Ethical Issues in Healthcare The WritePass Journal

Ethical Issues in Healthcare ABSTRACT Ethical Issues in Healthcare ). They must ensure that the woman has all the information regarding potential risks and problems, that measures to reduce levels of pain are implemented, and that the women is aware of what to expect prior, during and after the procedure (ICMA, 2012).   Additional staffing is also necessary for the provision of more efficient medical services, as well as more empathetic and highly trained staff.   Furthermore, those women who are considering an abortion must have their concerns and the circumstances surrounding their own ethical dilemmas addressed (Tremayne, 2000; Karasahin and Keskin, 2011). It has been argued by Rosenfeld (1992) that â€Å"healthy women who want to complete an unintended pregnancy in the first trimester have few significant or negative emotional consequences† (p. 137).   Although a few women may have feelings of ambivalence or guilt, many also feel a sense of freedom and experience other positive reactions, including relief. However, the emotional response of a woman and her family to medical or therapeutic abortion is complicated. A number of factors may help address women at risk of emotional problems and depressive symptoms after abortion (Rosenfeld, 1992). Women who terminate their pregnancy during the second trimester, have a history of multiple abortions, have pre-existing psychiatric problems or have a lack of support at home are more likely to have emotional problems (Rosenfeld, 1992). By being aware of this, health professionals can implement the appropriate pre- and post-abortion care. This is also the case for women who have an abort ion for medical or genetic reasons. These women are at increased risk of developing depressive symptoms and therefore health professionals are required to provide the appropriate psychological as well as medical support (Boss, 1994). Blumberg et al. (1975) explains, â€Å"Perhaps the role of decision making and the responsibility associated with selective abortion explains [sic] the more serious depression following [the abortion]† (p. 805). Medical ethics related to abortion are most relevant when they focus on the individuals choosing to have an abortion, as opposed to just health professionals carrying out the abortion or treating the aftermath. To this end, a philosopher, focusing on medical ethics can play a vital role in exposing problems which exist within hospitals.   Ã‚  There is an enormous demand for philosophers within the healthcare setting, suggesting a common ethical, moral and social viewpoint that could facilitate advice-giving to health professionals (Polaino Lorente, 2009). International Ethical Codes In the Hippocratic Oath, abortion is connected to medical ethics in both its actual form and contemporary reformulation such as stated in the World Medical Associations 1948 Declaration of Geneva (Kivity, Borow and Shoenfeld, 2009). According to this oath, all members of the human race have a right to life and this is agreed globally in conventions such as:   Ã‚  The Universal Declaration of Human Rights (1949)   Ã‚  Declaration of the Rights of the Child, which clearly refers to such rights as applying to the unborn (1959)   Ã‚  International Covenant on Civil and Political Rights (1976). However, the Society for the Protection of Unborn Children’s (SPUC’s) opposition to abortion is dependent on ethical principles which have masked universal acceptance (SPUC, 2012a). While the SPUC consists of members from many different religions, it is not an organisation based on religion. Nevertheless, this highlights the need of a focus on common acceptable (as opposed to religious-based) ethical dimensions in contemporary healthcare, especially in terms of considering the ethical implications of abortion. Abortion in the United Kingdom The main reason for legalising abortion in Britain was the suspected number of illegal abortions being carried out. Pro-abortionists indicated that every year, there were 100,000 illegal abortions before legalisation (SPUC, 2012b). The committee of the Royal College of Obstetricians and Gynaecologists provides evidence that in England and Wales, there were 15,000 illegal abortions annually in 2007 (Event, 2008). Thus, in the UK, the application of ethical theories along with related approaches to practical dilemmas in healthcare focusing on abortion is particularly important and relevant. Actual counts of legal abortions The Abortion Act was agreed in 1967 and a year later it became effective as a statute in England, Wales and Scotland. For the period of 30 years following the implementation of the Act, year on year the total number of abortions performed rose by 700% (SPUC, 2012b). In Britain, five million abortions were performed over this period. Yearly, 170,000 abortions occurred during the 15 years prior to 1997. It was over 187,000 in 1998, with more than 510 abortions a day, which was 87% higher than the pro-abortionists estimate of illegal abortions in the 1960s (Sedgh et al., 2012). Reasons for abortion Although more than 90% of abortions are authorised and performed to protect the mothers physical or mental health, the majority of these abortions are performed for social reasons rather than medical reasons, and this has become widely accepted (Corkindale et al., 2009). Indeed, in Britain abortion is efficiently practised on demand (Ingham et al., 2008). This poses further ethical implications for healthcare professionals since abortion is no longer only considered for medical reasons, but is frequently a social choice and a method of solving an unexpected or unwanted pregnancy (Koyama et al., 2005). Contraception and abortion Although the pro-life movement is reluctant to make a connection between contraception and abortion, with some contraceptives there is both a link to abortion and identification with abortion (Smith, 1993). Indeed, some contraceptives are abortifacients and work by causing early term abortion.   Furthermore, the number of abortions cannot be stopped primarily by contraception since pregnancy prevention also results in an anti-child state of mind; such unplanned babies are observed only as the unwanted result of contraceptive failure. The eugenics movement Eugenic ethics is protected as a religious belief, political philosophies, and judicial systems, and it is the reverse of the code that all human beings have equal value (Kasun, 1988). The mentality of the eugenic adjudicators is unusually narrow compared to physical, psychological or social situations (Connelly, 2008).   This leads to disabled and unborn groups. Thus, issues of disability and eugenics are remarkably relevant to the application of ethical theories focusing on practical dilemmas in healthcare. Foetal tissue in medical research The major source for research into foetal tissue is from babies that are the result of induced abortion; such research consists of the human genome project. If permission is given, the dead bodies may well be used for research, but a mother aborting her child would not likely provide such support. In research, the use of foetal tissue seems to justify abortion because it can be used to assist in the health and life of other people. At the same time, it could be argued that such research is morally wrong because it neglects the unborn babys right to life (Nie, 2002). Abortion and disability Every abortion involves an assumption that the existence of unborn babies is of lesser value than an adult humans life. It could be argued that abortion due to a disability diagnosed in the unborn child is not only an attack on the most vulnerable but on one who it is necessary to protect. It is also offensive to all disabled community members as it transmits to them the sense that they are inferior to, as well as of less worth than, the able-bodied (Sheldon and Wilkonson, 2010). Pre-natal screening In Britain, most pregnant women are offered regular pre-natal testing. It is a crucial activity, which has resulted in a greater number of women who may not have considered it before going on to have an abortion. Such tests are presented and if the results are positive for a disability, the immediate option given to parents is to make a choice between either continuing with the pregnancy or having an abortion. Britain offers pre-natal screening for disabilities only where a routine ultrasound has highlighted a potential problem, there is family medical history to suggest a child may inherit a condition, or the age of the mother puts her child at an increased risk of having, for example, Downs syndrome. In cases of artificial insemination, before implantation and hopefully fertilisation, the embryo is screened. Whilst still in the test tube embryos are monitored to determine their sex and genetic conditions, but can be superfluous. This approach prevents embryos from continuing to live (Hundt et al., 2011). Thus, medical and nursing professionals working in healthcare related to abortion must address the issues related to pre-natal screening adequately. Gene technology Genetic science is used to enhance the well-being of humanity, through exploration into gene therapy and to care for people with, for example, a genetic condition such as cystic fibrosis. However, this technology may be misused in order to limit human life. Genetic engineering attempts to engineer babies by manipulating their genes in the laboratory. However, the source from the genetic map position in the human genome program may be misused (Heinrichs, 2002). DISCUSSION The topic of abortion raises moral and ethical issues that need to be addressed by physicians, nurses, and clinic staff involved with conducting abortions.   While abortions for medical reasons are legal in Britain, some staff may question the procedure for personal and religious reasons.   Those staff   who are pro-life (and see abortion as akin to murder) will likely seek work in other settings and thus alleviate their sense of guilt.   Obstetricians, who often participate in the act of abortion, will need to have a professional view that sees the action as ethical, although some may hold private views of its morality, perhaps influenced by religious beliefs   (Chervenak and McCullough ,1990). For example, health professionals might ask the question, â€Å"When is the foetus a patient?† The answer is when it is viable, regardless of age of gestation.   Indeed, it could be argued that only the woman carrying the foetus can give a pre-viable foetus patient status. If the foetus is classified as a patient, it can be further argued that ending its life is almost never ethically justified. The statistical data discussed within this essay indicate that few abortions are actually for medical reasons, but rather for personal, social and economic reasons. This has generated a great deal of discussion in terms of the ethics of abortion.   Since the procedure is primarily used by the lower economic classes (who perhaps become pregnant because of lack of knowledge about birth control), abortion can be seen as a method to keep the future population of those likely to require government assistance in welfare and medicine somewhat reduced.   As yet, there doesn’t appear to be any political or ethical writer ready to take this issue up.   Some groups (such as African Americans) see this as an attack on their race.   Feminists likely support the procedure if it is the wish of the pregnant woman. Many health workers would continue to support abortion on demand as it eliminates reliance on illegal abortions, which were often dangerous to a woman’s health, as wa s a huge problem in the past. A few points should be made about the ethical issues posed by new technologies (such as embryos in stem cell research, sex selection and gene manipulation).   In all of these cases, decisions are being made to limit viable life.   Outka (2002) raised questions about the ethics of human stem cell research.   Many good embryos are destroyed for the sake of research.   This is seen as clearly unethical.   Outka concludes that it is acceptable to conduct research on ‘excess’ embryos by appealing to the principal of â€Å"nothing is lost. Modern science has made it easy to determine the sex of the foetus at a very early stage. If the sex is female (and the parents already have a girl), will they seek an abortion?   Is the doctor or clinic likely to raise moral and ethical concerns?   In many cultures, a son is deemed necessary, so with new technologies many female foetuses in India and China have been aborted. This raises the question of whether this cultural bias being seen in the large Indian population in the UK? 3.1. CONCLUSION Ethical Issues in healthcare related to abortion are becoming increasingly relevant, as it provides an opportunity for discussion on various dimensions of contemporary healthcare. It also examines the application of ethical theories along with related approaches focusing on abortion. However, it is suggested that medical institutes and hospitals providing safe abortions should be aware of all ethical issues and the human rights implications involved. Their workers, including doctors and nurses, should be trained on the ethical issues of abortion so that they can provide comprehensive medical care to women who consider or opt for an abortion. It is important to explore new opportunities for the in-depth study of ethical dimensions of modern healthcare, which examines the appropriate application of ethical theories and related approaches to effective dilemmas in healthcare focusing on abortion. There are many suitable applications of ethical theories and approaches to an ethical dilemma available, which mainly focus on the international and the population-control development, reasons for abortion, contraception and abortion, birth control and human life attitudes, disability and eugenics, abortion and disability, and other related ethical issues. Nevertheless, there remains a need to address each of these ethical issues specifically in terms of healthcare and the dilemmas experienced by healthcare professionals. REFERENCES Abortion Act, 1967. (C.87), London: HMSO. Aguirre, D.G. and BillingsL. 2007. Unwanted Pregnancy and Unsafe Abortion. TUFH Women and Health Taskforce. [online] Available from:   the-networktufh.org/sites/default/files/attachments/basic_pages/WHLP%20Unwanted%20Pregnancy%20and%20Unsafe%20Ab.pdf [cited 05 May 2012]. Blumberg, B.D., Golbus, M.S. and Hanson, K.H., 1975. The psychological sequelae of abortion performed for a genetic indication. American Journal of Obstetrics and Gynecology, 122(799-808), p. 806. Boss, J.A., 1994. First trimester prenatal diagnosis: Earlier is not necessarily better. Journal of Medical Ethics, 20(146-151), p.147. Brody, B., 1972. Thomson on Abortion. Philosophy and Public Affairs, 1(3), pp.335-340. Chervenak, F. A. and McCullough, L. B., 1990. Does obstetric ethics have any role in the obstetrician’s response to the abortion controversy?   American Journal of Obstetrics Gynaecology, 163(5 Pi), po.1425-1429. Connelly, M., 2008. Fatal Misconception: The Struggle to Control World Population   Cambridge: Belk nap Press of Harvard University Press. Corkindale, C.J., Condon, J.T., Russell, A. and Quinlivan, J.A., 2009. Factors that adolescent males take into account in decisions about an unplanned pregnancy. Journal of Adolescence, 32(4), p.995-1008. Department of Health., 2011. Abortion statistics, England and Wales: 2010. [online] Available from: dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsStatistics/DH_126769 [cited 05 May 2012]. Dudley,S. and Mueller, S. What Is Medical Abortion? National Abortion Federation. [online] Available from: prochoice.org/pubs_research/publications/downloads/about_abortion/medical_abortion.pdf [cited 05 May 2012]. Event, F.R., 2008. Proceedings of the International Consortium for Medical Abortion. Reproductive Health Matters, 16(31 Suppl), p.1-204. Harris, J., 1985. Abortion and Infanticide. Journal of Medical Ethics, 11(4), p.212. Heinrichs, L., 2002. Linking olfaction with nausea and vomiting of pregnancy, recurrent abortion, hyperemesis gravidarum, and migraine headache. American Journal of Obstetrics and Gynaecology, 186(5 Suppl Understanding), p.S215-S219. Hundt, G.L., Bryanston, C., Lowe, P., Cross, S., Sandall, J. and Spencer, K. 2011. Inside â€Å"Inside View†: reflections on stimulating debate and engagement through a multimedia live theatre production on the dilemmas and issues of pre-natal screening policy and practice. Health expectations an international journal of public participation in health care and health policy, 14(1), p.1-9. Ingham, R. Lee, E., Clements, S.J. and Stone, N., 2008. Reasons for second trimester abortion in England and Wales. Reproductive Health Matters, 16(31 Suppl), p.18-29. Karasahin, K.E. and Keskin, U., 2011. Pain and abortion. Contraception, 84(3), p.337. Kasun, J., 1998. The War Against Population. San Francisco, USA: Ignatius Press. Kivity, S., Borow, M. and Shoenfeld, Y., 2009. Hippocrates’ Oath is challenged. The Israel Medical Association journal IMAJ, 11(10), pp.581-584. Koyama, A. and Williams, R., 2005. Abortion in Medical Institute Curricula. McGill Journal of Medicine, 8(2), pp.157-60. MacGuigan, M., 1994. Abortion, Conscience Democracy.   Toronto, Canada: Dundurn, Hounslow Press. Marston, C. and Cleland, J., 2003. Relationships between contraception and abortion: a review of the evidence. International Family Planning Perspectives, 29(1), pp.6-13. Nie, J.B., 2002. Chinese moral perspectives on abortion and foetal life: a historical account. New Zealand Bioethics Journal, 3(3), p.15-31. Outka, G. 2002.   The ethics of human stem cell research.   Kennedy Institute of Ethics Journal, 12(2), pp.175-213. Polaino Lorente, A., 2009. Psychopathology and abortion. Cuadernos de bioetica revista oficial de la Asociacion Espanola de Bioetica y Etica Medica, 20(70), pp.357-380. Rosenfeld, J.A., 1992. Emotional responses to therapeutic abortion. American Family Physician, 45(1), p.137-140. Schultz, J.D., Van Assendelft, A., 1999. Encyclopedia of women in American politics. The American political landscape. (1st ed). Greenwood Publishing Group,   p. 195. Sedgh, G., Singh, S., Shah, I.H., Ahman, E., Henshaw, S.K. and Bankole, A. 2012. Induced abortion: incidence and trends worldwide from 1995 to 2008. Lancet, 6736(11), pp.1-8. Sheldon, S. and Wilkonson, S., 2010. Abortion and Disability. The disability studies reader. [online] Available from:   prochoiceforum.org.uk/aad5.asp. [cited 05 May 2012]. Smith, J., 1993. The Connection between Contraception and Abortion. University of Dallas. [online] Available from: goodmorals.org/smith4.htm [cited 05 May 2012]. SPUC, 2012. Abortion briefing. Society for the Protection of Unborn Children . [online] Available from:   spuc.org.uk/education/abortion/briefing [cited 05 May 2012]. The ICMA Information Package on Medical Abortion., 2012. Information for health care providers. INTERNATIONAL CONSORTIUM FOR MEDICAL ABORTION.   [online] Available from: medicalabortionconsortium.org/about.html [cited 05 May 2012]. Tremayne, S., 2000. Abortion in the Developing World. Journal of Medical Ethics, 26(6), pp.483-484. Warren, M.A. 2009. On the moral and legal status of abortion.   In Soifer (ed.). Ethical Issues: Perspectives for Canadians. (3rd ed). Toronto, Canada: Broadview Press.

Deferred Taxation Essay Example | Topics and Well Written Essays - 1500 words

Deferred Taxation - Essay Example Such differences only impact on the taxation computation of one period. Deferral method is where the tax effects of current timing differences are deferred and allocated to future periods when the timing differences reverse. Since deferred tax balances in the balance sheet are not considered to represent rights to receive or obligations to pay money, they are not adjusted to reflect changes in the tax rate or the imposition of new taxes. Under the deferral method, the tax expense for a period comprises of provision for taxes payable and the tax effects of timing differences deferred to or from other periods. Liability Method is where the expected tax effects of current timing differences are determined and reported either as liabilities for taxes payable in the future or as assets representing advance payment of future taxes. Deferred tax balances are adjusted for changes in the tax rate or for new taxes imposed. The balances may also be adjusted for expected future changes in tax rates. Under the liability method, the tax expense for a period comprises of the provision for taxes payable, the amount of taxes expected to be payable or considered to be prepaid in respect of timing differences originating or reversing in the current period and the adjustments to deferred tax balances in the balance sheet necessary to reflect either a change in the tax rate or the imposition of new taxes. 3. Nil provision, partial provision and full provision Nil provision is where no provisions are made for deferred tax whatever the circumstances. This is based on the principal that only the tax that is deemed to be payable in respect of a period should be accounted for in the financial statements. Full provision is where the tax effects of all timing differences are recognized as and when they arise. Although this method is arithmetically accurate it can lead to the building up of large meaningless provisions in the balance sheet. Partial provision lies between the two extremes stated above. Deferred tax should be accounted for in respect of the net amount by which it is probable that any payment of tax will be temporarily deferred by the operation of timing differenced, which will reverse in the foreseeable future without being replaced. 4. Discounting Discounting deferred tax assets and liabilities enables to reflect the time value of money. IAS 12 does not permit discounting due to the difficulty in ascertaining the timing of reversal of each temporary difference B) Critically assess the current IAS 12 requirements for accounting for deferred tax Deferred tax is an accounting term, meaning future tax liability or asset, resulting from temporary differences between book (accounting) value of assets and liabilities, and their tax value. This arises due to differences between accounting for shareholders and tax accounting. Deferred tax arises when the actual tax as a result of a particular transaction (tax payable or recoverable) arises in a different period from the period in which the transaction is included in the financial statements. The provision for taxes payable is calculated in accordance with rules for determining taxable income established by taxation authorities. In many circumstances these rules differ from the accounting policies applied to determine accounting income. The effect of this

Pro and Con Essay Example | Topics and Well Written Essays - 500 words

Pro and Con - Essay Example Eventually, this contributed to the health of the USA’s economy. It is vital to note that the author critiqued the lack of flexibility of the reform act as regards the control of immigration. The second article argues that illegal immigrants should not attain legal status in particular countries. He states that USA can attain lessons from Europe in terms of granting amnesty to illegal immigrants. Paul Belien, the author, argues that several European countries accorded legal status to illegal immigrants in the 2000’s. Countries, such as Italy and France, opened the floodgates for more immigrants that became unmanageable. This is because many undiscovered immigrants showed up for certification. In the analysis of Hinojosa article, it is vital that he provides three perspectives to the same. The first two arguments props the authors’ view of providing legal status to immigrants. The third article highlights the loophole of the IRCA act of 1987. The first argument highlights that legalized immigrants progress more economically. It is vital to note that the paper provided statistics, from the labor department, to prop this position. The hourly wages of legal immigrants had at increased at an average rate of 15.1 percent from 1987 to 1992 (Hinojosa-Ojeda 2). In the same period, the female immigrants had improved their wages at a rate of 20.5 percent. On the other hand, there had been an increase of 13.2 percent. These statistics correlated with the fact that a percentage of 38, of Mexican men, had adjusted to better-paying occupations. The paper argues that this translates to economic progress because the immigrants possess better bargaining powers (Belien 22). However, it only stresses on the economic benefits such as businesses, income and houses. This contributes to overall economic progress in terms of tax revenues for the government. It is crucial to note that the paper is comprehensive in noting that the IRCA act did not provide policies for managing

Eye Care Institute Analysis

Eye Care Institute Analysis Ishan Narma Jyotismaya Shabeer Pk Khayapam Raising Ujjval Rana Nahid Zafar Ipshita Prasad Usha Deepthi INTRODUCTION: The LV Prasad Eye Institute was established in 1987, with a mission to provide equitable and efficient eye care to all sections of society. Started with a goal to be a leader in combating global blindness through the direct impact of patient services and the indirect impact of training it provided to eye care professionals, LVPEI by 2011, had become a world class eye institute encompassing services such as clinical care, education, research, rehabilitation and high impact rural eye care. LVPEI was the brainchild of Dr. GN Rao, who after working for 12 years in the United States, was greatly inspired by the quality of eye care provided there. Born in a small village of Andhra Pradesh, Dr Rao was very sensitive to the health problems of the poor and wanted to do something for them. His dream of serving the poor was shared by film producer L.V. Prasad, who wanted to support a project dedicated to enhancement of vision. L.V. Prasad donated a 5 acre plot of land to Dr. Rao to start an eye hospital, along with the equivalent of 1 million US dollars. Dr. Rao named the hospital after L.V. Prasad, to respond to his generosity. Additional funds were generated for the hospital from the United States through the Indo-American Eye Care Society and finally the hospital started operations in 1987. The hospital was built with a keen eye for aesthetics. Dr. Rao did not want the hospital to look or feel like one, instead wanting a sunny and pleasant place with wide corridors and soothing dà ©cor. Dr. Rao wanted to focus on the patient, keeping in mind his dignity, needs and comfort. LVPEI offered services for all types of eye care diseases, from routine cataract surgery to complex procedures such as retinal, corneal and oculoplasty services. Special service facilities were set up for the vulnerable age groups such as children and the elderly. Since it was established in 1987, LVPEI had provided outpatient care to six million and surgical care to more than 585,000 patients, 52% of them free of charge. LVPEI had reached a total of 17 million people, and had built permanent eye care infrastructure in 16 districts of Andhra Pradesh. Vision 2020 – The Right to Sight In order to address the problem of increasing number of global blindness, WHO and the International Association for Prevention of Blindness jointly launched a common agenda for global action: Vision 2020 The Right to Sight. Five conditions were identified as immediate priorities based on their high prevalence, and the affordability of interventions to treat them. These were Cataract, Trachoma, Onchocerciasis, Childhood Blindness and Refractive Errors. PYRAMID OF EYE CARE In order to attain the aim of making eye care accessible to everyone, Rao and his team developed the LVPEI Pyramid of eye care. The main emphasis of this model was to provide eye care at appropriate level, easily accessible and affordable without any compromise in quality. This resulted in the creation of facilities within the community which are linked to higher levels of care. The pyramid consists of 5 levels of care. They are, Community Level Care, Primary Level Care, Secondary Service Centres, Tertiary Care Centres and Centre of Excellence. Community Level Care: The community level care is provided by the vision guardians. They look after the health of 5000 people. They monitor the health of children and elderly by doing door to door campaigns and through other means. They monitor those patients who have had surgery and provide readymade near vision glasses. They also refer those who need eye check up to the appropriate centre. Primary Level Care: The primary eye care is provided at the Vision Centres, managed by the Vision Technicians trained by LVPEI. They screen people at the centre and children at school. They cover a population of 50000. They dispense spectacles as well as educate the people about their use. They also identify people for surgery advanced eye care. Secondary Service Centres: At this level, outpatient services are provided where diagnosis of all eye diseases is done. They perform eye surgeries and also serve as the referral source for tertiary care. They serve a population of 1 lac. There are 11 secondary care centres and 9 partner centres. Tertiary Care Centres: They provide highest quality medical and surgical eye care irrespective of the socioeconomic status. They serve a population of 5 million. They offer finest medical education and surgical training to eye care professionals and also conduct innovative research. Centre of Excellence: It is situated at Hyderabad serving a population of 50 million. It provides services like management of complex cases, training to subspecialists and trainers, rehabilitation, research and capacity building of training centres. This model of LVPEI is so efficient that the Government of India has adopted the same model for eye care service delivery in current five year budget plan. EDUCATION AND TRAINING LVPEI considers training and education as an important factor which can influence the quality of eye health service delivery. The training aims to upgrade the skills of ophthalmologists and equip new entrants to the field with the appropriate skills and knowledge. The institute develops human resources internally through training and education. All the clinical staff, support staff, ophthalmic technicians and eye care administrators undergo a training program before they are recruited for the particular post which helps to maintain quality care across all the levels of care. It has a comprehensive co-operative agreement of mutual benefit in education and research with the University of Rochester Eye Institute, Case Western Reserve University, the University of Wisconsin, Duke University and Bascom Palmer Eye Institute in the United States and the University of New South Wales and University of Melbourne in Australia. This gives great opportunity for those who would like to excel in e ye care delivery. RESEARCH AND ADVOCACY LVPEI integrated research as a part of service delivery though it affected the clinical workload and productivity. It was 25 years ago, the research started at Hyderabad Eye Research Foundation (HERF), the research arm of the institute, with the support from Professor Brien Holden of the University of New South Wales, Sydney, Australia. The research concentrated on molecular genetics of inherited eye diseases, molecular diagnostics for early detection, microbiology of eye infections, biochemical features of cataract and stem cell technology for reconstruction of the damaged ocular outer surface. Research is spread over the centres at Hyderabad, Bhubaneswar, Visakhapatnam and Vijayawada. It not only conducts clinical research but also clinical trials. Each clinical research project and trial goes through a rigorous examination by Institutional Review Board (IRB), for its scientific and ethical aspects. Only those that are approved are taken up. The projects were supported by the grant s received from the Department of Biotechnology( DBT), Department of Science and Technology(DST), Council of Scientific and Industrial Research (CSIR), Indian Council of Medical Research(ICMR), National Eye Institute(NEI, National Institutes of Health), USA. HERF is one of the four pillars of the multinational research and development group called Vision Cooperative Research Centre (operating from Sydney, Australia). It conducts research on a series of clinical studies. Research at the Institute aims to be â€Å"relevant, rigorous and cutting edge†, and hopes to become one of the most productive eye research groups in the world. Towards this aim, there are six initiatives. They are a new Academy for Eye Care Education, Child Sight Institute, Institute for Eye Care for the Elderly, Centre for Ocular Regeneration (CORE), Institute for Eye Cancer, a Centre of Excellence in Eye Banking. The start of SRUJANA (a Sanskrit term meaning creativity), centre for innovation was a milestone. It is a bilateral program between HERF and groups at the Massachusetts Institute of Technology (MIT), Cambridge, MA, USA. INTERNATIONAL CENTRE FOR ADVANCEMENT OF RURAL EYE CARE (ICARE) International Centre for Advancement of Rural Eye Care (GPR ICARE), LVPEIs community outreach program, began in May 1998, with the aim of making high-quality, appropriate eye care accessible to all. Objectives LVPEI tried to develop high quality self-sustaining eye care services in neglected areas of India and other parts of the developing world and to train all cadres of eye care personnel for the provision of efficient eye care services. Its objectives include participating in planning eye health initiatives in the developing world to undertake operations and research projects. Also LVPEI collaborated with international NGOs like Operation Eyesight Universal (OEU), in turn to support the hospitals to scale up their capacity to perform affordable cataract surgeries and provide comprehensive eye care services around the world. This support of LVPEI helped the hospitals to increase the number of patients by 100 per cent. Organisational Excellence Rao gives the full credit of organisational excellence to the employees. It is achieved by constant nurturing of its employees by giving continuous education program and training activities at various levels. The culture of the institute is build around quality care. To instil quality consciousness, they conduct presentation once a month at 7am meeting on already audited files and will see how they had complied with the standards. This effort will reinforce the quality consciousness among the employees. Since the organisation is depending on their employees the biggest challenge in front of LVPEI is in finding right people at right position. According to them they don’t want to hire somebody to fill a slot, but need people with exceptional potential. Their recruitment process is unique as they try to bring young people from rural areas and train them both clinical teachings and the culture, which they are following in the institute. They always prefer to have fresh minds over personnel with previous experience, since the experienced people couldn’t follow the institute. LVPEI gives importance to individual growth and career development as well, as they allow doctors to allocate their time at hospital between patient care, education and research. LVPEI culture is highly patient centric, we can see it from their practices like, doctors directly go to the waiting room to fetch the next patient, instead of waiting for the nurse to do so. The closest parking area is reserve d for patients rather than doctors and the staff members. The founder of LVPEI, Gullapalli N Rao, did his graduation in medical science (MBBS) at Guntur, Andhra Pradesh and completed his post graduation from AIIMS, Delhi in ophthalmology. He then went to the US in 1974 and came back in 1986 and established LVPEI in 1987 in Hyderabad (Andhra Pradesh). The idea behind this institute is to help poor and needy people in terms of alleviation of blindness. By the technical knowledge and experience gained in India and US and his strong desire and passion toward the work for the poor and needy people develop his leadership quality. DR. RAO’S LEADERSHIP SKILLS As we are talking about the work done by Rao and his leadership under which LVPEI gets the highest level of honor in people’s mind, it is to be emphasized that this is achieved solely by strong desire. Dr. Rao displays basically three kinds of leadership – People oriented leadership Transformational leadership Contingency leadership In People oriented leadership there is a mutual trust that exists between the leader and the followers. Leader is very much concerned about the desire, demand and welfare of his follower and this gains him respect and popularity among the followers. Dr. Rao’s patient- centric approach is clearly seen from his own quotation -â€Å"Patient is king; his dignity, needs and comfort supersede everything also , regardless of whether he pays for it or is treated free of cost†. His nature towards the patients can be understood with the help of certain scenario described by his staff member and patients. For example, in terms of reducing the waiting time of the patient come for the treatment in OPD doctors of the hospital has to walk in the lobby to approach the patient. Another example is about the parking arrangement of the hospital where the area is clearly defined for the staff and the patients come for the treatment. Parking area of the patient is nearer to the hospital as compared to staff so the patient is given prior importance. There are mainly three kinds of qualities which we have observed in a transformational leader charismatic, inspirational and individual consideration. In case of Rao, he is a visionary in nature. He is totally devoted to his goal to alleviate blindness and plan and work accordingly to meet his desired goal. He is very professional and his communication skills are excellent and so people feel comfortable in approaching him. His long term planning quality makes him a charismatic personality. Rao is very good in technical knowledge and skills and these are built on the foundation of his hardworking and passionate nature. His hardworking attitude made him popular in the hospital under the name of ‘Task maker’ and he unwillingly became the inspirational model for many people. By rewarding the staff he motivates them to do best for the hospital and for the patients. He strives to resolve even the personal problems of his staff and provide moral support. Contingency leader is the person who responds according the situation required. In case of Rao many people give different opinion; some would say he is autocratic in nature, some would say he is charismatic but democratic in nature, and further some would say he is very supportive in nature. Actually he responds differently according to the situation required. He becomes autocratic when matters of policy making, decision making, task completion and quality of work are concerned; becomes democratic when we are talking about long term projects and providing help to the staff and he becomes supportive when his staff have any issues may they be personal or professional. Rao’s leadership might be different from other leaders but he is the one who has made LVPEI the pioneer institute for eye care in India. Apart from LVPEI, Aravind Eye Hospital has gained massive popularity among the people. All this has been possible by the transformational leadership of Dr. Venkataswamy, who started this not for profit institute on great Indian mystic Aurobindo’s philosophy. QUALITY MANAGEMENT LVPEI follows standard protocols and processes for providing best quality eye care. By having proper support from appropriate systems, the doctors are able to treat lot of patients in the OP. They are following data driven approach to monitor quality. They periodically review the programs to modify them accordingly and to implement policies. FINANCIAL VIABILITY LVPEI is under the supervision of two not for profit institutes, Hyderabad Eye Institute and Hyderabad Eye Research Foundation. Even after treating a large chunk of patients at free of cost, they managed to generate profit. The main source of income for LVPEI was through cross subsidization of treatment where the treatment cost of poor patients is covered by rich patients. They are receiving donations from like-minded organizations, who support its work. FUTURE OF LVPEI The Indian health care industry is entering into new era with significant changes in greater affordability, increased awareness in patients, and presence of more health care providers. The population opting for health insurance is about 2% in India and about 20-30% of insured patients visit urban hospitals for seeking health care services. Now-a-days patients’ requirements have shifted from good quantity of vision to good quality of vision. There are more specialized clinics that educate patients on various methods of eye treatment and their outcomes. Due to all the above issue LVPEI has been forced to restructure and reorganize its system of delivering eye care facility. ORGANIZATION LIFE CYCLE AND LEADERSHIP A FUTURE PERSPECTIVE Being a 27 years old organization, LVPEI has already reached a state of maturity in its life cycle, which is characterized by delay in decision making, being less proactive, less innovative and more risk-averse. LVPEI has a functionally based structure that is primarily led by doctors and exhibits as fairly centralized. So for this LVPEI has developed a bureaucratic style of functioning and decision making. Its focus is mainly on efficiency rather than novelty. The future head of LVPEI should to be an ophthalmologist having an outstanding track record and who could take forward the organization into a desirable state of its functioning. LVPEI prefers its future head to be a clinical scientist respected both nationally and internationally. COMPARING DR. VENKATASWAMY’S LEADERSHIP WITH DR. RAO Both the legendary leaders from India, who tried to held head up in the global eye care. The main attracting feature of Dr. Venkataswamy’s leadership was his clear vision about the hospital and its function, while Dr. Rao is very much concerned about the needs and welfare of his followers and this make him respectful among the followers. Dr. Rao put emphasis on quality care and highly patient centric approach in the institute’s culture, Dr. Venkataswamy believed in social marketing strategy for the development and expansion. CRITICAL ANALYSIS WITH ARAVIND EYE HOSPITAL LVPEI has got a clear cut strategy for community outreach programs, but Aravind eye care lacks clarity on it. LVPEI focused on producing human resources internally, while Aravind eye care preferred persons with experience. LVPEI’s focus is on quality care, Aravind eye care focused on quantity, by increasing the number of patients. CONCLUSION Facing great challenges from both environment and leadership change, LVPEI had set a few goals for itself in the next five years, such as, strengthening its brand as a cutting-edge eye care delivery system, providing good quality of services and education, strengthening the ability of the institute to conduct breaks through clinical research, improving the ability of LVPEI to provide high level community health services, and improving its ability to enhance the capacity of LVPEI to become a role model globally in eye care health delivery system. Ultimately the main focus of LVPEI is to provide eye care facility to 200 million people directly by 2020. LVPEI also aimed to enhance the eye health policy across India and globally through providing quality eye health. Finally Dr. Rao articulated in his dream that, â€Å"when people talk about best eye institutes globally, LVPEI must come up for discussion† REFERENCES: http://www.lvpei.org/

Emily Dickinson :: Author Biography Emily Dickinson Essays

Emily Dickinson Breaking news revealing the truth about Emily Dickinson’s life has recently been uncovered. For the past hundred-plus years literary historians believed Dickinson to be a plain and quiet type of person who did not communicate with the public for most of her life. Her romanticism poetry drew attention from fellow literary legends. After corresponding with the well-known Thomas Wentworth Higginson, who showed interest in her work but advised her not to publish it, she became defiant to publish any of her work. Dickinson grew up in a very strict Puritan family. However, her poetry did not reflect her Puritan upbringing at all. As the late eighteen sixties came about, Dickinson became very attached to her family home and refused to leave it. She cut off most of her relationships with her friends. The only way she could express her feelings was through her writing. She eventually died in 1886 of a kidney condition called Bright’s disease. Against Dickinson’s request, her sister Lavinia turned over the rest of her work to be published. The biography you have just read is a summary of the life of Emily Dickinson we have all taken to accept. The following story is the truth revealed. The shocking discoveries will leave you in amazement. One hundred-fifteen years later, who would have thought historians could ever crack a scandal like this one? Emily Dickinson grew up as a New England Puritan. The values she was taught were all but revealed in the poetry she wrote. How could such strict Puritan parents raise a child to express such anti-Puritan values in her writing as Emily Dickinson did? That question has recently become invalid now that scientists have discovered that Emily Dickinson indeed had a twin sister to whom the credit for all of the poetry is now given. How and why did such a disgrace take place, you ask? It was a complicated situation-one which would probably never happen today! Sexuality and enjoyment were things thought of as satanic to Puritans. When Emily Dickinson’s parents gave birth to twins in Amherst, MA, society saw them as grotesque and the parents themselves were humiliated. To Puritans, having twins meant the couple enjoyed sexuality twice as much as others. They would have been shunned and looked down on if they kept both of the babies. With the idea of murdering one of the babies out of the question, one of the twins was given to a caretaker of the Dickinson’s.

Phoenix Rising Essay

The Young adult novel Phoenix Rising: or how to survive your life by Cynthia D. Grant is a candid sensitive story about the serious effects of seventeen-year-old Helen Castle’s death from cancer on her family. The story is told through the eyes of Jessie who has been traumatized by her older sister’s death. Jessie and the other members of her family begin a healing process, while Helen, whose world we see through Jessie comes to terms with a life that seems capricious and unjust to Jessie. She feels pain, anger, loneliness, confusion and withdrawal throughout the novel. The family is shattered. Its new dynamics are realistically revealed with the already strained relationship between Lucas, and the father that become explosive. Jessie reads on in the journal to learn Helen’s feelings as her cancer progresses, which ranges from morbid despair to soaring hope that is made more poignant to the readers reading along with her. The setting of the story is white, comfortably middle-class, California suburbia. The characters in Phoenix Rising are of average intelligence and are raised above being stereotypical characters by the pain, reflection, and eventual growth of Helen’s death forces upon them. They remain true to their backgrounds and natures throughout their trials and adjustments. It is the mark of Cynthia D. Grant’s talent that the reader never doubts they are reading this novel through believable teenage eyes. The central character of the novel is Jessie, and the one who is most dangerously affected by the older sister’s death. Jessie’s tendency is not only to idealize her sister making her feel worthless, and unattractive but she also feels that she has failed to reach Helen and talk to her about her illness making Jessie shut herself off from her father, mother, her friend Bambi, Helen’s boyfriend Bloomfield, and their next-door neighbor; little Sara Rose. Jessie not only stops eating toward the end of the novel, she also shuts herself off more ultimately refusing to leave her room. Jessie’s brother Lucas is the kind family philosopher. On the surface, however he plays a role of a rebellious youth whose love for loud rock music. He is an exceptionally good electric and acoustic guitarist and this puts him at odds with his father, whom he engages in arguments at the slightest opportunity. Jessie’s hard-working architect father seems fixated on his role as a family provider and Lucas as the antagonist. Jessie tells the reader â€Å"My father thinks he won’t cry as long as he keeps screaming. It is as if the father and the other members have been so traumatized by the Helen’s death that a kind of static role-playing is easier for them than facing their world and moving on with their lives. Jessie’s mother seems simply to have been bludgeoned into being a relatively passive person who can do little more than to keep up with the necessary household chores, to weep for her oldest daughter, Helen as well as the self destructive, Jessie and to drink several glasses of wine to dull her pain. Two more important characters round out the characters in this novel. One is Bloomfield, who is always called by his last name. He is Helen’s boyfriend and the other is Bambi. Bambi is both sister’s plump, loud mouthed, and mildly sex-crazed friend. Jessie reads further into the Helen’s journal and discovers Bloomfield is not the fair-weather friend she has criticized him as being. Similarly, she finds there is more to the tattooed, fake nailed Bambi than meets the eye. She is surprisingly admirable for her down-to-earth, her common sense ability to cut through the silliness that ordinarily surrounds her.

The Decimating Effects of Infectious Disease in the New...

The Decimating Effects of Infectious Disease in the New World It is often said that in the centuries after Columbus landed in the New World on 12 October, 1492, more native North Americans died each year from infectious diseases brought by the European settlers than were born. (6) The decimation of people indigenous to the Americas by diseases introduced by European invaders is unprecedented. While it is difficult to accurately determine the population of the pre-Columbian Americas, scholars estimate the number to have been between 40 and 50 million people. The population in Mexico alone in 1519 is believed to have been approximately 30 million. By 1568, that number was down to 3 million inhabitants. Although there†¦show more content†¦However, tracing epidemiology in the 15th century is difficult because so little was done to identify and classify diseases and their symptoms during this time period. One might say that the New World was ripe for the onslaught of hitherto unknown diseases due to several demographic shifts prior to 1492. These are parallel to shifts that occurred in Europe such as the creation of large urban areas. Since city planning wasnt what it is today, cities were overcrowded, sewers were nonexistent or inefficient, and disease carrying vermin multiplied. This created a welcome mat for infectious disease in addition to the general uncleanliness of the population and the great number of transient people such as soldiers, students, thieves and the mentally ill. Another factor leading to the assault of disease on medieval Europe was the domestication of large mammals. These animals were the origins of some of the most cursed afflictions of the time. Smallpox is a derivative of cowpox, measles of canine distemper, and influenza of hog diseases. At first, neither young or old were spared. After generations, susceptible individuals were eliminated and resistant survivors dominated the gene pool. Diseases went from epidemics to childhood ills. (6) It was in this form that diseases were carried to the New World by unsuspecting conquistadors, to a population that had experienced its own shifts to largely urban andShow MoreRelatedSience23554 Words   |  95 PagesEnvironmental Issues Webquest Global Warming and the Greenhouse Effect Go to http://www.globalissues.org/article/233/climate-change-and-global-warming-introduction and answer the following questions. 1. What is the greenhouse effect? 2. How does it relate to climate change? 3. Draw and label the greenhouse effect. 4. Scroll down to the section â€Å"The Greenhouse Effect is Natural. What do we have to do with it?† What are some ways that humans are thought