Liquidity Cushions on foreign exchange creating a scenario whereby foreign investors withdraw their investment capitals. In addition, it would lead to a scenario of jeopardized financial stability within foreign markets thus creating vulnerability in their levels of development (http://www.ny.frb.org, n.p). "U.S. Monetary Policy and Emerging Market Economies - Federal Reserve Bank of New York." U.S. Monetary Policy and Emerging Market Economies - Federal Reserve Bank of New York. N.p., n.d. Web. 20 July 2014.

Ethics of the Sale of Body Parts Essay Example | Topics and Well Written Essays - 1250 words - 2

Ethics of the Sale of Body Parts - Essay Example These laws prohibit the sale of body organs but allow individuals to voluntarily donate their body organs (parts). The Uniform and anatomical Act is the most ancient law having been formulated in 1968, to regulate the national distribution and donation of body parts. This act offers individuals an opportunity to voluntarily donate their whole body or part of it, and hospitals and medical institutions have an opportunity to accept such donations (Organ Donation Law, 2012). This law allows citizens of sound mind and who are of legal age to engage in voluntary organ and tissue donation (Organ Donation Law, 2012). According to the law, individual who expect to donate their body parts, must record their intensions most probably in a will (Organ Donation Law, 2012). The donation form should be signed by the potential donor in the presence of two other people. In case the dying patient is unable to write, he or she can indicate his or her intensions orally but in the presence of at least tw o people or; he or she can inform the attending doctor. However, the attending doctor cannot perform the actual organ removal or transplantation of the donated organ. In addition, close family members or guardians have a limited legal mandate to allow their dying patient’s body parts to be donated. ... , research and educational institutions; or individuals who meet all the requirements for receiving the organ or body part(s), the permission to accept donated organs. Ethical issues associated with legalization of the sale of body parts (Phadke & Anadh, 2002). Exploits the poor The legalization of the sale of body parts will lead to situations that exploit the poor. Middlemen involved in the sale of body parts will end up obtaining body parts for sale from unsuspecting poor individuals at a cheaper price. With an increase in the demand for body parts, such middle men may end up selling the body parts at a much higher price. Jeopardizes human dignity The sale of body parts is an act that reduces human dignity. It equates the human body to money. It is morally wrong to exchange human body parts for money. Commercializes the human body Commercialization of the human body is an immoral act. The human life and body are God given and cannot be commercialized. Deters altruism retarding the living-related and cadaver transplant programs The legalization of the sale of body parts will discourage individuals with intentions of donating their body parts to other persons in need. Such individuals may feel discouraged in case they realize that their voluntarily donated body part was commercialized. This will profoundly affect current cadaver transplant programs. Goes against medical professional ethics Medical professional are charged with the responsibility of safeguarding human life. Medical ethics does not allow for the commercialization of the human body. Since the legalization of the sale of body parts will allow its commercialization, it will have gone against the medical code of conduct. Ethical Theories: legalization of the sale of body parts Ethical code of conduct lies

The Doctrine Of Judicial Precedent Essay Example | Topics and Well Written Essays - 1750 words

The Doctrine Of Judicial Precedent - Essay Example Nonetheless, decisions in the divisional courts influence the decisions of judges sitting individually in several cases. Another section involves the Crown Court that remains bound on the judgments delivered by juries sitting in both the House of Lords as well as the Court of Appeal. It is also worth applying judgments by individual judges presiding over cases in the Crown Court to make deliveries by High Court judges. Magistrate and county courts do not precedent authorities and remain bound by decisions in the superior courts. Each case in the courts must have obiter dictum that constitutes a statement made in the process of delivering judgment and the ratio decidendi, which entails the major factor resulting from the decision. The corridors of justice also have other sources carrying persuasive authority and include books among them Bracton thirteenth century, Glanville twelfth century, Blackstone eighteenth century, as well as the Coke seventeenth century. Summarily, it is of con sequence to note that common laws do not need their binding authority using a single act of parliament enactment. However, it requires a series of enactments. The essence is not on the quantity constant changes, but on the process through which the same law develops starting from the ratio decidendi in several cases. Sometimes cutting an exact difference between obiter dicta and ratio decidendi becomes difficult because they flow in a continuous manner. The fact is that the law did not develop in a single law-making exercise.

Electronic Health Record Essay Example for Free

Electronic Health Record Essay In the proposed scenario, a Clinical Nurse Specialist (CNS) with a Post-Masters Nursing Informatics Certificate has decided that the 100 bed hospital that she works in would benefit from transitioning from paper charting to using an electronic health record (EHR) system. She has done initial clinical research and has a solid foundation of best-patient-practice reasons that support this change. She has also researched and studied the information on the government’s websites HealthIT.gov, and CMS.gov pertaining to the American Recovery and Reinvestment Act and the Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009. HITECH is a stimulus package approved by the US government allowing $19 billion dollars to be divided between hospitals and doctors â€Å" who demonstrate â€Å"meaningful use† of electronic medical records†(ARRA HITECH Solutions, 2015). She knows that the best way to select and institute an EHR is to assemble a team of members with various specialties pertaining to the goals outlined in the stages of HITECH. Stage 1- Data capture and sharing, Stage 2- Advance clinical processes and Stage 3- Improved outcomes. Each of these stages has it’s own meaningful use criteria. As seen in the diagram to the  left. The CNS begins by choosing the members of her team from various disciplines in the hospital. Because this will mean corporate wide changes and adoption. Her list includes the following, from the IT department, a Clinical Nursing Informatacist- chosen for a specialty in how nurses interact with software and what is required for nurses to effectively care for patients, and the Director of Clinical Informatics- chosen for an overall knowledge base of the hospitals informatics resources and requirements including what software and hardware is currently available, what has worked or failed in the past and what changes will need to happen to keep the hospital compliant with patient privacy and safety regulations. She will also need a Corporate Project Manager to organize and disseminate information to the various off-site entities related to the facilities that will need to be on board with this change across the corporation. A Chief Medical Information Officer will be key in providing the perspective of the physicians and their particular needs and goals, and to be a liaison for the staff physicians when the EHR rollout occurs. A Chief Information Officer will bring knowledge about the hospital’s day to day functions that will need to integrate into the new EHR along with how those systems currently function. A Chief Nursing Information Officer will have their finger on the pulse of each nursing unit and be aware of the different user interface requirements that will be needed by different departments for the the specific type of flow and care given. Lastly, a Chief Financial Officer will be able to guide the team on topics concerning governmental funding and current assets along with helping to create and maintain a budget as required with the acquisition of new software and hardware, he will also be able to work with each department’s budget makers when the time comes for allocating training hours and equipment purchases. Along the way the team will need to bring in sub-specialists to give information and feedback as they hone the new system, but for now the assembled team will be responsible for researching, choosing and implementing the best EHR for their hospital. A.2 a-e) Choose 2 real-life computerized management systems and analyze them by comparing their advantages and disadvantages, recommend the best choice to meet the ‘MU’ requirements, describe how the features of the recommended system meet the guidelines outlined in the three stages of meaningful use, describe the impact on quality of patient care, documentation and outcomes. The team is aware that currently they have a computerized system that they use for reporting and tracking labs, radiology and scheduling, but all documentation is paper based. They consider the price point involved with adding modules to the existing McKesson software vs purchasing and implementing an entirely new EHR called EPIC. EPIC appears to be user friendly and able to seamlessly connect all of the facilities under the umbrella of their corporation. They make a list of some of the pros and cons associated with each system. McKesson has the upside of being a system they have already worked with and it has different programs that can be pieced together to meet some of the meaningful use (MU) criteria for compliance. They already have a working relationship with this vendor and some experience with the product. Once the discussion gets going, the team realizes that there are many more bad points than good with McKesson. In their experience, the software modules are connected in a piecemeal fashion that makes it difficult for programs to interface. Quite frequently data is just lost and not retrievable. There are different data entry systems for the different types of departments i.e. OR, ER, labor   delivery, Med/Surge, radiology, and pharmacy. The different systems do not allow for across the board data harvesting and that makes it difficult and time consuming to track reportable nursing and CMS indicators. The aesthetics of McKesson are something that is frequently complained about by the staff, due t o lack of distinctive color transition and eye fatigue. Lastly, the group is very reluctant to continue on building their EHR base with McKesson because the PCPs in the area will not be able to access hospital records, and office visit information will not be available to the hospital based staff. Due to the need for increased man hours in servicing McKesson, lack of discrete data sampling, and the poor continuity of care related to PCPs not having access to hospital data and vice versa, the team decides to choose Epic instead. Epic has the down side of being a system that will require a large initial outlay of funds. The hospital will have to purchase software, and related hardware. They will have to expand the IT and biomedical engineering departments to support and maintain the new system and equipment (something that would have been necessary to a smaller degree with McKesson). They will have to address some retrofitting needs related to wiring and computer instillation and lastly training will be a very big issue. Despite the potential down sides, the team comes up with a long list of reasons that EPIC is the right system to choose. To begin with EPIC is all one system. It allows for seamless interdepartmental interfacing. The PCPs in the area already use a version of EPIC and this will allow for easy data exchange and a patient’s information will follow them easily. The EPIC system has a medication reconciliation form that is easily viewable to all care givers and pharmacies in the area, keeping track of each patients reported medication dose and frequency. EPIC has a ‘my chart’ feature that allows patients see labs, after visit summaries , and to interact with physicians about scheduling, medications and lab results. EPIC has  many built in safe guards, including password protection, continuous backup and recovery programs so no dat a is lost, and the vendor provides continuing support as needed. EPIC comes in 3 pre-bundled, customizable templates, each already set up to meet the Meaningful Use (MU) criteria without having to alter the program. The team can look at the three available options and determine if one fits them perfectly, or find the closest one and alter it to fit their specific needs. Some examples of how EPIC will meet the Stage 1 MU criteria are computerized physician order entry, checking for drug interactions and allergies automatically, tracking demographics, keeping current diagnosis, medication and allergy lists, allowing patients to have electronic access to discharge summaries, and it gives patients electronic access to physicians. Once the hospital has used EPIC for at least two years, some examples of how EPIC will help meet the Stage 2 MU criteria are ongoing patient data entry and discreet sampling for report generation. The team will continue to develop the software that demonstrates interoperability in sharing of lab results with other providers and systems. Security risk assessment will be ongoing and built into the system. Smoking status will be tracked on all patients 13 and older and the EPIC software is designed to guide the facility from meeting the Stage 1 criteria to meeting the Stage 2 criteria. Stage 3 MU objectives are projected to improve outcomes. The team is waiting on the final ruling for what the Stage 3 guidelines will be and in the mean time they have a projected goal of focusing on primary prevention measures and improving overall population health. This will include recommended vaccination reminders, smoking cessation assistance, healthy lifestyle and meal planning recommendations, and yearly checkup reminders generated by primary physicians that will crossover to hospital patient charts. Some of the better benefits of EPIC include point and click tabs in the assessment fields, this allows for discrete sampling of information. EPIC utilizes a reporting workbench that will harvest requested, reportable data  and assemble it into a user friendly template. This will benefit the hospita l by reducing former man-hours required to find and collect data for clinical quality measures, public health reporting, and CMS indicators. Discrete data sampling from EPIC will make the hospital a benefit to the community as well by allowing it to track trends and provide information to community health nurses. EPIC comes with the ability to establish hard stops and reminders that allow real-time users to be aware of needs for care coordination and patient specific follow-ups or recommended testing related to treating chronic conditions. It will also allow for symptom driven order entry fields to be immediately available in emergent situations where time taken to look for those things could mean a worse outcome. This is especially important when people present with symptoms of stroke or heart attack. Another EPIC benefit is the different levels of bedside specific PHI protection related to sensitive care. EPIC has a ‘break the glass’ functionality pertaining to all sexual assault and psychiatric admits. This function only allows relevant staff to open and view these patients charts, any others are shown a pop-up warning and a notice is sent to start an investigation of any other person who logs in to theses charts. The team is impressed with the information provided by EPIC concerning scanning patients and medications at the bedside and the reduction in medication errors this causes. The scanners will integrate with the medication dispensing machines already in use at the hospital. One of the major benefits of EPIC is the order entry build. Each physician, with a minimal amount of training, can customize the order entry process to reflect their needs. Medication orders are instantly linked to a pharmacist to double check for allergies, and correct dosing information, and then the medication becomes available, via PYXIS machines on the unit for the RN to administer at the bedside. The bedside dosing requires the patient and medication to be scanned, further eliminating potential erro rs, and provides a pop-up warning if an emergency override is required during any of these steps. While the team acknowledges that training and time to become familiar with the new charting and bedside routine changes will initially impact patient care in a negative way, they have a plan in mind to keep the patients educated on the new system changes and the anticipated better care available to the patients across the board from instituting an EHR system. Having the patients ask questions and give real time feedback will help the team tweek their training and bedside routines to give better, more organized care that results in trackable outcomes. This is just an overview of some of the many functions EPIC has that persuaded the team to choose it as the new EHR system for the hospital. (EPIC and McKesson related information was culled from the authors own experience with the systems and personal interviews with multiple members of the informatics department at St Francis Hospital, Indianapolis campus). A.3 a) Use of Quality Improvement Data EPIC has point and click assessment tabs and a standardized documentation format that links related data. This allows for discrete data sampling related to things like CMS indicators. The hospital will be able to track compliance with things like ‘door to EKG’ times in the emergency department, Foley catheter use and resultant CAUTIs, and the time from when a patient presents with stroke symptoms until a cat scan is done and/or whether the patient receives antithrombolytics as a result. The hospital will also be able to generate reports on errors that occur the via the Risk Monitor Pro incident tracking software. This will allow them to continue researching and improving processes. A. 3 b) Security Standards and Methods EPIC has 24 hour monitoring of staff use while logged in, and the records they access. This is important because hundreds of staff members will be using the system and there has to be accountability if employees were to look up their own records, or the records of friends or family. This  information can be tracked and the employee interviewed and disciplined if needed. EPIC also comes equipped with incident reporting software called Risk Monitor Pro. All staff members are encouraged to use this format to report any incident that might warrant further investigation. It covers every location, type of employee, type of equipment, patient, visitor or vendor. Risk Monitor Pro forms are used to report potential or perceived injuries, faulty equipment, sentinel events and things that have the potential to cause harm or damage. This information can be followed up on by the risk management team, so that process improvement is an ongoing process. The team works with members from the IT department and plans for primary data storage with a redundant back up storage unit that simultaneously updates so if the primary server fails there is no loss of information. They have also planned for a second, off site data storage center that can be used in case of emergency to ensure continuity of services, and keep things up and running while the primary system is off line for upgrades. Lastly back up tapes will be kept at a third site in case both of these areas are compromised, and the system can be rebooted and running again within 72 hours. A. 3 c) Explain how the system will protect patient privacy and meet HIPAA requirements EPIC will protect patient privacy in a number of ways. End User access is limited to only being able to access the information needed to do their jobs. Making the accessible information different for nurses, physicians, registration clerks, radiology technicians, committee members etc. Personnel will only be granted access once they have completed security training and have signed documentation stating that they understand the legal risks and responsibilities when accessing protected health information (PHI). Individuals outside the hospital will have access to EPIC as well, for example nursing home physicians. They will have a read only access granted, but will require multiple patient identifiers to access the information. Also, as mentioned earlier, EPIC will employ security related  chart hard stops like ‘Break the Glass’. A. 3 d) Explain how the recommended system meets HIPAA requirements EPIC helps to meet HIPAA requirements with automated enforcing of access policies, and pro-active alerting that links directly to the risk management department, requiring strong password policies, and automatic logout at end user work stations. EPIC allows providers to protect the integrity of data and recover original data in the case of it being altered or damaged. EPIC users are required to have appropriate training to be able to access the system, and can be locked out in the case of termination. Portable devices carry encryption software that does not allow for third party data extraction or access. EPIC can also quickly generate reports with discrete sampling related to various forms of access. The majority of compliance will be the responsibility of the staff with written policies, documented sanction programs and investigation that is on-going, consistent and documented. A. 3 e) Describe how adopting the system will reduce costs to the organization Instituting this new system will initially generate more costs, but in the long run will save the hospital money in many ways. Meeting the ARRA/HITECH Act requirements will help to offset those cost with financial incentives and avoiding fines and penalties. Having readily available test results will decrease the costs and labor associated with repeating lost or illegible results. With superior organization and data summary tools, the cost for labor associated with studying charts individually and generating reports will be exponentially lower. The need for transcriptionists will be greatly reduced by utilizing dictation software. Facilities for storage of paper charting cost money for upkeep and staffing. An electronic database should make billing and insurance claims easier to process and thereby generate revenue faster. The time it takes for physicians to spend going over complicated medical histories with patients is greatly reduced by  having that information readily available in a database. â€Å"According to a recent study, when hospitals rely on advanced electronic health records they can save up to 10 percent per patient admission† (Advanced EHR Cuts Hospital Costs By 10% Per Admission, 2014). 4. A) Explain why active nursing involvement in the planning, selection, and implementation of the systems is important to the success of the implementation process and meeting meaningful use requirements Active nursing involvement is important to the success of implementing any process that affects care given at the bedside. For the system to be optimized for use, nursing suggestions and feedback are critical. EPIC knows this and has a team of nurses on staff to work with the facility  in developing end-user interface. ‘Nurses’ from the hospital include the advocates, CNS’s, NP’s, LPN’s, managers, and bedside care givers, each with a specific focus and experiences that are valuable when helping to decide how charting should work. Any thing that pulls a nurses attention away from the patient, or is distracting or difficult to work with decreases the perceived level of care and increases the potential for errors. The health care goals of meaningful use include improving efficiency, safety and quality while decreasing discrepancies, involving patients and their families in their care, improving public health outcomes, improving care coordination, and advancing security and privacy of PHI (Gregory Klepfer, 2010). All of these things are the foundation of every interaction a nurse has with a patient. This is why nursing is one of the most trusted professions, according to the Gallup pole website, nurses come out on top at 80% when people were asked to rate â€Å"the honesty and ethical standards of people† in different given fields (Honesty/Ethics in Professions | Gallup Historical Trends, n.d.). Because standard nursing care already meets the goals outlined for meaningful use, the most important thing the average  nurse can do is to work hard to be competent utilizing the selected EHR software. Advanced users and nurse leaders are important to help guide the EHR selection process in the direction that will improve the bedside interactions and user interface. Clinical nurse specialists have advanced educations and bring the nursing philosophy to the selection and implementation process. All of these roles are vital to the success of any EHR implementation.

William Wordsworth Essay -- essays research papers

William Wordsworth William Wordsworth was, in my eyes one of the best know romanticist writers of his time. Most of his pieces talk about nature and religion. He, like most romantic poets of his time revolted against the industrial revolution and wrote many pieces about nature in order to go up against it. During the industrial revolution there were many factories being built up that took away most of the open countryside that everyone enjoyed. In these factories, workers were given long hours and little pay for their harsh working conditions. Wordsworth saw this and was appalled at how the factories could first come and take over the land and hire workers for practically no pay and long hours, so he wrote about nature to rebel against the factories. He wrote these poems to let people escape the reality of their lives and have something that was positive to live for. Wordsworth is considered a romantic because his writings were very imaginative, emotional, and visionary. He regularly discussed poetry with his friend Samuel Coleridge, who at the time was also a romantic writer. In their time as friends they wrote and discussed many poems, which later led to the writing of a prelude for his wife whom he had four children with. Originally Wordsworth was from England and was born in 1770 and graduated from Cambridge University. After he graduated he began his work on the idiom of the eighteenth century, which rebelled against the industrial revolution. Dorothy Wordsworth, Wi...

Developmental Paper Essay

bstract The basis of this paper will outline the cognitive and personality development of a young adult female, identified as â€Å"Caroline.† This will be in contrast and comparison to Erikson’s Epigenetic Theory of Personality Development is Intimacy vs. Isolation and Piaget’s Theory of Cognitive development. The paper will address what outside factors influence the developing as well as nursing interventions that will help Caroline obtained optimal functioning for each appropriate developmental level according to Erikson and Piaget. Keywords: developmental, Erikson, Piaget, personality, cognitive, intimacy, isolation, formal operations The Developmental Level: For the purpose of this paper, I will identify the person I am outlining as â€Å"Caroline.† Caroline is a young adult. The developmental level during this stage of Erikson’s Epigenetic Theory of Personality Development is Intimacy vs. Isolation; the virtue being love. A normal adult in this stage will have a strong sense of self and be able to form intimate, close relationships with other individuals. Success in this stage will lead to strong committed relationships (Cherry). Erikson believed that a person must successfully complete one stage in order to complete the next. According to Piaget’s Theory of Cognitive development, Caroline is in the formal operations period. A normal young adult in this stage would manifest adult like thinking, is not limited by own perception or concrete references for ideas, combines various ideas into concepts, develops morality or restraint and cooperation in behavior, uses rules to structure interactions in a socially acceptabl e way, solves problems mentally and considers alternatives before acting, relates concepts or constructs not readily evident in external world, increases intellectual ability to include art, science, humanities,  religion, and philosophy, and is increasingly less egocentric. Caroline is in her early adult hood years. A tremendous time for self-discovery, independence, and in some cases, loneliness. Caroline’s personality and cognitive development have blossomed in ways and have been hindered in others. This is due to many factors; biological, social, genetic, situational. The list goes on. One thing is certain, there is always a good reason why individuals do the thing they do. If we as people look beyond others actions and instead look at what causes their actions to manifest, I believe we would be much more accepting and less judgmental as a whole. Throughout this paper I will be discussing ways Caroline compares and contrasts to Piaget and Erikson’s theories, how this impacts her development, and nursing interventions that could help her through these stages. Compare and contrast: After careful observation of Caroline, it does not show evident that she has developed a true sense of self to be able to complete the stage of intimacy with another individual. Even with platonic friendships it seems that when her and an individual start to become close on more of a spiritual and emotional level, she retreats to isolation because she feels that she cannot trust herself or others. According to Piaget’s Theory of Cognitive Development, I see that Caroline is mastering the formal operations period to a certain degree. In many ways Caroline would be a poster child for what an example of someone in the formal operations period would think like, and in other aspects of the period, she does not show to be operating in this period what so ever. Three examples of how Caroline compares to these levels would include the following: 1. When it comes to romantic relationships, Caroline strives for a deep emotional and physical connection with another human being. However, deep down she is unable to fully commit to another because she doesn’t have a clear understanding of who she is. Subconsciously, she gravitates towards men that are not emotionally available. This includes anyone who is in a relationship, is going to move away, or is obviously not interested in giving her a committed relationship. She wants the commitment, but she is used to men in her life not being available so she is drawn towards that because that is what she is used to. At the end of the day, this leaves Caroline frustrated and isolated. The  crisis between intimacy and isolation, according to Erikson, is clear in Caroline’s life. 2. Caroline is extremely cognitively driven, artistic with her words, and philosophical and spiritual with her beliefs. She looks beyond the world that is seen and challenges her way of thinking with the unseen world. She finds happiness through her writings and connections through spiritual conversation. This side of her is a small glimpse of her essence and what her inner being craves; to be emotionally, artistically, and spiritually stimulated. This very much so aligns with Piaget’s Theory of Cognitive Development. 3. A contrast to the Formal operations period is that she does not seem to solve problems mentally and considering alternatives before acting. Caroline bases a lot of her talk on impulsivity and is emotionally driven when making decisions. Caroline is a â€Å"feel good† kind of gal, and if it feels good in the moment, she will grab it. If it does not feel good, she will alter whatever her situation is to make herself feel good, no matter how bad or good the outcome will leave her. This contrasts with the norm because someone who is successfully mastering this stage would weigh the outcomes before acting, consider the outcomes, and go towards which action would better benefit their being as a whole. Even though Caroline knows something is hurting her, she will continue to repeat this action, hoping for a different outcome. This is mainly in regards to abusive relationships, but can be applied to the work place and friendships with other females. What Impacts Development Three factors that have or are currently affecting Caroline’s stage of development: 1. As I mentioned previously, it is vital for Caroline to develop and true sense of self before she can successfully build intimacy with other individuals. Caroline feels whole with her writings, and spending time with people who truly love her, but she has not fully embraced her inner being. From observation, Caroline has a very low self-esteem. She strives to please others. When others are pleased with her, she is pleased with herself. When others are no pleased with her, she will do what she can to reverse that opinion. She seeks to please others before pleasing herself and that is a clear manifestation of not having a concrete, strong sense of self. 2. Caroline is far away from her family, which live several states away. She stayed in the state she resides because of a romantic  relationship. This romantic relationship has ended. For Caroline, she does not have a firm sense of belonging a t her current location. Being away from loved ones and not having a steady partner can cause an individual to feel isolated and lonely. 3. I am not sure exactly what Caroline’s relationship with her father is or was like, but I would imagine it to be one of low emotional or spiritual connection. Her dad was most likely not a constant in her life and not available to her as a girl in was that she needed, but was not aware of. There is always a good reason why people do the things they do and I would not be taken a back if Caroline was this way with other men in her life because normal to her is not available. Her body, soul, and mind is used to inconsistency and has developed patterns within itself to be drawn to these inconsistencies and behaviors. It has also been shown that engaging in sexual activates with a partner before the proper time, especially before monogamy, can cause much inner turmoil and depression. Sexual activity must be performed in the right context in order for it to be beneficial for the human being. (Carter) Nursing interventions: 1. Before talking to Caroline, if she were my patient and I the nurse, I would first need to assess her physical and mental status. She would need to be fully alert and oriented in order to proceed with the nursing process. I would assess her level of consciousness and willingness to cooperate. I would need to assess her support system, whether it be family, friends, or coworkers. A strong support system is vital to growth and development in any stage of life. 2. In order for Caroline to be eager to listen to what have to offer and cooperate with enhancing her inner self, there would have to be established trust. I would do this by sharing intimate parts of my life and laying the foundation of a healthy, trustworthy relationship. There will be little to no willingness to exchange in such personal matters until trust between us is established. It will also make her much for comfortable to share intimate details of her life with me. 3. I would provide Caroline with therapeutic communic ation. This would include appropriate touch as much as she is comfortable with, paraphrasing, asking open ended questions that encourage communication, maintaining eye contact when appropriate, and not pushing situations when she does not feel at ease. These actions will hopefully cause Caroline to feel more comfortable to share thoughts,  feelings, and encouragement to implement action to better her inner self. 4. In order to master the stage of isolation, Caroline needs to be confident in herself and cater to her inner self. She needs to participate in activities that benefit her in a healthy way and bring healing to where she feels broken. I would encourage her to write in her journal for at least thirty min before she goes to bed. 5. I would encourage her to do simple things to increase healthy living. This would include waking up early, going to bed at a decent hour, getting adequate exercise, eating a diet high in whole grains, fruits, and vegetables, and drinking plenty of water. I would encourage her to avoid alcohol and any other mind altering substances that cause her behavior to be irrational. Addressing the underlying cause of irrational behavior can be much more effective then addressing the irrational behavior as it self. 6. Because Caroline reaches for wholeness in sources that leave her feeling empty, I would ask Caroline to put herself first when she is seeking attention from empty sources. I would have her sit with herself and her emotions and work through them without desperately reaching out to things that cannot fulfill her. In order to be happy with someone else, it is vital that she become happy with herself. 7. Caroline loves to read and with this passion for books I would strongly suggest investing in self-help books that will mentally stimulate her to building a strong, happy inner self. There are so many self-help books that caters to every type of inner self difficulty and roads to self-discovery. Sometimes simply finding a book that speaks directly to your soul can bring some of the most healing and freedom. If Caroline were to follow these nursing interventions and invest whole heartedly to developing a strong inner being, I believe she would begin to see amazing results within a weeks’ time. Of course it would be a journey. Self-reflection is not always easy and can be hard, but in the end it is extremely rewarding. Coming face to face with our inner demons and conquering them is one of the best things you can do for yourself, future partner, and future children. In order to have healthy relationship you must be a healthy person and if Caroline wants to be healthy, she will be. References: Cherry, Kendra. â€Å"Intimacy Versus Isolation – Stage Six of Psychosocial Development.† About.com Psychology. N.p., n.d. Web. 26 May 2014. Carter, Don. â€Å"Intimacy Skills and Human Development Stages.† Intimacy Skills and Human Development Stages. Internet of the Mind, n.d. Web. 03 June 2014.

Enzymes are important for food digestion Essay

Enzymes are protein molecules produced y the living cells as â€Å"instructed† by genes on the chromosomes. Enzymes referred to as biological catalyst – biological molecules that catalyze metabolic reactions. A catalyst is defined as an agent that speeds up a chemical reaction without being consumed in the process (Burton, G. R. W. , 2004). Enzymes are important in digestion of food in our body because they act as the vehicle in the chemical reactions of breaking up the food elements. If the enzymes are not present in the digestion of the food, the energy of the chain reaction will face different problems such as acidity, diarrhea, bloating and burning sensation and it also helps strengthening the immunity of the body. There are different types of enzymes. These are metabolic enzyme, digestive enzyme and food enzyme. Metabolic enzymes are responsible for the destruction and removal of toxins in the body. Digestive enzymes are responsible for the digestion of food, absorption and the delivery of nutrients throughout the body and food enzymes enables the body to digest the food by breaking down the various nutrients and this enzyme are responsible for maintaining the optimal health. I will focus more on the digestive enzyme because it has an important role in the digestion and distribution of nutrients in the body. This enzyme can also help on the recovery of many diseases such as Irritable Bowel Syndrome (IBS) and Crohns disease. There are 3 important enzymes for the digestion and these are protease which digests protein; amylase which digests carbohydrates and lipase which digests fat. The two groups of digestive enzyme are intrinsic and extrinsic digestive enzyme. The intrinsic digestive enzyme is naturally produced inside the body and secreted from several organs to break down foods. Salivary gland is the most common enzyme produced by the mouth and the gastric gland produced by the stomach. If you experienced burning sensation and bloating and always in need of antacids after eating a certain types of food, the most common reason for this is due to eating of highly processed or over cooked food. This is commonly called indigestible foods. This type of food has naturally occurring enzymes but some healthy nutrients have been removed. The foods that has no enzymes and indigestible is bad for your health. The enzymes will work with the help of other necessary nutrients called the co-factors such as vitamins, minerals and essential fatty acids. In the absence of the co-factors of the enzymes, enzymes will have no activity. In some studies, it shows that the burning sensation you feel after eating a heavy meal like steaks, chickens, hamburgers and the like is because the digestive system demands more enzymes to digest them but if you eat raw type of food like fresh fruits and vegetables you will not feel any burning sensation because fresh vegetables and raw already contains lots of enzymes that digestion can be easier. We can eat any kind of foods that are rich in fat and sugars and our body will try to break it down by means of enzyme (Garcia, B. , n. d). To prevent the burning sensation, acidity and excessive gas, we should eat a natural raw kind of food and light cooked foods. Over cooked foods and processed destroys the enzymes that we need. Reheating the left over food at 47 degrees Celsius also destroys the enzyme that we need for digestion. The best way to have a good digestion is we should eat fresh fruit, steamed vegetables and dairy products to get plenty of digestive enzymes for easy digestion and absorption of nutrients in our body. If we are about to eat roasted meat, try to add some raw vegetables because it contains vegetable enzyme that will help for easy digestion. Eating this kind of food is very economical and it helps with digestion illnesses. Enzymes are important in our life. Without enzymes we easily get sick or acquire diseases. Lacks on enzyme in our body makes our blood dirty and dirty blood are the basis of acquiring diseases. One specific function of enzymes is to reduce and lighten the inflammation such as arthritis. We should always remember that the healthier that we eat, the longer we live. With the help of this enzymes other diseases or illnesses such constipation and gastroesophageal reflux disease or GERD will be prevented. Proper nutrition and exercise is the key to a healthy life (Garcia, B, (n. d).. References: Burton, G. R. W. (2004). Biochemistry: The Chemistry of life. Goucher, J. (Ed. ), Microbiology for health sciences (p. 149). Lippincott Williams and Wilkins. Garcia, B. (n. d). How the Different Types of Enzymes Support the Process of Life. Retrieved from http://ezinearticles. com/? How-the-Different-Types-of-Enzymes-Support-the-Process-of-Life&id=291981 Garcia, B. (n. d). Enzymes: An overview. Retrieved from http://ezinearticles. com/? Enzymes:-An-Overview&id=275873