Monday, May 18, 2020
President Donald Trump - Free Essay Example
Sample details Pages: 1 Words: 416 Downloads: 9 Date added: 2019/03/27 Category Politics Essay Level High school Tags: Donald Trump Essay Did you like this example? He went from businessman to modern-day Hitler. Trump has many corruptions, fraud, obstruction of justice, and broken campaign promises. Trump, for example, has a conflict of interest in his business models and institutions are facing scrutiny from members of Congress because of his Pro Russian and Ties to countries with authoritarian policies. Donââ¬â¢t waste time! Our writers will create an original "President Donald Trump" essay for you Create order He doesnt have a traditional presidency cause of his failure to follow protocol, and his handling of administrative power. He doesnt want to release his tax return history. Trump abuses his power of the executive branch. Trump has always been the leader of something in the public eye before becoming President. He was the leader of his familys real estate company in 1971. He co-authored several books, including The Art of the Deal. He owned the Miss Universe and Miss USA beauty pageants from 1996 to 2015, and he produced and hosted the reality television show, The Apprentice, from 2003 to 2015. Forbes estimates his net worth to be $3.1 billion. Trump has always been a rich man working his way up in the world. He won the election because many people didnt vote and the few that did were males who believed that men should rule and racist believing he would make America great again. The false rumors on social media helped out with the election because ;instead, of doing research people based their opinions off things they read on Facebook. Trump has made many broken promises, to create an affordable healthcare, and he claimed to make America better. Trump has caused nothing but trouble since winning the election. He should not be in office again; otherwise, America will have a lot to fear. Trump came into office and took over and made republicans who were in office leave. Candidate Trump had two strategies to reduce the debt. He promised to grow the economy 6 percent annually to increase tax revenues. Once in office, he lowered his growth estimate to 3.5 percent to 4 percent. If you look at Trumps history, you learn many things about him. He seems to have always been good with words and convicting people to do things. Trump is not a perfect man no one is but, he is a great liar. CNN says You could write an encyclopedia about the ways in which Barack Obama is different from his successor, Donald Trump. On Saturday, Michelle Obama provided a more concise explanation for what distinguishes the two presidents from one another: Obama put country first; Trump puts himself first. Telling us how wrong Trump is for us.
Wednesday, May 6, 2020
The Ethics And Public Policies - 1233 Words
When studying personality psychology, a researcher uses theories, methods, and relies heavily on ethics, reliability, and validity. Using the ââ¬Å"LOTS of dataâ⬠acronym, personality researchers gather information to study people. These include, L-data (life record data), O-data (observation data), T-data (Test data) and S-data (self-report data). (Cervone Pervin, 2013) Each method has strengths and weaknesses. As well as ââ¬Å"LOTSâ⬠, researchers must form a theory to ââ¬Å"decide what to measure and how to measure it (Cervone Pervin, 2013, p. 42).â⬠Theory without research can be speculation and research without theory is gathering meaningless information. Once a theory is made, one can start to gather a lot of data. However, before gathering theâ⬠¦show more contentâ⬠¦By gathering research from observers, such as teachers, parents, and peers, a researcher might find information the individual may not be conscious of when self-reporting. This information is usually gathered by using questionnaires or other forms of rating the individualââ¬â¢s personality. (Cervone Pervin, 2013) T-data, information gathered from experimental procedures, are useful when looking at large studies. Newer technology and large numbers are beneficial to this method. T-data is objective, meaning it measures the goal of ââ¬Å"his/her performance on a task (Cervone Pervin, 2013, p.37).â⬠Finally, S-data, is information gathered when an individual is self-reporting about themselves. Questionnaires are the most common form of S-data. The individual will observe their own personality and report it to the researcher, but S-data has its limitations. Because the individual is self-reporting, they may not be aware of some personal characteristics and fail to report them accurately. Even with this limitation, Self-reports are still widely used more and more today with the advancement of technology and large numbers of diverse samples contributing to resear ch studies. (Cervone Parvin, 2013) Theory, ââ¬Å"consisting of a systematic body of ideas about a particular topic or phenomenon (Cozby Bates, 2012),â⬠is arguably the most important part of research studies. The theory guides which assessment will be used to study which aspect of personality. The information
Old Male Patient Has Got Admitted In Hospital â⬠Free Samples
Question: Discuss About The Old Male Patient Has Got Admitted In Hospital? Answer: Introducation Mr. Donald John, 81 years old male patient has got admitted in the hospital B side on 10.01.2017 in room no: 261. His feelings, self- esteem and perception level was assessed. He has past history of moderate dementia because of transient ischemic attack and is suspected to have Alzheimers disease since 2014. He also had hyponatraemia secondary to dehydration, low mood, anxiety, hypercholesterolemia, Ischemic heart disease with anterior MI, moderate left anterior descending lesion and stenosis of circumflex. He was an engineer and lives with his wife in his village. During history collection, he was found to have difficulty in expressing emotions and inability to write but has good reading skills. He has feelings of inferiority and is reluctant to interact with others due to his disabilities. He has feelings of unworthiness and lack of meaning for his life. His wife is his full support and his one son and one daughter rarely visits him. Mr. John is diagnosed to have dementia which is a condition in which there can be a gradual deterioration of memory, judgment, language, other cognitive abilities and/or sensorial skills along with orientation to time, place as well as person that declines an individuals ability to participate in daily activities. Dementia develops if any changes or damages occur in the brain (Hinkle, 2014). The important cause of dementia involves brain diseases in whichthe neurons of brain degenerates and destroys quickly as compared to that of normal ageing. Mr. John has Alzheimer's disease(a type of neurodegenerative disorder) which is a type of dementia. It is responsible for 2/3rds of dementia in elderly as in Mr. John. InAlzheimer's disease(AD), the degeneration of brain cells leads to shrinkage of brain especially cerebral cortex, which is the grey matter layer that covers the brain and hypothalamus (Linda, 2011). This grey matter functions in processing of thought as well as many complex bra in functions that includes storing memories, retrieval of memories, mathematics-calculation, spelling the words, planning and organizing. Clumps of abnormal protein fragments (beta-amyloid) called as plaques or twisted protein strands (tau) tangles slowly develops and deposits in the brain, which are responsible for increased loss of brain cells (NHS, 2014). This can cause loss of connection between brain cells and reduce the production of neurotransmitters that are needed to relay impulses from one neuron to another. Moreover, Acetylcholine that is responsible for certain activities that are associated with learning skills, attention abilities and memory capacity (Lewis, 2013, Aminoff, 2016). People having Alzheimers disease can feature with decreased acetylcholine production in the brain along with production of glutamate that is much needed for connecting between brain-neurons are also reduced causing trouble in learning and long-term memory (Jurczak, 2014, NHS, 2015). As dementia progresses, the degeneration of neurons spread affecting the neurons of remaining brain parts. Alzheimers disease, ischemic stroke, low s elf-esteem, reserved personality and cardiac diseases of Mr. John has contributed to progression of dementia to its moderate stage (Zhang, 2014,Fairfax, 2014). Alzheimer's disease (AD) features with slow decline in memory, thinking, reasoning as well as behavior skills that causes interference with daily activities in its severe stage. Some features of Alzheimer's disease might be similar to that of age-related changes and other forms of dementia but the differential diagnosis could be made based on the a trace line difference which is discussed as follows. All the persons may encounter 1 or more of these features as they age. 1) Memory loss that affects daily activities- This is the most common feature of Alzheimer's with loss of memory, particularly forgetting the informations that are recently learned, unable to remember important occasions, dates and/or events, repeating the words, asking the same question again and again, increased reliability on memory aids as reminder- notes and/or some electronic devices and/or relatives for activities that they were handling by their own previously as in Mr. John whereas in age- related degeneratio n, the persons may forgets persons names and/or appointments sometimes but can remember it later (Alzheimer's Association, 2017). 2). Difficulties in planning and problem solving- Persons with AD may find difficulties in developing and following a plan/ work that requires numbers, trouble in remembering familiar food-recipes and tracking monthly bills as John suffers. They may not be able to concentrate in things and may take more time to do work than before while in age-related changes, only occasional mistakes occur while working with a checkbook. 3). Problems in completing familiar activities at home or working place or at leisure time- AD persons often find difficulty in completing daily activities. They may have trouble in driving to a well-known place, checking budgets and remembering game rules whereas in senile degeneration, occasional help may be needed to change the microwave settings and/or recording a TV show which is evidenced in Mr. John (McKhann, 2011). 4). Confusing with time and/or place- AD people may not be able to track the dates or seasons, difficulty in understanding things that has not occurred at present and forgetting the place where they are present and how they came there which is similar to Mr. John (McKhann, 2011). In senile degeneration, older person may confuse with the day of the week but trace it out after. 5). Difficulty in understanding visual images with spatial relationships- Having vision problem is a feature of AD as Mr. John. These persons may have trouble reading, differentiating colors or judging distance that can create problems in driving. But in ageing-related changes, the vision changes occur due to cataracts or senile degeneration (Alzheimer's Association, 2017). 6). Troubles with speaking words and/ or writing- AD people may have difficulty in conversing with others; may stop in between conversation and/or trouble in continuing conversation or may repeat words within themselves as like John (McKhann, 2011). AD people may have trouble with vocabulary, selecting right words or naming the things wrongly while trouble occurs only in finding the correct words in age-related changes. 7). Misplacing items with trouble in re-tracing steps- AD people may have difficulty in keeping things in correct places, losing things and inability to go back through steps again and may abuse others. In contrast, people with senile degeneration may misplace things and find trouble with retracing at few times. 8). Poor or impaired judgment- AD people may have poor judgment and/or decision-making process and may pay less attention in self-care activities whereas making bad decision is common in age-related changes. 9). Withdrawal from activities- AD persons may withdraw from routine activities, hobbies, sports, social activities, etc and feels isolated which is similar to Mr. John with feelings of isolation while in age-related changes, they may withdraw from work and familial activities at times (McKhann, 2011). 10). Mood swings and personality changes- AD persons may have confusion, suspiciousness, depression, fearfulness and/or anxiousness as like John who is depressed and confus ed (Alzheimer's Association, 2017). But in a typical age-related degeneration, they may become irritable in performing daily activities. Differential diagnosis has to be made clearly between AD and age-related alterations by comparing the signs and performing appropriate diagnostic examinations (Table-1). The features of diseases other than AD that can cause confusion in thinking, difficulty in focusing on things, loss of memory includes iron-deficiency anemia,diabetes-mellitus, renal disorders, liver diseases, infection, some vitamin deficiencies, thyroid disorders and cardiac, lung and blood- vessel abnormalities (Alzheimer's Association, 2017, Albert, 2011). There is no any single test to confirm the diagnosis of AD. A complete diagnosis should be made by performing clear assessment by considering all the causes. The first step involves collecting medical history with past illnesses and medicine history with family history of AD. Mr. John had transient ischemic attack with suspected Alzheimers disease, depressiveness and anxiousness which suggests that the patient has developed moderate dementia because of AD and its medications. There is a family history of AD with dementia in his father who has died at 81 years of age (Lewis, 2013). Physical examination was performed to rule out diet pattern, alcohol intake, and use of drugs (current, over-the counter medications supplements), vital signs, heart sounds and general assessment. His examination shows that he has trouble in letting emotions with difficulty in writing but not in reading (Alzheimer's Association, 2017). He has forgetting, repeatedly asks questions, short-temperedness, isola ted and boredom feelings, performing activities repeatedly, wanders with-out purpose, aggressiveness, abusing others, shouting, beating, screaming, agitation, depressive features as trouble ventilating his emotions, poor judgmental capacity, lack of self- control with self- esteem, suspiciousness which makes Mr. John to be anxious, with-drawn, low-mood, confused, lost and frustrated (NHS, 2014). Genetic test may be performed to trace out APOE-e4 and autosomal- dominant AD gene which is not performed in John. Neurological exam was performed carefully to rule out conditions that may indicate brain diseases other than AD as smaller/ large stroke, brain tumors, hydrocephalus, Parkinsons disease or other disorders which can cause memory/ thinking impairment (Sperling, 2011, Alzheimer's Association, 2017). Reflexes, coordination of movements, muscle tone as well as strength, eye movement, speech and sensation were assessed in Mr. John which shows that his movements were not coordinated due to poor muscle strength whereas his speech and sensation remained intact (Hinkle, 2014). His mental status examination shows that his memory is impaired and is unable to solve problems with poor thinking skills. He has trouble in saying the date, place and time; remembers words and follows instructions very slowly and unable to perform simple calculations. The Mini-mental status examination scor e of John is assessed to be 15 which suggest that he has moderate dementia. Mini-cogtests by asking him to recall and repeat things after few minutes of 3 common things were performed in which he was able to recall one objects name only after 3 minutes whereas he was unable to recall other 2 objects name (Jack, 2011). His CT exam shows that he has areas of transient ischemic attack with stenosis in circumflex of brain. Mood assessment shows that he is withdrawn, depressed, anxious, isolated with absence of interest in life. Dementia can lead to varied difficulties in cognition as memory loss, learning difficulties, poor thinking, poor judgment, language with praxic functioning difficulties, decreased psycho-motor speed, and poor problem- solving abilities. Behavioral problems involves self- care deterioration, trouble communications, lapse in speech, absence of clarity, hallucination with delusional thoughts, alterations in gait with balance (NHS, 2014). Emotional problems includes dis-regulated with poorly organized behavior, apathy, energy loss, unwilling to work, delayed thinking, agitation, neglect, paranoia, with mood swings (DH, 2012). The trouble arises based on the shrinkage in the brain lobe. If frontal lobe is involved, the persons self and others awareness are affected as in Mr. John whereas if parietal lobe is affected, the language with speech-comprehension, vision as well as meaning of objects can be impaired. When temporal lobe is damaged, short and long- term memories will be impaired an d memory fades when the damage moves deep into brain areas. Mr. John is on Tab. Risperidone- 500 mg to control his agitation and schizophrenic features. It is a Benzisoxazole derivative which is an antipsychotic medicine that has higher affinity on 5-hydrotryptamine as well as dopamine receptors. Risperidone is mainly for managing schizophrenia, behavior alteration in John with dementia and mood swings (depression) (Galbraith, 2015). The features of John suggest that he is in moderate stage of dementia as forgetfulness, more marked changes, requires more support for daily activities, highly aggressive, gets upset easily, anger, difficulty performing activities, low mood, withdrawn, inability to recall address, names, etc, confusion, needs help for choosing clothes, difficulty to control bladder and bowels, alterations in sleep patterns, personality with behavioral changes (suspiciousness, repetitive behaviors as wringing hands/ tissue-shredding) ((McKhann, 2011, DH, 2012). Mr. John requires a structured physical, mental, emotional, societal, cognitional, sexual as well as spiritual care by social-care specialists that is rendered in aged-care homes. The treatment for John should be provided in stages so as to promote the quality care. Firstly, they will evaluate the reasons for his altered behavior. The workers in aged-care home will establish rapport with him and his family (NHS, 2015). In aged-care homes, they will refer to psychiatrists to evaluate his mental problems, counselors to give individual and family counseling, clinicians to manage his medical issues, staff-nurses to meet his personal-needs and occupational-therapists to make John to perform simpler activities. In aged homes, the societal workers will be assessing, counseling, communicating, caring, supporting and guiding John by developing a framework of management and will be managed accordingly. The nurses have to clearly diagnose the stage of patient by comparing it with diagnostic criteria. She should assess his background, history, likes/ dislikes; capacities and abilities to plan interventions. Nurses should provide person- centered care which involves caring persons at the centre of other care rendered based on his needs, wishes, believes and preferences. This person- centered care can minimize agitated feelings in John. This approach involves valuing him, giving respect, enabling social relationships and choices, giving opportunities to John to stimulate him, recognize as well as consider him as a whole (NHS, 2015). Nurses should identify Johns needs and plan for supportive care based on his preferences. Nurses should meet his daily needs, support him to perform elimination and provide diversion activities. Non- personal-centered care can also be given by dictating the care-needs to his wife by considering his needs. John can be referred to support workers who focus on his skills with abilities rather than the skills he has lost. Strategic plans can be developed based on his disabilities as urinary bowel incontinence, anxiety, depression, agitation, repetitive words, etc (Gray, 2013). The history of John indicates that he has depression because of his ageing process and Alzheimers disease. His disabilities have affected his self- identity; respect, and esteem which have developed negative thoughts in him (Orth, 2012).On examination, he assessed to have inability to express his feelings and write. He has inferior feelings and feels hesitant to mingle with others because of his disabilities. He looks to have low mood, anxious, isolated and withdrawn. He expresses that he is worthless, hopeless and there is no meaning for his life. His modified behavior may lead to inability to express his needs that may again stimulate frustration in John expressing with challenging- behavior. AD is found to interfere with the regulation of neurotransmitter which affects the mood (begins at the early stage of AD development) and hence it leads to the development of depression (Ellison, 2016). Moreover, damage/ error theories suggest that presence of chronic diseases such as hypertension, ischemic stroke, cardiac diseases, etc contributes to depression development which is similar to John (Jin, 2010). The disabilities that are caused by his multiple disorders has increased his feelings of stress that made him dependent on his wife for support which has lead to worthless, hopeless feelings and insomnia resulting in depressiveness. Even, the disengagement theory suggests that as the person ages, he starts to withdraw and isolate himself from interaction with society that causes decline of continuity in daily activities causing physical with psychological changes as in John. The immunological theory adds that as the person ages, the functions of immunology declines slowly resulting in Alzheimers disease, cardiac diseases, etc leading to depressive ideas as John experiences. Depressive features increases and takes a different quality, as AD intensifies. Apathy commonly occurs when the depressive features emerges in the moderate stage of AD with classic symptoms that includes feelings of agitation, withdrawn, weeping, difficulty in expressing feelings of joy (anhedonia), lack of appetite, severe hallucinations, suicidal thoughts and psychotic delusions which is evident in Mr. John with these features. When the neuro and cognitive impairment intensifies to a more severe stage, the affected persons may not able to remember depressive symptoms and/or to clearly understand or articulate its meaning (Ellison, 2016). In the severe stage of dementia, the unwanted disruptive behaviors that include resisting for getting care, expressing delusive feelings or showing increased agitation behavior and sometimes self- destructing behaviors will provide cue for developing depression. Though these are not evident in Mr. John, he should be closely observed for these featu res to handle it at the earliest. Thus, adequate treatment and proper care can delay the progression of dementia and its related feature. Reference Albert, M.S et al. (2011). The diagnosis of mild cognitive impairment due to Alzheimers disease: recommendations from the National Institute on Aging-Alzheimers Association workgroups on diagnostic guidelines for Alzheimers disease:Alzheimers Dementia.7:2709 Alzheimer's Association. (2017). 10 Early Signs and Symptoms of Alzheimer's. Retrieved from https://alz.org/10-signs-symptoms-alzheimers-dementia.asp Aminoff, J.F et al. (2016). Handbook of Clinical Neurology. London: Elsevier Department of Health- DH. (2012). Caring for our future: Reforming care and support (White paper) Norwich: The stationary office. Ellison, J.M. (2016). Depression and Alzheimer's disease. Retrieved from https://www.brightfocus.org/alzheimers/article/depression-and-alzheimers-disease Fairfax, C.N. (2014).Social Work, Marriage, and Ethnicity: Policy and Practice: J Human Behav Soc. Environ. 24:83-91. Retrieved from https://www.researchgate.net/.../272123480_Social_Work_Marriage_and_Ethnicity_Poli... Galbraith, A., Bullock, S. Manias, E.(2015). Fundamentals of Pharmacology: An Applied Approach for Nursing and Health. Retrieved from https://books.google.co.in/books?isbn=1317325877 Gray. (2013). Transforming adult social care. Retrieved from https://books.google.co.in/books?id=p0UbAgAAQBAJpg=PA232lpg=PA232dq= Hinkle, J.L. (2014). Brunners and Suddarths Textbook of Medical Surgical Nursing. (13th ed.). Philadelphia: Lippincott Williams and Wilkins. Jack, C.R et al. (2011). Introduction to the recommendations from the National Institute on Aging-Alzheimers Association workgroups on diagnostic guidelines for Alzheimers disease:Alzheimers Dement.7:25762. Jin, K. (2010). Modern Biological Theories of Aging: Aging Dis. 1(2): 7274. Retrieved from https://www.ncbi.nlm.nih.gov NCBI Literature PubMed Central (PMC) Jurczak, W., Porzych, K Polak-Szabela, A. (2014). Nurses Role In Taking Care Of A Patient With Alzheimers Disease: Medical and Biological Sciences. 28(2): 5-10. doi: https://dx.doi.org/10.12775/MBS.2014.014 Lewis, S.M., Heitkemper, M. M., Dirksen, S.R. (2013). Medical Surgical Nursing: Assessment and Management of Clinical Problems. (9th ed.). Missouri: Mosby. Linda, C et al. (2011). Alzheimer's Disease. Retrieved from https://books.google.co.in/books?isbn=0313381100 McKhann, G.Y. (2011). The diagnosis of dementia due to Alzheimers disease: Recommendations from the National Institute on Aging-Alzheimers Association workgroups on diagnostic guidelines for Alzheimers disease: Alzheimers Dementia. 7Answer(3): 263269. doi:10.1016/j.jalz.2011.03.005 NHS. (2014). Dementia guide. Retrieved from https://www.nhs.uk/Conditions/dementia-guide/Pages/dementia-behaviour.aspx NHS. (2015). Dealing with challenging behavior. Retrieved from https://www.nhs.uk/Conditions/social-care-and-support-guide/Pages/challenging-behaviour-carers.aspx Orth, U. (2012).Life-span development of self-esteem and its effects on important life outcomes: J PersSocPsychol. 102: 1271-1288. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/21942279 Sperling, R.A et al. (2011). Towards defining the preclinical stages of Alzheimers disease: recommendations from the National Institute on Aging-Alzheimers Association workgroups on diagnostic guidelines for Alzheimers disease:Alzheimers Dement. 7:28092 Zhang, L. (2014).Self-esteem as mediator and moderator of the relationship between stigma perception and social alienation of Chinese adults with disability: Disabil Health J. 7: 119-123. Retrieved from https://europepmc.org/abstract/med/24411516
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