Universal Health Care In Singapore Samples †MyAssignmenthelp.com

Question: Discuss about the Universal Health Care In Singapore. Answer: Introduction: Health care can be considered one of the necessities that each and every individual of the society has a right to. However, various external and internal factors continue to influence the health care provided to different sectors of the society. These elements are diverse, and they vary greatly, ranging from race to gender to age to socioeconomic status, and all the different factors facilitate health care disparities in both accessibility of care and quality of care. However there have been some strategies being implemented to reduce the disparities prevalent in the health care system by the global healthcare monitoring authorities, and universal health coverage policy is one of the robust steps that have been taken to improve the situation. Out of all the countries that have implemented universal health coverage scheme, Singapore had been the country that has achieved excellent progress in their health care system by incorporating this strategy. And that is the reason why the healt hcare system of Singapore is considered as the role model for other countries to look up to (Boerma et al., 2014). This assignment will attempt to explore how Singapore has adapted to the universal health coverage scheme and how it has contributed to overall progression in both their health care system. Overview of Singaporean health care: As per the recent statistics shared by the World Health Organization, the healthcare system in place in Singapore is ranked 6th position from the top of the global list and is considered to be the provider of 4th best healthcare standards in global comparison. Along with that, it has to be mentioned that Singapore is also deemed to have the best health care system in all of Asia, and Singapore proudly serves as the showcasing representative for providing outstanding medical technology and optimal health care standards. The island state has a population of 5.4 million and the surprising elements that attract the attention of the world towards its revolutionary health care system, is the universal coverage or accessibility that it has provided, and appreciable health benefits provided at minimal government spending. According to the Alma-Ata principle of WHO, one of the most significant components of global health improvement strategies is the universal health coverage; the health care system of Singapore entertains universal health coverage at the heart of their policies and principles (Boerma et al., 2014). The presiding health care body for Singapore is the Ministry of Health or MOH, and this authoritative entity is responsible for policies and protocols being designed and implemented in Singapore. The mission statement for the health care system in place in Singapore is to accelerate multidimensional transformation in the healthcare sector by means of introducing infocomm-enabled care delivery system. To meet this goal the MOH invested 6.6 billion dollars in the year of 2015 which is approximately 30% higher than that of 2014. Elaborating more on the history of the progress made by the MOH in the past decade, it has to be mentioned that the turning point for the health care system had been the establishment of health promotions board in the year 2001, which facilitated the disease prevention and national health programs in the nation. The health care system of the nation in the present day scenario is governed by the healthy living masterplan, that by the end of 2020 acclaims to make extensive health care services accessible and affordable for all the citizens regardless of their socio-economic standing. Regarding annual government expenditure, Singapore takes pride in the fact that it spends half of what the rest of the developed countries spend on the healthcare, roughly 4.7% GDP. There are three core principles that have been developed over the course of the past decade in the Singaporean health care system; the first principle integrates the concepts of preventative health care strategies with robust health promotional campaigns and promoting healthy lifestyles. It has to mentioned in this context, that under the guidance of Mr Khaw Boon Wan, the health minister for Singapore in the past decade, the government realized the need for integrative early and accessible primary health care services; and improvement can only be facilitated by improving both the quality and cost-effectiveness of care (Chongsuvivatwong et al., 2011). The second principle of Singaporean health care system promotes healthy living by the 3M system, Medisave, Medishield, and Medifund. Medisave can be defined as the national insurance scheme which provides the citizens with both primary hospitalization expenses and few outpatient treatments as well, by their compartmentalized savings for the medical expenses. Medishield, on the other hand, is a rather complementary scheme to the Medisave scheme, which provides the citizens with catastrophic insurance coverage. Lastly, Medifund is the endowment fund that is operated and generated by the government which is designed to help the citizens with their health care expenses is not compatible to be covered by their Medisave and Medishield. This health care coverage scheme is the key facilitator in the radically low annual government spending in the nation and yet having decent life expectancy rates (Moh.gov.sg.). Considering the progress of the healthcare delivery pattern of Singapore, it has to be mentioned that 80% of the advanced primary care is provided by the public hospitals and the entire transition in the dependency from the privatised sectors to public sectors happened in the last decade itself. The growth in the public health care services can be represented by the fact that in the year 2010, there had been 11509 hospital beds, with 8881 from public sectors and rested from privately owned facilities. Hence it can be stated that the health care system of Singapore has witnessed a progressive growth in the last decade and adhering to the idea of universal health coverage has helped it attain the place that it has in the global list (Guinto et al., 2015). Health care principles facilitating universal coverage: The primary understanding of the universal health coverage scheme is the fact that it entertains the accessibility given to each and every citizen using curative, preventative, palliative and rehabilitative health services. The principle objectives of the universal health coverage scheme are to establish and maintain equity in health care service accessibility, maintaining the quality benchmark for the services provided and protecting the citizen from the financial risk of healthy acre expenses so that all the socio-economic sectors of the society can avail similar health care coverage. It was declared by the WHO in the year of 1989 in the Alma Ata declaration for all the nations to follow. For the Singaporean context, one of the key measures taken to improve the health care services had been to adhere to the UHC scheme (Holmes, 2012). Now one of the key principles that have been followed in order to ensure optimal adherence to the UHC is a strong policy focus at promotional and preventative care pattern for the non-communicable diseases. The Singaporean health care system adapted to a philosophy that boasts a shared responsibility between the government and the citizens to ensure healthy living. Their health care policies like affordable care policy hint at compliance to this key philosophy, so that there is an informed responsibility of the patients and their families to ensure healthy living, while the government overlooks the funding and maintaining cost-effectiveness of the entire health care services. The cost-effectiveness of the healthcare expenditure is maintained in the Singaporean health care services by the help of incentivising the health care providers; so that the financial risk to citizens is mitigated effectively. Hence it can be stated that the government of the Singaporean context provides a safe ty net to the citizens while the citizens contribute financially according to their preferences for their future in a government controlled insurance scheme (Ibrahimipour et al., 2011). It has to be mentioned in this context that the main principle of the UHC is to ensure that health care services are accessible to each and every sector of the society and there should not be any disparity in the delivery of the care services. In order to maintain compliance with this key principle of UHC, a robust and sound monitoring policy is a mandate for the government. In case of Singaporean health care, there is no such monitoring framework, however it has to be mentioned that the key indicators for accessibility, quality and affordability is reported by the Key performance indicator system to the ministry of health (McKee et al., 2013). The role played by the government: he healthcare system in Singapore has seen a drastic change in the past decade, and the most of the credit for the same goes to the initiatives invested by the government. Between the window of 1999 to 2010, the Singaporean health care has seen a rapid boost in the life expectancy in general facilitated by a radical decrease in the premature mortality, coronary heart conditions, cancer and stroke. And this appreciable outcome in the healthcare sector has achieved by the Singaporean government by just spending 4% of the annual GDP. Now this has been possible for the nation to achieve only by the health care expenditure maintenance scheme introduced by the Singaporean government under the guidance of the former health minister Mr Khaw Boon Wan (Tan et al., 2014). The revolutionary steps that the government has taken to ensure the overall accessibility of the health care services distributed to the citizens with equity rather than equality is commendable. The public funding scheme introduced by the government has three different yet interconnected variables. As discussed above, these three elements are nothing hut three insurance coverage schemes that allow the citizens to invest their share in accordance to their affordability and in turn be able to access excellent hospitalisation expenses and along with that coverage for specific outpatient care services as well. Elaborating more on this context, it has to be mentioned in this context that Medisave allowed the citizens to save their own pennies so that their own future can be secured in terms of primary health care expenses, while Medishield provided coverage to the citizens for catastrophic health care needs or incidences. Lastly, the Medifund is the endowment scheme that is the proverbial safety net for the citizen from the government and for the unfortunate ones whose insurance coverage cannot cover the health care expenses they have exhausted. This public funding scheme or system incorporates the principle of equity into the entire scenario so that the support is given to the individuals who need it the most (Tangcharoensathien et al., 2014). Now it has to be mentioned in this context, that the uniqueness of the health care system established in Singapore does not provide a linear or equal health care services to all socioeconomic sectors of the society. Instead, this health care system covers the different needs of different sections of the society with justice and equity. Hence, this initiative from the Singapore government provides the essential element that ensures adherence to the UHC scheme maintaining absolute accessibility to the citizens. Along with that it also has to be mentioned that the Singapore governments deserves more appreciation for the incentivising scheme that propels the healthcare providers to adhere to the system, and along with that the monitoring indicator system also ensures that the compliance to the UHC scheme is not interrupted in any manner (Wirtz et al., 2017). Conclusion: On a concluding note, it has to be mentioned that the Singapore has been successful in presenting an illustration at a remarkable development in the extensive health care delivery for all the nations to follow. By the virtue of three pillars of progress, incentivising, coverage monitoring, and financial protection, it has been able to reduce their annual spending at health to the half of what the rest of the world pays. And yet maintain a quality standard that is truly enviable; all the while shifting the focus of the citizens to public health sectors from privatised entities. Hence, it can be hoped that the initiatives taken by the government in facilitating this revolutionary transition can be an excellent benchmark for the rest of the countries to follow in order to establish equity and uncompromised quality in health care. References: Boerma, T., AbouZahr, C., Evans, D., Evans, T. (2014). Monitoring intervention coverage in the context of universal health coverage. PLoS medicine, 11(9), e1001728. Boerma, T., Eozenou, P., Evans, D., Evans, T., Kieny, M. P., Wagstaff, A. (2014). Monitoring progress towards universal health coverage at country and global levels. PLoS medicine, 11(9), e1001731. Chongsuvivatwong, V., Phua, K. H., Yap, M. T., Pocock, N. S., Hashim, J. H., Chhem, R., ... Lopez, A. D. (2011). Health and health-care systems in southeast Asia: diversity and transitions. The Lancet, 377(9763), 429-437. Guinto, R. L. L. R., Curran, U. Z., Suphanchaimat, R., Pocock, N. S. (2015). Universal health coverage in One ASEAN: are migrants included?. Global health action, 8(1), 25749. Holmes, D. (2012). Margaret Chan: committed to universal health coverage. The Lancet, 380(9845), 879. Ibrahimipour, H., Maleki, M. R., Brown, R., Gohari, M., Karimi, I., Dehnavieh, R. (2011). A qualitative study of the difficulties in reaching sustainable universal health insurance coverage in Iran. Health policy and planning, 26(6), 485-495. McKee, M., Balabanova, D., Basu, S., Ricciardi, W., Stuckler, D. (2013). Universal health coverage: a quest for all countries but under threat in some. Value in Health, 16(1), S39-S45. Moh.gov.sg. (2017). Moh.gov.sg. Retrieved 7 October 2017, from https://www.moh.gov.sg/ Rodney, A. M., Hill, P. S. (2014). Achieving equity within universal health coverage: a narrative review of progress and resources for measuring success. International journal for equity in health, 13(1), 72. Saksena, P., Hsu, J., Evans, D. B. (2014). Financial risk protection and universal health coverage: evidence and measurement challenges. PLoS medicine, 11(9), e1001701. Savedoff, W. D., Ferranti, F. D., Smith, A. L. (2012). Transitions in Health Financing and Policies for Universal Health Coverage. Washington, DC: Centre for Global Development. Tan, K. B., Tan, W. S., Bilger, M., Ho, C. W. (2014). Monitoring and evaluating progress towards universal health coverage in Singapore. PLoS medicine, 11(9), e1001695. Tangcharoensathien, V., Limwattananon, S., Patcharanarumol, W., Thammatacharee, J. (2014). Monitoring and evaluating progress towards universal health coverage in Thailand. PLoS medicine, 11(9), e1001726. Tangcharoensathien, V., Patcharanarumol, W., Ir, P., Aljunid, S. M., Mukti, A. G., Akkhavong, K., ... Mills, A. (2011). Health-financing reforms in southeast Asia: challenges in achieving universal coverage. The Lancet, 377(9768), 863-873. Wagner, A. K., Quick, J. D., Ross-Degnan, D. (2014). Quality use of medicines within universal health coverage: challenges and opportunities. BMC health services research, 14(1), 357. Wirtz, V. J., Hogerzeil, H. V., Gray, A. L., Bigdeli, M., De Joncheere, C. P., Ewen, M. A., ... Mller, H. (2017). Essential medicines for universal health coverage. The Lancet, 389(10067), 403-476. World Health Organization. (2015). Tracking universal health coverage: first global monitoring report. World Health Organization.

Noninvasive Ventilation for Ventilator - MyAssignmenthelp.com

Question: Discuss about theNoninvasive Ventilationfor Ventilator Assistance. Answer: Non-Invasive ventilation technique is a method that entails the use of ventilator assistance in the affected patients nasal way (nasal passage way/nostril) using a mask or similar devices and not through surgical means. It may also be identified as the technique that provides and enhances alveolar ventilation without the use of an endotracheal intubation (Linda Gray-Clinical Specialist). Popularly abbreviated as NIV, it is very different from other ventilation methods. Noninvasive ventilation is majorly used to adult patients. The method does not involve the use of a tracheal tube, laryngeal mask or tracheostomy. While all other methods are considered invasive, Non-Invasive Ventilation as its name suggests is not invasive. It does not involve tubes being put in your nasal airway or body. It is divided in two ways; one is the NPV meaning negative pressure ventilation while the other is NIPPV to mean non-invasive positive pressure ventilation. This ventilation method is used to help ad ults with difficulty in gas exchange in the lungs, chronic hypercapnia respiratory failure and COPD meaning chronic obstructive pulmonary disease. In this case BiPAP or CPAP is applied. BiPAP means Bilevel Positive Airway Pressure, while CPAP means Continuous Positive Airway Pressure. Each of these models i.e. BiPAP and CPAP requires a certain machine. The machine is connected to an electrical outlet which allows air under pressure to enter into the respiratory system of the patient, with respiratory problem. The air under increased pressure passed through a tube to a patients mouth whereby a tightly fitted mask to ensure that no air is leaking to the environment, and thus all air is entering the patients respiratory system. This is done to ensure that the patients lungs do not dilate hence the live of the patient is saved. In addition to mouth mask, a nose mask is also used. In order to keep the mask tightly placed at the mouth or the nose, a string is connected to the mask and tie d at the back of the patient head Respiratory failure is the inability to maintain the required air circulation and change in gas. It mostly is characterized by abnormal tensions of gases in the arterial blood (Bourke, Bullock, Williams, Shaw and Gibson, 2011). Non-invasive ventilation has a number of benefits which includes avoiding intubation with its accompaniment of death rates and prevalent sicknesses that include pneumonia. It also allows for intermittent ventilator assistance thus allowing for gradual weaning and eating normally. When NIV is applied, they mostly consider the Continuous Positive Airway Pressure (CPAP), that is, for sick individuals who have reduced functional residual capacity (FRC), type 1 respiratory failure and acute LVF. Bilevel Positive Airway Pressure (BiPAP) can also be considered for sick individuals with type 1 respiratory failure where these patients are tiring PaCO2 TV LOC and type 2 failure with patients of acute episodes. Although it is a preferable method for ventilation, it is no t advisable for every sick individual who has respiratory failure. It should only be applied by a trained technician or physician using an optimal ventilator on appropriate clinical environment. Consider a scenario whereby adult patient at the advanced levels of neuromuscular illness that is progressive with breathlessness at arrival in hospital. Deep breathes of difficulty followed by tiring gasps (Brochard, Mancebo, Wysocki, Lofaso, Rauss and Isabey,2009). Such respiratory illnesses show some certain indications and contraindications that the medical practitioners use to determine whether to use the non-invasive techniques or use the past ventilation techniques. Non-invasive indications are conditions that satisfy or allow for use of the non-invasive ventilation techniques on patients. They mostly are like symptoms that are shown by the patient to allow for such treatment ( Confalonieri, Potena, Carbone, Porta, Tolley and Umberto Meduri, 2008). For a patient to qualify for the non-invasive ventilation method they should pass through a screening process and the indications should include; obstructive sleep apnea syndrome, which is a proper candidate for the technique, chronic obstructive pulmonary disease with exacerbation qualify for the technique, bilateral pneumonia are proper candidates. There are also other syndromes to be considered in order to determine a patient who need noninvasive ventilation. These includes, A patient with acute congestive heart failure with pulmonary edema is also a proper candidate, neuromuscular disorders, a patient with acute lung injury is a potential candidate, asthma also qualifies to be a candidate for the technique (Girou, Schortgen, Delclaux, Brun-Buisson, Blot, Lefort and Brochard, 2008). Patients with difficulty in gas exchange in the lungs accepting lung resection surgery may allow for use the non-invasive ventilation technique, patient with obesity hypoventilation syndrome is a qualified candidate for the technique, weaning from ventilator. Non-Invasive Ventilation method also has its contraindications. Contraindications are signs that disqualify the use of the Non-Invasive Ventilation method on a patient. These are the signs and symptoms that the patient portrays that make the use of this method harmful to the patients health (Gray, Goodacre, Newby, Masson, Sampson and Nicholl, 2008). There are two types of contraindications when it comes to Non-Invasive Ventilation. There is both absolute contraindications and relative contraindications. The absolute contraindications of this method are quite a number and they include; Respiratory arrest or unstable cardiorespiratory status (Hilbert, Gruson, Vargas, Valentino, Gbikpi-Benissan, Dupon and Cardinaud, 2008). In case a patient is about to go on a respiratory shock or has unstable cardio flow; it is mostly advisable to resist application of the NIV. It may result in lots of complications which may include death. Such a state may require the use of invasive techniques in order to stabilize the respiratory system. Other absolute contraindications include, uncooperative patients. Some patients may not prefer the use of Non-Invasive Ventilation equipment due to some discomfort. Most patients will refuse the use of facial or nasal masks. Inability to protect airway (Kramer, Meyer, Meharg, Cece, Hill, 2008). When the patient has impaired swallowing and coughing, that is, the food may leave the esophagus into the trachea. This may cause lots of complications. Trauma or burns involving the face. When the patient has burns or injuries involving the face, the toxic gases released by the wound may cause skin irritation or many other unintended diseases. Facial, esophageal or gastric surgery. In case the patient has had facial, esophageal or gastric surgery, it is very much advised not to use the non-invasive ventilation because it may make upsets to the unhealed wounds. This may lead to lots of complications. In addition to absolute contraindications include Patients with Apnea (poor respiratory drive) should not be encouraged to follow through on application of Non Invasive Ventilation technique. Sick individuals with reduced or low consciousness are not advisable patients to be put under such a technique because it may lead to the suffocation and choking of the patients (Shneerson and Simonds, 2009). When a patient has air leak syndrome, it is strongly advised to use invasive ventilation method and not the non-invasive method. Life threatening dysrhythmias in a patient is severe and thus the use of invasive technique encouraged over the use of its counterpart. Continuous Positive Airway Pressure (CPAP) in lung injury is also a disqualification from the non-invasive ventilation technique. The non-invasive ventilation method commonly preferred is the BiPAP which is used by individuals suffering from sleep apnea. It prevents the lungs from collapsing and allows for relaxed breathing during sleep. The comparative advantage of BiPAP is that the breaths can be timed for maximum delivery of gaseous exchange in the lungs thus providing comfort. This allows for the individual to get greater air in and out during breathing reducing clogging. An indication that BiPAP is superior to CPAP is that BiPAP is quite oftenly used when CPAP is not successful in treating a patient. BiPAP machines come in different sizes allowing for easy movement and storage and self-operation after understanding its use and operation. BiPAP is mostly referred to candidates with breathing problems. The steps to be taken or procedures to be followed while using BiPAP masks may include: Within 24 hours of initiation of therapy, a clear plan for the nursing care should be provided and documented while the patient is getting Non Invasive Ventilation (Nava, Ambrosino, Clini, Prato, Orlando, Vitacca and Rubini, 2008). The Oral hygiene of the patient should be maintained at an interval of two hours as long as the patients tolerance to cessation of the non-invasive ventilation is greater than or over five minutes. The patients eye care is to be checked at an interval of two hours by the proper clinical physicians. This should be done without hesitance or delay. A full body wash, including shaving the patients face, is to be done every single day or many times as instructed or requested and required in response to the patient diaphoresis and the patients level of tolerance. Other steps are, all patients are to receive pressure injury prevention management as instructed by the practitioners, professionals and supervisors. This is to reduce the fatality and complications that sometimes arise from the use of the non-invasive ventilation method. Every Patient is should be advised and encouraged to sit out of bed as allowed by the technique. When in bed they are to be put in an upright position to facilitate and allow for chest wall expansion to give way for comfort in the ventilation process for the patient (Murgu, Pecson and Colt, 2010. The mobility or movement of the patient should be encouraged, assessed and monitored as per the guidelines provided by the medical practitioners and the doctors of the hospital. Assistance should be provided during such exercises. On clinical presentation or initiation of therapy, Pharmacotherapies are to be noted down and implemented as required in response to patient evaluation and assessment. Any referral to an allied he alth professional is to be implemented where services are available in the clinical environment to support the patients and their significant others psychosocial wellbeing. Every human method ever invented has its pros and cons, and the Non-Invasive Ventilation method including the BiPAP machine has no exception. As much as Non-Invasive Ventilation may be used to support respiratory failure disease, it may cause problems. The use of Non-Invasive Ventilation such as BiPAP may not be 100% or even 90% accurate for solution to the health care problem. It may even result to certain complications which may deteriorates the patients health. Non-invasive ventilation technique is associated with frequent life-threatening and frequent adverse effects which are very severe. This should encourage thorough screening of patients before suggestion or referral to the technique. This will reduce the number of severe complications experienced. The complications are strongly correlated with the degree of pulmonary and cardiovascular involvement. Non-Invasive Ventilation is to be applied with great care in sick individuals with pulmonary process such as lobar pneumonia. BiPAP being a form of ventilation method that is non-invasive is very useful. One of its uses is by sick individuals with sleep apnea. Its function is very similar to the CPAP. It is of two levels that is time-pedaled to achieve maximum efficiency in its functions. These machines can be used in a controlled environment which includes hospitals and homes but with close supervision and maintenance to date of the equipment and machines. Distention of the stomach because of aerophobia aspiration following vomiting while still negative pressure ventilation (Mehta and Hill, (2010). This may cause preload reduction and hypertension. This also includes Inability to or difficulty in relieving dyspnea and Inability to or difficulty in improving gas exchange in the respiratory system. However, failure of the Non-invasive ventilation technique depends on factors such as delayed application of the Non-invasive ventilation treatment. Whereby it may worsen the patients respiratory illness and create some complications that the non-invasive ventilation cannot be useful. Other failure includes inappropriate or unwanted ventilation pressures, Low or inexperience of the clinical staff or team and also, the patients clinical state or condition which maybe be as a result of two or more organ failures. In conclusion, the application of the Non Invasive Ventilation method is widely accepted and used in many clinical environments. It has proven to reduce mortality than its invasive counterpart and still provide respiratory comfort to the patient. Despite its complications, the method is quite effective and very efficient. If every procedure for its application is followed to the latter, then the success stories will be its only tale to tell. Much improvement still needs to be implemented and that will be done with more researches as time passes. But all in all, the non-invasive ventilation method should be administered in all clinical settings. References Bourke, S. C., Bullock, R. E., Williams, T. L., Shaw, P. J., Gibson, G. J. (2011). Noninvasive ventilation in ALS Indications and effect on quality of life.Neurology,61(2), 171-177. Brochard, L., Mancebo, J., Wysocki, M., Lofaso, F., Conti, G., Rauss, A., ... Isabey, D. (2009). Noninvasive ventilation for acute exacerbations of chronic obstructive pulmonary disease.New England Journal of Medicine,333(13), 817-822. Confalonieri, M., Potena, A., Carbone, G., Porta, R. D., Tolley, E. A., Umberto Meduri, G. (2008). Acute respiratory failure in patients with severe community-acquired pneumonia: a prospective randomized evaluation of noninvasive ventilation.American Journal of Respiratory and Critical Care Medicine,160(5), 1585-1591. Girou, E., Schortgen, F., Delclaux, C., Brun-Buisson, C., Blot, F., Lefort, Y., ... Brochard, L. (2008). Association of noninvasive ventilation with nosocomial infections and survival in critically ill patients.Jama,284(18), 2361-2367. Gray, A., Goodacre, S., Newby, D. E., Masson, M., Sampson, F., Nicholl, J. (2008). Noninvasive ventilation in acute cardiogenic pulmonary edema.New England Journal of Medicine,359(2), 142. Hilbert, G., Gruson, D., Vargas, F., Valentino, R., Gbikpi-Benissan, G., Dupon, M., ... Cardinaud, J. P. (2008). Noninvasive ventilation in immunosuppressed patients with pulmonary infiltrates, fever, and acute respiratory failure.New England Journal of Medicine,344(7), 481-487. Kramer, N., Meyer, T. J., Meharg, J., Cece, R. D., Hill, N. S. (2008). Randomized, prospective trial of noninvasive positive pressure ventilation in acute respiratory failure.American journal of respiratory and critical care medicine,151(6), 1799-1806. Masip, J. (2010). Non-invasive ventilation.Heart failure reviews,12(2), 119-124. Mehta, S., Hill, N. S. (2010). Noninvasive ventilation.American journal of respiratory and critical care medicine,163(2), 540-577. Murgu, S. D., Pecson, J., Colt, H. G. (2010). Bronchoscopy during noninvasive ventilation: indications and technique.Respiratory care,55(5), 595-600. Nava, S., Ambrosino, N., Clini, E., Prato, M., Orlando, G., Vitacca, M., ... Rubini, F. (2008). Noninvasive Mechanical Ventilation in the Weaning of Patients with Respiratory Failure Due to Chronic Obstructive Pulmonary DiseaseA Randomized, Controlled Trial.Annals of internal medicine,128(9), 721-728. Nava, S., Gregoretti, C., Fanfulla, F., Squadrone, E., Grassi, M., Carlucci, A., ... Navalesi, P. (2010). Noninvasive ventilation to prevent respiratory failure after extubation in high-risk patients.Critical care medicine,33(11), 2465-2470. Nava, S., Navalesi, P., Carlucci, A. (2009). Non-invasive ventilation.Minerva Anestesiol,75(1-2), 31-36. Ozyilmaz, E., Ugurlu, A. O., Nava, S. (2014). Timing of noninvasive ventilation failure: causes, risk factors, and potential remedies.BMC pulmonary medicine,14(1), 19. Shneerson, J. M., Simonds, A. K. (2009). Noninvasive ventilation for chest wall and neuromuscular disorders.European Respiratory Journal,20(2), 480-487. Vianello, A., Arcaro, G., Battistella, L., Pipitone, E., Vio, S., Concas, A., ... Iliceto, S. (2014). Noninvasive ventilation in the event of acute respiratory failure in patients with idiopathic pulmonary fibrosis.Journal of critical care,29(4), 562-567.

Puddnhead Wilson free essay sample

An analysis of this novel by Mark Twain and the use of metaphors in the story. This paper first provides a brief bio of Mark Twain. It then provides quotes from the novel which characterize Mark Twains use of darkness and its context. The storyline is presented briefly and the reader is shown a vivid picture of the South during the days of slavery. `The well-known author Marl Twain was born in Florida, Missouri, and when he was four years old he moved with his family to a port on the Mississippi River called Hannibal, Missouri. He began setting type for in 1851 and at the same time contributed sketches to his brother Orions Hannibal Journal. Later, Twain was a steamboat pilot on the Mississippi River until the American Civil War. Further on, in 1863 on the Territorial Enterprise in Virginia City, Nevada he became a reporter in 1862, and began signing his articles with the pseudonym Mark Twain which was a Mississippi River expression that meant two fathoms deep. We will write a custom essay sample on Puddnhead Wilson or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page And thus, in 1865 Mark Twain published The Celebrated Jumping Frog of Calaveras County and the author as well as the story became national sensations within few months (Under the Sun).`

buy custom New Technology and the Sociological Point of View essay

buy custom New Technology and the Sociological Point of View essay In the contemporary world, using advanced technology is evident in almost all aspects of life. The public and private sectors, and including the formal and informal sectors, have all embraced the use of advanced technologies in their routine activities. Due to advancement in technology, the world has turned into a global village where, information generated from one corner of the continent is transmitted to all corners of the continent in a matter of seconds. Manufacturers are being able to produce their products from their home countries, and market them to the rest of the world through the internet. Individuals are able to acquire higher education from different learning institutions across the globe, right from their home countries, through the internet. Nowadays, many people do not make daily trips to their offices in order to work; they simply work from their houses using personal computers, which are linked to other computers located in their offices. Suppliers, manufacturers, retailers, and consumers are able to conduct business transactions without any physical interactions with each other. Production of commodities has become more economical as manufacturers adopt the use of computer-aided processing machineries and equipments. The medical sector has also embraced the use of advanced technology in provision of health care. Health care providers use computer-aided methods of storing information, to store their patients medical information: medical information systems. Medical information systems, also known as healthcare informatics, are a combination of computer science, information technology, and health care provision. It is concerned with collection, analysis, storage, and retrieval of medical information of the patients and the general population, using the patients and populations medical information in provision of care, using medical resources, and using medical devices (Barnett, 1997). Medical information systems include not only the use of computers, but also the use of information and communication systems, medical terminologies, clinical procedures, and clinical guidelines. All these systems apply in the fields of pharmacy, nursing, dentistry, occupation health, public health, clinical care, and medical research. The main reason for the application of information systems in the medical field is to achieve improved efficiency and effectiveness of operations. The world is currently experiencing increased use of mobile devices. In 2002, the Finnish Medical Society developed a mobile medical information system for use by health care providers across the globe (Tetard et al., 2005). The system consisted of medical guidelines, which are common in the medical practice. In 2005, the system was developed further, whereby, information features such as databases of addresses and contact information for almost all hospitals, health centers, and pharmacies, emergency care guides for various medical issues, laboratory guide, pharmacology database, and more than 50,000 acronyms used in the medical field were included (Tetard et al., 2005). The mobile medical information system is accessible to all medical care providers across the globe in different languages. Currently, the system is supported by mobile devices, which are supported by windows CE, Palm OS, and Symbian (Tetard, 2005). A good example of mobile device that supports the mobile medical inf ormation system is the Nokia 9210 communicator. Currently, almost 80% of all medical care providers in developed countries; USA, UK, Germany, France, and Japan, are making use o information systems in their operations (Kaissi, 2010). The medical departments of the US military and the Finland military have also adopted the use of mobile medical information system (Tetard et al., 2005). The main reason for using this type of technology in the medical field is to assist health care providers to achieve efficiency and effectiveness in provision of medical care. However, there are other various positive and negative impacts of using medical information systems in the medical field from a sociological point of view. According to Kaissi (2010), one of the social benefits of using information systems in the medical field is that it allows the doctors to concentrate on the patient needs during office visits. This is because the doctors are able to access patients medical information on real-time basis. Instead of spending a lot of time searching for patients medical information from paper records kept in bulk files, doctors spend much time talking to their patients and assessing their current medical needs. Doctors also do not waste much time making phone calls to the laboratories to inquire about patients lab results, thanks to the medical information systems where patients data for lab test results are captured and the doctors are able to access them immediately from their offices. As a result, the society has been able to obtain quality health care services, leading to improved qualities of life. In addition, medical information systems have helped in improvement of patients education during hospital visits (Kaissi, 2010). This is due to easy access of patients medical information, whereby, a patient, a physician, and/or a family member can evaluate together on the screen, the medical history of the patient, the current problem list, the alternative methods of care, and the medication list through the internet (Kaissi, 2005). This allows a patient to understand his/her medical condition(s) better because; he/she can see the information as the physicians explains to him/her. Involvement of patients in their treatment procedures has helped the society to change its perspectives about provision of medical care. The society has now understood that the responsibility of ensuring the recovery of a patient is not vested on the physicians or medical care providers alone, but it involves both the patient and the medical care provider. Improved communication between patients and physicians has allowed many people to participate more in all procedures of health care provision. That is, from diagnosis, to treatment, and to prognosis. Through the medical information systems, patients can contact their doctors to ask questions, report on their medical progress, or ask for further clarifications about certain medical conditions. It is therefore clear that medical information systems are assisting in encouraging patients to participate more in their medical needs. This has resulted into a society, which is more knowledgeable about its health, and the importance of actively participating in health care provision. According to Kaissi (2010), while many experts argue that collecting patients medical information in a digital form that can be viewed on a computer and easily shared by all health service providers has numerous benefits, a new study suggests that it can also lead to serious problems in communication. When electronic gadgets are located in the physicians examination room, instant messages alerts can really distract the physician when communicating with a patient. The patients concentration while communicating with the physsician is also distracted by these gargets. In addition, because physicians are able to access patients medical information even before seeing the patients in person, the amount of time spent by a physician on a patient is reduced. In many instance, physicians are aware of the potential medical problem(s) the patients are suffering from through the analysis of their past medical information. Therefore, when the patient enters the examination room, the physician engages with the patient for some time, makes a prescription for the patient, and then the patient leaves. From the sociological point of view, the afore-mentioned negative impacts of using medical information systems have contributed to less physical interactions between patients and physicians. Patients and physicians are spending more time interacting with each other via the computerized devices than they are spending in physical interactions. Therefore, the physical connection between patients and physicians is drifting apart. Instead of physicians concentrating more on their patients, they are concentrating more on their information gargets. According to Kaissi (2005), lack of enough physical interactions between patients and physicians may lead to a situation where medical information systems will be more important that the patients. If this occurs, then the quality of medical care provided to the society is likely to decrease. Another negative implication of using medical information systems in the medical field is that, people no longer value the importance of keeping their personal medical information private. Although many medical institutions have privacy policies, which provide guidelines concerning disclosure of patients medical information, personal information about ones medical status has become almost like public information (Kaissi, 2005). Unlike in the past where people used to value the importance of privacy of personal matters, people no longer view medical information about others as private. For this reason, the contemporary society is lacking some moral values, which traditionally, used to provide guidelines for respect of other peoples personal information. The security of patients medical information is a great concern, which has greatly affected the wide adaption of this technology in the medical field. Many patients have been getting concerned that their private medical information may be exposed to unauthorized users. Others are worrying that the physicians may capture some of their medical information, which they do not feel comfortable sharing with other people. All these security concerns discourage patients and the entire population from disclosing their historic medical information, especially when they are aware that the concerned health care provider makes use of information systems to capture their data. This has made it difficult for medical institutions to use medical information systems in providing medical care to their patients even where such systems are in existence. Nevertheless, from a sociological point of view, the positive implications of using medical information systems in the medical field outweigh the negative implications of the latter. The quality of health care has increased, resulting into improved societal wellbeing, and many people have been able to participate more in procedures involved in health care provision. Technological advancement offers the medical field with an opportunity to improve its efficiency and effectiveness in provision of health care, hence resulting into more improved wellbeing of the entire society. Buy custom New Technology and the Sociological Point of View essay

Expalin what is meant by 'environmental security'. with reference to Essay

Expalin what is meant by 'environmental security'. with reference to appropriate empirical examples, asses how far environmental - Essay Example Environmental security translates into cultural, political, religious and social security. The environmental security focuses on the effects and impacts of international relations and human conflict on the environment. The environmental security involves three elements such as protecting the environment, responding and preventing conflicts due to the environment and repairing and preventing damage to the environment caused by the military action (Dobson 2006, p. 206). Background to Environmental Security It is vital that a nation properly withstands environmental risks and adverse changes, environmental asset scarcity, environmental conflicts and tensions. When climatic changes are managed within nations, and affected regions, the changes caused such as shortages in food production and altered resource alignments may not necessarily result into ethnic tensions, political disputes, regional defence alignments and global conflict. The environmental security study has a concern that the environmental problems, specifically environmental degradation and resource scarcity, could result into vicious conflict between societies and states. In fact, it is true that environmental issues such as pollution, depletion of the ozone layer and many others with environmental designation have become part of the political discourse internationally (Linklater 2006, p. 77). The environmental security proponents argue that if environmental change can be considered as a source of social unrest and if environmental change is a danger to societies, the concept of security and its policies have to be changed. This argument led the emergence of two groups during the 1980s that were considering the relationship between security and environment. There was environmental policy community to address the security implications environmental change and a security community to look into new definition of the national security. Security has always been seen to have two main functions such as to pr eserve a sate’s territorial integrity and the state’s preferred political leadership (Balzaqc 2005, p. 180). Though presently there is no preferred clear definition of environmental security, the cause effect analysis can be used to come up with a more reasonable, more encompassing and accommodating definition. To achieve environmental security, the support of training, education, capacity building, and information exchange are highly necessary. This achievement can easily be realized when the international institutions and eco- geographical regions are clearly defined (Linklater 2006, p. 77). Environmental changes can be considered as both a cause and a result of conflict. These conflicts can lead to serious economic strain as well as regional and global animosity. History has shown that there is territorial demarcation, which is dependent on the link between resource scarcity, environmental degradation and territorial fights over continental shelves, raw materials, i slands, food and energy. In the traditional and native governments, state powers were dependent fundamentally on the natural scarce resources contained within its territory. The state power increased to be dependent on other key natural resources that are not within its territory (Balzaqc 2005, p. 182). In the modern days, state powers are dependent on the state’s ability to change and convert these natural resources into consumer goods. This transformation may lead

Globalization and Inequality in Developing Nations Research Paper

Globalization and Inequality in Developing Nations - Research Paper Example However, globalization has progressively changed these aspects thereby introducing a new view and ways of governance, conducting business and living. It has been argued that gradually, globalization leads to a rising tide of income for particular groups in developing nations thereby creating inequality (Yusuf 32). Opponents of globalization, on the other hand, argue that while the aspect does improve overall income standards (in the eventual long run); such benefits are however not shared equitably, amongst a nation’s citizenry population (Yusuf 34). Moreover, they are concerned with the fact that widening income disparities, do not only raise both social and welfare concerns but that they also do limit the pertinent drivers of growth and industry. This is informed by the fact that the various opportunities created by the process, may not necessarily become fully exploited especially by the low-income earning bracket (Yusuf 36). Thus ultimately, they envisage the sustainability of the process (globalization), being adversely affected by the rising standards of inequality. This is despite its dependence on the maintenance of broader support across not only state but also global populations (Yusuf 37). This is perhaps the main reason why there continues to exist, continuous heated debate, on the need and importance of the process of human development. Without doubt, the process of globalization has benefited mankind and at the same time brought a cost to overall social contexts through inequalities.

Risk and Compliance Evaluation Essay Example | Topics and Well Written Essays - 4000 words

Risk and Compliance Evaluation - Essay Example In fact, there are specific provisions of the Data Protection Act of 1998 and the Financial Services Authority’s Business Principles that would be violated should the Brokerage Firm forces the issue of using such concept in its operation without any proper control or safeguards. The use of Software as a Service and Cloud computing would also expose the Brokerage Firm to be open to Breach of Confidence legal actions. To prevent such legal actions it is strongly advised that the Retail Investment Brokerage Firm adopt an Information Security Management System that will provide the controls that will protect the information of the clients. The implementation of an Information Security Management System would make the Brokerage Firm diligent in the protection of its client’s information. ... The operational possession of client information requires a huge amount of responsibility since any unauthorized release of information would cause undue harm or it can expose the client to dangers (Marshall, 2001). Even the European community in general has recognized the right to privacy of financial information as a right not to be trifled with. The Parliament of the United Kingdom has passed the Data Protection Act of 1998 to safe guard against such unauthorized intrusion to the lives of its subject. While the Financial Services Authority that is tasked to govern organizations that provides financial service to select clients have mandated several edict that aims to protect the clients of organization providing financial services. The financial services and the information technology industry also responded in kind by delivering a set of standards that can be used as framework with the sole purpose of protecting client data (Davidson, 2010). The advent of technology not only made it easier to bring enormous profit or revenue to the financial services organization’s clients it also made it easier to procure information that could adversely affect the life of its owner. The delicate balance between what is permissible exposure to threat in the face of enormous profit at the soonest possible time made it mandatory for financial services organization to manage the risks involved (Snedaker, 2007). The internet has spawned several innovations that would increase productivity in the same manner that it would raise the revenue for the client of the Retail Investment Brokerage firm. One such innovation is the Software as a Service concept or simply SaaS (Adler & Benoiff, 2009). Companies wishing to have the flexibility with the number of users that uses