Gerontologic Considerations of Diabetes Mellitus - 1500 Words

Gerontologic Considerations of Diabetes Mellitus According to the Department of Health and Human Services (2011), 18.5 % of the United States population is over the age of 60 years. Of these, 10.9 million (26.9%) are diagnosed with diabetes mellitus (ADA, 2011.) In Lewis and associates’ text book on Medical- Surgical nursing, Lewis states that the incidence of diabetes mellitus (DM) increases with age (Lewis, Dirksen, Heitkemper, Bucher, and Camera, 2011.) The purpose of this paper is to explore the disease process of diabetes mellitus in the geriatric population. Pathology According to Lewis and associates, DM is a chronic disease that affects multiple body systems. For the purpose of this paper, only DM type 2 will be discussed based†¦show more content†¦The study was inconclusive on the factors involved, but the researchers suggest more studies need to be completed. (Salpeter, Khalaileh, Weinberg-Corem, Ziv, Glaser, and Dor, 2013) Another study suggests that diminished insulin sensitivity in the elderly is multifactoral as well. (Chen, Bergman, Pacini, Porte, Jr., 1985) Factors contributing to altered carbohydrate metabolism in aging include obesity and a progressive decline in physical activity. (Lewis et al., 2011) Lastly, the elderly also may take medications that treat comorbidities that effect insulin and glucose. Some of these include coreg, lipitor, corticosteroids, and lotensin. (Vallerand and Sanoski, 2013) Signs and Symptoms Typically, clinical manifestations of DM type 2 are nonspecific due to the fact that the onset is so gradual. Nevertheless, some may present with the classical signs of polydipsia, polyphasia, and polyuria. Common signs and symptoms associated with type 2 DM include fatigue, frequent infections, recurring yeast infections, dry skin, poor wound healing, and visual changes. (Lewis et al., 2011) According to the American Diabetes Association, seven million people are presumed to live undiagnosed with DM (ADA, 2011.) Many of these patients are overShow MoreRelatedEssay on Virginia Henderson, the Nursing Theorist1924 Words   |  8 Pagesapproach is going to be used to better understand concept and show how it is the foundation of the nursing process still used today. Case Study Mr. Jones is a 64 year old well nourished man with a history of long-standing non-insulin dependent diabetes mellitus (NIDDM). He had an open heart -surgery bypass graft 7 weeks ago. The graft site got infected and had to undergo an emergency surgery to improve circulation to his left lower limb. Mr. Jones is relieved that his leg was saved and he is now being

Analysis Of A Doll s House - 1180 Words

The role of being a husband in both A Doll’s House by Henrik Ibsen and Fences by August Wilson is failed to a certain extent due to the fact that they cannot meet the expectations of their wives. By failing to do so, they both damage their relationships. In Fences, we learn that Troy Maxon’s failure as a husband started when he cheated on his wife, Rose, with another woman, who soon became pregnant with his child. In A Doll’s House, Nora would do anything to save her husband, Torvald, but that that feeling wasn’t mutual, and in the end, Torvald shows Nora who he really is, someone she did not expect him to be. In Fences, we learn that, when Rose and Troy first met, Troy told Rose, â€Å"Baby, I don’t wanna marry, I just wanna be your man†Ã¢â‚¬ ¦show more content†¦Rose may have thought an affair was possible in the early years of their marriage, but after eighteen years, those expectations have changed. His excuse for this affair was that it got him â€Å"†¦away from the problems and pressures† in the house and that he could â€Å"†¦be a different man† (Wilson 180). â€Å"I can sit up in her house and laugh. Do you understand what I’m saying. I can laugh out loud†¦and it feels good,† said Troy (Wilson 180). Rose responded, â€Å"What the hell was I there for? That was my job, not somebody else’s† (Wilson 180). Troy doesn’t understand the role that he plays as a husband. He doesn’t understand that, just because he hit a bump in the road, it doesn’t mean he can do whatever pleases him. Rose explains to him that she’s had problems and pressures in her life as well, but she decided to be strong and hold on to Troy no matter what, because that is her responsibility as a wife. â€Å"†¦Don’t you think it ever crossed my mind to want to know other men? That I wanted to lay up somewhere and forget about my responsibilities? That I wanted someone to make me laugh so I could feel good? You not the only one who’s got wants and needs,† said Rose (Wilson 181). Even those Rose knew Troy wasn’t the finest man in the world, she stood by his side as a loyal and loving wife. Troy failed to meet the expectations of being a husband and keeping up with his responsibilities as one. Rose knew finally saw that after the announcing of his affair

Baldwin Norman Free Essays

The profundity of silence is a theme that plays a significant role in the works â€Å"Sonny’s Blues† by James Baldwin and â€Å" ’night, Mother† by Marsha Norman. The two tales represent confessions by family members that uncover the profound effect that each person’s communication method has had on the other. In particular, one identifies a lack of communication within both family relationships that demonstrates itself in an overabundance of silence. We will write a custom essay sample on Baldwin Norman or any similar topic only for you Order Now Baldwin’s tale recounts the woes of a certain brother who feels himself somehow responsible for the tragic events that have faced his younger sibling, and it portrays a relationship that lacks effective communication. Likewise, Norman portrays a family that has spent its usefulness in the avoidance of conversation. She eventually reveals the inadequacies of the mother who is at last unable to rescue her child from the pressures that cause her to contemplate death as the only acceptable option. The protagonists of each story find themselves in family relationships that fall short of the support necessary to prevent each from receding beyond the point of recovery. The tale rehashed in Marsha Norman’s play â€Å" ‘night, Mother† explores the hopelessness that leads to suicide, and in so doing, closely maps the psychological condition of the character Jessie (Whited 65). It takes the analysis of the situation into the realm of the family and considers that cocoon to be the engine that generates and exacerbates the problem Jessie faces. The â€Å"problem† is given its lineage in the relationships experienced by the members of the family. The relationships appear to be filled with action and devoid of communication. Of her own culpability, Mama says, â€Å"I didn’t tell you things or I married you off to the wrong man or I took you in and let your life get away from you or all of it put together† (lines 611-613). This circumstance points toward an overemphasizing of action and the downplaying of the type of conversation that allows true feelings to come to the fore. Jessie also recalls the silence of her father, and Norman hints that this silence has for the past decades stabilized or subdued the appearance of Jessie’s mental condition. Yet, this same silence has perhaps created the environment in which her mental or psychological illness has been allowed to germinate (Whited, 67). The idea that Jessie breaks her silence precisely at that hour in which her mental condition has become overwhelming and irreparable gives the idea that the lack of communication within her family setting may actually have been to her detriment. The exploration of the relationship between the narrator and his brother Sonny in James Baldwin’s â€Å"Sonny’s Blues† also represents a crisis of silence and suffocation within a family setting. This family in which Sonny resides also betrays a tendency toward continual action that precludes the kind of conversation which might have allowed the brothers to truly understand each other. Without understanding Sonny, the narrator (his brother) and their mother make plans to protect him for the rest of his life. They encourage him to live in situations that are not conducive to his spirited nature, such as his residence with Isabel while his brother goes off to war. Yet the silence Sonny endures, like that of Jessie, has the appearance of being his preferred mode of existence. The narrator says, â€Å"Sonny has never been talkative,† yet he goes on to say something more insightful that hints at the true desires that Sonny has always had. He continues, â€Å"So I don’t know why I was sure he’d be dying to talk to me when supper was over the first night† (Baldwin, 8). This hints at the underlying idea that though silence prevailed within the family, probing by his brother and mother might have dispelled both the silence and the dismal circumstances that later defined Sonny’s life. Literary analyst Tracey Sherard writes: â€Å"the narrator comes to understand his brother Sonny through the latter’s apparent struggle to strike out into the deep, unexplored waters of jazz improvisation† (691). Therefore, it is only through the music that Sonny’s brother is able to communicate with and understand him in the end. Comparisons between the two tragic characters of the stories, Sonny and Jessie, can be made in regard to their life choices. The two characters can be seen to choose silence during the early years of their lives, and this might be connected to another form of silence throughout the later stages of their lives. Sonny’s choice of life has led him to heroin, and this dangerous drug might be considered one that paves a path to death in a manner that is very similar to the suicide that Jessie contemplates. Both characters, therefore, choose suicide as the only means of silencing the worries and discontent of their lives. Jessie expresses a desire to sleep â€Å"whenever she wanted to, just by closing her eyes† (line 637), and this she has not been able to do since she was a â€Å"pink and fat† baby (639-40). This choice to commit suicide is therefore an extension of the idea of closing one’s eyes to problems of life. Sonny, in a similar way, chooses to close his eyes to his problems via his use of heroin. And likewise, the extension of this action (continued heroin use) is precisely concurrent with the death that Jessie so openly craves. Jessie’s mother, who desires not death, says â€Å"I’m not like you, Jessie. I hate the quiet and I don’t want to die† (lines 626-27) and this juxtaposition of death and quietness underscores the idea that the death desired by Jessie and Sonny can be seen also to be a form of silence. The motif of silence can be carried through even further within the analysis of the stories told by these authors. During the few short moments before her death, Jessie takes a break from her silence to explain the essence of it to her mother. Within this time she uncovers all the pain that her silence has embodied for the years preceding (Whited, 67). She also enumerates the problems that her ensuing death will hope to silence within her. This moment of conversation can be compared to (and in fact prefigures) the bullet that breaks for a split second the silence that has defined Jessie’s life. It also effects the reconstruction of that silence by guaranteeing its continuation in death. Death guarantees not only that the disappointments and fears in Jessie’s psyche will be quieted, but also that the events that have generated or exacerbated these problems will also cease to trouble her. The forms of silence to which Sonny subscribes are heroin (as has been uncovered above) and music. While heroin promises to lead him toward that final and inexorable death of the body, music provides a spiritual release for him that also provides an effective (if temporary) silence from his turmoil. Sonny’s escape to music as a means of silencing his demons can be compared to the way his brother describes their father as being â€Å"on the lookout for ‘something a little better. ’† Yet he goes on to say that his father â€Å"died before he found it† (Baldwin, 8). Sonny, too, looks to music as a form of escape—a means of quieting his dissatisfaction with his circumstances, a way of searching for something better. While as a youth he annoyed Isabel’s family with his constant piano playing, everyone was able to sense that â€Å"Sonny was at that piano playing for his life† (16). The piano’s music silenced not only the troubles that haunted his mind, but also the voices of hoodlums and vagrants on the street that would have called him into a life of crime and dissipation. It was, in fact, the eventual silencing of the piano by the screams of Isabel’s family that precipitated the demise that his music had been holding at bay. This re-establishes and supports the idea that music was a means of silencing the call of the inner city life and pressures that threatened to overtake Sonny in his youth. The lives and relationships explored within â€Å"’Night, Mother† and â€Å"Sonny’s Blues,† as told by Marsha Norman and James Baldwin respectively, speak loudly and portray vividly a distinct and almost impenetrable silence that enveloped the main characters. For Jessie, silence has been the defining characteristic of her relationship between her father during both his life and his death. During his life, he demonstrated his love with actions, and while Jessie appeared to be comfortable in that silence, the very essence of it provided the environment in which her psychological demise germinated and matured. Her mother, though disliking silence, has rarely been able penetrate Jessie’s, and this proves to facilitate the more permanent form of silence to which she graduates: that of death. Sonny too experiences silence within his relationships—a silence that becomes extended and embodies by the activities of his life. He refuses to speak to his family, silencing the discomfiture with music or heroin. Like Jessie, Sonny’s major life decisions place him on a path toward the ultimate silence: death. Works Cited Baldwin, James. â€Å"Sonny’s Blues. † Wright State University. 1957. Online Text. http://www. wright. edu/~alex. macleod/winter06/blues. pdf Norman, Marsha. â€Å"’Night, Mother. † Literature: Reading, Writing, Reacting. Laurie G. Kirzner Stephen Mandell (Eds). 4th Ed. New York: Harcourt College Publishers, 2001. 1708-1743. Sherard, Tracey. â€Å"Sonny’s Bebop: Baldwin’s ‘Blues Text’ as Intracultural Critique. † African American Review. Vol. 32, Issue 4. (Winter 1998): 691-705. Whited, Lana A. â€Å"Suicide in Beth Henley’s Crimes of the Heart and Marsha Norman’s ‘night, Mother. † Southern Quarterly 36 (Fall 1997): 65-74. How to cite Baldwin Norman, Papers

Business Corporations Law and Consultants

Question: Discuss about the Business Corporations Law and Consultants. Answer: Introduction The Corporations Act, 2001 lays down various duties which are to be followed by the directors, as well as, the officers of the companies. Such duties are assigned on the directors, as well as, on the officers of the company, as the companies are managed under or by the directors of the company, with the help of the officers. And the directors and the officers are in a position of trust; and their position can be easily used for personal benefits. The duties covered in the act relate to the duty of care, the use of information, and the like (Australian Institute of Company Directors, 2016). In the following segments, the case of Vines v ASIC has been discussed to evaluate the duties breached by the executive officers of the company. Vines v ASIC (2006) Geoffrey Vines was a former chief financial officer of the GIO Australia Holdings Limited and he had violated the duty of care regarding the forecasts of profits during the takeover bid (Jacobson, 2007). The ASIC, i.e., Australian Securities and Investments Commission, initially started the civil proceedings, in 2011, against Geoffrey William Vines, along with two other executives, Francis Timothy Robertson and Timothy John Henry Fox in relation to the Part B Statement which was published by the GIO when the takeover bid, in the late 1998, was being carried out (Piper Alderman, 2007). This Part B Statement contained a forecast of profit at $80 million, from the reinsurance division of the GIO. However, the reinsurance division of GIO was exposed to some major allegation due to Hurricane Georges, which struck in September 1998, at the Virgin Island and Puerto Rico. The predecessor of section 181(1) of the Corporations Act, 2001, i.e., section 232(4) of the Corporations Law was alleged to be breached by Vines and the two executives (Webster and Swan, 2007). The directors also failed to exercise the duty of care covered under section 180 of the Corporations Act, 2001. This matter was majorly related with the rationality of inclusion of the $80 million forecasted profit due to the allegations as a result of exposure to Hurricane Georges (Piper Alderman, 2007). Duties Breached Section 180 of the Corporations Act, 2001 contains the provisions regarding the duty of directors to act with care and diligence. As per 180(1) the directors have to discharge their duties and exercise their powers with a degree of care, as well as, diligence, which a prudent person in similar circumstances would do (Australasian Legal Information Institute, 2016a). As per section 181(1) of the Corporations Act, 2001, the directors, along with the officers of the company, have to act in good faith. As per this section, while discharging their duties and exercising their powers, a director has to do so in good faith, which is in the best interests of the company, and for a proper purpose (Australasian Legal Information Institute, 2016b). The contravention of both these sections attracts civil penalties stated under section 1317E; under which a declaration of contravention is made by the court. Decision of the Court The Court of Appeal affirmed that the standard of care contained in section 232(4) of the Corporations Law did not require a high order of negligence to established, in comparison to the duty stated under the general law. The court was of the view that the standard of care and diligence, that was applicable on Vines, did extend to the Part B Statements contents. Moreover, the information that was provided did fall in the structure of the due diligence procedure, which was designed to make certain the materially, as well as, adequately finalized disclosures to the shareholders of GIO as per the law, and in such a manner which would safeguard the involved individuals from liability in case a defect is established at a later stage (Webster and Swan, 2007). The Court of Appeal agreed with the earlier findings of Justice Austin regarding the contravention of directors duties by Vines on three instances: When Vines signed the management sign-off regarding the due diligence report, without even taking the requisite positive steps, which required the advise to the due diligence committee of GIO regarding the assumption of the forecasted profit of $80 million. When he did not inform the due diligence committee of GIO that he had no issues with the reliability of the profit forecast of GIO. And when he did not provide the proper attention to the fact, whether or not the reinsurance division of GIO could be attained in the estimated time subsequent to the issuance of the Part B Statement, and prior to the end of the takeover process (Webster and Swan, 2007). Though the contentions of the ASIC regarding some of the issues were overturned and the court held that Vines was not in violation of the duty of care: On November 9, 1998, when Vines made the unqualified statement of management confidence to the board within the reinsurance division of GIO regarding the profit forecast. When Vines did not provide the information pertaining to the basics on the forecast of profit calculations, in the email of November 22, 1998 sent to the due diligence committee and the report of November 17, 1998 which formed the base for the media release (Webster and Swan, 2007). Even though Vines was found to have acted with honesty, the seriousness of contraventions could not grant him relief. And it was held that Vines had to consider, whether or not the material information had to be disclosed, which he was aware about (Stephens Lawyers Consultants, 2007). Upon finding that the directors had indeed breached their director duties, in accordance with the draft of ASIC, the court made the declaration of contravention. And disqualification orders were made for Vines and Robertson for a period of three years, and for Fox, a disqualification order for a period of 12 years was made. The directors were also awarded pecuniary penalty order, as follows: Vines- $100,000; Robertson- $50,000; and Fox- $220,000. Along with this, a compensation order was also passed against Fox for AUS dollar which is equivalent to US$143,750 at the exchange rates of June 3, 1999. The ASIC costs to be paid by the three were Vines- 22%; Robertson- 28%; and Fox- 33% (Jade, 2016). Conclusion From the above case study of Vines v ASIC, it can be summarized that Vines, along with two other directors, i.e., Fox and Robertson had failed in their duties of care and diligence and to act in good faith, by being the executive officers of the company. The verdict of this cases helps in establishing the responsibilities of the executives of the company, especially while preparing the forecasts of profits during a takeover bid. References Australasian Legal Information Institute. (2016a) Corporations Act 2001 - Sect 180. [Online] Australasian Legal Information Institute. Available from: https://www.austlii.edu.au/au/legis/cth/consol_act/ca2001172/s180.html [Accessed on: 16/12/16] Australasian Legal Information Institute. (2016b) Corporations Act 2001 - Sect 181. [Online] Australasian Legal Information Institute. Available from: https://www.austlii.edu.au/au/legis/cth/consol_act/ca2001172/s181.html [Accessed on: 16/12/16] Australian Institute of Company Directors. (2016) What are the duties of directors?. [Online] Australian Institute of Company Directors. Available from: https://www.companydirectors.com.au/membership/the-informed-director/what-are-the-general-duties-of-directors [Accessed on: 16/12/16] Jacobson, D. (2007) ASIC v Vines Appeal Decided. [Online] Bright Law. Available from: https://www.brightlaw.com.au/asic-v-vines-appeal-decided/ [Accessed on: 16/12/16] Jade. (2016) ASIC v Vines [2006] NSWSC 760. [Online] Jade. Available from: https://jade.io/article/1022 [Accessed on: 16/12/16] Piper Alderman. (2007) Piper Alderman Legal Update. [Online] Piper Alderman. Available from: https://www.piperalderman.com.au/__files/f/4017/PA%20eBulletin%20June%202007.pdf [Accessed on: 16/12/16] Stephens Lawyers Consultants. (2007) Corporations Law Update: Recent Decisions About Directors' Duties And Liabilities. [Online] Stephens Lawyers Consultants. Available from: https://www.stephens.com.au/Sites/2196/Images%20Files/Newsletters/October%202007%20-%20Corporations%20Law%20Update.pdf [Accessed on: 16/12/16] Webster, J., and Swan, C. (2007) Focus: Implications Of Vines v ASIC. [Online] Allens. Available from: https://www.allens.com.au/pubs/ma/fomamay07.htm [Accessed on: 16/12/16]