Roles in an Investigation Essay Example | Topics and Well Written Essays - 1500 words

Roles in an Investigation - Essay Example investigation, I would play the role of helping the investigators carry out their duties to know the cause of the death and act as a counselor as well. I would do research and aid in investigating all the possible reasons that might have caused the Chief’s death. After identifying the cause of the death, I would know the cause of the death, as well as the possible criminal responsible for the act. Therefore, the issue leading to the death of the chief would be discussed and counseling would be a major role to play to help people prevent future reoccurrence of the incidents. By playing a role of counseling, I would also assist the affected family to recover quickly from stress show them how to deal with problems and handle them effectively. Kocsis (2009) believes that the concept of psychology autopsy is not a simple concept hence hard to explain. He depicts that psychology autopsy is a mechanism that is largely recognized for evaluating possible circumstances that were behind a certain death. Further still, other psychologists consider it as a research paradigm in which all the types and reasons that may lead an individual to committing suicide are studied. Despite the fact that its operational application has its origin from coroner’s investigation, it developed to a point where the state of mind of the deceased person is evaluated. This reconstruction is usually based on information that is obtained from individual documents, police reports, and interviews with friends or the families, medical records and other people who had the contact with the victim before his death. The purpose of psychological autopsy is to carry out an accurate death process of the decedent, hence classifying the death mode in the deat h certificate. This method requires detailed information in the decedent’s life and many interviews from decedent’s social environment, friends, and families. There are two major trends that are used in psychological autopsies, which include

Answer the 5 questions of investment portfolio management Essay

Answer the 5 questions of investment portfolio management - Essay Example Present value of Dividends employs the cost of equity as the discount figure. Operating free cash flow is the cash residue after eliminating direct costs, working capital and capital expenditure needed for future growth, but before any payments to suppliers of capital. The firm’s weighted average cost of capital (WACC) is the discount rate employed in determining operating free cash flow. Free cash flow to equity refers to operating free cash flow less payment to debt holders (Strong, 2008). The firm’s cost of equity is used as the discount rate. Present value of Cash flow allows a degree of flexibility for changes in sales and expenses, which implies varying rates of growth over time. However, present value of cashflow valuation approach has a weakness in that it is heavily dependent on growth rates of cash flows and the discount rate estimates. Relative valuation approach to security valuation offers information on how the market is presently valuing the stock. Compon ents measured using the relative valuation technique include the price earning ratio, price to sales ratio, price to book value and the price to cash flow. Unlike the present value of security valuation, relative valuation approach does not offer insights as to whether current valuations are appropriate. Thus, valuations could be too low or high at a certain point in time. As such, Relative valuation is suitable when there are comparable firms in terms of the risk, industry and size in the market. It is also appropriate when the aggregate market and the entity’s industry are not under valuation extreme. That is to mean that the collective market and the firm’s industry should not be acutely overvalued or undervalued (Strong, 2008). Both cash flow approach and relative valuation approach have several factors in common. One is that they are both affected by the investor’s required return on the stock since this return rate becomes a significant element of the disc ount rate. Secondly, the two valuation approaches are affected by the growth rate estimation employed in the valuation technique such as dividends, sales or earnings. Therefore, the two approaches may be considered as complementary. 2. The concepts of systematic and unsystematic risk, variance, covariance, standard deviation and beta as each of these relate to investment management. Unsystematic risks refer to the kind of uncertainty that is associated with the industry in which a company operates. Unsystematic risks are also referred to as specific risks or diversifiable risks for they are specific in each industry, and they are reduced through diversification. Unsystematic risks arise as a result of factors particular to an industry or the firm such product category, marketing, research and development and pricing. Systematic risks refer to the kind of uncertainty that is inherent in the whole market segment. They are also referred to as market risks or non-diversifiable risks bec ause they are inherent in the entire market and diversification do not result in their reduction. Systematic risks are such as war, inflation, change in taxation, global security perils and political instability that affect the functioning of firms in all industries. Total risk is a combination of systematic and unsystematic risks. Variance is the measure of volatility from the mean. Variance helps an investor to establish the risk involved in purchasing a certain security. A higher variance indicates greater variability and thus greater risk. A greater variance also

Roles in an Investigation Essay Example | Topics and Well Written Essays - 1500 words

Roles in an Investigation - Essay Example investigation, I would play the role of helping the investigators carry out their duties to know the cause of the death and act as a counselor as well. I would do research and aid in investigating all the possible reasons that might have caused the Chief’s death. After identifying the cause of the death, I would know the cause of the death, as well as the possible criminal responsible for the act. Therefore, the issue leading to the death of the chief would be discussed and counseling would be a major role to play to help people prevent future reoccurrence of the incidents. By playing a role of counseling, I would also assist the affected family to recover quickly from stress show them how to deal with problems and handle them effectively. Kocsis (2009) believes that the concept of psychology autopsy is not a simple concept hence hard to explain. He depicts that psychology autopsy is a mechanism that is largely recognized for evaluating possible circumstances that were behind a certain death. Further still, other psychologists consider it as a research paradigm in which all the types and reasons that may lead an individual to committing suicide are studied. Despite the fact that its operational application has its origin from coroner’s investigation, it developed to a point where the state of mind of the deceased person is evaluated. This reconstruction is usually based on information that is obtained from individual documents, police reports, and interviews with friends or the families, medical records and other people who had the contact with the victim before his death. The purpose of psychological autopsy is to carry out an accurate death process of the decedent, hence classifying the death mode in the deat h certificate. This method requires detailed information in the decedent’s life and many interviews from decedent’s social environment, friends, and families. There are two major trends that are used in psychological autopsies, which include

Physiological vs. Technological birth Essay Example | Topics and Well Written Essays - 750 words

Physiological vs. Technological birth - Essay Example Before a choice is made, one however has to analyze the pros and cons associated with both the normal physiological route of delivery and technology assisted cesarean section (Lowden, 2002; Cohen, 2003). In an age where time is considered equivalent to money it is not surprising when people opt for quicker and also pain-free delivery procedures rather than time-consuming vaginal ones. Many mothers also have a constant fear about the passage of a baby through the birth canal and a c-section prevents all these anxieties. Additionally the oozing of the amniotic fluid, excretion of human wastes in some cases, sweat and tears which are normally associated with normal vaginal birth is also avoided. In other words, a c-section ensures a more clean and hygienic delivery in keeping up with the modern trend. While these are the pros associated with a c-section, one should also consider the after-effects of such a procedure. The procedure does ensure a pain-free delivery, however, post-op there are several problems which have to be overcome by the mother. The pain after a c-section persists for a while and the mother would have to take pain killers and in case they have an infection they will have to take more drugs to control them. There is also the burden of the scar left from the surgery which would present for quite a long time. The time taken to recover is more compared to that of normal pregnancies and hence such mothers cannot get into their routine for quite some time. Thus if the mother has other small children it would be quite a task to manage them. Above all, the risk of maternal death is high in cesarean sections as compared to vaginal deliveries. The presence of a scar or any other tissues after delivery can also lead to other problems such as bowel obstructions or infertility and might affect subsequent pregnancies. Moreover research also states that cesarean mothers are

Couples counseling Essay Example for Free

Couples counseling Essay Woman is a greatest creature of the god. Woman plays an important role in every man’s life. There is a woman behind the every successful man. Men and women are made for each other. Actually they are life partner of each other, but the chance of the death of a partner is more for women than for men. There is a ratio of 1:4 between men and women. It means chance of the death of a married man is 4 times greater than the chance of the death of a married woman. Generally aged men become widower than young man (U. S. Census Bureau). There are many of similarities and differences between the experiences of the widowers and widows. Comparisons are done by the many people between widows and widowers. But there are some unique experiences in the life of widowers. The course of bereavement is wrought with diversity and variability among widowers. Widowers are not able to adapt the death of their wife easily. Some widowers face greater difficulty in adaptation the death of their wives. But many widowers ultimately become able to withstand or recover quickly from difficult conditions. (WIDOWERS, 2007) Couple’s counseling is a way of solving the problems of widowers. Couple’s counseling is based on the problems of the widower. A widower can take help of the Couples counseling for recovering. It has proved that Couples counseling is very beneficial for widowers. Problems are handled in a best way in the Couples counseling. Widowers have to attend the counseling session to discuss the problems in life. Solutions are suggested by the experts and â€Å"how to get those solution? †, is also suggested in Couples counseling. â€Å"How to deal with current problems of life? † is also learned to the widowers in these Couples counseling sessions. There specific problems are also discussed and solved in these sessions. The main aim of the Couples counseling is to provide a better way to solve the problems. The problem of loneliness, emptiness and past memories are the main problems of a widower. (Will) When a man lost his wife then he feels like a limb is cut from his body. Wife is a very important part of a man’s life. She is a person who kept them organized. A man is not called complete without a woman. That’s why loosing wife is very painful. Couples counseling has become very essential at this time for widowers because wives are â€Å"the primary source of protection, support, and comfort† for men. Wives show a right direction to the husbands. Death of the wife means being lost without a compass. Widowers feel great loneliness after the death of their wives because they are dependent of wives for many things such as organization the home, caring of children and wives are supposed only true confidant of the husbands. Hence widowers need help after the death of their wives and this help is provided by the Couples counseling. It is very difficult for a widower to express himself. He cannot express his emotions easily. In such type of conditions Couples counseling sessions are very helpful. . (WIDOWERS, 2007)

Effect of Spontaneous Breathing Trial (SBT) Duration

Effect of Spontaneous Breathing Trial (SBT) Duration Effect of Spontaneous Breathing Trial (SBT) Duration on the Clinical Outcomes of Mechanically Ventilated Patients Admittted at Medical Intensive Care Units of a Tertiary Government Hospital In Davao City INTRODUCTION Background of the Study: Mechanical ventilation (MV) is primarily used to support patients whose respiratory function is compromised due to a variety of reasons. However, several studies have shown that prolonged MV among intensive care patients is associated with adverse clinical outcomes. Thus, MV should be discontinued promptly as soon as patients are capable of breathing spontaneously. Furthermore, patients who are dependent on MV stay longer in the intensive care unit, requiring dedicated care and frequent monitoring. The inadequate number of intensive care unit beds necessitates maximizing the use of limited resources in delivering essential care to critically ill patients. Discontinuing mechanical ventilation in a well-timed and safe manner should lead to desirable outcomes for both patients and clinicians. Hence, strategies that assist in early withdrawal of patients from mechanical ventilation should be investigated. The process of liberating from mechanical support is known as weaning. In most studies, it was noted that nearly half of the total duration of mechanical ventilation is spent in the weaning process. Each day, a set of weaning predictors is tested and patients who meet the criteria proceeded to a spontaneous breathing trial (SBT). Several researches set the SBT at 120 minutes. The American Thoracic Society guidelines recommend SBT for 30 minutes to no longer than 120 minutes. In our institution, current practice involves an overnight duration of SBT. The optimal duration of SBT, however, is not known. The long duration of SBT requires close monitoring of a critically ill patient, which is challenging for the limited number of intensive care unit staff. Hence, this study will investigate the hypothesis that short (30 minutes), intermediate (120 minutes) and long (overnight) duration of SBT have similar clinical outcomes. Review of Related Literature: Mechanical ventilatory support is used when spontaneous ventilation is insufficient for the sustenance of life. The word supportis emphasized in this context since mechanical ventilation is not a cure for the underlying disease, but it is at best a type of support, offering rest to the patient while the disease processes are treated. A study by Esteban et al showed that half of the intensive care units in North America had at least 40% of adult patients receiving mechanical ventilation. This data is similar to that of a prospective study involving 20 countries in 2004, where it was reported that 33% of patients required mechanical ventilation. Invasive mechanical ventilation is a risky, uncomfortable, and costly procedure that should only be utilized when indicated. Major indications for mechanical ventilation are: (1) partial pressure of oxygen in arterial blood (PaO2) cannot be maintained above 50 mm Hg despite high levels of delivered oxygen; (2) partial pressure of carbon dioxide in arterial blood rises above 50 mm Hg; (3) ventilation becomes inefficient and/or exhausted; (4) airway protection. According to Esteban et al (2002), the most common causes for mechanical ventilation were acute respiratory failure in the postoperative period (20.8%), pneumonia (13.9%), congestive heart failure (10.4%), sepsis (8.8%), trauma (7.9%), and acute respiratory distress syndrome (4.5%). The goal of mechanical ventilation is to improve ventilation, oxygenation, and lung mechanics. However, as is the case with other medical therapies, the benefit of mechanical ventilation comes at a price. An Indian study revealed that 55 of the 100 mechanically ventilated patients admitted at a university hospital developed complications as follows: nosocomial pneumonia (29%), gastrointestinal hemorrhage (11%), airway complications, (10%), cardiovascular complications (8%), equipment failure (7%), and barotrauma (2%). The most common complication is ventilator-associated pneumonia (VAP) which occurs 48 to 72 hours or thereafter following endotracheal intubation. The incidence of VAP ranges from 9 to 27%, with mortality rate of between 33 to 50 %. A local private tertiary institution reports a lower incidence of VAP at 7.6%.In this institution, a total of 621 adult patients were intubated from September to December 2014. Of these patients, 13.3% developed ventilator-associated pneumon ia. Numerous studies report that weaning from mechanical ventilation after the underlying reason of respiratory failure has been resolved, account for more than half the total duration of mechanical ventilation. In some trials, however, weaning comprise only 40% of the whole duration of mechanical ventilation. Nevertheless, the duration of weaning is an important component that needs close attention. In a study by Coplin et al higher mortality, more cases of pneumonia and longer hospital admission was reported in patients who underwent more than 48 hours delay of liberation from mechanical ventilation. Hence, physicians should be encouraged to minimize the duration of weaning. Researchers have long recognized the complications of mechanical ventilation. They have proposed multiple techniques to facilitate the transition to spontaneous ventilation. Successful weaning from MV at any time was reported to be associated with a higher survival rate. Generally, weaning has two components. The first component is a list of â€Å"readiness to wean† criteria based on clinical factors that help decide if a patient is ready to breathe spontaneously. Ely and colleagues developed a scoring system wherein all five criteria should be met to pass the screening test. The criteria are as follows: the ratio of the partial pressure of arterial oxygen to the fraction of inspired oxygen (PaO2/FiO2) had to exceed 200; the PEEP should not exceed 5 cm H20; there had to be an adequate cough during suctioning; the ratio of the respiratory frequency to the tidal volume should be less than 105 breaths per minute per liter; and no infusions of vasopressor agents or sedatives. The second component is the spontaneous breathing trial (SBT), a period of unassisted breathing during which the patient is observed for signs of respiratory failure. Several studies have investigated the methodology for weaning. The commonly used techniques are T-piece, synchronized intermittent mandatory ventilation (SIMV), or Pressure Support Ventilation (PSV). The traditional mode of weaning is the T-piece weaning, which involves attaching the endotracheal tube to a T-piece such that one of the two remaining limbs of the T is connected to a humidifier, which supplies humidified oxygen while the third limb is left open to allow for exhalation. The primary disadvantage of this method of weaning is that apnea, low VE and airway pressure alarms are disabled, and close visual monitoring is required. However, this type of weaning provides an estimation of post-extubation breathing, resulting in rapid recognition of patients who are able to tolerate weaning. One of the potential areas of study is improving processes that shorten the spontaneous breathing trial. Three previous studies conducted in years 1999, 2002 and 2003 demonstrate the equivalence of 30 minutes and 120 minutes SBT using both T-piece and PSV protocols. Based on these trials, Macintyre (2012) recommended that an SBT should be at least 30 min but no longer than 120 min to allow proper assessment of ventilator discontinuation Similarly, White reported that the length of an SBT should be approximately 30 minutes to 120 minutes. However, an overnight duration of SBT has been in practice in this institution for many years due to limited data on the success rate of extubation using a shorter SBT duration. After the patient is able to sustain spontaneous breathing, the next step is to ascertain whether the patient can tolerate extubation. This is an important decision, as both delayed and failed extubation are associated with prolonged ventilation and mortality. Several factors may predict extubation failure after a successful SBT. The decision to extubate patients is largely based on the ability to clear secretions and protect the airway. A weak cough and moderate volume of secretions are also associated with extubation failure. Some studies suggest that a Glasgow coma score of ≠¤ 8-10 is correlated with extubation failure since increased risk of aspiration occurs in patients with reduced level of consciousness. Other characteristics recognized as risk factors for extubation failure are: older age, severity of illness on ICU admission, prolonged duration of ventilation prior to extubation, and continuous sedation

Succot: The Jewish Holiday :: essays research papers

Succot: The Jewish Holiday After the Exodus from slavery in Egypt, the wandering Jews lived in tents or booths, called Succots. They were pitched wherever they happened to stop for the night. Today it is called the Succot the festival of booths remembering both the ancient agricultural booths and those of the Exodus. The harvest festival of thanksgiving, Succot, begins five days after Yom Kippur, and lasts for eight days. The first two days are the most holy, during which most Jews do not work. The families construct the booths and decorate it with branches, and leaves, fruits, and other designs. The roof is covered lightly, so the stars and the sky can still be seen. Most Jewish families eat all their meals in the Succot, while some even sleep in them. During the Succot festival, thanks are given for all growing plants by using four plants which are symbolic of all the rest. These four plants also represent the Jewish people. The Etrog, or the citrus fruit, stands for the people who are educated in the Torah and who do good deeds. The Lulav, or branch of the date palm, stands for the Jewish people who have knowledge but no good deeds. The Hadas,or myrtle, symbolizes the people who do good deeds, but are not educated. The Aravah, or willow, stands for the people who have no good deeds and no education. These plants are carried around the synagogue in a procession while prayers are recited for blessings on the land and fruit of Israel. In biblical times, the willow, the palm, and the Etrog were used in decorating the Succot. At the end of the Autum harvest, on the fifteenth day of Tishri (September-October) Succot is celebrated. It is believed that the festival originated with the ancient Canaanite celebration after the grape harvest at the end of the annual dry season. During this time rites were performed to incourage the rains. Boughs of fruit trees and evergreens were made into little booths which the early Jewish farmers lived during the festival. The last day of Succot is called Simhat Torah. It means the "rejoicing of the Torah." On this day, the reading of the Torah is completed, and is then Succot: The Jewish Holiday :: essays research papers Succot: The Jewish Holiday After the Exodus from slavery in Egypt, the wandering Jews lived in tents or booths, called Succots. They were pitched wherever they happened to stop for the night. Today it is called the Succot the festival of booths remembering both the ancient agricultural booths and those of the Exodus. The harvest festival of thanksgiving, Succot, begins five days after Yom Kippur, and lasts for eight days. The first two days are the most holy, during which most Jews do not work. The families construct the booths and decorate it with branches, and leaves, fruits, and other designs. The roof is covered lightly, so the stars and the sky can still be seen. Most Jewish families eat all their meals in the Succot, while some even sleep in them. During the Succot festival, thanks are given for all growing plants by using four plants which are symbolic of all the rest. These four plants also represent the Jewish people. The Etrog, or the citrus fruit, stands for the people who are educated in the Torah and who do good deeds. The Lulav, or branch of the date palm, stands for the Jewish people who have knowledge but no good deeds. The Hadas,or myrtle, symbolizes the people who do good deeds, but are not educated. The Aravah, or willow, stands for the people who have no good deeds and no education. These plants are carried around the synagogue in a procession while prayers are recited for blessings on the land and fruit of Israel. In biblical times, the willow, the palm, and the Etrog were used in decorating the Succot. At the end of the Autum harvest, on the fifteenth day of Tishri (September-October) Succot is celebrated. It is believed that the festival originated with the ancient Canaanite celebration after the grape harvest at the end of the annual dry season. During this time rites were performed to incourage the rains. Boughs of fruit trees and evergreens were made into little booths which the early Jewish farmers lived during the festival. The last day of Succot is called Simhat Torah. It means the "rejoicing of the Torah." On this day, the reading of the Torah is completed, and is then