THE CAUSAL LINK BETWEEN GERD AND CHRONIC COUGH Essay

THE CAUSAL LINK BETWEEN GERD AND CHRONIC COUGH - Essay Example Fortunately, the many studies and publications on the relationship between GERD and chronic cough have helped pediatrics to treat and mange GERD-related chronic cough better. However, there are still debates on the causal links between GERD and chronic cough, prompting the writing of this state of the science paper, which seeks to explore the already researched and published findings on the subject. Objectives: To assess the GERD treatment on chronic cough in adults and children with prolonged cough and GERD that is not interrelated to an underlying respiratory illness (for example, nonspecific chronic cough). Literatures and study findings reviews will highlight the causal link between these conditions so that the management and treatment of infants, children, and adolescents with GERD and GERD-related chronic cough could be made more accessible and effective. In this state of the science paper, different types of literatures will be reviewed, among them books, magazines, electronic and print articles from public and institutional libraries. The paper will focus on the various issues on the topic on which medical experts agree and disagree, mentioning any gaps therein. Specifically, the causal link between GERD and chronic cough in pediatric patients will be explored. ... State of Science Paper Topical Outline I. Introduction Gastroesophageal reflux disease (GERD) and chronic cough are examples of the many diseases that pediatricians encounter in their professional interaction with infants and children. GERD is a condition characterized by food (solid or liquid) already in the stomach being thrown back into the esophagus, causing irritation and the commonest and most obvious symptom of GERD, heartburn (Benich & Carek, 2011). Statistics show complications that result from GERD include asthma, Barrett's esophagus, and chronic cough or hoarseness. Research supports that chronic cough, though an indication of underlying disease is a major cause of health facility visits among infants and children. Among the causes of cough are sinus infections, allergic rhinitis, asthma, and esophageal reflux of stomach contents. Even with a recommendation and research support, the ever-changing definition of GERD, insufficient equipment, and lack of randomized controlled trials also make it rather difficult to establish the causal links between chronic cough and GERD (Fishwick & Barber, 2008). Consequent to these difficulties in ascertaining the causal and effect links between cough and GERD, opinions greatly vary between respiratory and gastroenterology stakeholders on the link between these conditions. Background Information: This will be used to establish the context and depth of the problem and will provide a foundation to explore a number of chronic cough prevention and management guidelines that have been designed with some having more positive effects on patients. Information will include the following: 1. Statistics of chronic cough in patients with gastroesophageal reflux 2. Supportive research and

Supply Chain Management Essay Example | Topics and Well Written Essays - 1500 words

Supply Chain Management - Essay Example Certainly, when great service and quality is the focus, the supply chain becomes the center of attention of the company. When it comes to dealing with issues like rising energy and materials prices and the growing challenges of global supply chains, GSK is focused on factors like countering market dynamics, Global Pack Management, speeding up packaging, efficient communication, and other production and operational challenges of the supply chain. According to sources, when energy and material prices rose, GSK turned to the late pack customization program in which production runs were labeled as 30,000numbers for cost effectiveness with 100-5packs at one point in time. In order to match the packaging speed, GSK also introduced online printing that reduced the costs of online printing. Other than that, the company has also initiated coordination efforts through electronic CAD package. The package manages to communicate minor details regarding packaging as well as reviews so that regulat ions are kept under strict check with its suppliers. In future, the aim of this company is to maintain similar tooling and machines among its suppliers. In order to meet the global supply chain challenges, GSK has very efficiently introduced several implementation programs for standardized changes in packaging, pack catalogue for optimization in packaging, and standard Apple Macintosh computers and software for uniform output as well as input (SCM, n.d.). As far as the corporate response to environmental degradation is concerned, GlaxoSmithKline has encouraged a responsible use of most of the dangerous and harmful chemicals in the production.Inculcating this concept in its supply chain, GSK has managed to apply strict and steady standards in its manufacturing operations. GSK makes sure that its suppliers operate according to requirements that arelegal (Schatsky,2012). It has also managed to establish standardized global EHS requirements for both, the suppliers as well as the manufac turers. In this process, it is made sure that the potential suppliers undergo strict pre-contract EHS evaluations. GSK also manages to perform audits where it is made sure that the concerned parties are provided with the needed encouragement and assistance. The parties in this context are referred to as manufacturers and key suppliers. The GSK thus maintains a sound EHS performance metrics that makes it to the Corporate Social Responsibility Report of the GSK, mentioning the performance of suppliers and manufacturers. The chemicals of priority are hence communicated to the suppliers and contract manufacturers that encourage responsible care programs (Global Public Policy Issues, 2011). Organization no. 2: InterfaceFLOR After its inception in the year of 1995, InterfaceFLOR evolved from a square idea in a broadloom to shaping the future on its industry. Over the years of its operations, the company has always focused on reducing the deadly toxins from the facilities as well as the pr oducts it provides to ensure greater sustainability as it has become one of the biggest requirements for today’s organizations (Appendix).InterfaceFLORalso aims at erasing wastes, and thus uses new and creative manufacturing processes to deal with the global challenges. According to the company’s mission, InterfaceFLOR aims to get rid of any bad impact its operations have on the environment by the year of

Monkeywrenching Or Ecological Sabotage Philosophy Essay

Monkeywrenching Or Ecological Sabotage Philosophy Essay Ethics is a set of moral principles which concern the right and wrong doings in which those values. There are two approaches in ethics: Descriptive and Normative approaches. Descriptive approach is the process of identifying and analysing existing values or norms. It aims to describe and explain what attitudes people have, to create a normal and acceptable behaviour. The other approach (normative) are derived from sets of prescriptions and the process. It setting standard of rules to produce standard behaviour. there are three theories in normative approach: Consequantialism, Deontology, and Virtue (Jamieson 2008). Consequentialism is the view that an agent is morally required to perform the act with the best consequences. Most consequentialists are utilitarians. They focus on welfare and insist that the best consequences are those containing maximum welfare. Deontology is the view that certain types of act are morally forbidden even when the performance of those acts would bring about the best consequences. In principle, deontologists can disagree over whether the deontic rules function as absolute prohibitions or are somewhat weaker and can be broken if enough is at stake. They can argue the kinds of action that are morally forbidden. A biocentric deontologist might claim that we are morally forbidden from killing living organisms intentionally (Jamieson 2008). Virtue theory the focus is not so much on what kinds of act are right, but what a virtuous person would do. Virtue ethicist might claim that the moral evaluation of something like deforestation cannot be based exclusively on consideration of what consequences that would have, or on the question whether there is a constraint on acts which lead to deforestation. Instead we must look at the character of the person who performs the act (Jamieson 2008). Environment ethics Environmental ethics is a new sub-discipline of philosophy that deals with the ethical problems surrounding environmental protection. It aims to provide ethical justification and moral motivation for the cause of global environmental protection. It is also known as the study of ethics in the context of the natural world, on both individual and societal levels; the part of ethics which deals with human choices about the environment. It does not concerns only cutting back on pollution, reduce waste, and saving endangered species, it goes beyond that (Alder Wilkinson 1999). Environment ethics begins where the ethics of concern for animals becomes an issue. It concerned with the rights and wrong of how human treat the nonhuman and a quality environment. Thus it considered not only natural but also urban environment: how human are being affected physically, mentally and spiritually by the design and materials of the building in which they live and work, the layout of cities, provision of public services and so on (Alder Wilkinson 1999). Varieties of Environment Ethics Environment ethics was basically divided into two main school of thoughts: anthropocentric perspective and non-anthropocentric perspective. Anthropocentric theorists rely on traditional values based on human well being or human rights while non-anthropocentric theorists claim that natural objects have value irrespective of human concerns (intrinsic value). It also can be distinguish between approaches: individual and collective approach. Individual approach (biocentric) believe that all species have inherent value, and that humans are not superior in a moral or ethical  sense while collective approach (ecocentric) values groups such as species or ecosystems and treats the individual as morally considerable only in relation to the group (Alder Wilkinson 1999). There are different perspectives of anthropocentrism. There are traditional, enlightened and extended anthropocentrism. Traditional anthropocentrism during 1800s abranch of consequentialist (Gilbert Pinchot and James Watt) theory, human centeredness. This perspective focus on environmental consumption. For example, Aristotles saying: Everything in nature fulfils a purpose and that ultimate purpose of nature is the satisfaction of human needs. (Benson 2000) Enlightened anthropocentrism perspective took place later in 1950s to 1960s. It taught the people to be careful on using the resources (conservation steps). It was a branch of deontology and virtue ethics. They believe that we are part of the nature and that in our own interests we should respect nature for its existence and a resource.The third perspective, extended anthropocentrism surfaced in late 1970s. This concerns more about future generations where people have started to plan on sustainable development. It is a branch of deontology and virtue theory (VanDerVeer Pierce 2004). Non-anthropocentric argues that natural objects have value irrespective of human concerns (intrinsic value). Subject matters include animal welfare, biocentric ethics (respect for nature/reverence for life) and aesthetic approach (nature as art). Ecocentric perspective value the systems as a whole (for example, species that form a biological life line or ecosystems or the whole biotic community). It looks at all living things as part of systems. Land ethics: changes the role of Homo Sapiens from conqueror of the land-community to plain member and citizen of it. It implies respect for his fellow-members, and also respect for the [land-] community as such. It was founded by Aldo Leopold to put forward the basis of environmental preservation. Te overall well being of the ecosystem is the measure of what is right or wrong. Deep ecologist, Arne Naess, has tried to synthesize the anthropocentric and ecocentric and re-orientate how we perceive nature and to cultivate a mental state of being in harmony with nature (live an environmentally friendly lifestyle). Naess believed that we should cultivate direct, hands-on sensuous, experiences of natural objects (Benson 2000). Monkeywrenching Monkeywrenching, eco-sabotage (ecotage), ecodefense, eco-terrorism carry the same meaning: they are illegal acts of sabotage associated with environmentalism. It is said to be focusing on creating serious economic damage that will cause temporary or permanent stop to activities that are considered unwanted. Even though the activists might believe in different ethical codes, the activity is directly related with the environmental movement. The term monkeywrenching comes from Edward Abbeys novel, The Monkey Wrench Gang that was published in 1975. The novel tells a story of people doing campaign of eco-sabotage in the south-western United States. They set fire to billboards, disable construction equipment, and pull up survey stakes (VanDerVeer Pierce 2004). Monkeywrenching occurs long back in time. From a novel to manual, monkeywrenching act has managed to make its way to recent world. The novel (The Monkey Wrench Gang) was published in 1975 written by Edward Abbey (writer and essayist) and manual (Ecodefense: A Field Guide to Monkeywrenching) published by Dave Foreman (US environmentalist and co-founder of the radical environmental movement, Earth First!) were and still being used at some point as references to monkey wrench. The act might occurs gently or very dangerous. The group might try to either permanently or temporarily damage the machineries and equipments. Thus monkeywrenching can either cause the development to stop or buy time to negotiate and discuss about the issue. Authorities refer this group of people as eco-terrorism (to purposely relate their doing with terrorists) and as expected many environmentalists, strongly disagree with this usage. They prefer to distinguish between eco-sabotage (an assault on inanimate objects) and terrorism (an assault on people or living things). The environmentalist David Brower, for instance, has argued that the real terrorists are those who pollute and despoil the earth, not those who seek to protect it. Monkeywrenching with regard to Environment Ethics Many consequentialists are utilitarians. They believe that an ethical act is one which increases utility or pleasure, happiness or absence of pain. Despite being violent or out of control for example, that monkeywrenching is acceptable as long as it give desired outcomes and loss nothing in the end. For example, a consequentialist could claim that his/her action of starting a fire in the forest (which is very dangerous) is right since he/she managed to keep the logger from coming into the forest. Deontology, on the other hand, is the view that certain types of act (for example threatening to harm the innocents) are morally forbidden even when the performance of those acts would bring about the best consequences. Deontologists define morality in terms of rights and duties. Monkeywrenching might be accepted depending on the leader or the leading principle. For example, the Earth First!ers strongly believe that monkeywrenching will help them keep the environment save and have a leader with high knowledge of it. Virtue theory focus on the act of a virtuous person and not what kinds of act are right. A virtuous person might think that monkeywrenching is ethical without looking at its consequences whether its positive or negative. But once the outcome become the main concern, that person would not get involve it. Ecofeminism is one example of virtue ethics. Ecofeminism exists as its practitioners pointed out that the domination of male character in protecting the environment causing the aesthetic value of the nature becoming less appreciated. Anthropocentrism concerned the human interests above everything else. The act of monkeywrenching (or the act of sabotage of protecting the environment) most probably being viewed as a waste of time and resources since it does not give any direct benefit to human. Holistic approach believes that something is greater (and more valuable) as the whole than the individual parts. Biocentrism (life-centred ethics), ecocentrism (ecosystem-centred ethics) and deep ecology (identificationà ¢Ãƒ ¢Ã¢â‚¬Å¡Ã‚ ¬Ãƒ ¢Ã¢â‚¬Å¾Ã‚ ¢ and kinship ethics) are included in this approach. According to biocentrism, living things have their own desire making them having the intrinsic value. This group of people believe that monkeywrenching can be useful as a mean to protect the environment as they feel morally responsible to protect the nature. Same thing goes with ecocentrism. Ecocentrism looks at living things as parts of system hence making human having responsibility for being a part of nature. Deep ecologists believe that all life systems are sacred and valuable despite being unuseful to human beings. All living things evolved and bound to responsibility. Being a part of radical environmentalists, deep ecologists approved of monkeywrenching as a medium to protect the nature. Conclusion Environmental activists are divided into two when discussing monkeywrenching. Some approved of monkeywrenching as a way to prevent environment while others disagree of the methods and prefer softer way (such as letters to authorities and public converence). Supporters also divided into two: some accepted the act as they thought it will bring safety to natures living things while others think of negative impacts (cause injury or death, or it might turn public opinion against wilderness preservation) when it come to monkeywrenching. Thus, it is encourage to make sure all participants know about the risks they are going to face by joining the act. Monkeywrenching is considered ethical as long as it does not involves violence and being conducted with care. The practitioners are encourage to follow the guidelines provided by non-government organization when conducting it to avoid any defect. However, authorities do not approved monkeywrenhing as it can cause million and billion of loss for the country and encourage public to be disobedient. Personally, I prefer a gentler way of preventing environmental damage, instead of monkeywrenching the whole development operation. Plus, judging by the way monkeywrenchers function (under cover not and anonymously to avoid being capture by the authorities) itself, shows that monkeywrenching is not an ethical way to do things. I think it is not overrated to say that monkeywrenching is simply an act of a coward.

Boys Will be Boys in Tom Sawyer :: Tom Sawyer Essays

Boys Will be Boys in â€Å"The Adventures of Tom Sawyer† Mark Twain uses â€Å"The Adventures of Tom Sawyer† to reveal his own childhood; thus, many specifics in the book, such as the characters and the setting are very dear to his heart. It is the story about life in a boy’s world, and it discloses the feelings of Mark Twain concerning his boyhood, his town, and the people there. The time period is about two decades before the Civil War, and the setting is in St. Petersburg, Missouri, a small village on the Mississippi River. The main character in the book is Tom Sawyer, of course. Throughout the book, the author compares himself to Tom and his adventures. Tom is all boy, meaning that he is about as rambunctious and mischievous as a little boy can be. He despises anything that places restrictions on his boyhood freedom including school, church, and chores. Not only does he despise these restrictions, but he also will do anything to get out of them. For example, he skips school, and he cons friends into doing his chores for him. While he detests the restraints of life, he loves the liberating parts of life. He longs to take advantage of nature and all it has to offer. A quote from the book that exemplifies Tom Sawyer’s attitude toward life is when the author reveals his philosophy, â€Å"that work consists of whatever a body is obliged to do, and that play consists of whatever a body is not obliged to do.† The other characters in the story revolve around Tom’s character. Tom lives with his Aunt Polly because of the death of his mother. She tries to keep Tom in line, but she struggles because she has such a soft spot in her heart for Tom. When she does discipline Tom, she feels terrible, and in a way, she punishes herself. Sidney is Tom’s half brother who seems to always be making Tom look bad. While Tom is the so-called bad boy who is always getting into trouble, Sidney is the good boy who always does what he is told. However, Tom is presented in a compassionate way, but Sidney is portrayed as a tattler and a deceiver. He is shown to be deceitful when he allows Tom to take the blame and punishment for the broken sugar bowl even though he is the one who broke it.

Lab Safety Essay

Lab safety is very important if you are going to work in a science lab. First off, you need the right equipment and you need to read the signs of each machine or are you are working in, so you can see what safety gear you will need to put on. First off, if you are going to work in an area involving fire, you should wear something non-flammable or an apron to protect yourself and your clothes. you should make sure that there is a fire extinguisher near by. If you nsee a flask symbol on something, that means that there is glass in that area. That is why you should never wear open toed shoes, or if any glass breaks or falls of the table, you have a lower risk of stepping on it and getting it stuck in your foot. When working around chemicals or acids, you should always wear safety goggles. If you happen to get some in your in eyes, it will most likely sting very badly. You will need to rinse your eyes under some water for about 15 minutes to get all of the chemicals out. If you see a hand symbol on something, that means you should wear heat resistant gloves. You will most likely need to wear them, because you will be touching something with a very hot temperature and you could badly burn yourself. When ever working with an electrical device, never use it near water. First of all, you could badly electricute yourself, and it could also start a fire which could be disasterous. That is what you need to do to be safe in the lab. You must use all of those required items. If there is an accident, you should get help immediatly.

Promote positive behaviour Essay

Communication Environment Power imbalance Excessive demands Boredom Lack of boundaries or goals Emotional expression Sensory needs Physical Health Mental Health An individual’s past experiences Age and gender Setting boundaries and rules together, for everyone to work within. Do observations to help understand why behaviours are happening or what resources are being accessed in the setting. Adapting the environment if it’s found that any aspect triggers challenging behaviour. Changing routines if any aspect is found to trigger challenging behaviour Have policies and procedures in place that help colleagues deal – reactively with incidents of conflict and reporting causes/triggers. self-injury physical aggression verbal aggression disruption and destruction of property or the environment stereotyped behaviours (eg rocking) inappropriate or unacceptable sexual behaviour smearing and urination stealing manipulative, deceitful and non-compliant behaviour absconding. People must always be treated with dignity and respect, this may be difficult when their behaviour is threatening to their friends or members of staff, however it is essential to remember that it’s the behaviour that is adverse and not the individual. When challenging the behaviour it is important to disapprove of the negative behaviour, not the individual. Should the situation require reactive strategies, it is important to uphold best practise and continue to treat the individual in a person centred way, according to their placement plan, risk assessment and positive handling plan, paying attention to the individuals faith, beliefs, culture while maintaining dignity. Read more:Â  Promote Positive Behaviour Essay a) how they were feeling at the time prior to and directly before the incident.Aim: to identify the mood, emotion, level of stress. This helps the individual recognise what part their feelings may of played within the incident. b) their behaviourAim: to identify actions. This helps to critically analyse what went on, the physical contact that occured, verbal language and body language. c) the consquences of their behaviourAim: to see what arose from their actions, who if anyone was hurt emotionally or physically, if an object broke, was part of the incident. If the consequences were negative or positive. d) how they were feeling after the incident.Aim: to give names to emotions and feelings, with the possibility to explore alternative means of resolving differences, diffusing challenging behaviour. After the incident you may feel tired and upset, judgemental, shocked, surprised, angry, sad, glad its over. It is important to talk to someone else about what has happened. The individual should be checked over by a member of staff who was not involved in the incident of challenging behaviour. Immediate action should be taken to ensure medical help is sought if there are any injuries which require more than basic first aid. All injuries should be reported and recorded using the appropriate systems.