Abstract This paper examines the controversy regarding the use of feeding tubes at the end of life for terminal patients. The author presents the research from a nursing perspective. Additionally, the paper considers the questions of whether prolonging life with a feeding tube is in the best interest of the patient. The author includes an extensive literature review with regards to patients with dementia, cancer and other end of life issues and reviews what has been concluded about using feeding tubes at this stage. The writer also touches on the issue of living wills.
Outline:
Introduction
Literature Review
References
From the Paper "The past few years have seen many controversial stories played out in the news regarding end of life feeding tubes and their use. Society lines up on both sides of the issue and hotly debate whether or not using a feeding tube at the end of one's life is something that should be done even if the patient is not capable of consenting. Meanwhile patients all over the nation languish between the two sides of the debate with their families trying to make the most humane and compassionate decision regarding the placement of a feeding tube into their loved one. Many studies have been conducted regarding the use of a feeding tube on a patient who is at the end of life with differing results. With a small risk in the actual placement of the tube the question centers around whether prolonging life with a feeding tube is really in the best interest of the patient. "
Abstract This paper reviews, discusses and analyzes the Alcoa Company, one of the global leaders in the production of alumina, aluminum and the coordination of supply chains specifically for the natural materials used for creating these products. The paper reports that the company's center of operations is located in Pittsburgh, PA employing 129,000 people in over 350 operating locations in 42 countries. According to the paper, raw material prices are critical to the present and future profitability of Alcoa.
Outline:
Company Description
Company Analysis
SWOT Analysis
Industry Analysis
Global Aluminum Demand
Alcoa Financial Analysis
From the Paper "Primary Metals. - This business segment of Alcoa generated After Tax Operating Income (ATOI) $480MM in Q4'06 vs. $346MM in Q2'06 and $242MM in Q4'05. This segment is benefiting year-over-year from rising aluminum prices and higher production offset by start-up costs at the new state-of-the-art smelter in Iceland and higher carbon and pitch costs that affect production costs. This specific operation of Alcoa is also heavily influenced by aluminum prices, and performance in this specific segment will also be heavily influenced by the efficiency of their supply chain."
Abstract This paper examines the metal aluminum, looking at its history, physical and chemical properties, natural occurrence, mining, processing, and uses.
Abstract This paper attempts to determine from existing literature if there is a causal connection between aluminum (AL) and Alzheimer's disease (AD). The paper begins with a description of the symptoms of AD and an explanation of the physiological deterioration that AD causes. This is followed by a discussion of the reasons that hereditary causes have been ruled out, a review of the literature on AD, and the potential causal relationship to AL.
From the Paper "One of the most distressing elements of the crippling Alzheimer's disease AD is that patients have no way of determining if they are at risk for the disease, nor treating the disease once it begins to set into the brain. Patients are slowly robbed of the ability to remember small details of life, and then ultimately fail to be able to process even the simplest thoughts. Thus researchers are looking for elements which are connected to the onset of AD, and one of the most promising connections found to date is the connection between AD and the presence of aluminum (AL) in the body. Researchers do know currently know if AL is a causative agent, or appears in the tissues as a byproduct which is attracted from other parts of the body as a result of the neurological breakdowns."
Abstract This paper provides a literature overview of chest tube removal with regard to pain management. It further discusses the appropriate nursing interventions that are most applicable to chest tube removal in the light of the research data and studies that are available. It concludes, based on the literature, that there is a need to explore new avenues in addition to the present standard protocols. It also examines how these new techniques, and means of reducing pain in chest tube removal, revolve around a more inclusive and interactive approach to pain management, where aspects such as anxiety and information flow are catered to.
Outline:
Introduction
Literary Overview of the Problematics of Pain Management
Conclusion
Appendix
From the Paper "Standard pain management techniques for chest tube removal relate to medications such as Morphine. " Morphine is one of the most often, if not routinely, used opioids for treating pain due to chest tube removal." (Puntillo and Ley, 2004) However, this is not always the most effective procedure in this situation. "...when morphine was used in small doses (ie, a mean [less than or equal to] 3 mg), pain associated with chest tube removal was rated as moderate to severe. Higher morphine doses have not been tested for their effect on such pain. " (Puntillo and Ley, 2004) Other medications include the use of Ketorolac, which is a nonsteroidal anti-inflammatory drug and is considered to be an effective analgesic for pain due to chest tube removal. "
Abstract In "Tube of Plenty. The Evolution of American Television", Erik Barnouw provides us with the amazing history of television. He shows us that television is not only a technological reality, but also a sociological phenomenon. Television, in other words, moulds society in the same way that society moulds television. Barnouw demonstrates that we can not really understand our own history without examining the effect that television has had on almost every aspect of our lives. He is especially interested in television's newest features. Thus, the "Tube of Plenty" is not only the history of television, but also the exploration of the development and impact of the latest phases of the communications revolution.
Abstract This paper looks at three aspects of aging: the use of feeding tubes; euthanasia/physician assisted suicide; and the dangers to the elderly by powerful nursing home executives. It describes the characteristics of patients and nursing homes relative to feeding tube use. It then describes experiences with euthanasia and physician assisted suicide in the Netherlands; and then describes what can happen to the elderly who have no one to stand up for them against unfair nursing home practices.
From the Paper "This paper by Curtin discusses a case study of unethical treatment of an elderly woman living in a retirement community. The woman and her husband both were married for years were very close and financially well-off. They were living in the facility when the..."
Abstract This paper discusses a research which measures the effects of having a PEG tube (as opposed to NGT) inserted, on the patient's quality of life as it relates to their ability to communicate and swallow. Two research questions are answered in this paper: "Does a PEG procedure have an effect on the patient's ability to communicate their wishes and improve there satisfaction with the quality of their life in regards to self-care"? and "Does the PEG method offer more satisfaction in regards to quality of life than the NGT method"? The paper illustrates the importance of taking the individual patient's feelings, concerns and wishes into account and not just focusing on the clinical side of things.
From the Paper "There are two primary methods for administering food to patients who can no longer swallow or have difficulty swallowing. The first is by way of an NGT tube, which is inserted through the nasal cavity and goes into the stomach. This procedure severely limits the patient's ability to speak or swallow. The other popular method is PEG where a tube is inserted through an incision in the abdominal wall. In this case a patient's ability is speak or swallow is not limited by the procedure itself. However, in stroke patients this ability may already be impaired. Many of us consider the ability to communicate our own wishes and enjoy conversation with other human beings a factor in determining our quality of life. Being unable to communicate with another creates a feeling of isolation or helplessness."
Tags: stroke, dysphagic, aspiration, methodological, study
Abstract This paper is a critique of a nursing research paper on enteral tubes in children. It critiques the style of the paper, the worthiness of the research, the quality of the literature review, the description of the work by the researchers, the credibility of the results, the usefulness of the results, and the relevance of the results to nursing today.
From the Paper "This study is a preliminary study and needs to be followed up by several other studies to clarify the results obtained and to get more statistically relevant numbers for some of the parameters being measured."
Abstract The paper discusses the insertion of a chest tube that is used for spontaneous pneumothorax, a common clinical problem involving air in the pleural space, between the lung and chest wall. The paper explores the goals of nursing regarding this procedure, which include pain management, prevention of complications and health teaching for the patient and family.
From the Paper "Insertion of a chest tube is used for spontaneous pneumothorax, which is a somewhat common clinical problem involving air in the pleural space, or air between the lung and chest wall. Traumatic pneumothorax is rare and results from injury to the chest. In either case, if excess fluid or air accumulates in the pleural space, the patient will experience shortness of breath and increased respiratory rate and effort. A chest tube inserted into the pleural space will drain the air or excess fluid and relieve respiratory distress Coughlin & Parchinsky, 2006). "Nursing care includes preventing complications, resolving the pneumothorax, managing pain, and educating the patient and family" (Roman & Weinstein, 2003, p. 161)."
Abstract This paper argues that the allegation that Iraq had weapons of mass destruction, which were never discovered, was a deliberate deception by the Bush administration to justify their aggression in terms of containing terrorism by maintaining the international balance of power. The paper further asserts that Bush ignored the truth that he heard from his advisers and deliberately misled the American people to make an excuse to go to war with Iraq. The paper contends that Bush wanted to secure America's position of dominance, power and access to oil resources in the Middle East and tricked the American people into thinking that going to war with Iraq was a way of waging war on terrorism.
From the Paper "The primary thrust of Bush's argument for the invasion of Iraq was that Iraq was a serious threat to the rest of the world because it was building WMD. This is an interesting allegation, given that the only country that really has a large supply of WMD is the USA. However, it must be borne in mind that those countries who seek to justify owning WMD - such as the USA - seek to do so in terms of deterrence theory. The idea is that if rational countries such as the USA and Russia possess nuclear weapons, their mutual knowledge that the other country has WMD will deter either country from ever deploying the WMD."
Tags: lies, balance of power, terrorism, aluminumtubes, imbalance
Abstract This paper explains that domestic water supplies across the world vary enormously in quality. The author points out that aluminum has long been linked with an increased risk of Alzheimer's disease, bone diseases, and anemia, and nitrates are known to have gastric effects, neurological implications, and other effects on human health. The paper relates that lead is well-documented to play a role in intellectual retardation, impacts abdominal pain, and has other health effects.
Table of Contents
Introduction
Aluminum Nitrate
Lead
From the Paper "Interestingly, aluminum in drinking water may be introduced into the water supply by water treatment processes themselves. Aluminum sulphate is added as a coagulant that removes suspended matter during the water treatment process in many facilities. The aluminum nitrate is then removed through filtration and clarification, but trace amounts may remain. In the European community, the maximum acceptable concentration of aluminum in drinking water in the UK is 0.2 mg/l, based on the incidence of problems with dirty water, rather than health implications."
Abstract The paper relates that with a company history that spans more than a century, Alcoa, Inc. is a leading global provider of a wide range of engineering products for consumers and industries alike. The paper shows that Alcoa, Inc. is a global provider of a wide range of aluminum and non-aluminum products for both consumers and industrial applications. This paper provides a brief history of Alcoa, Inc. and an analysis of the company and the industry in which it competes. The paper analyzes the company's financial performance and presents a summary of the research. The paper concludes that Alcoa has emerged as a premier global enterprise in the 21st century. The paper recommends that the company continue to place a high priority on corporate governance and its strategic partnerships to help it continue this pattern of growth in the future.
Outline:
Introduction
Review and Discussion
Company Analysis
Industry Analysis
Financial Performance
Conclusion and Recommendations
From the Paper "The company changed its name from Aluminum Company of America to its current version, "Alcoa Inc.," in 1999, based in New York City (Alcoa, 2006) but with its headquarters in Pittsburgh (Aluminum Company of American, Inc., 2006). Today, Alcoa, Inc. (hereinafter alternatively "Alcoa" or "the company") is a leading producer of aluminum. The encyclopedic entry for Alcoa reports that the company's operations range from mining bauxite and other ores to smelting and processing aluminum, fabricating aluminum products, and marketing and shipping; further, the company has a majority ownership of Alcoa of Australia Limited, a leading producer of aluminum oxide (alumina)."
Abstract This well-researched and detailed paper explores the effects of acidic precipitation (acid rain) which has been a major factor in fish kills throughout countries in the northern hemisphere. The writer of this paper cites numerous studies which have linked aluminum toxicity along with acid rain as the main cause of fish extinction. This paper stresses the urgency in developing a successful management tool in determining the viability of fish populations in various natural settings. This paper also contains detailed information and results of various case studies as well as two graphs that support the author's claims in this report.
From the Paper "The fish used in this experiment were obtained from a trout farm which ensures the relative similarity of the fishes used in the experiment. They were acclimated to artificial soft water for 2 weeks before they were used in the experiment. They were then transferred to flux chambers for the experiment and given 24 to 48 hours to recover from the handling stress before they were exposed for 24 hours to low-pH water (pH 4.4, 4.8, or 5.2) A control group (N=36) for each of these pHs was left in these conditions for 10 days. The experimental group after this 24 hour exposure to low pH levels were exposed to concentrations of Al of 111, 333, or 1000 ug/L at the same pH (N=72)."
Abstract This paper explains how scientists have developed a computer that processes information running on DNA. It discusses how the computer is so microscopic it can?t be seen by the human eye. The implications for the future are tremendous, and it is now feasible to believe that sometime in the future, man will become part human and part computer. It discusses how the technology that scientists are currently developing may allow tiny computers to analyze, assess and correct biochemical abnormalities before they manifest themselves as problems.
From the Paper "Test Tube computers came about as the idea that a computer can be so small that ?a trillion of it's kind can fit into a test tube.? The idea was developed by researchers at the Weizmann Institute in Israel, who developed a nano-computer that consists of DNA and DNA-processing enzymes which are dissolved in a liquid (Noble, 2001). DNA has always functioned as somewhat of a mini computer, and strands of DNA are so small they can?t be detected by the human eye. The discovery has lead researchers to believe that it is possible to perhaps develop a device that is "capable of processing DNA inside of the human body, finding abnormalities and creating healing drugs" (Noble, 2001). A momentous occasional in revolutionary history."
