The Prevalence And Overprescription Of Adhd Drugs

Below is a research paper about the prevalence and overprescription of ADHD drugs in the US. It highlights my ability to construct a logical, concise argument as well as my interest in writing about science for a larger audience. America s Need for Speed Attention Deficit Hyperactivity Disorder, commonly referred to as ADHD, is the most commonly diagnosed mental disorder among minors in the United States according to the journal of Policy History (309). Treatment for ADHD as a mental illness involves behavioral conditioning and pharmacology, mainly the use of prescription amphetamines such as Ritalin, Adderall, and Vyvanse as a form of medication. Over the last twenty years, however, a horrifying and dramatic spike in the diagnosing†¦show more content†¦In order to understand the debate surrounding the controversy of ADHD and its treatment options, one needs to understand precisely what the disorder is and its history. ADHD has gone by several different labels since the early 1930s, such as Organic Drivenness, Hyperkinesis, and even Minimal Brain Damage Disorder (Mayes and Erkulwater 309). As scientific information about mental disorders progressed in the 20th century, so too did knowledge about ADHD . Ethical Human Psychology and Psychiatry states that by 1970, only 2000 American children were diagnosed with the disorder, yet the, standard method of treatment was behavior modification, not amphetamines (109). A social stigma surrounding mental disorders and pharmaceutical treatment still remained in the 1980s, particularly in regards to children. Lawsuits and negative media attention by the likes of Oprah Winfrey and Phil Donahue on the treatment for children with ADHD led to an almost, 40 percent decrease in the number of Ritalin prescriptions from 1988 to 1990 (Mayes and Erkulwater 313). As a result, the amount of children diagnosed with ADHD was not as high as the numbers we see today, nor was the use of amphetamines as common for treatment as it is currently. Within the next decade, however, the amount of prescriptions prescribed to children increased exponentially due to rising trends in culture and the availability of physicians to prescribe

Two U.S. Vacation Hot Spots Essay - 566 Words

In all of my travels across the United States of America, the `hottest vacation spot hands down is in Key West, Florida and the `coolest place to travel to is Denali National Park in Denali, Alaska. These vacation destinations are the two most beautiful and most relaxing places in the nation! I personally have experienced a week of enjoyment at both locations and find myself wanting to go back to each of them in the future because I had such a great time. Even though these are both awesome places to spend a week of vacation time, they differ in weather and climate patterns, they each have unique attractions and activities to do, and both vary in travel costs and various other expenses. Weather and climate conditions are one major†¦show more content†¦Since both vacation spots have different climates, they both offer a variety of different activities to do and adventures to have. In Key West, vacationers are literally surrounded by water and have numerous water activities to partake in like deep sea fishing, boating, swimming, snorkeling, scuba diving, jet skiing, going to the beach, etc. I would suggest packing your travel bags full of shorts, tee shirts, water apparel, and extra sunscreen! In the arctic area of Alaska, recreational activities include biking, climbing, camping, fishing, hiking, winter sports, scenic driving, wildlife viewing, and visiting various exhibits. Your travel bags for Denali National Park should consist of warm, water resistant clothing, hiking equipment, camping equipment, and nutritional and energizing camping food. One of the most important issues about traveling and vacations is the cost and the overall expense of the trip. From Allentown, Pennsylvania, a round trip ticket for a week to Key West, Florida is going to cost between four hundred and five hundred dollars, including a rental car and gas. However, a round trip ticket for a week to Anchorage, Alaska, and also gas and a rental car to drive four hours north to Denali, is going to be slightly more expensive. It is going to cost between six hundred and nine hundred dollars to travel. These costs do not even cover food, hotels, or shelter you are going to stay in. There will also be numerous activity costs like boating, fishingShow MoreRelatedThe United State Private Prisons1350 Words   |  6 PagesBecause of this law, and the fact that it was pass under Bill Clinton administration, the prison population skyrocket in America personal increase by 1600% (13th). According to American Civil Liberty Union (ACLU) in 2010 the two largest companies alone, which is CCA Corrections Corporation of America and GEO global leader in evidence based rehabilitation$3 billion in revenue in 2010. Each of these company’s executive receive 3 million dollars each. Private prisons didn’t really existRead MoreWest way to Yellowstone National Park Trip Theme This trip starts from Denver, Colorado to1400 Words   |  6 PagesYellowstone National Park, Wyoming. â€Å"Natural landform† is the main theme for this trip. I will explore the mystery of geothermal features in Yellowstone National Park. Yellowstone National Park, a national park mostly located in Wyoming, on March 1, 1872 U.S. President You Lixi Simpson Grant Adams signed the bill passed by Congress after the establishment of the worlds first national park. Yellowstone National Park, its abundant wildlife species and geothermal resources famous Old Faithful geyser is oneRead MoreThe Mind Can Never Break Off From The Journey Essay1496 Words   |  6 Pagesscenery. Besides the natural beauty, this country is known for it’s friendly accepting â€Å"kiwis†, the people of New Zealand who call themselves that, and it’s friendly laid-back lifestyle. New Zealand lies in the southwestern Pacific consisting of two main islands, the North and South island, both marked by volcanoes and glaciation. The airfare from San Jose to New Zealand is about $1200 year round - it might be cheaper to fly out from San Francisco or Oakland. One can get there by plane of courseRead MoreResearching and Planning a Trip to Europe Essay1943 Words   |  8 Pagesdetermined that I simply had to be on that plane when it left at the end of the semester. What I wish that I had known then is the one thing that the brochures and tour directors wont tell you: Travel with a professional tour company is not the ideal vacation for everyone. As a college student, money was a critical factor in this decision. Just because I got a reasonable package price that included airfare, ground (and sea) transportation, lodging, guided tours, all admission fees to museums, and breakfastRead MoreMinimum Wage Should Be Legal1427 Words   |  6 Pageswould be affected by the rule, which is still in the proposal process.Some top U.S. schools do not grant research that restricts participation to foreign citizens because they feel it counters policies on academic freedom and non-discrimination. Universities claim that the rule would offset the balance between national security and academic freedom. In a FBI report they recorded just under a million foreign students at U.S. colleges in the 2014-2015 school year, 31 percent of whom were chinese. TheRead MoreB ed Breakfast Marketing Plan1349 Words   |  6 Pagesa strong marketing plan the owners will gather data from general environmental trends. These trends will include household income, population changes, travel, and employment trends. The information will be obtained from known sources such as the U.S. Census Bureau, Bureau of Labor Statistics, Forrester and SC Department of Commerce. A competitor analysis will be conducted to determine Lester Estate’s competitors. The analysis will allow owners to develop a strategy for each competitor in itsRead MorePolice Enforcement On The State Level1608 Words   |  7 Pageshow he got his start in law enforcement. He told me that he was eighteen when he joined the military, becoming a military police officer for the next eight years. After he was discharged from the military, he went on to become a road trooper for two years, and branched out into investigative services, which included drug and criminal investigations, and undercover work, lasting approximately four years. After fourteen years in law enforcement, he stated he was kind of a â€Å"lost soul†. So, he actuallyRead MoreIdentification And Evaluation Of Main Source1995 Words   |  8 PagesPart I: Identification Evaluation of Main Source The Vietnam War is a huge part of American history, it is the first war that the United States lost. Many already know what happened to the U.S. during the Vietnam War, but not many know about what happened to Vietnam during the Vietnam War and how the U.S. affected that country. The bias of the Americans not speaking upon what happened to the Vietnamese brings up a question; To what extent has foreign influence by the United States during the VietnamRead MoreWinter Camping Can Be A Disaster1860 Words   |  8 PagesDinner can be cooked over an open fire or on a barbeque. Foil packets are made for single servings with one or two hamburgers in them depending on a person s appetite. Our family loves the potatoes, carrots, and onions so I always make one large foil packet of them so we have extra. Spray aluminum foil with cooking spray so food doesn t stick. Form hamburger into patties. Lay one or two in the center of the aluminum foil. Wash vegetables. Cut potatoes into slices. Cut carrots into lengths. CutRead MoreTravel Of The Travel Nursing Industry7670 Words   |  31 Pagesregistered travel nurses that form part of a $2 billion dollar industry, along with countless staff recruitment agencies sharing in the pie. As of April 2006, there are around 5000 travel nurse openings available; a significant upward climb from the 2500 spots available three years ago. This speaks volumes over the potential of the healthcare travel industry in the future. Travel nursing allows experienced and honed nurses to practice their craft caring for patients while exploring different parts of the

The Assassination Of Abraham Lincoln - 1535 Words

Michael Cardenas Ritmann History 2B October 16, 2015 The Assassination Of Abraham Lincoln On April 14, 1865 at twelve o’ clock midnight John Wilkes Booth lay in his bed at the National Hotel. Three days earlier he had attended a speech given by President Abraham Lincoln at the White House. The civil war had commenced just two days earlier and the crowd was jubilant. When Lincoln concluded his speech with the the acknowledgment of black suffrage, Booth became incensed and declared that â€Å"Now by God, I’ll put him through, that will be the last speech he makes†. Booth was a staunch Confederate sympathizer and he had previously plotted a kidnapping involving the president in exchange for POWS between the northern and southern states. With that plan failed, he became desperate in figuring a way to put the power back in the Confederacy. Along with three other conspirators Booth realized exactly what needed to be done and that night at Ford’s Theatre, while a performance of the play â€Å"Our American Cousinâ €  was appearing, Booth slipped into the Presidential Box seats where Abraham Lincoln and his wife Mary Todd were seated and shot him. Booth jumped onto the stage below and fled the scene among the chaos. As Lincoln lay dying a young surgeon named Charles Leale and other doctors in the audience tended to Lincoln and decided that traveling to the White house was out of the question, so carrying him out of the theatre on a stretcher, Lincoln was taken to the Petersen Boarding HouseShow MoreRelatedThe Assassination Of Abraham Lincoln861 Words   |  4 PagesAppomattox Courthouse, one of America s greatest presidents, Abraham Lincoln, was shot and killed by a man named John Wilkes Booth. Specifically, John Wilkes Booth was an American play actor and a big sympathiser for the Confederacy. Booth was well known for his hatred towards the President and his crazy ideas and motives, which lead to the killing of Lincoln. Many conspiracies and theories today believed the assassination of A braham Lincoln was handled by John Wilkes alone, but other conspiracies believedRead MoreThe Assassination Of Abraham Lincoln1064 Words   |  5 PagesColin Shafer Abraham Lincoln’s Assassination President Abraham Lincoln was the first United States president ever to be assassinated while in office. He was president during the Civil War and had many people that did not like him. John Wilkes Booth did not like Abraham Lincoln and was responsible for the President’s death. Abraham Lincoln was born in Harden County, Kentucky on February 12, 1809. His parents were Thomas and Nancy Hanks Lincoln. In 1818, his mother died while he was just nine yearsRead MoreThe Assassination of Abraham Lincoln511 Words   |  2 PagesThe Assassination of Abraham Lincoln The assassination of President Abraham Lincoln occurred on April 15, 1865, Washington, D.C. Lincoln was watching the play â€Å"Our American Cousin† at Ford’s Theatre located in Washington D.C. John Wilkes Booth entered the theatre during the play and shot and killed President Lincoln. This tragic event changed history. President Lincoln was the President of the United States during the time of slavery. He was also the president during the Civil War. Lincoln wantedRead MoreThe Assassination Of Abraham Lincoln Essay1317 Words   |  6 Pagesâ€Å"Sic Semper tyrannis† or â€Å"Thus always I bring death to tyrants† were the famous words of Confederate actor John Wilkes Booth after he shot President Lincoln at Ford’s Theatre. The assassination of Abraham Lincoln was a tragic event that will be forever remembered in the hearts of all American citizens. On April 20, 1999 in Littleton, Colorado, Booth’s words would make a comeback during another Am erican tragedy; Columbine high school was the setting for arguably one of the most notorious school shootingsRead MoreThe Assassination Of Abraham Lincoln Essay1342 Words   |  6 Pagesâ€Å"Sic Semper Tyrannis† or â€Å"Thus always I bring death to tyrants† were the famous words of Confederate actor John Wilkes Booth after he shot President Lincoln at Ford’s Theatre. The assassination of Abraham Lincoln was a devastating event that will be forever remembered in the hearts of all American citizens. On April 20, 1999 in Littleton, Colorado, Booth’s words became a part of another American tragedy; Columbine high school was the setting for arguably one of the most infamous school shootingsRead MoreThe Assassination Of President Abraham Lincoln Essay983 Words   |  4 PagesOne of the most tragic moments throughout all American history in my opinion is the Assassination of President Abraham Lincoln. With no surprise I am writing about certain event that oc curred leading up to, during, and after this unfortunate event. This historical event is clouded with conspiracy but I will try to avoid specifics of that particular view. Abraham Lincoln was born in a little town located within Hardin Country, Kentucky on February 12, 1809 (www.whitehouse.gov/abrahamlincoln). HeRead MoreThe Assassination of Abraham Lincoln Essay913 Words   |  4 PagesAbraham Lincoln was the 16th president of the United States of America. He was elected into presidency on November 6, 1860. Many of the southern states were unsupportive of Lincoln becoming president because he had run on an anti-slavery platform. Lincoln being elected into presidency caused states such as South Carolina, Mississippi, Florida, Alabama, Georgia, Louisiana and Texas to split from the Union. In his inaugural address Lincoln proclaimed it was his duty to maintain the Union; a month laterRead MoreThe Assassination of Abraham Lincoln Essay1646 Words   |  7 Pagesorphaned child-to do all which may be achieved and cherished a just and a lasting peace among ourselves, and with all other nations†-Abraham Lincoln, Second Inaugural Address (Great Documen ts of America 19). Abraham Lincoln was the sixteenth president of the United States and perhaps one of the most hated presidents that ever served, this hatred for president Lincoln came from his options and actions regarding the nation’s conflict at the time; the Civil War, this came after the succession of fourteenRead MoreThe Assassination Of Abraham Lincoln1456 Words   |  6 Pagesbe the same today if Abraham Lincoln was never assassinated on the unfortunate night of April 14, 1865. His killer, John Wilkes Booth, had a strong resent for the Union that subsequently caused a dramatic shift in history. This hatred was caused by many factors, such as his background and where he grew up, his lust for power and fame, and his mental illness. John Wilkes Booth, a master assassinator and conspirator, hoped to strengthen the confederacy by killing Abraham Lincoln. However, this murderRead MoreAbraham Lincoln s Assassination Of President1176 Words   |  5 PagesAbraham Lincoln’s Assassination President Abraham Lincoln was the first United States president ever to be assassinated while in office. He was president during the Civil War and had many people that did not like him. John Wilkes Booth was one of those people and was the man responsible for the Presidents death. The following is about Abraham Lincoln, John Wilkes Booth, Booth’s plan for Lincoln, the President’s assassination, Booth’s capture and how it affected history. Abraham Lincoln was born

Models of God, Humanity, and Nature My Experiences,...

Models of God, Humanity, and Nature My Experiences, Thoughts, and Critical Analyses I ask a lot of questions; I’m a curious person. I once asked my mom why people die, why there are bad things in the world if God is so good and all-powerful. Her response was that we just couldn’t really understand why God does anything because we can’t comprehend God’s â€Å"master plan.† I’m sure that she was right, but that response is not very satisfying to a curious little boy. I saw an inconsistency in my understanding of reality, and I wanted to get things straight. I guess this little anecdote begins to illustrate a couple of my basic life principles. A concise explanation of how I look at the world is just this: We humans, as†¦show more content†¦Once one has that understanding (or â€Å"model†), one then does one’s best to live in a way consistent with that model and perhaps in the process, persuade others of your world view. Before going back to my own story though, I just wanted to clarify the difference between inconsistency and simplification. I feel that it is possible to simplify a complex idea without it being necessarily inconsistent. I could simplify the weather in two ways. I could say that direct sunlight makes it warmer outside. I could also say that sunny days are warmer than cloudy days. Both models of the weather are simplifications of a very complex system. However, my first one is consistent with my experience since sunlight usually makes me feel warmer than when there is no sunlight. Saying that sunny days are warmer than cloudy days is not always true though. Therefore simplification doesn’t necessitate inconsistency. Now since I’ve set up my view of models and life, I can tell my story, using these ideas as a framework for understanding my life. I think that in telling my story, I can communicate my ideas without being technical, philosophical, or lecturing. Maybe it will be effective, maybe not. I’ll find personal enjoyment just in telling my story though, and maybe some ideas will be persuasive in an experiential context. Every now and then, I’ll try to draw my conclusions in a way that is conciseShow MoreRelatedKhasak14018 Words   |  57 Pagescriticism and analyses the novel for recurring mythical and archetypal patterns. The concluding chapter studies how psychoanalytic theory and mythological studies can account for the universal appeal of the work and also suggests areas for further research. Posted by Preethu at 02:05 No comments: Introduction Literature, with its immense scope and appeal that goes beyond the horizon of zeitgeist, demands a touchstone with equally infinite bound, as it is a cultural product of humanity, and an offshootRead MoreThe Philosophy of Happiness11705 Words   |  47 PagesChapter 1 The Philosophy of Happiness Aristotle on Happiness Since the earliest days of Western thought philosophers have concerned themselves with the nature of happiness. One of the earliest to ask the question ‘what is happiness?’ was Aristotle, who, in a manner typical of philosophers, before providing an answer insisted on making a distinction between two different questions. His first question was what was meant by the word ‘happiness’—or rather, its ancient Greek equivalent eudaimonia. HisRead MoreOcd - Symptoms, Causes, Treatment131367 Words   |  526 Pages1-57230-963-6 ISBN-13: 978-1-57230-963-0 (hardcover: alk. paper) ISBN-10: 1-59385-375-0 ISBN-13: 978-1-59385-375-4 (paperback) 1. Cognitive therapy. 2. Obsessive–compulsive disorder. I. Title. RC489.C63C57 2004 616.85†²2270651—dc22 2003020283 To my parents, Albert and Ardith, for their support and encouragement About the Author About the Author David A. Clark, PhD, is a professor in the Department of Psychology, University of New Brunswick, Canada. He received his PhD from the InstituteRead MoreOrganizational Behaviour Analysis28615 Words   |  115 PagesWorkshop Topics And Themes The Nature and Scope of Organisation Theory Levels of Analysis The Metaphorical Approach Organising Processes Understanding Change Conflict, Negotiation, and the Politics of Change Group and Team Working Cultures and Leaders as Cultural Agents Trust Linking the Themes Introductory Notes on Organisational Analysis Understanding Organisations The Limits of Rationalism Levels of Analysis: The SOGI Model Limitations of the SOGI Model The Individual Level The Group LevelRead MoreEquality and Diversity in Childcare9428 Words   |  38 PagesIntroduction My name is and I am currently doing a FETAC level 6 Early Childhood Care and Education course. One of the modules is Equality and Diversity in Childcare. For this exercise I will explore equality and diversity concepts as relevant to Irish Society. Analyse approaches to diversity education including, assimilation, multicultural, intercultural and anti-bias. Explore equality and diversity terminology; including prejudice, discrimination, racism, sexism and abelism etc. Examine currentRead MoreCorporate Social Responsibility10163 Words   |  41 Pagesmust work in tandem or there is no purpose for any of its existence. Unethical practices are what harbor ill will and create a climate of contempt and distrust, which is no way to run a business, be it personal or otherwise. Â…It is a necessary and critical ingredient in the successful enterprise (Ruin, 1997, p. PG). Beauchamp et al (1996) clearly imply that establishing such ethical fortitude is not a difficult objective if one maint ains a moral and conscientious outlook. Ethical concerns run rampantRead MoreMasculinity in Chuck Palahniuks Work7062 Words   |  29 PagesDavid Fincher’s adaptation helpfully put Palahniuk’s thoughts into the cinematic forefront. This increased the popularity of Palahniuk’s other works and placed him in the cannon of Post-modern American fiction. It is the issues of modern masculinity that grasps critics’ attention more so than any other Palahniuk themes. It is very apparent that masculinity has changed as a natural progression of modernisation. This dissertation will analyse masculinity as it is depicted in Palahniuk’s writingsRead MoreOrganisational Theory230255 Words   |  922 Pages. Organization Theory Challenges and Perspectives John McAuley, Joanne Duberley and Phil Johnson . This book is, to my knowledge, the most comprehensive and reliable guide to organisational theory currently available. What is needed is a text that will give a good idea of the breadth and complexity of this important subject, and this is precisely what McAuley, Duberley and Johnson have provided. They have done some sterling service in bringing together the very diverse strands of workRead MoreEnergy Healing Essay examples10168 Words   |  41 Pagesexplored in sacred literature throughout the world. An excellent summary of ancient and contemporary information on the subject can be found in Michael Murphys landmark book The Future of the Body: Explorations Into the Further Evolution of Human Nature. In the closing years of the Twentieth Century, the intimate connection between body and mind is widely acknowledged. Once the domain of speculation by mystics and philosophers, this realm has in recent decades been visited and revisited by scientistsRead MoreEssay about Postmodernism, Deconstructionism, and the Ethnographic Text5376 Words   |  22 Pagesnarratives and mythologies in which the corporeal â€Å"I† who speaks dissolves itself in a disembodied, depersonalized, institutional speech of power and knowledge (Nichols 1994:7), in the postmodern context, he argues, â€Å"movement and travel become an experience of displacement and dislocation, of social and cultural estrangement, of retrieval, survival, and self-preservation (1994:7). nbsp;nbsp;nbsp;nbsp;nbsp;The Postmodernist view in ethnography, then, questions the basic assumptions underlying the

The Australian Government Failing Health and Minimize Suffering

Question: Describe about The Australian Government for Failing Health and Minimize Suffering. Answer: As the population of Australia ages, an increasing number of the elderly become frail and weak and require specialised care. Even if they do not suffer from a medical condition, the elderly residing at home or in residential care need care and in some cases a constant assistance may be required. As they progress towards the end of life, it is important that the focus of the care team is their quality of life and the transition from life to death be as smooth as possible even as their family members are prepared to face their failing health and minimize suffering. The decision of whether to leave the hospital and spend the last days of the life at home should rest with the aged as far as possible. Effective communication with patient and the family is n important aspect of delivering care. Assessing and managing the patient's condition is an important aspect of providing care. Coping with the needs of the patient and while preparing the family for a loss and bereavement takes an emoti onal toll on the care staff. Specialist palliative care addresses the needs of patients suffering, maximises life and facilitates bereavement and is usually directed at patients suffering from malignant disease. The employment of the key tenets of palliative care for the betterment of the aged under the care of a healthcare team by a general practitioner in conjunction with family members follows the path of a palliative approach. This approach has been promoted by the Australian government department of Health and Ageing. A publication that provides the detailed guidelines for palliative approach in residential aged care was published by the department in 2006 (Palliative care in residential aged care, 2016). (Toye, et al., 2012). More recently, a policy initiative that espouses 'Living longer living better' has focussed on the need to provide better services for the aged who are being cared for at home, provision of support to informal carers and bringing the benefits of healthcare systems to aged care. The residents of aged care facilities may at times develop health conditions due to ageing that may need palliative care even if they have not been diagnosed with cancer. But emotional and physical palliation that is relevant to cancer patients is often found useful in the treatment of age-related conditions. Examples include administration of small doses of opioids may relieve symptoms of aged patients suffering from arthritis (Grbich, et al., 2005). Many aged people prefer to die at home rather than in community settings where they remain separated from the family. A survey has pointed out that of the 800 people studied, 60% were in a hospital on the last day of their life. The objective of a palliative approach is to minimize the need to transfer the aged to a hospital. Physical, mental and cognitive decline are often associated with old age and present difficult challenges to the care -giver. Guidelines on when and how to provide professional help to ease or assist the task of ca re giving have been provided in the Guidelines for a Palliative Approach for Aged Care in the Community Setting. These guidelines have been approved by the National Health and Medical Research Council and provide detailed resources and information for those engaged in practice (Toye, et al., 2012). End of life treatment in home care is often a challenge for General Practitioners because through the several ups and downs of the health of the aged person in their care, it is often difficult to determine the kind of treatment that will prolong life and the decision of when to 'let go'. The adoption of palliative care and a general attitude of acceptance towards patient's death is a common. The erratic course of the terminal illnesses often make it difficult for the General Practitioners to decide the appropriate point at which the 'letting-go' approach needs to be adopted. Help from the palliative care team can help them address this issue better (Sercu, et al., 2015). The best course is adopted in a palliative approach rather than treating the problem focuses on improving quality of life which is more relevant in cases where problems such as dementia occur in end of life stages (Toye, et al., 2012). An important aspect of the delivery of palliative care is effective communication between the care-provider, friends and family members and the care-recipient. The communication should be two-way and sensitive. All information about the care received by the care-recipient should be shared and the family should be prepared to understand the outcomes expected in palliative care. It is important to understand the concerns of the family and both parties should be able to respect each other's points of view. The communication needs to focus on the care outcomes and inform the family about the expected responses to the care provisions made to the care-recipient (Effective communication in palliative care, 2016) Ineffective communication can often jeopardise the delivery of healthcare to the aged care recipients in need of palliative care and lead to unnecessary distress for their family and friends. The family may be left unprepared for the process of dying and may also not understand the complexity of the situation in the absence of proper communication. Anxiety, fear and confusion about the status of the deteriorating health is likely among friends, family and the care givers in a home setting, so preparing them for the end through communication is important. Since treatment is being provided by the healthcare team, relatives and friends may have unrealistic expectations about the outcome. The lack of effective communication makes the family members unable to take informed decisions. There are several ways in which the staff can communicate effectively with friends and family of the care-recipient. A demonstration of a caring attitude that is warm, compassionate and patient create a supportive environment that helps the family to get a better understanding of the situation of their loved one. Mutual understanding between the healthcare team and the family through effective communication can make the experience of providing end-of-life less distressing. But if they are unsure of what is happening regarding the relative's health, it could be due to ineffective communication (Caswell, Pollock, Harwood, Porock, 2015). Another study pointed out that large number of care staff and frequent changes affected continuity and had a negative impact on care giving. Low levels of communication between primary and secondary care providers often were viewed in a negative light by family care givers. Greater comfort and reassurance was present and there was a sense of control wh en communication was better and organisational continuity was maintained (Seamark, et al., 2014). Several steps can be taken by the staff to show involvement and communicate with the family. Provision of emotional support, active listening to understand the concerns of the family care giver, ensuring that the information has been processed as intended by the listener, because often, anxiety and fear can affect the way the information communicated is understood. Inclusion of the family in providing collaborative care and letting them have their say in issues that pertain to their role in the care giving process. Changes in the health status of the care recipient should be communicated to friends and family in a way that is understood by them. Facilitate their proximity with the aged person in residential care when the end is near, providing references to support services that may be required in the event of bereavement, and an understanding of the loss and the associated grief and sadness felt by the family are all part of the effective communication between the care staff and the family and friends of the aged person (Effective communication in palliative care, 2016). In a survey of carers four mrkers of satisfaction were considered important. Feeling that sharing of information happened, feeling of inclusion in decision-making about the plan of treatment, feeling that help is available and someone is available during a difficult situation and that the care staff responds to the needs. Majority of home carers reported dissatisfaction with the extent of involvement (Walker Dewar, 2001). Diffrent people who suffer from different ailments go through different illness trajectories. People suffering from cancer have a definite terminl stage which is spread over a shorter period of decline in health. Those suffering from cardiovascular disease suffer from intermittent serious episodes spread over a longer period of decline while slow prolonged decline occurs in people with dementia and fraility. Progressive chronic illnesses usually follow an illness trajectory as above but episodic and sudden death is common among people with cardiovascular disease (Murray, Kendall, Boyd, Sheikh, 2005). Each patient's case requires an individual treatment. At times the care-recipient suffers less if all treatment is withdrawn. There may be requests for treatment options from thre patient's family that the medical team does not believe in. Assessment and management of the patient's symptoms is an important aspect of providing palliative care alongside treatment for an illness that the care-recipient is suffering from. For example, if a patient is suffering from a progressive neurological disorder, the neurologist can refer the patient for palliative care. The patient can be treated for symptoms, psychosocial issues and spiritual distress. A palliative approach for the treatment of prolonged illnesses that pose challenges such as cognitive decline, behavioral issues and deficits in communication can address issues in order to manage the symptoms. Depression and anxiety are frequently obserbed in ptients with neurologicl disorders but my be left untreated if referrals for palliative tr eatment are delayed (Boersma, Miyasaki, Kutner, Kluger, 2014). As much as I have tried to remain detached from patients while delivering care, the long term care that is often the case while caring for patients in palliative aged care engages me in such a way that I have developed emotional bonds with patients. It is only human to feel and respond to the patient's plight. While the patients are away from the family they look to us, the care staff to fill in the emotional support that they would hve otherwise received from friends or family. I have often discussed the matter with collegues and we have agreed on the need for some kind of support to be able to deal with loss and grief associted with the death of those in our care. Each one of has different abilities to cope with grief, in my case I find it difficult when the lone and aged spouse who is also at times frail and undergoing treatment for a chronic disease has to be comforted until the family arrives. It has been the subject of many studies that care staff who interact with patients on a daily basis need support to cope with loss of patients when death occurs (Marcella Kelley, 2015; Durall, 2011; Slatten, David, Phillips, 2011). In conclusion it emerges that end of life palliative care tht is targetted at improving the quality of life of an aged person in residential care or at home can improve the well-being of the person, the family members and ensure a relatively calm and peaceful end in a dignified manner. The guidelines and updates released by the government of Australia advocate a palliative approach for care of the aged in residential and home settings. The knowledge of specialist palliative care can be employed to treat symptoms of pain and ease the life of frail individuals or those who are suffering from chronic diseases that are non-malignant. Training of medical personnel in making the decision between life prolonging treatment and knowing when to 'let go' are important in letting the patient live a good quality of life while alive. Effective communication is important in making the patient and the family involved in the decision taking process so that they feel involved in the various aspects of care provision. Assessment of the patient's medical condition and management of end of life care are key to reducing the symptoms such as, pain and difficult movement. The emotional involvement of the care staff with the patient and the family and coping with grief when death occurs is difficult to deal with and professional help for dealing with bereavement at the end of long term care is necessary. References Boersma, I., Miyasaki, J., Kutner, J., Kluger, B. (2014). Palliative care and neurology Time for a Paradigm Shift. Neurology, 83(6): 561567. Effective communication in palliative care, (2016, October 1). Retrieved from https://www.agedcarecomplaints.gov.au: https://www.agedcarecomplaints.gov.au/.../effective-communication-in-palliative-care Palliative care in residential care, (2016, October 1). Retrieved from https://www.aihw.gov.au: https://www.aihw.gov.au/palliative-care/residential-aged-care/ Caswell, G., Pollock, K., Harwood, R., Porock, D. (2015). Communication between family carers and health professionals about end-of-life care for older people in the acute hospital setting: a qualitative study. BMC Palliative Care, 14, 35 10.1186/s12904-015-0032-0. Durall, A. (2011 ). Care of the Caretaker- Managing the Grief Process of the Healthcare Professional. Pediatric Annals , 40(5): 266-273. Grbich, C., Maddocks, I., Parker, D., Piller, N., Brown, M., Willis, E., Hoffmeyer, A. (2005). Palliative care in aged care facilities for residents with a non-cancer disease: Results of a survey of aged care facilities in South Australia. Australasian Journal on Ageing, 22(4):5-14. Marcella, J., Kelley, M. (2015). Death Is Part of the Job in Long-Term Care Homes. SAGE Open , 5 (1) 2158244015573912; DOI: 10.1177/2158244015573912. Murray, S. A., Kendall, M., Boyd, K., Sheikh, A. (2005). Illness trajectories and palliative care. . BMJà ¢Ã¢â€š ¬Ã‚ ¯: British Medical Journal, 330(7498), 10071011. Rosenwax, L., McNamara, B., Murray, K., McCabe, R., Aoun, S., Currow, D. (2011). Hospital and emergency department use in the last year of life: a baseline for future modifications to end-of-life care. The Medical Journal of Australia, 194(11):570-3. Seamark, D., Blake, S., Brearley, S., Milligan, C., Thomas, C., Turner, M., . . . Payne, S. (2014). Dying at home: a qualitative study of family carers' views of support provided by GPs community staff. British Journal of General Practice, 64(629):e796-803. doi: 10.3399/bjgp14X682885. Sercu, M., Renterghem, V., Pype, P., Aelbrecht, K., Derese, A., Deveugelea, M. (2015). It is not the fading candle that one expects: general practitioners perspectives on life-preserving versus letting go decision-making in end-of-life home care. Scandinavian Journal of Primary Healthcare, 33(4): 233242. Slatten, L., David, K., Phillips, P. (2011). Compassion Fatigue and Burnout: What Managers Should Know. Health Care Manager, 30(4):325-333. Toye, C., Blackwell, S., Maher, S., Currow, D., Holloway, K., Tieman, J., Hegarty, M. (2012). Guidelines for a palliative approach for aged care in the community setting: A suite of resources. Australasian Medical Journal, 5(11): 569574. Toye, C., Robinson, A., Jiwa, M., Andrews, S., McInerney, F., Horner, B., . . . Stratton, B. (2012). Developing and testing a strategy to enhance a palliative approach and care continuity for people who have dementia: study overview and protocol. BMC Palliative Care, 11:4. doi: 10.1186/1472-684X-11-4. Walker, E., Dewar, B. (2001). How do we facilitate carers' involvement in decision making? Journal of Advanced Nursing, 34(3):329-37.

Scalable SQL And NoSQL Data Stores Click Now to Get Solution

Question: Discuss about the Scalable SQL and NoSQL Data Stores. Answer: Introduction Over the past decade, technology has evolved greatly. This has resulted in a lot of data being generated from different platforms. The requirements for data storage and accessibility have also evolved due to increase in data types creating a problem for the conventional relational databases which is mostly used for structured data. The conventional relational databases have a strict schema and once defined it is impossible to alter it without taking the database offline. For Industries that generated a large volume of data varying in types and formats, the NoSQL database offers a flexible, and scalable alternative. NoSQL Databases NoSQL stands for not only SQL or not relational(Cattell 2011). This type of databases are normally open source and tend have a flexible data model compared to the relational databases. The NoSQL databases are distinguished by their BASE (Basically Available, Soft-state, Eventually consistent) properties which do not conform to the CAP (consistency, Availability, Partition-tolerance) theorem which requires data systems to have at least two of this properties according to Brewer (2010) as cited by Birgen (2014). NoSQL databases favour availability over consistency allowing them to accommodate a lot of read and write commands at the same time. Horizontal scalability and performance NoSQL databases allow distribution of data over different servers that do not share disk space or RAM; once a server is added, the database automatically spreads the data into the new server resulting to load distribution increases the performance of the database (Cattell 2011). This is cheaper than vertical scaling supported by SQL databases as it basic servers involves working together as clusters as opposed to a single very specialized server used by relational databases(Mongodb n.d.). Unlike in relational databases-SQL databases where the schema has to be predefined, NOSQL databases has the capacity to allow the addition of new data types and the schema evolves as new data types are added in. Limitations NoSQL databases are becoming more popular in this digital age as they are very useful in storing big data, however, there are a few areas where they may not be the best choice for everyone. They are open source and therefore lack dedicated support as compared to the relational databases who have readily available experts to help in case there is a problem. They are also not very useful for industries that require manipulation and querying of data as they mostly require manual querying of the database due to lack of a structured language (Leavitt 2010). Key-Value databases They are usually schema-less and use a simple Key and Value relationship where the key acts as a unique index while the value is the data itself (Gurevich 2015). An example of this database is e-bay where one searches for items using a keyword and the database provide the information relating to the keyword. A key value database is a hash table that is used primarily when access is made through primary key. Regarded as the simplest NoSQL database, key value database is the simplest to use. A client can put the value for the key, get its value, or delete a key. The value is just stored. The database is unaware of what lays inside. The application understands what is stored inside the data store. Riak is a key value database that helps to store keys in buckets. It is a way to segment keys. Information related to shopping cart, user preferences, and session data can be stored in the same bucket having a single value and key (Sebastian et al., 2013). Graph databases Graph databases utilize graph structures to store and restore data. The graph is the key concept of the system and relates directly to the data items. Graph databases are relatively older ones in the NoSQL database. Birgen (2014) stated that they employ nodes, edges, and properties to represent and store data. They create relationships between the different nodes and hence are best used to stored data highly interconnected data (Hazim 2014). An example that uses this type of database is facebook where it is used to create relationships between friends and even friends of friends. Neo4J can be taken as a graph database and can be used to solve problems related to application. Graphs like FlockDB and Infinite Graph provide a distributed storage for the nodes. The last transaction IDs are kept track by using Apache ZooKeeper. Java objects are stored as edges and nodes in Infinite Graph. Such databases also use the properties of location and distance so that the application used by the client can give recommendations of entertainment options or good restaurants in nearby places (Miller, 2013). Conclusion This evolution of data to big data which is not easily stored by the common relational databases has created a gap that these databases have filled. They may not be useful for everybody and are by no means on the path to replace the relational databases but are very useful for industries which do not require the consistency offered by relational databases and favour availability more. References Birgen, Cansu. Advanced Process Stimulation: SQL vs NoSQL . Technologynorwegian University Of Science And Technologynorwegian University Of Science And Technologynorwegian University Of Science And Technology Norwegian University Of Sciencnorwegian University Of Science And Technology Cattell, Rick. Scalable SQL and NoSQL data stores. SIGMOD Rec. vol. 39, no. 4, 2011: 12-27. Gurevich, Yuri. Comparative Survey of NoSQL/ NewSQL DB Systems. Department of Mathematics and Computer Science, The Open University of Israel, The Open University of Israel, 2015. Hazim, Dhulfiqar. Document - Oriented NoSQL Databases Performance analysis of Mongodb and MySQL using PHP. THAPAR UNIVERSITY, 2014. Leavitt, Neal. Will NoSQL Databases Live Up to Their Promise? Computer (IEEE Computer Society) Volume 43, no. Issue 2 (02 2010): 12-14. Mason, Robert T. NoSQL Databases and Data Modeling Techniques for a Document-oriented NoSQL Database. Informing Science IT Education Conference (InSITE). 2015. 259-268. Miller, J. J. (2013, March). Graph database applications and concepts with Neo4j. In Proceedings of the Southern Association for Information Systems Conference, Atlanta, GA, USA (Vol. 2324). Mongodb. Mongodb. https://www.mongodb.com/security (accessed 11 02, 2016). Sebastian, Abraham, Swaroop Jagadish, S. U. N. Yun, Robert M. Schulman, and Shirshanka Das. "Transactional key-value database with searchable indexes." U.S. Patent Application 13/935,130, filed July 3, 2013. Sharma, Sugam. An Extended Classification and Comparison of NoSQL Big Data Models. Iowa State University, 2015.