Healthcare Policy & Management Project - Mothers Room and ADA Research Paper

Healthcare Policy & Management Project - Mothers Room and ADA Compliant Bathrooms - Research Paper Example passed specific structural needs to enhance the accessibility of the people and provided an enhanced level of support to the employees particularly for mother workers and the employees with disability. This project involves developing a plan to provide Mothers (Lactation Aid) Room in The Company’s global headquarters located in New York City to provide private rooms for new mothers who wish to continue breastfeeding after returning to work. The policies will be designed in accordance with the workplace breastfeeding support provision in the Patient and Protection and Affordable Care Act (Section 4207) and the guidelines established by the Department of Labor, Fair Labor Standards Act (FLSA). According to Murtagh & Moulton (2011) the requirement for a workplace that supports the different needs of the employees is extremely important in the present day context. Angeletti (2009) noted that there has been a primary need for lactation rooms in the workplace for breast-feeding working mothers. Mensah (2011) further mentions that owing to the fact that the child bearing ages and the employable years of a women’s life is suffering and thus the employers should be providing them with additional support to maintain their work life balance (Tsai, 2013). Department of Labor (2010) articulated that the new policies have been reframed in order to enhance better support to the working mothers. The companies are reframing their policies in order to enhance their structural support to the new mothers to provide care for their babies and enhance their work life balance (York, 2008). The companies need to efficiently handle their structural development to provide with the lactation rooms. This would enhance the new mother’s confidence to join back office post delivery (CDC, 2004). Furthermore, it would also help the working mothers to enhance their balance between professional and personal life. Lleras (2008) further stated that the number of working women has increased in

Diabetes Essay Example | Topics and Well Written Essays - 750 words - 1

Diabetes - Essay Example This paper focuses majorly on the bariatric surgery as an intervention for the treatment of diabetes in adults. Bariatric surgery is a consideration for people with type 2 diabetes who have BMI exceeding 35 kg/m ². It involves several surgeries on the gastrointestinal tract. These include the gastric banding or transposing, resecting, or bypassing sections of the small intestine. Interestingly, the gastrointestinal tract surgery had originally been developed for the treatment of morbid obesity. Later on, it was employed as a powerful intervention to ameliorate diabetes in severely obese patients by normalizing blood glucose levels. It reduces or completely avoids necessity for medications alongside being a cost-effective approach for the treatment of the disease. The American Diabetes Association (2014) recommends bariatric surgery consideration especially for adults with BMI 35 kg/m2 and type 2 diabetes. It applies particularly when the diabetes or the associated comorbidities prove to be difficult to manage through lifestyle and pharmacological therapy. An observation has been made that patients who have at a time undergone the bariatric surgery in most cases require lifelong medical monitoring and lifestyle support. Research has provided evidence related to the glycemic benefits of bariatric surgery patients with type 2 diabetes and BMI 30–35 kg/m2. The evidence has played a significant role in the recommendation of the bariatric surgery. However, there has been criticism that in well-designed controlled trials which have optimal medical and therapy as the comparing factor, the longtime benefits, cost-effectiveness and risks of bariatric surgery in individuals with type 2 diabetes should be reconsidered in further studies. In terms of the desired normalization of glycemia, studies have shown that Bariatric surgery achieves very close or complete normalization. Buchwald (2009), in a survey carried out on a population of people with type 2 diabetes,

Hospitality Industry and Environment Forces Essay

Hospitality Industry and Environment Forces - Essay Example In addition, diplomatic relations among governments have diverse effects on the hospitality industry. A government may choose, when it ascertains it is appropriate, to advise its citizens against visiting certain countries depending on how the prevailing diplomatic relations between the two nations. Economic factors influence the hospitality industry. A booming economy leaves a people with spare cash to spend on holidays. A weak economy presents, however, little cash flow to governments and relevant agencies that may lack the resources to invest in the hospitality industry. In addition, technology influences the hospitality industry. Tourists can enjoy their tours in many ways due to the advances in technology. Tourists can now film their adventurous trips and share their experiences with friends and family through social sites. Hotels can also provide booking services to their travelling clients online through their websites (Mok, Beverley and Jay 139). Surveillance and security provided in the hospitality industry have improved because of technology. There are fewer incidences of terrorist attacks targeting the hospitality industry because of technology applied in gathering and sharing intelligence by relevant agencies. Socio-cultural factors influence the hospitality industry. The manner in which local people interact with tourists determines their satisfaction levels. In addition, hospitable societies receive the highest number of tourists. Societies with unique cultural practices also attract many

Diabetes Essay Example | Topics and Well Written Essays - 750 words - 1

Diabetes - Essay Example This paper focuses majorly on the bariatric surgery as an intervention for the treatment of diabetes in adults. Bariatric surgery is a consideration for people with type 2 diabetes who have BMI exceeding 35 kg/m ². It involves several surgeries on the gastrointestinal tract. These include the gastric banding or transposing, resecting, or bypassing sections of the small intestine. Interestingly, the gastrointestinal tract surgery had originally been developed for the treatment of morbid obesity. Later on, it was employed as a powerful intervention to ameliorate diabetes in severely obese patients by normalizing blood glucose levels. It reduces or completely avoids necessity for medications alongside being a cost-effective approach for the treatment of the disease. The American Diabetes Association (2014) recommends bariatric surgery consideration especially for adults with BMI 35 kg/m2 and type 2 diabetes. It applies particularly when the diabetes or the associated comorbidities prove to be difficult to manage through lifestyle and pharmacological therapy. An observation has been made that patients who have at a time undergone the bariatric surgery in most cases require lifelong medical monitoring and lifestyle support. Research has provided evidence related to the glycemic benefits of bariatric surgery patients with type 2 diabetes and BMI 30–35 kg/m2. The evidence has played a significant role in the recommendation of the bariatric surgery. However, there has been criticism that in well-designed controlled trials which have optimal medical and therapy as the comparing factor, the longtime benefits, cost-effectiveness and risks of bariatric surgery in individuals with type 2 diabetes should be reconsidered in further studies. In terms of the desired normalization of glycemia, studies have shown that Bariatric surgery achieves very close or complete normalization. Buchwald (2009), in a survey carried out on a population of people with type 2 diabetes,

Why men's basketball is better than women's basketball Essay

Why men's basketball is better than women's basketball - Essay Example This paper analyses the above preposition from three different writers, and considers their perception and the rhetorical tools they have used to drive their points and how effective the tools are in accomplishing the writer’s objective. The first article written by Josh Kramer posits that by comparison, men’s basketball is better than that of the women in more than one way. In this sense, the writer employed the use of strategies in order to communicate and deliver his arguments and views. Where as he acknowledges that every ones opinion matters in this assessment, he also asserts that there are some inherent things with men’s basketball that makes it much cherished compared to that of the women (Kramer). He considers the airtime that the two are given and explains that men are given more than women and the situation makes it possible for men to dominate the game than women. On the other hand, the author also posits that in women basketball, there is no overall excitement as compared to that of men. These among other thing like the predictability of the women game makes it too boring to attend to and watch. In order to drive his point home, the author has used rhetorical tools to channel the same, for example.

Analysis of “The Story of an Hour” by Kate Chopin Essay Example for Free

Analysis of â€Å"The Story of an Hour† by Kate Chopin Essay The short story â€Å"The Story of an Hour† was written by Kate Chopin and first appeared in 1984. It tells about the ‘one hour’ brief story of the main protagonist, Louise Mallard, and her reaction upon hearing the news of her husband’s death by a car accident. And because she had a heart problem, her sister Josephine and her husband’s friend Richards decided to break to her the news as gently as possible. Not long after the supposedly bad news was revealed, Brently, Louise’s husband, suddenly comes home alive disproving the former, causing death to her by heart attack. Majority of the story’s progression revolve around Louise’s reaction upon hearing the news about her husband’s death (Brian, 2001). The scenes where Louise isolate herself in her room and savor her new-found freedom add up to the hanging idea of the real reason behind her death. It seems that the author actually give two possible emotional state to answer the underlying question of Louise’s joyful death: one is that she has become too overwhelmed to see her husband alive in contrary to the news about his involvement in a recent car accident and the other one is that she is saddened by the realization of the freedom that she thought she will have after hearing her husband’s loss is completely taken away from her again. Contrasting Representations Suprisingly, the short-story is written in complete contrasts of the main theme. First of these contrasting representations within the story is Louise’s reaction upon hearing the news. The news about her husband’s death should bring her agony and tears but instead; she sits calmly â€Å"facing the open window, a comfortable, roomy armchair. † Here we see a strange approach to the situation with the word â€Å"comfortable† being used to modify the chair near the window. Louise, a new widow herself, must not see the chair as â€Å"comfortable† as it seems just right after hearing the unbearable news of her husband’s death. Added to this, the scene outside the window also symbolizes something in contrast to the story’s progression. The spring day from the view outside her window shows a contrasting image to the situation she has. The spring is a symbol of â€Å"rebirth† or â€Å"new life† thus the spring prognosticates Louise’s new life after Brently’s death. Another interesting symbol in the story is the description of the view laid upon Louise’s eyes as she sits near the window: â€Å"The delicious breath of rain was in the air. In the street below a peddler was crying his wares. The notes of a distant song which some one was singing reached her faintly, and countless sparrows were twittering in the eaves† (Brian, 2001). For the readers, the description made by Louise about the view she was seeing clouds what her true emotions were at that moment. It seemed that as she isolated herself in a room, she completely disregarded the news of her husband’s death. These representations had become tricky in contrasting the main theme the story supposes to have or tell. Kate Chopin’s idea of a Joyful Death: Appearance versus Conflict What the readers may discover in reading this story is the possibility that there is an ironic truth behind the death of the main protagonist’s beloved. In the main setting of the story where Louis sits in a comfortable chair, she mouth over the words we never expect to read or hear from her. She seems to be happy rather than being sad about Brently’s loss with what the story emphasizes on her shouting â€Å"free, free, free! The freedom she pertains here signifies of her having the will to live a life all by herself, after her husband is gone. As she plays a youthful characteristic of a woman, it is a well played proof that she was indeed after the freedom, of doing what she want to do and make decisions for herself. With this fact, the story seems to have a conflict of its own: conflict between the ideas of appearance and reality. From the moment that the story emphasizes about Louise having her â€Å"freedom† at last, it could suggest the notion to the reader(s) that she is not saddened by the news. Unlike what she had shown in the central point of the story, Louise somehow is expected to grieve by the people around her, all having the idea that her marriage with Brently was a happy one. This is what her sister Josephine completely understood with her reaction as she misinterprets Louise’s behavior and thinking. She hysterically calls out her sister in the room, believing that Louise is heart-broken but in reality, Louise is more lightened up by the news. The doctors’ judgment about Louise’s death also deals with this conflict. For them, it seemed that Louise died after realizing that her husband is alive. This appearance of Louise’s happiness is more illustrated when they predicted that due to heart attack â€Å"of joy that kills† (Brians, 2001). Never did they think of the reality that she died because of another reason. That she dies because she was heart-broken to recognize the truth that she will not be able to gain her freedom as what she expected earlier. Role of Woman versus Man Another conflict in the story accentuates the role of woman versus man in the society. It is illustrated in the story that Louise is a submissive wife to Brently. But there is an internal struggle within her that tells that she was not happily married at all. As what Louise thinks, â€Å"What could love, the unsolved mystery, count for in face of this possession of self-assertion which she suddenly recognized as the strongest impulse of her being† justifies more to the idea that she, indeed, had loved Brently but more were the times she feel not. Maybe for Brently, Louise appeared to be happy with their relationship or he thinks and assumes that she is. Apparently, Louise wanted more the freedom she had felt for in that short while. After finding out the truth that she was not yet totally free, she had thought that only by death that she would took possession of it at last. There in death she would find peace and liberty. Ironically, Louise took the realization that her husband was alive and chose to die in able to attain the freedom she longed for. Character Analysis Chopin made her characters compliment along with the theme of the story. The main character, Louise plays a youthful wife who tends to have her freedom despite her marriage with Brently. Her youth marked up the end of her life and this irony of life, of choosing liberty by death, seemed to be one of the uncertain situations in the matter of choosing life over death. Brently, although his character is not discussed further on in the story, seemed to be playing a role of a husband who wants her wife under his control. Louise would never want liberation if he was a good man to her. His characteristic gives a deeper impact in the story, making Louise choose to die with freedom rather than living with him in a life full of despair. Josephine, Louise’s sister, was recognized here as a doting sister who takes care of her and all the matters that has a connection with her. Josephine, together with Richards, had taken care of gently telling to her the â€Å"death† of her husband Brently. She half-concealed the truth, in order for Louise to accept it without suffering her heart problem. Richards, Louise’s friend, is the one who brought the news to the house, he is responsible for assuring Brently’s death. As he rushes to tell the news to his friend, there is a suggestive truth that he was worried about what his friend’s reaction would be after hearing the news. If he had not rushed over to deliver the news, there is a possibility that Brently could arrive first in the house and justify that his name in the news is a big mistake, preventing Louise’s death and would have lived more. Apart from Brently, Richards is also responsible for the protagonist’s death. The story gives us the impression that not every death could bring grief to someone. It could be, in another way, a joyful event. Chopin had also brought about the issues of women and their role in the society. The story, written in the nineteenth-century, showed how women years back had no rights to be at their own will. Women then were still under the prying eyes of the society and men dominate over them. Chopin tackles a lot of moral issue within the story. Her story suggests that it would still be better if women of her own time maintain their roles in the society. In the nineteenth-century, men are expected to be superior over women and not the other way around, not what Louise wanted to be. Her insights within the story inspires us with the vision of what harmonious relationships are ought to be and the wide complexity in bearing the contrasting truth between appearance and reality. References: Brians, Paul. et al. Reading about the World. (Vol. 2) 3rd Edition. Texas: Harcourt Brace College, 2001.

Radiation Doses vs Patient’s Life Styles

Radiation Doses vs Patient’s Life Styles Radiation doses from 131I treated hyperthyroidism patients’ vs life style- A  survey A.S. Shah*, Hameedullah, F. Saeed, K.A.Shah, A. Khan, M. Rauf Khattak ABSTRACT The Radioactive Iodine is widely used for the treatment of various thyroid disorders. The patients  undergoing such treatments are advised to restrict their social and work related activities to limit  radiation exposures to others. The present work describes the results of a structured survey  conducted on patients visiting Institute of Radiotherapy and nuclear Medicine (IRNUM), Peshawar,  for the thyrotoxicosis treatment. The patients were asked about their housing conditions, family set  up, number of kids, travelling mode and time back home from the hospital. The radiation doses to the  other people with whom they might come in contact in their living environment were estimated. The  radiation doses to others at one meter from the patients were calculated as 0.76, 1.53, 2.29, 3.06, 3.82  and 4.58mSv. The results of the survey indicate that the radiation protection advice and other  regulatory requirements need to be reviewed keeping in view individual patientâ⠂¬â„¢s circumstances. INTRODUCTION The radioactive iodine (RAI) is widely used for the treatment of various thyroid disorders  since long. The differentiated thyroid cancer (DTC) is treated by admitting the patients in  hospital where as hyperthyroidism patients are treated on out patient basis in most of the  countries (1-4). The safety issues for the patients, their families, comforters, hospital staff and  the general public arise with either treatment approach. The radiation hazards are more in  case of hyperthyroidism treatment than the DTC treatment due to shorter effective half life  of the 131I in the later application. Therefore at the time of release of the patient from  medical confinement, the retained radioactivity in DTC patients is much lower causing low  risk of radiation exposure to other people. In case of thyrotoxicosis treatment the  administered radioactivity is much lower as compared to DTC treatment but radiation  doses to others are more due to high uptake of RAI by these pa tients (5-8). The patients  undergoing such treatments are advised to restrict their social and work related activities  to reduce radiation exposure to others when they return to their families in community (9-16). This radiation protection advice is usually based on residual activity or radiation exposure level and is not specific to an individual patient circumstances or socioeconomic  condition. These advices are usually formulated by the developed countries and are  adopted as such in most of the developing countries. In actual practice the compliance to the  protection advice depends on socioeconomic conditions and the life style of the patients. Therefore keeping in view this aspect of RAI treatments, an interview based structured  survey was conducted on patients visiting our hospital for the treatment of thyrotoxicosis. The patients were asked about their housing conditions, family/home set up, number of  kids, mode of travelling and travelling time to back home from the hospital. The radiation  doses to the other people with whom they might come in contact in their living  environment MATERIAL AND METHODS The patients were asked about their housing conditions, family set up, number of kids and  travelling periods back home. The total number of patients inducted in the present survey  was 419. The data collected was tabulated and reviewed for completeness. A calibrated  dose of 131I (185-1106MBq) was administered to the patients. The exposure rate from the  patient was measured at a distance of one meter from standing position with a hand-held  pressurized battery operated ÃŽ ² ÃŽ ³ survey meter, Victoreen Model 450P, calibrated from  secondary standard dosemetry laboratory, Islamabad. The dose rate was recorded in units  of ÃŽ ¼Svhr-1. The patients were instructed to sleep alone, drink fluids liberally and avoid prolonged close personal contact with others for the first 2 days. The patients and familymembers were told that they could resume normal activities thereafter (9-12). The estimated  radiation doses to the maximally exposed person were calculated using the form ula given in  equation 2 (14). RESULTS There were 385 (93%) patients residing in joint and 29 (07%) in separate family system  Table 1. It was found that 15.27 % of the patients were male and 84.73% females with age  wise distribution as shown in Table 2. The measured hospital leaving dose rate at one meter from the patients were 5.7, 11.0, 15.7,  18.7, 23.0 and 28.0ÃŽ ¼Svh-1 for administered RAI activity of 5, 10, 15, 20, 25 and 29.9mCi  respectively. The corresponding radiation doses to others from exposure to the patient at  one meter using occupancy factor of 0.25 were calculated as 0.76, 1.53, 2029, 3.06, 3.82 and  4.58mSv Table 3. They survey showed that 4.77, 17.66, 22.91, 24.10, 12.66 and 17.90% patients had  accommodation consisting of one, two, three, four, five and more than five rooms  respectively Table 4. It was observed that 78.04% patients used public transport and 21.96% used private  transport for back home after RAI administration. The radiation doses to others during  travelling were estimated using occupancy factor of 0.1m and 1m distance plotted versus  travelling time of the patient from hospital to back home Figure 1 and Figure 2 respectively.   It was also observed that 1.67% of the patients had no sanitary arrangements at home and  they used open space in the fields as toilet. The patients residing in localities where there is  comparatively better sanitation arrangements had one (31.74%), two (36.04%), three  (17.42%) and more than three (13.13%) toilets available Table 5. In addition 11.93% of the patients had no kids where 10.74% lived in joint family system  and 1.19% as separate. The survey showed that 88.7% of the patients had kids and 82.33%  of these lived in joint family system where as 5.73% lived separate. The number of kids and  the family status showed that 17.18%, 31.50% and 33.65% patients had 1-3, 4-6 and more  than 6 kids respectively lived in joint family system while 2.86%, 1.91% and 0.95% patients  had 1-3, 4-6 and more than 6 kids respectively and they used to live in separate family  system Table 6. DISCUSSION The patients treated for thyrotoxicosis with RAI (131I) are advised certain restrictions on  behavior in order to ensure the radiation safety of all other individuals with whom they may  come into contact. Generally it is assumed that the patients are unlikely to create a hazard  to other persons. A dose limit of 5mSv and 1mSv had been recommended for these peoples  depending upon the nature and type of their interaction with the patient (17). The  compliance to the safety instructions depend upon patient’s literacy level, decision making  capacity, health education, grasping and understanding disclosure of treatment in general  and patient’s socioeconomic conditions and life styles in particular(18,19). The over all literacy level of the survey region is 37.26 % (20). Literacy level reflects the  ability of the patients to comprehend that they emit detectable levels of radiation for  specified period of time after their treatment which are hazardous for other peoples. It was  observed that 93% of the patients inducted in the survey used to reside in joint family  system and 07% lived in separate system Table 1. This aspect coupled with the low literacy  level puts emphasis on the patients receiving treatments to comply with the instructions  strictly to limit radiation exposure to others. The restriction on mode of travelling back to home is important factor in RAI treatment  especially when 78.96% of the patients used public transport to back home from hospital. It  is practically difficult to measure radiation doses to other passengers traveling in the same  vehicle. The measured hospital leaving dose rate at one meter from the patients suggest  that the time restrictions to travel by private transport (at 1m distance) are not required,  although they should not sit immediately adjacent to another passenger, accompanying  person or driver Table 3. Similarly restrictions would not be required for public transport (0.1m distance) for one  hour journey. It was observed that radiation doses to others at 1m and 0.1m with  administered 131I radioactivity of 185, 555 and 1106MBq increases linearly with the travelling time Figure 1 2. The patients needing greater travelling time back home should  use private transport after RAI administration. Therefore regulatory authorities need to  reassess the situation with respect to private or public mode of travelling while  recommending discharge limits for RAI treatments. The radiation doses from the exposure  to the patient to total decay (t=∞) at one meter using occupancy factor of 0.25 for RAI  administered were well within recommended dose limit of 5mSv for adult comforters Table  3. However for patients residing in single room accommodation, with kids and joint family  system, the dose limit of 1mSv is unlikely to be adhered. This aspect becomes more  important where a very large percentage of the patients (88.07%) had kids and 82.33% of  those used to live in joint family system as observed in the present survey Table 6. The  sanitary conditions of the patients at home are important to protect family members from  radioactive contamination and associated external radiation exposure. It was observed that  patients having better sanitation arrangements would not pose radiation related problems. However patients having no proper sanitation (1.67%) are source of concern for the  communities where they reside Table 5. The trends observed indicate that the patients with single room accommodation, having  kids and joint family system need strict compliance to radiation protection advice to restrict  radiation doses to the immediate family members. Therefore RAI treatments need to be  carried out keeping in view patient’s living conditions and life styles. CONCLUSION The radiation protection advice and regulatory requirements need to be formulated  keeping in view patient’s socioeconomic, life style and living conditions. It needs to be  reviewed depending upon individual patient’s circumstances. Table 1 Family Status (N=419) Status No of patients (%) Joint Family 390 (93) Separate Family 29(07) Table 2 Age and Sex Distribution of Patients Age No. of Patients (%) 17 to 28 36(8.59) 29 to 40 161 (38.42) 41 to 50 119 (28.4) 51 TO 60 67 (15.9) >60 33 (7.8) *15.27 % of patients are males ** 84.73 % of patients are females Table 3 131I administered Vs Average Radiation Doses S.No 131I activity (mCi) No. of patients (%) Average leaving dose rate at 1 meter (ÃŽ ¼Sv/hr) Average Dose* to others at 1 meter (mSv) 1 05 12 (2.88) 5.7 0.76 2 10 18 (4.3) 11 1.53 3 15 99 (23.62) 15.7 2.29 4 20 233 (55.6) 18.7 3.06 5 25 47 (11.21) 23 3.82 6 29.9 10 (2.3) 28 4.58 * Average doses to total decay (t=∞) to other individual exposed to the patient at one meter using  occupancy factor of 0.25. Table 4 Status of Patients in Relation to No. of Rooms in Joint/ Separate System No. of rooms in home No. of Patients (%) Patients living in Joint Family System Patients living in Separately 1 20(4.77) 18 2 2 74(17.66) 69 7 3 96(22.91) 90 7 4 101(24.10) 96 4 5 53(12.66) 46 4 More than 5 75(17.90) 71 5 Table 5 Sanitary Status of Patients No. of Toilets in home of Patients No. of Patients (%) Open without flush 07(1.67) With one flush 133(31.74) With two flush 151(36.04) With three flush 73(17.42) More than three flush 55(13.13) Table 6 Kids Status Vs Family System Figure 1 Radiation Doses (mSv) at 0.1m Vs Travelling Time (Hrs) Kids Status Joint Families (%) Separate Families (%) Without Kids 50(11.93) 45(10.74) 05(1.19) With Kids 369(88.07) 345(82.33) 24(5.73) Up to 3 Kids 4 to 6 Kids 7 and above 72(17.18) 132(31.50) 141(33.65) 12(2.86) 08(1.91) 04(0.95) Figure 2 Radiation Doses (mSv) at 1m Vs Travelling Time (Hrs)