Neutropenia in the chemotherapy patient Annotated Bibliography

Neutropenia in the chemotherapy patient - Annotated Bibliography Example This article was concerned with providing information about the consequences and prevention of chemotherapy-induced neutropenia. It also identified who may be at risk from febrile neutropenia regardless of the status of their chemotherapy treatment. This aritcle was useful and relevant to the paper because it provided a lot of information and statistics about the prevalence of neutropenia in these patients as well as the usual methods of treatment. This was published in a journal that was peer-reviewed and found on a reliable database and so the information found here can be said to be reliable. Lyman, G. (2011). A comparison of international guidelines for the prevention of chemotherapy-induced neutropenia. Current Opinion in Haemotology, 18(1), 1-10. Retrieved May 15, 2011, from the Science Direct database. This article studied the differences between international guidelines for the prevention of neutropenia in chemotherapy patients. From this, there were many conclusions made about which were the most effective guidelines. This was useful to the paper because it provided information on how to prevent neutropenia in these patients and the various different treatments available. The article was published in a peer-reviewed journal and was found on Science Direct, a renowned database, so reliability is high. The information in this article centers around neutropenia in general and how this leads to a higher prevalence of bacterial infections. It also gives information on how this may be dangerous to patients. This was relevant in the writing of this paper because it gave more information about how neutropenia can lead to disease and thus why it is such an important problem. It did not give information specific to chemotherapy patients, and thus the information must be used carefully when generalizing. The information was found in a peer-reviewed journal on a reliable database and is thus reliable. Rolsten, K. (2005). Challenges in the

Government and Offshore and Outsourcing Companies Term Paper

Government and Offshore and Outsourcing Companies - Term Paper Example The term paper "Government and Offshore and Outsourcing Companies" discusses if the government should impose stiff penalties on companies that offshore and outsource. Over the recent past, there has been a growing debate about the role of the government in the problem of offshoring and outsourcing of production among many corporations in the US.The debate has been so entrenched in the country that it formed part of the 1992 presidential debate between Bill Clinton and George Bush. The former had commented that offshoring would lead to more gains for the country in the long run. Recently, the debate has shifted focus into suggesting and proposing harsh penalties for companies that ship their operations overseas in a bid to slowing the practice. Many workers and trade unions have demonstrated against the perceived injustice and decried the lack of compensation for the same. It is understandable when such groups press such grievances forth but implementing what they suggest is totally i mpractical. While in truth locals do lose their jobs when companies move their operations elsewhere, it is not factual to assume that this loss surpasses the gains achieved. It is only prudent that one looks at it from both the company’s viewpoint and that of the larger population. To start with, offshoring is ideally a responsive strategy in dealing with the challenges that companies face in trying to make profits. Treating offshoring as an evil would be to miss an important factor that helps us understand the rationale behind it.

Gender Inequalities in Health Sociology

Gender Inequalities in Health Sociology This essay aims to understand why there are health inequalities between both genders and the social classes. This will be achieved by analysing the findings of sociological research, whilst discussing the main problems with how health inequalities are measured. The cultural and structural explanations on why health inequalities occur will also be evaluated. In 2009, The House of Commons Health Committee published a report, which found that even though peoples health was improving in all social groups, the gap between the health of the social classes had widened. The reason stated for this, was that the health of those in higher social classes was improving far quicker than the health of those in the lower social classes. The figures within in the report showed that if you are in a higher social group you are more likely to live longer than someone in the lower social classes. The report also stated that not only do poorer people die younger; they also suffer more years of ill health. Access to health care for the lower classes is also uneven and those who are poor, elderly and disabled are less likely to receive proper treatment than those who are young and able-bodied. A report done by the Learning Disabilities Observatory alleged that this was because the elderly and disabled were unable to access health care due to reduced mobility, being unable to communicate health problems to professionals and their carers failing to identify health problems. (Eric Emerson, 2010) The Health Committee report also illustrates the interrelations of gender inequalities and socioeconomic status. On a geographical level females who were born in the more affluent areas of London, such as Kensington and Chelsea had a significantly higher life expectancy (87.8 years) than females who were born in Glasgow (77.1 years), which has the lowest life expectancy figure in the UK. Subsequently, even though the life expectancy for males and females in social class l (professional) and social class V (unskilled manual) has improved compared to previous years, the disparity between them, is still widening. (House of Commons, Health Committee, 2009) A cultural explanation was also given for why mens life expectancy is more severely affected than womens life expectancy. It was suggested by the Mens Health Forum that men are more likely to take risks with their health due to them trying to cope with stress and conforming to role models in society. Men, compared to women also make poor use of primary care services such as pharmacies and GP surgeries. This is thought to be because men find it culturally unacceptable to discuss their health problems. Men are also more likely to die of health problems relating to their weight, as they are less able than women to identify when they are overweight, as weight is seen as a womens issue. (Memorandum by the mens health forum, 2008) However, even though the data found within the Health Committees report looks convincing the majority of the data is based on morbidity rates, which are not always reliable, as not everyone who gets ill may report their illness. Even human error and illness not being recorded accurately can mean that data based evidence of health inequalities can be unreliable. A previous report done in 2004 by Hilary Graham, featured evidence that suggested that if your parents were poor or in poverty then you were already predisposed to having poor health and having a higher mortality and morbidity rate. This was due to mothers who are poor not being able to afford nutritious food and not being able to access health care. This in turn can lead to babies being born with a lower birth weight, and poor cognitive and physical development. This can influence further problems in health as an adult and therefore, further inequalities in health than someone who was born to parents with a higher income. The findings of the report done by Graham also showed that those living with illness or an impairment were less likely to avoid economic hardships due to their persisting health difficulties and the discrimination they faced, meaning they were less likely to maintain long term employment. In turn, those who did belong to a higher socioeconomic group had a far bette r chance of staying in employment even when faced with ill health. It was also suggested within the report that socioeconomic position affects an individuals health indirectly by influencing intermediary factors such as their home and environment (e.g. poor living and working conditions) and psychosocial factors such as their stress levels and relationships within their family. (Graham, 2004) On analysing Grahams report, there are certain criticisms that can be made on the reliability of her findings. For instance, all the data that featured in her report is secondary; none of it is her own. Therefore, the validity and reliability of the findings featured in her report is only as good as the people she collected it from. However, the research she did use was up -to date and from credible resources. There are cultural and structural explanations that also help us understand why there are inequalities in health between the genders and social classes. In relations to gender inequalities in health the cultural/ behavioural explanation suggests that men are far more likely to suffer ill health and die younger than women due to role models in society and the need for them to feel masculine. Because of this, young men in particular are more likely to smoke, drink alcohol and take drugs. A higher consumption of alcohol and drug taking in particular is thought to be a prime reason why young men are more likely to commit suicide. Women, on the other hand have been socialised to pay greater attention to their health and body as it is seen as a way to define their femininity. However, more women suffer from eating disorders than men do. (Waugh,C. et al 2008) Many feminists believe that women no longer have control over the health care they receive, and any health care they are given is sui ted to doctors and hospital hours. They also argue that women are left to suffer at the hands of male doctors, who are more likely to diagnose female patients symptoms as that of a mental illness. (Browne, 2008) The structural/ materialistic explanation for inequalities in health has suggested that women are more likely to get ill because of their role in society as caregivers because they are more likely to suffer from stress and mental illness. Women who do part-time work are also more likely to suffer from ill health as they are less well paid and have fewer perks than women who are able to do full time work. Men on the other hand often do jobs that are dangerous, stressful and physically demanding (e.g. warehouse work, armed forces jobs etc.) The structural explanation also suggests that those who are in the lower social classes are more likely to suffer from ill health because they are less able to engage in healthy lifestyle choices due to lack of income. They are also more likely to do manual jobs and have less money to buy good quality foods. Lack of transport may make it harder to access medical care and stress of not having enough money can lead to further health problems, which ma y eventually lead to unemployment. Marxists claim capitalist society causes people to become ill as it aims to serve only the higher classes. Being unable to work is seen as the definition of sickness, whilst Doctors are seen as agents of social control with the power to sign people off work. Yet not working can equally make people ill by increasing the risk of ill health, depression and suicide. (Kirby,M. et al 1997) Both explanations are equally valid; however, the structural explanation looks at the wider picture of why people in lower classes or certain genders are more likely to suffer from high morbidity and mortality rates, as they cannot afford healthy lifestyles like the higher classes. The cultural explanation gives insight into why one gender more than the other seeks health care and why data for morbidity if higher for women than men yet mortality levels are higher than men than in women. (Martin Holborn, 2004) In conclusion, the findings in both the reports from the Health Committee and by Hilary Graham both show that the lower your social class, the higher your risk of suffering from poor health and lower life expectancy. Furthermore, the cultural explanation gives reason to why men are less likely to visit the doctor due to wanting to conform to masculine stereotypes, whereas women are encouraged to look after their health. Alternatively, the structural explanation gives greater insight into how your social class can affect your health by limiting your access to healthcare and the means to living a healthier lifestyle.

Jay Gatsby of The Great Gatsby Essay -- F. Scott Fitzgerald

â€Å"A man’s dreams are an index to his greatness† -Zadok Rabinwitz Jay Gatsby lives for his dreams. His dedication to making his dreams a reality, self-made fortune and social prestige, and the unquestionable love for Daisy Buchanan result in Jay Gatsby’s greatness. In F. Scott Fitzgerald’s novel The Great Gatsby, one can determine the world’s view of what greatness truly is. Jay Gatsby is not born great, nor is greatness thrust upon him, but he achieved greatness. Jay Gatsby represents the American Dream: life, loyalty, and the pursuit of happiness. Jay Gatsby dedicates his life to make his hopes and desires real. Jay Gatsby started his life out in the mid-west, as an ordinary, lower class citizen. However, Jay Gatsby did not grow up as Jay Gatsby, but as James Gatz, a Jewish boy. â€Å"James Gatsby- that was really or at least legally, his name† (Fitzgerald 98). He worked for over a year along the shore of Lake Superior. Once he saw Dan Cody’s yacht anchored off shore, he knew that life in the small mid-west town was not for him, he had bigger and better plans for his life. Dan Cody was much older than Gatsby, and he made his wealth from the silver fields of Nevada and the Yukon and every metal since the late 1800s. â€Å"Cody was fifty years old then, a product of the Nevada silver fields, of the Yukon, and every rush of metal since seventy-five. The transactions in Montana coppers that made him many times a millionaire found him physically robust, but on the verge of soft-mindedness, and, suspecting this, an infinite number of women tried to separate him from his money† (Fitzgerald 98). Gatsby knew that having a contiguous relationship with Cody was his chance to make all his dreams come into existence. Gatsby he rowed his boat ... ...m just for a minute, when they were first married—and loved me more even then, do you see?† (Fitzgerald 152). However, Gatsby and Daisy’s feigned relationship went into asunder. Gatsby misconceives Daisy’s love for him, Daisy does not equally love Gatsby as he does her. Daisy chooses to stay with Tom Buchanan, her peremptory husband, for her own security. Gatsby’s greatness resides with his dreams. He pursues the things he hopes, longs, and desires for. Jay Gatsby held onto his dreams, and held on to them as long as it took to make them into reality. Nick saw the greatness in Gatsby â€Å"They’re a rotten crowd. You’re worth the whole damn bunch put together† (Fitzgerald 154). Jay Gatsby represents those who take life extract a greater meaning from it and lives for a purpose. Works Cited Fitzgerald, F. Scott. The Great Gatsby. New York: Macmillan, 1992.

Spina Bifida Research Paper

Spina Bifida A type of birth defect that affects the skeletal system is Spina Bifida. Spina Bifida is a nueral tube defect that occurs when the bones of the spine or the vertebrae do not form accurately around the spinal cord. In severe cases it can inhibit a persons walking or daily activities. There are three basic forms of Spina Bifida. The mildest form is Occulta, the next would be Meningocele and the most severe is Myelomeningocele. (http://www. uptodate. com/contents/overview-of-the-management-of-myelomeningocele-spina-bifida 2012) Myelomeningocele is the case that affects the skeletal system the most.With this, the nerves in the spine protrude out of the spinal canal and a bulge in the skin may appear. If nerves become damaged, there may be a high chance that there could be problems with walking, coordination and bowel and bladder control. The exact cause of Spina Bifida is not known. (Foti 2012) Some say that it could be genetic and is more likely to happen in women that are obese and have diabetes. Symptoms that may indicate that a child has Spina Bifida, include, a curve in the spine, nerves coming out of the back and swelling of the spine.Also, the child will have nerve damage, which can mean that they will have little or no feeling in the legs, feet and or arms. (http://www. mayoclinic. com/health/spina-bifida/DS00417 2012) Another indicator could be a build up of fluid in the brain. Spinal deformity occurs most frequently in patients with Myelomeningocele. It can manifest as kyphosis, scoliosis or lordosis. Most children diagnosed with Spina Bifida also have an allergy to latex. (http://www. everydayhealth. com/health-center/spina-bifida-symptoms. aspx 2012) The diagnosis for Spina Bifida is usually determined by a blood test that a woman has during pregnancy.Most people find out that their child has this defect before he or she is born. If it is not determined before birth, it may be diagnosed by how the baby’s back looks and as they get to the pint of where they should start crawling and standing. You will be able to notice how the weekness in the muscle and bones are. Children that are born wih Spina Bifida may also have mental disabilities as well because it affects the brain just as much as it affects the spine and nerves. (http://www. spinabifidaassociation. org/site/c. evKRI7OXIoJ8H/b. 8029563/k. 83B2/

Dramatic scene Essay

The courtroom scene of act two is described as the most dramatic scene of the play. How does Miller make it dramatic? In your opinion is it more dramatic than act 4?  The Crucible was written in 1953 by Arthur Miller who was born on the 17th October 1915 in New York City, and wrote many plays including No Villain and All My Sons. The play is based on real events that happened in Salem Massachusetts, and even uses real people for characters in the play such as John Proctor and Abigail Williams, although some details like Abigail’s age has been changed to make the play more acceptable. In 1692 mass hysteria took over due to the witch trials as a group of girls started falling ill and accused people of being witch’s and claimed they where helping the devil, casting spells, sending their spirits out, and various other acts of witchcraft. By the time the trials where over, 140 people where accused in Salem alone and 19 where hanged, 13 died in jail and 1 man named Giles Co rey, who is a minor character in the play, was crushed to death. When Miller visited Salem he was able to look at the court papers, and other resources which helped him to write the play. The crucible was written during McCarthyism when Senator Joseph McCarthy, chairman of the HUAC (House of Un-American Activities Committee), started searching for Communist within the American public. People with grudges would accuse their own neighbours of being involved with communism. Senator McCarthy and special congressional committees would then investigate and the accused would have to go to court and be put on trial where it would be decided whether or not they would go to prison as a consequence, which has a similar structure of that to what happened in Salem. Miller had been interested in the witch trials in Salem since he had started writing plays at the University of Michigan and saw the parallel between the two events and wrote â€Å"The Crucible†. Critic’s newspaper etc immediately saw this as an act against the court, and so in 1956 he was called to court accused of being involved with communism. These chapters of his life where capturing those of a mixture of the characters in his play, as when Miller was asked to give names of those he had seen at a communist meeting, he refused even though it could of resulted in prison. Fortunately Miller did not go to prison. The trials had started to come to an end so that could of effected the result of his trial, but he was also married to Marilyn Monroe at the time who was a well known wealthy celebrity who had contacts who where high up in court and so, that may of also had an helped keep him out of prison. The play starts of inside Reverend Paris’s house. His daughter Betty is lying unconscious on the bed and he is praying at her bedside. The doctor has suggested that her illness may be unnatural, and there are rumours of witchcraft going round the village. Parris is scared to go down and talk to them as it could put his position as minister in jeopardy. We find out that Betty had been dancing in the woods with her cousin Abigail Williams, Tituba who is a black slave from Barbados, and other girls in the village, and Parris suspects that it was what caused Betty’s condition, and challenges Abigail about it. She tells him â€Å"it were only sport† and that Betty took fright and fainted when he jumped out at them. Ruth, the daughter of the Putnam’s is also ill and Mrs Putnam talks of her seven dead babies and tells us she thinks they where murdered by a witch. She introduces the theme of revenge as she believes Rebecca Nurse, who was her midwife and praised throughout the village, killed her babies and wants revenge on her for that. Once the girls are alone Abigail threatens them not to tell of what they did in the woods â€Å"Let either of you breath a word, or the edge of a word, about other things, and I will come to you in the black of some terrible night and bring a pointy reckoning that will shudder you†. Abigail goes on to talk about what happed to her parents, who where murdered in front of her by Indians â€Å"I’ve seen some reddish work done at night† and we feel so I sympathy for her, and understand why she would be so aggressive. Betty wakes up screaming and Abigail violently tries to shut her up. When John Proctor arrives on the scene Mary Warren is intimidated and he tells her to leave, the rest of the girls soon follow leaving Abigail and Proctor alone. Like Abigail John is also aggressive, especially towards Mary as at the end of act 2 he puts her in a position where she must choose between him and Abigail, and throws her to the floor where she is left in hysterics as she is being threatened by two powerful and aggressive people who are both threatening to hurt her is she doesn’t side with them â€Å"(In terror) I cannot I cannot they will turn on me -â€Å".