Saturday, February 8, 2020
Nationalism in Italian and German Unification, 1815-1871 - Essay Example Particularly in the smaller states the prince remains the embodiment of national ideals. This dynastic loyalty implied by the seventeenth century, in any case, the works of a prevalent national consciousness concentrated though it could be upon the governing divine monarch. All over Europe the mercantilist scheme put emphasis on the precedence of national consciousness and interest over those of other nations. Nationalism assumed on various forms as it infiltrated different ways of observing the world and the nation. There is no solitary nationalism; there is in its place a diversity of nationalisms. Furthermore, these nationalisms developed within the paradigm of the varied European countries. However, in this development we can make out a number of common milestones. Otto Van Bismarck of Germany, the genuine politician, approached the front, whereas in Italy the ambitious Giuseppe Mazzini was succeeded by the pragmatic Camillo Cavour, whose preferred philosopher was Jeremy Bentham, a renowned Utilitarian (llobera 1994). National aspirations were guided toward practical accomplishments through peacekeeping or military hostility. This was merely one transition in nationalism after 1848, nonetheless; there was another. This essay will attempt to discuss a comparative point of view on the form of nationalism that developed in Italy and Germany in the Unification attempts initiated in the nineteenth century.
Wednesday, January 29, 2020
Patient Teaching Essay Introduction: I have chosen breastfeeding as my teaching topic for this assignment. The specific clientÃ ¨le will be the new mother at between 2 and 7 days postpartum, newly discharged from hospital. As a community health nurse working with children and young families, I do initial postpartum visits at home. Breastfeeding is a very complex skill, natural, yet sometimes difficult to do. The client is often overwhelmed with information received in hospital, so sessions must be kept short, and made easy to understand. The area in which I work is multicultural. There is often a language barrier which further complicates teaching and learning. Finding a teachable moment is easy (London, p. 95). New mothers are eager for help in providing the best for their babies. Mothers whose babies refuse to latch onto the breast or who have an incorrect latch, may sometimes become very tense and stressed. It is important to remain calm and supportive during teaching. The client must be educated, not simply taught new skills (Rankin, p. 73). The newly acquired information will allow her to make her own decisions and to be the head of her own health care team. Assessment: I have been working with postpartum women for the past 6 years, and have 3 children of my own. I am able to use my own personal experiences with breastfeeding, my last having stopped only 2 years ago. I work well with my co-workers, I know that I cannot do it alone (London, p.51). We help each other every step of the way and have a good back-up system available in the community. These include lactation consultants, breastfeeding clinics, doctors, social workers and community agencies. The learner and her family are at the head of the team (London, p.47). They are usually very motivated to learn and ultimately want what is best for the baby. It is easier to form relationships with the client at home (London, p. 63). The environment is non-threatening to the learner and teacher. I can also learn a lot about the client by observing the home. I have had many clients tell me they were breastfeeding exclusively who had half empty bottles of formula on the kitchen counter. The assessment process begins on the telephone before the visit. All new mothers are contacted when they arrive home. All are offered a home visit, some refuse. By help of a detailed questionnaire, we know the problems to focus on before the visit. This is very helpful as we can be better prepared with the necessary tools. Many patients are Ã¢â¬Å"red flagÃ¢â¬ patients (Rankin, p. 160). Some speak very little English, have financial problems, are on welfare, or are single mothers. Culture and religion can influence teaching (London, p.296). It is impossible to generalize about one culture, so we must be careful to dig deeper when presented with a situation which may be affected by ones background. The area I work in is multicultural. The women speak many languages and I often need to have a family member translate the teaching. This is sometimes quite challenging as I am not always sure that what is being translated is actually what I am saying! I try not to let my own beliefs get in the way of my patient care. I may not always agree with the decisions of others but always stay focused on the desired outcome. Some clients would prefer to breastfeed and others would prefer to bottle feed but are being influenced by family members. Support from family members generally improves the outcome (Stalling, p.163). The client will have an easier time adjusting to breastfeeding and will breastfeed for a longer period of time with family support. We need to make adjustments in our teaching based on each individuals views. (London, p. 303). We should never make assumptions about anything. Self-efficacy is a very important factor in learning to breastfeed. The learner who thinks she can do it, will be more successful. My department organizes a group that meets at the community center once a week. New mothers have a chance to meet each other and learn about breastfeeding. Using these role-models sometimes helps a woman with low self-efficacy learn to breastfeed (London, p.311). When I walk into a home, I can often tell within the first 10 minutes whether I will have to make a follow-up visit. At a typical visit I assess the baby and mother, help with breastfeeding if necessary and provide the mother with helpful information she will need in the first few months of the babys life. A typical visit lasts 1-2 hours. I usually provide printed material on the common breastfeeding problems to my clients. On the website WWW.Medela.com, there is very helpful information on breastfeeding in several languages. I use this site often to print out information on latching, sore nipples and engorgement. The information on the site is generally well written and edited. The vocabulary is easy enough to understand by most women. It is grammatically correct. There are no difficult or very technical terms. The subject in this paper is a mother of two who did not breastfeed her first child. She speaks English and works as a clerk in a drugstore. She has a university degree, so can easily understand information at the 12th grade level. Planning: The general goal of this teaching is for the client to be able to breastfeed in the proper manner and to understand the benefits of breastfeeding in order to prolong breastfeeding for as long as possible. The following are the specific objectives for this clientÃ ¨le. At the end of the session: The client will state at least 5 benefits of breastfeeding vs bottle feeding. The client will demonstrate 3 different breastfeeding positions one time each. The client will describe the treatments for engorgement and sore nipples. The client will list 3 resources for further information after the visit. The client will recognize and state 3 factors which indicate the baby is receiving sufficient milk from breastfeeding. Teaching tools used will be demonstration, discussion, and hand-outs. It is important to prioritize learning needs. There are some facts which are very interesting but which are not necessary for the client to know. (Rankin, p. 191 and 197). The breastfeeding mother does not need to know the physiology of the breast, but she does need to understand the relationship between frequent feedings and increased milk production. Content outline: Discussion of the benefits of breastfeeding. Discussion of the factors indicating that the baby is receiving sufficient milk. Observation of the client breastfeeding using 3 different positions. Demonstration of proper breastfeeding technique for each position as needed. Discussion of breast engorgement and sore nipples and their management. Discussion of resources for further information about breastfeeding and the assess the need for a follow-up visit. * The teaching is mostly done by discussion and demonstration. This is a good way to get continuous feedback from the client. It is also a good way to ensure that all the important material is not forgotten. Practice makes perfect. Adult learners need to be involved in the teaching (Rankin, p. 196) and want to apply what they learn right away. This is especially important with breastfeeding, as the new mother must be able to master it within a very short time. It is not always necessary to cover all the information with each client. Some are too overwhelmed with information already; others may already have the knowledge base and simply need help with latching. Implementation: I generally start teaching about breastfeeding immediately after having evaluated the client. I begin by discussion of the benefits of breastfeeding and the factors which indicate that the baby is receiving enough milk. Many women do not believe that they have enough milk and worry about the need to offer a supplement. It is important to explain this to them. If they do offer a supplement, their own milk supply may be reduced. Then, I assist the client at putting the baby to the breast using different positions as needed. I sometimes use a dummy breast to show the client the correct angle to use while feeding to ensure a proper latch. Visual aids sometimes help to make it seem more real. When that has been mastered, I continue with a discussion of the two most common problems found in the first weeks of breastfeeding, sore nipples and engorgement. I provide the client with written material on proper latching technique, sore nipple management and engorgement. Since these problems sometimes occur after a few days or weeks, it is helpful for the client to have this information in writing. I also provide an information sheet on the resources the client can use if she should need further help after the visit. I generally make a follow-up call one to three days after the visit and a follow-up visit as necessary. I sometimes refer the clients to the company Medelas website, www.medela.com. This site provides helpful information on breastfeeding and the common associated problems. The computer is only a tool, however. It provides information, not education (London, p. 246). I remain available to my clients by telephone or by email at all times. Recording transcribed: (T=teacher, L=client) T: Did you breastfeed with your first child? L: No. I tried for about 3 days but gave up due to the pain. T: Did you receive any help? L: No. But it was less important to me then. I was ok with bottle feeding. T: Do you want to breastfeed Joshua? L: Yes. I will be taking a year off of work and would like to breastfeed him as long as possible. Many of my friends have had babies in the past years and all are breastfeeding. They make it look so easy. I decided to try harder this time. T: Joshua is 3 days old. How have you been feeding him? L: I tried to put him at the breast right after birth but he was too sleepy, and so was I. The first day he had a few bottles. Yesterday, I tried for the first time. I think it went ok but my nipples are very sore. I would like to learn how to breastfeed properly. T: Well, we can discuss a few things now and I can show you the proper technique for a few different positions when he wakes up. L: OK T: First of all, why do you want to breastfeed? L: Everyone is telling me that it is the best thing for my baby. T: They are right, but what do you think? L: I want to do whats best for Joshua. T: Breast milk is definitely the best for babies. One of the best things about breastfeeding is that the milk is always ready. You dont have any bottles to warm up or prepare, especially at 2:00 in the morning when youre exhausted. Because it is available right away, you dont have to make the baby wait. This will make it easier to calm him before he gets too agitated. It is also a great time to bond with the baby and will make Joshua feel more secure. Breast milk is the best thing for your baby. Do you know what colostrum is? L: Yes. I have been reading up on breastfeeding since I found out I was pregnant again. It is the yellow liquid that comes out before the milk comes in. I know that it helps to prevent jaundice. T: Yes that is true. It acts as a mild laxative to encourage the baby to pass his first stools of meconium. It can also help to prevent ear infections and allergies. It is very rich in nutrients and allergies. Did Julia have jaundice? L: No, she didnt. T: Do you know of other benefits of breastfeeding? L: I know that breast milk is the perfect formula for babies with the exact right nutrients that they need. It keeps babies from becoming overweight. I also know that it can help me lose the baby fat that much quicker. T: Thats true. It can also save you money. The average cost of formula for 1year is about $1800, and that doesnt include the bottles and other supplies. Breastfeeding requires you to eat about an extra 500 calories per day. This should cost, by comparison about $300 for the year. L: With all the expenses of a new baby, we can use that money for many other things. T: Thats for sure. L: Can breastfeeding keep me from getting pregnant again? T: No. It is not a sure form of contraception. Although it is relatively effective in the first 6 months if you breastfeed exclusively. Some women ovulate as early as 6 weeks postpartum even when breastfeeding. L: Good to know. T: Do you know how to tell if the baby is receiving enough milk? L: He will gain weight. T: Yes. Thats a very good sign in the long run. There are other things as well. He should have at least 3 urines today since he is 3 days old. Then, you should see one more each day until the sixth day. That means that on the 4th day, he should have at least 4, on the 5th day at least 5 and from the 6th day onwards, at least 6 per day. How many has he had today. L: So far he had 1 at 2:00 and another at 7:00. I dont think thats a problem. T: Good. We would also expect to see a few stools everyday. They should gradually change from the black meconium stools, to brown and then to yellow. Many breastfed babies have a stool with every feed, but some have only 1 or 2 per day. Both are normal. L: He has one almost every time he feeds. T: Thats great. He should also be satisfied between feeds. That means he would feed every 1 to 3 hours in the first few weeks and have some period in between when he sleeps or remains calm. You told me that he feeds about every 2.5 hours and usually sleeps in between, so it sounds like he is right on target. A baby who is too sleepy and needs to be woken up for feedings may also not be getting enough. Do you have any questions so far? L: No. Im glad hes getting enough milk and cant wait to see if hes gained weight. T: You mentioned that your nipples are very sore. Have you done anything for the pain? L: I am taking Advil and I was given some Lanolin ointment at the hospital. Do I need to wash it off before I feed the baby? T: No, it is harmless for the baby. The best way to avoid sore nipples is correct positioning at the breast. If you have sore nipples already, I will show you how to have Joshua latch on properly. Meanwhile, for the soreness, you should apply a small amount of your own breast milk on the nipples after each feeding. Then let it air dry as much as possible. After that, you can apply a bit of lanolin. Sometimes it helps to use different feeding positions during the day. L: The nurse at the hospital told me to let my breasts air dry, but that is not easy in the hospital. How often can I use the lanolin? T: You can use it 2-3 times per day. L: Ok. I will try that. T: Your milk has not come it yet, but should come in in the next few days. It usually comes in by the 3rd to 5th day. It is important to feed regularly to encourage your milk production and also to prevent engorgement. Do you know what engorgement is? L: Yes. I was very engorged about a week after Julia was born. T: Engorgement can be very painful and can make it impossible for the baby to latch on properly. (baby wakes up. L gets the baby) L: What should I do if I get engorged? T: Engorgement usually lasts only a few days. Some women just produce more milk than others. If you get engorged, it is important to continue feeding often. You can apply warm compresses and massage your breasts. If it is more severe, you may need to express a bit of milk for relief, which you can do manually or you may need to use a pump. A well-fitted supportive bra may help. L: I have bought a good bra, but havent worn it yet. I will send my husband out to buy a pump today. What kind do you recommend? T: It depends on how often you would like to use it. If you are planning to breastfeed all the time, then a manual pump may be enough. There are however, some inexpensive electrical pumps which you can buy for under $40. These may be easier and quicker to use. You can use them to relieve engorgement and to pump if you go out from time to time. L: My friend uses a Safety First pump which is electric. She bought it at Walmart for about $35 and says it works well. T: Thats probably a good choice for you too. Do you have access to the internet? L: Yes T: If you check out the site www.medela.com, you can find information about choosing a pump. If you pump to relieve engorgement, you should only pump for a few minutes. If you pump too much milk, you will only encourage more milk production. L: Thank you, Ill check the site. Would you like to see how I feed him now? T: Sure. (L puts baby to the breast using cross cradle positioning. The baby does not take enough of the areola so L has pain.) T: He is not on properly. To release the suction, place your finger gently between his gums, like this. In order to get him to latch on well, you first need to make sure that you are comfortable since you will be breastfeeding so often. Use pillows to get yourself comfortable. Take your time and relax before you start. When you are ready, make sure the babys nose is facing the nipple. His head should be aligned with his body. Gently stroke his upper lip with your nipple. When he opens his mouth, pull him quickly towards you, so that he can take as much of the areola as possible. L: How do I know if he is taking enough? T: The most important cue is that you will have no pain. Generally the babys chin is touching the bottom of the breast, and there is a small space between his nose and your breast. Hold your baby close to you and support his head. There is no normal or standard way to breastfeed. If the baby is feeding well and you have no pain, it is working well. L: I dont feel any pain now. T: Can you hear him swallow? L: Yes. T: Excellent. Then you are doing it very well. Notice how his body is aligned with his head, he is most comfortable that way. Look at his chin and his nose. See how they are positioned. You can see that he has opened his mouth very wide and is taking enough of the breast. Would you like me to show you how to hold him in some other positions? L: Yes. I would like to learn how to lie down to feed. It would be so much easier at night. T: Thats true. When youre very tired, its a lot easier. The basics are the same. You want to ensure that the baby is facing you and that his body is aligned with his head. Make yourself comfortable. Use a pillow behind your back or between your knees if you need one. (L Demonstrates the technique.) T: That is very good. Are you comfortable? L: Yes, very. And no pain! T: Breastfeeding is not always as easy as some people make it seem. It takes practice. The beginning is a learning process for you and for the baby. Let me show you one more position that you may like to use. This is the football hold. It is easier to use when the baby is small like Joshua; but is sometimes more difficult later on. Hold him so that his legs and body are under your arm, like this. Then place your hand under his head and neck. If youve ever played football, thats how a football is held. L: I dont like that one. It is much easier the other way. T: Not everybody likes that position. You have to do whats best for you and for your baby so use the position thats most comfortable. (Baby weighed Ã¢â¬â lost 8.5% of birth weight) T: He lost a bit more weight. But thats normal. Most breastfed babies lose 10% or more of their birth weight in the first few days. They usually regain their birth weight within 10 days. Do you remember how to tell if he is drinking enough? L: Yes. He should have at least 6 wet diapers every day after the 6th day and a couple of stools. He should also wake up alone to feed and sleep well between feedings. And of course, he should gain weight. T: Exactly. T: I will be returning to weigh Joshua again Wednesday (in 48 hrs). I will continue to follow him until he starts to gain some weight. If you need help before then, you can call the CLSC (community clinic) at the number I gave you earlier. As I told you earlier, there is a breastfeeding clinic every Thursday morning as well. At the clinics, there are nurses available to weight the baby and to help you more with breastfeeding. Here is some information on breastfeeding that we discussed today (pamphlets on latching, sore nipples and engorgement given). If you have any questions about them, let me know. Evaluation of learner: I always do a telephone follow-up within 1-3 days. This is very effective as the client will have had some time to process all the information (London, p.62). If necessary, a repeat visit will also be planned. Unfortunately I cannot always have the client do three separate demonstrations (London, p. 386) due to budget and time constraints. Discussion worked best with the subject in this paper. She was educated and was eager to learn proper techniques. She had self-efficacy, skills and knowledge Ã¢â¬â all important factors if changing behaviors (Rankin, p 292). She was alert and very interested in learning. She participated in the discussion. She was able to apply the information immediately during my visit. At the follow-up visit 2 days later, the client was doing very well. She was able to breastfeed without any pain or difficulty. We discussed engorgement again, a problem which had developed since my first visit. She explained what she had done to relieve the engorgement, which was how I had explained it to her. The Ã¢â¬Å"what ifÃ¢â¬ scenario had worked .(London p.386) Evaluation of teacher: I could have done more assessment of the learner while I was teaching. I find myself being drawn into a routine with my teaching that is sometimes hard to get out of. Most of the teaching is very repetitive from one client to the next, however, each client learns in her own fashion. I try to keep the client interested in what I have to say. I encourage her and give her positive feedback. Sometimes I forget the goals of the session and get off track, or provide the client with unnecessary information. I find that using a checklist helps me to stay on the right track and to not omit anything important. Evaluation of resources: The handouts I usually give out to my clients on latching, engorgement and sore nipples, all score over 70% by the SAM test (Rankin, p.238), thus making them good resources. I provide this information to my clients to use as the situations arise. Although I explain the handouts to all my clients, not all women get engorged; for those that do, it usually happens after my visit. Having the handouts at home allows them to refer to the information as a reference when they need it most. Conclusion: The teaching session went very well. The client was intelligent, educated and eager to learn. Overall this teaching technique used for teaching breastfeeding works well with most of the clientÃ ¨le I see at home. Every person is unique and adjustments always need to be made accordingly. Bibliography: Forrest, S. (2004). Learning and teaching: The reciprocal link. The Journal of Continuing Education in Nursing, 35(2), 74-79. London, F. (1999). No time to teach? A nurseÃ¢â¬â¢s guide to patient and family education. New York: Lippincott. Medela (2007) Your Resource for breastfeeding products and information. [on-line]. Available: http://www.medela.com. Rankin, S.H., Stallings, K.D., London, F. (2005). Patient education in health and illness (5th ed.). New York: Lippincott.
Tuesday, January 21, 2020
Chemistry: Acid-Base Titration Purpose: Ã Ã Ã Ã Ã The objective of this experiment were: a) to review the concept of simple acid-base reactions; b) to review the stoichiometric calculations involved in chemical reactions; c) to review the basic lab procedure of a titration and introduce the student to the concept of a primary standard and the process of standardization; d) to review the calculations involving chemical solutions; e) to help the student improve his/her lab technique. Theory: Ã Ã Ã Ã Ã Titration was used to study acid-base neutralization reaction quantitatively. In acid-base titration experiment, a solution of accurately KHP concentration was added gradually to another solution of NaOH concentration until the chemical reaction between the two solutions were completed. The equivalence point was the point at which the acid was completely reacted with or neutralized by the base. The point was signaled by a changing of color of an indicator that had been added to the acid solution. Indicator was substance that had distinctly different colors in acidic and basic media. Phenolphthalein was a common indicator which was colorless in acidic and neutral solutions, but reddish pink was result in basic solutions. Strong acid (contained H+ ion) and strong base ( contained OH ) were 100% ionized in water and they were all strong electrolytes. Procedure: Part A. Investigating solid NaOH for use as a possible primary standard First o...
Monday, January 13, 2020
The theory of deontology is derived from the writings of German philosopher Immanuel Kant (1724-1804). Kant stated that a universal law should provide the basis for each act, and that the intention was of more importance than the result. Deontology is a duty-based ethical position, where oneÃ¢â¬â¢s actions are based on what is ethically correct, regardless of the consequences (Porche, 2004). Deontological theories hold that actions are morally right are those in accordance with certain rules and duties, rights or maxims. Actions can be morally obligatory, allowed, or prohibited and consequences do not matter. In deontology intention is relevant. A person is right in acting certain way only if this person acts for the right reason. Examples of deontological rules are Divine Command Theory, Golden Rule, Natural Law and Rights Theories, Kantian Ethics, The Non-Aggression Principle. Deontological theories hold that an actionÃ¢â¬â¢s rightness or wrongness depends on its conformity to a certain moral norm, regardless of the consequences for example right vs good. According MottaÃ¢â¬â¢s opinion listed on web site www. E-how. com, the differences between deontological and utilitarianism is: Ã¢â¬Å"Duty-based ethics are often called deontological and consequentialist ethics are often labeled as utilitarianÃ¢â¬ . The site further explains that deontological pertains to theory of binding responsibility or duty. Such theories are also called Ã¢â¬Å"a prioriÃ¢â¬ in that they are based upon knowledge gained prior to experience. No concrete lived-through experience is necessary in order to attain these duties deductively from reason. If in deontology intention is more important than the results, Utilitarianism is a normative ethical theory that places the locus of right and wrong solely on the outcomes or consequences of choosing one action/policy over other actions/policies. As such, it moves beyond the extent of oneÃ¢â¬â¢s own interests and takes into account the interests of others. In other words consequentialist believe the ends always justify the means, deontologist declare that the rightness of an action is not simply reliant. References http://www.ehow.com/how_2180734_between-dutybased-ethics- resultsoriented-ethics.html
Sunday, January 5, 2020
Joseph Michael Swango is a serial killer who, as a trusted doctor, had easy access to his victims. Authorities believe he murdered up to 60 people and poisoned countless others, including co-workers, friends and his wife. Childhood Years Michael Swango was born on October 21, 1954, in Tacoma, Washington, to Muriel and John Virgil Swango. He was the middle son of three boys and the child that Muriel believed was the most gifted. John Swango was an Army officer which meant the family was constantly relocating. It was not until 1968, when the family moved to Quincy, Illinois, that they finally settled down. The atmosphere in the Swango home depended on whether or not John was present. When he was not there, Muriel tried to maintain a peaceful home, and she kept a strong hold on the boys. When John was on leave and at home from his military duties, the home resembled a military facility, with John as the strict disciplinarian. All of the Swango children feared their father as did Muriel.Ã His struggle with alcoholism was the main contributor to the tension and upheaval that went on in the home. High School Concerned that Michael would be under-challenged in the public school system in Quincy, Muriel decided to ignore her Presbyterian roots and enrolled him in the Christian Brothers High School, a private Catholic school known for its high academic standards. Michaels brothers attended the public schools. At Christian Brothers, Michael excelled academically and became involved in various extracurricular activities. Like his mother, he developed a love of music and learned to read music, sing, play the piano, and mastered the clarinet well enough to become a member of the Quincy Notre Dame band and tour with the Quincy College Wind Ensemble. Millikin University Michael graduated as class valedictorian from Christian Brothers in 1972. His high school achievements were impressive, but his exposure to what was available for him in selecting the best colleges to attend to was limited. He decided on Millikin University in Decatur, Illinois, where he received a full music scholarship. There Swango maintained top grades during his first two years, however, he became an outcast from social activities after his girlfriend ended their relationship. His attitude became reclusive. His outlook changed. He exchanged his collegiate blazers for military fatigues. During the summer after his second year at Millikin, he stopped playing music, quit college and joined the Marines. Swango became a trainedÃ sharpshooter for the Marines, but decided against a military career. He wanted to return to college and become a doctor. In 1976, he received an honorable discharge. Quincy College Swango decided to attend Quincy College to earn a degree in chemistry and biology. For unknown reasons, once accepted into the college, he decided to embellish his permanent records by submitting a form with lies stating that he had earned a Bronze Star and the Purple Heart while in the Marines. In his senior year at Quincy College, he elected to do his chemistry thesis on the bizarre poisoning death of Bulgarian writerÃ Georgi Markov. Swango developed an obsessive interest in poisons that could be used as silent killers. He graduatedÃ summa cum laude from Quincy College in 1979. With an award for academic excellence from the American Chemical Society tucked under his arm, Swango set out to get accepted into medical school, a task that was not so simple during the early 1980s. At that time, there was fierce competition among a massive number of applicants trying to get into a limited amount of schools throughout the country. Swango managed to beat the odds and he got into Southern Illinois University (SIU). Southern Illinois University Swangos time at SIU received mixed reviews from his professors and fellow classmates. During his first two years, he earned a reputation for being serious about his studies but was also suspected of taking unethical shortcuts when preparing for tests and group projects. Swango had little personal interaction with his classmates after he began working as an ambulance driver. For a first-year medical student struggling with tough academic demands, such a job caused great stress. In his third year at SIU, the one-on-one contact with patients increased. During this time, there were at least five patients that died after they had just received a visit from Swango. The coincidence was so great, that his classmates began to call him Double-O Swango, a reference to the James Bond and the license to kill slogan. They also began to view him as incompetent, lazy and just strange. Obsessed With Violent Death From the age of three, Swango showed an unusual interest in violent deaths. As he got older, he became fixated on stories about theÃ Holocaust, particularly those that contained pictures of the death camps. His interest was so strong that he began to keep a scrapbook of pictures and articles about fatal car wrecks and macabre crimes. His mother would also contribute to his scrapbooks when she came across such articles. By the time Swango attended SIU, he had put together several scrapbooks. When he took the job as an ambulance driver, not only did his scrapbooks grow, but he was seeing firsthand what he had only read about for so many years. His fixation was so strong that he would rarely turn down the chance to work, even if it meant sacrificing his studies. His classmates felt that Swango showed more dedication to making a career as an ambulance driver than he did for getting his medical degree. His work had become sloppy and he often left unfinished projects because his beeper would go off, signaling him that the ambulance company needed him for an emergency. The Final Eight Weeks In Swangos final year at SIU, he sent off applications for internships and residency programs in neurosurgery to several teaching colleges. With the help of his teacher and mentor, Dr. Wacaser, who was also a neurosurgeon, Swango was able to provide the colleges with a letter of recommendation. Wacaser even took the time to write a handwritten personal note of confidence on each letter. Swango was accepted in neurosurgery at the University of Iowa Hospitals and Clinics in Iowa City. Once he nailed down his residency, Swango showed little interest in his remaining eight weeks at SIU. He failed to show up for required rotations and to watch specific surgeries performed. This astounded Dr. Kathleen OConnor who was in charge of overseeing Swangos performance. She called his place of employment to schedule a meeting to discuss the matter. She did not find him, but she did learn that the ambulance company no longer permitted Swango to have direct contact with patients, although the reason why was not disclosed. When she finally did see Swango, she gave him the assignment to perform a complete history and examination on a woman who was going to have aÃ cesarean delivery. She also observed him entering the womans room and leaving after just 10 minutes. Swango then turned in a very thorough report on the woman, an impossible task given the amount of time he was in her room. OConnor found Swangos actions reprehensible and the decision to fail him was made. It meant that he would not be graduating and his internship in Iowa would be canceled. As the news spread about Swango not graduating, two camps were formed--thoseÃ for and those against SIUs decision. Some of Swangos classmates who had long decided that he was not fit to be a doctor used the opportunity to sign off on a letter describing Swangos incompetence and poor character. They recommended that he be expelled. Had Swango not hired a lawyer, it is likely that he would have been expelled from SIU, but shrinking from the fear of being sued and wanting to avoid the costly expense of litigation, the college decided to postpone his graduation by a year and give him another chance, but with a strict set of rules that he had to follow. Swango immediately cleaned up his act and refocused his attention on completing the requirements to graduate. He reapplied to several residency programs, having lost the one in Iowa. Despite having an extremely poor evaluation from the dean of ISU, he was accepted into a surgical internship, followed by a very prestigious residency program in neurosurgery at Ohio State University. This left many who knew Swangos history completely dumbfounded, but he apparently aced his personal interview and was the only student out of sixty accepted into the program. Around the time of his graduation, Swango was fired from the ambulance company after he told a man having a heart attack to walk to his car and have his wife drive him to the hospital. Deadly Compulsion Swango began his internship at Ohio State in 1983. He was assigned to the Rhodes Hall wing of the medical center. Shortly after he began, there was a series of unexplained deaths among several healthy patients being cared for in the wing. One of the patients who survived a severe seizure told the nurses that Swango had injected medicine into her just minutes before she became critically ill. Nurses also reported to the head nurse their concerns about seeing Swango in patients rooms during odd times. There were numerous occasions when patients were found near death or dead just minutes after Swango left the rooms. The administration was alerted and an investigation was launched, however, it seemed as if it was designed to discredit the eyewitness reports from the nurses and patients so that the matter could be closed and any residual damage curbed. Swango was exoneratedÃ of any wrongdoing. He returned to work, but was moved to the Doan Hall wing. Within days, several patients on the Doan Hall wing began to die mysteriously. There was also an incident when several residents became violently ill after Swango offered to go get fried chicken for everyone. Swango also ate the chicken but did not get sick. License to Practice Medicine In March 1984, the Ohio State residency review committee decided that Swango did not have the necessary qualities needed to become a neurosurgeon. He was told he could complete his one-year internship at Ohio State, but he was not invited back to complete his second year of residency. Swango stayed on at Ohio State until July 1984 and then moved home to Quincy. Before moving back he applied to get his license to practice medicine from the Ohio State Medical Board, which was approved in September 1984. Welcome Home Swango did not tell his family about the trouble he encountered while at Ohio State or that his acceptance into his second-year residency had been rejected. Instead, he said he did not like the other doctors in Ohio. In July 1984, he began working for Adams County Ambulance Corp as an emergency medical technician. Apparently, a background check was not done on Swango because he had worked there in the past while attending Quincy College. The fact that he had been fired from another ambulance company never surfaced. What did begin to surface was Swangos weird opinions and behavior. Out came his scrapbooks filled with references to violence and gore, which he doted on regularly. He began making inappropriate and strange comments related to death and people dying. He would become visibly excited over CNN news stories about mass killings and horrific auto accidents. Even to hardened paramedics that had seen it all, Swangos lust for blood and guts was downright creepy. In September the first noticeable incident that Swango was dangerous occurred when he brought doughnuts for his co-workers. Everyone who ate one ended up becoming violently ill and several had to go to the hospital. There were other incidents where co-workers became ill after eating or drinking something Swango had prepared. Suspecting that he was purposely making them ill, some of the workers decided to get tested. When they tested positive for poison, a police investigation was launched. The police obtained a search warrant for his home and inside they found hundreds of drugs and poisons, several containers of ant poison, books on poison, and syringes. Swango was arrested and charged with battery. The Slammer On August 23, 1985, Swango was convicted of aggravated battery and he was sentenced to five years behind bars. He also lost his medical licenses from Ohio and Illinois. While he was in prison, Swango began trying to mend his ruined reputation by doing an interview with John Stossel who was doing a segment about his case on the ABC program,? 20/20. Dressed in a suit and tie, Swango insisted that he was innocent and said that the evidence that was used to convict him lacked integrity. A Cover Up Exposed As part of the investigation, a look into Swangos past was conducted and the incidents of patients dying under suspicious circumstances at Ohio State resurfaced. The hospital was reluctant to allow the police access to their records. However, once the global news agencies got wind of the story, the university president, Edward Jennings, assigned the dean of Ohio State University Law School, James Meeks, to conduct a full investigation to determine if the situation surrounding Swango had been handled properly. This also meant investigating the conduct of some of the most prestigious people in the university. Offering an unbiased assessment of the events that had occurred, Meeks concluded that legally, the hospital should have reported the suspicious incidents to the police because it was their job to decide if any criminal activity had occurred. He also referred to the initial investigations performed by the hospital as superficial. Meeks also pointed out that he found it astounding that the hospital administrators had not kept a permanent record detailing what had occurred. Once full disclosure was obtained by police, the prosecutors from Franklin County, Ohio, toyed with the idea of charging Swango with murder and attempted murder, but due to a lack of evidence, they decided against it. Back on the Streets Swango served two years of his five-year sentence and was released on August 21, 1987. His girlfriend, Rita Dumas, had fully supported Swango throughout his trial and during his time in prison. When he got out the two of them moved to Hampton, Virginia. Swango applied for his medical license in Virginia, but because of his criminal record, his application was denied. He then found employment with the state as a career counselor, but it was not long before weird things began to happen. Just like what happened in Quincy, three of his co-workers suddenly experienced severe nausea and headaches. He was caught gluing gory articles into his scrapbook when he should have been working. It was also discovered that he had turned a room in the office building basement into a kind of bedroom where he often stayed for the night. He was asked to leave in May 1989. Swango then went to work as a lab technician for Aticoal Services in Newport News, Virginia. In July 1989, he and Rita got married, but almost immediately after exchanging vows, their relationship began to unravel. Swango began ignoring Rita and they stopped sharing a bedroom. Financially he refused to contribute to the bills and took money out of Ritas account without asking. Rita decided to end the marriage when she suspected that Swango was seeing another woman. The two separated in January 1991. Meanwhile, at Aticoal Services several employees, including the president of the company, began suffering from sudden bouts of severe stomach cramping, nausea, dizziness, and muscle weakness. Some of them were hospitalized and one of the executives of the company was nearly comatose. Unphased by the wave of illnesses going around the office, Swango had more important issues to work out. He wanted to get his medical license back and start working as a doctor again. He decided to quit the job at Aticoal and started applying at residency programs. Its All in the Name At the same time, Swango decided that, if he was going to get back into the medicine, he would need a new name. On January 18, 1990, Swango had his name legally changed to David Jackson Adams. In May 1991, Swango applied for the residency program at Ohio Valley Medical Center in Wheeling, West Virginia. Dr. Jeffrey Schultz, who was the chief of medicine at the hospital, had several communications with Swango, mainly centering on the events surrounding the suspension of his medical license. Swango lied about what had happened, downplaying the battery by poisoning conviction, and said instead that he was convicted for an altercation he was involved in at a restaurant. Dr. Schultz opinion was that such a punishment was far too severe so he continued to try to verify Swangos account of what happened. In return, Swango forged several documents, including a prison fact sheet which stated that he had been convicted of hitting someone with his fists. He also forged a letter from the Governor of Virginia stating that his application for Restoration of Civil Rights had been approved. Dr. Schultz continued to try to verify the information that Swango had provided to him and forwarded a copy of the documents to the Quincy authorities. The correct documents were forwarded back to Dr. Schultz who then made the decision to reject Swangos application. The rejection did little to slow down Swango who was determined to get back into medicine. Next, he sent an application to the residency program at the University of South Dakota. Impressed by his credentials, the director of the internal medicine residency program, Dr. Anthony Salem, opened up communications with Swango. This time Swango said the battery charge involved poison, but that coworkers who were jealous that he was a doctor had framed him. After several exchanges, Dr. Salem invited Swango to come for a series of personal interviews. Swango managed to charm his way through most of the interviews and on March 18, 1992, he was accepted into the internal medicine residency program. Kristen Kinney While he was employed at Aticoal, Michael had spent time taking medical courses at the Newport News Riverside Hospital. It was there that he met Kristen Kinney, to whom he was immediately attracted to and aggressively pursued. Kristen, who was a nurse at the hospital, was quite beautiful and had an easy smile. Although she was already engaged when she met Swango, she found him attractive and very likable. She ended up calling off her engagement and the two began dating regularly. Some of her friends felt it was important that Kristen know about some of the dark rumors they had heard about Swango, but she did not take any of it seriously. The man she knew was nothing like the man they were describing. When it came time for Swango to move to South Dakota to begin his residency program, Kristen immediately agreed that they would move there together. Sioux Falls At the end of May, Kristen and Swango moved to Sioux Falls, South Dakota. They quickly established themselves in their new home and Kristen got a job in the intensive care unit at the Royal C. Johnson Veterans Memorial Hospital. This was the same hospital where Swango began his residency, although no one was aware that the two knew each other. Swangos work was exemplary and he was well liked by his peers and the nurses. He no longer discussed the thrill of seeing a violent accident nor did he exhibit the other oddities in his character that had caused problems at other jobs. Skeletons in the Closet Things were going great for the couple until October when Swango decided to join the American Medical Association. The AMA did a thorough background check and because of his convictions, they decided to turn it over to the council on ethical and judicial affairs. Someone from AMA then contacted their friend, the dean of the University of South Dakota medical school, and informed him of all of the skeletons in Swangos closet, including the suspicions surrounding the death of several patients. Then on the same evening, The Justice Files television program aired the 20/20 interview that Swango had given while he was in prison. Swangos dream of working as a doctor again was over. He was asked to resign. As for Kristen, she was in shock. She was completely ignorant of Swangos true past until she watched a tape of the 20/20 interview in Dr. Schultz office on the day Swango was being questioned. In the following months, Kristen began to suffer from violent headaches. She no longer smiled and began to withdraw from her friends at work. At one point, she was placed in a psychiatric hospital after the police found her wandering in the street, nude and confused. Finally, in April 1993, unable to take it anymore, she left Swango and returned to Virginia. Soon after leaving, her migraines went away. However, just a few weeks later, Swango showed up on her doorstep in Virginia and the two were back together. With his confidence restored, Swango began sending out new applications to medical schools. Stony Brook School of Medicine Incredibly, Swango lied his way into the psychiatric residency program at the State University of New York at Stony Brook School of Medicine. He relocated, leaving Kristen in Virginia, and began his first rotation in the internal medicine department at the VA Medical Center in Northport, New York. Again, patients began to mysteriously die wherever Swango worked. Suicide Kristen and Swango had been apart for four months, although they continued to talk on the phone. During the last conversation that they had, Kristen learned that Swango had emptied out her checking account. The next day, July 15, 1993, Kristen committed suicide by shooting herself in the chest. A Mothers Revenge Kristens mother, Sharon Cooper, hated Swango and blamed him for her daughters suicide. She found it inconceivable that he was working at a hospital again. She knew the only way he got in was by lying and she decided to do something about it. She contacted a friend of Kristens who was a nurse in South Dakota and included his full address in the letter stating that she was glad that he could not hurt Kristen anymore, but she was afraid of where he was working now. Kristens friend clearly understood the message and immediately passed along the information to the right person who contacted the dean of the medical school at Stony Brook, Jordan Cohen. Almost immediately Swango was fired. To try to prevent another medical facility from being duped by Swango, Cohen sent letters to all the medical schools and over 1,000 teaching hospitals in the country, warning them about Swangos past and his sneaky tactics to gain admission. Here Come the Feds After being fired from the VA hospital, Swango seemingly went underground. The FBI was on the hunt for him for falsifying his credentials in order to get a job in a VA facility. It was not until July 1994 that he resurfaced. This time he was working as Jack Kirk for a company in Atlanta called Photocircuits. It was a wastewater treatment facility and frighteningly, Swango had direct access to Atlantas water supply. Fearing Swangos obsession over mass killings, the FBI contacted Photocircuits and Swango was immediately fired for lying on his job application. At that point, Swango seemed to vanish, leaving behind a warrant for his arrest issued by the FBI. Africa Swango was smart enough to realize that his best move was to get out of the country. He sent his application and altered references to an agency called Options, which helps American doctors find work in foreign countries. In November 1994, the Lutheran church hired Swango after obtaining his application and falsified recommendations through Options. He was to go to a remote area of Zimbabwe. The hospital director, Dr. Christopher Zshiri, was thrilled to have an American doctor join the hospital, but once Swango began working it became apparent that he was untrained to perform some very basic procedures. It was decided that he would go to one of the sister hospitals and train for five months, and then return to Mnene Hospital to work. For the first five months in Zimbabwe, Swango received glowing reviews and almost everyone on the medical staff admired his dedication and hard work. But when he returned to Mnene after his training, his attitude was different. He no longer seemed interested in the hospital or his patients. People whispered about how lazy and rude he had become. Once again, patients began mysteriously dying. Some of the patients that survived had a clear recall about Swango coming to their rooms and giving them injections right before they went into convulsions. A handful of nurses also admitted to seeing Swango near patients just minutes before they died. Dr. Zshiri contacted the police and a search of Swangos cottage turned up hundreds of various drugs and poisons. On October 13, 1995, he was handed a termination letter and he had a week to vacate hospital property. For the next year and a half, Swango continued his stay in Zimbabwe while his lawyer worked to have his position at the Mnene hospital restored and his license to practice medicine in Zimbabwe reinstated. He eventually fled Zimbabwe to Zambia when evidence of his guilt began to surface. Busted On June 27, 1997, Swango entered the U.S. at the Chicago-OHare airport while in route to the Royal Hospital in Dhahran in Saudi Arabia. He was promptly arrested by immigration officials and held in prison in New York to await his trial. A year later Swango pleaded guilty to defrauding the government and he was sentenced to three years and six months in prison. In July 2000, just days before he was to be released, federal authorities charged Swango with one count of assault, three counts of murder, three counts of making false statements, one count of defrauding by use of wires, and mail fraud. In the meantime, Zimbabwe was fighting to have Swango extradited to Africa to face five counts of murder. Swango pleaded not guilty, but fearing that he could be facing the death penalty on being handed over to the Zimbabwe authorities, he decided to change his plea to guilty of murder and fraud. Michael Swango received three consecutive life sentences. He is currently serving his time at the supermax U.S. Penitentiary, Florence ADX.
Saturday, December 28, 2019
Ã¢â¬Å"Think not of yourself as the architect of your career but as the sculptor. Expect to have to do a lot of hard hammering and chiseling and scraping and polishing,Ã¢â¬ (B.C. Forbes, n.d). The case study involves an executive Lance Mannion who is offered prestigious position at his fatherÃ¢â¬â¢s firm, but prior to accepting the offer he wants to further develop his personnel management skills. Lance accepts a senior administrative position in overseas tourist firm; he finds considerable success in his new position and assists the organization with lowering their overall expenses. Lance suggests to the management and fellow executives that they could contribute to the cost savings by reducing their expenses, but his met with opposition from his fellow colleagues. Lance decides to investigate the executives expense records and his alarmed by his findings. Lance soon discovers that executives are misusing their expense accounts on personal purchases and some are even using it t o conduct an affair. Lance is presented with an ethical dilemma in how to respond to the executivesÃ¢â¬â¢ misuse of companyÃ¢â¬â¢s resources. Ã¢â¬Å"All that evil requires to triumph is for good men to do nothing,Ã¢â¬ (Gregg, 2007, p. 13). Lance has ethical responsibility to himself, the organization and to the shareholders to develop a strategy to address the ethical dilemma. Lance has set a personal goal to further develop his personnel management skills and this presents a great opportunity to advance his skills. In order toShow MoreRelatedCase Study : An Executive Lance Mannion777 Words Ã |Ã 4 Pagessculptor. Expect to have to do a lot of hard hammering and chiseling and scraping and polishing,Ã¢â¬ (B.C. Forbes, n.d). The case study involves an executive Lance Mannion, who is offered a prestigious position at his fatherÃ¢â¬â¢s firm, but prior to accepting this offer he wants to further develop his personnel management skills at another organization. Lance accepts a senior administrative position in an overseas tourist firm; he finds considerable success in his new position and assists the organization with
Thursday, December 19, 2019
Sports, a very popular past time today, have been around since ancient times. Greek Olympic Games featured events from chariot races, javelin throws, to wrestling. In addition, a game similar to soccer was played in China by the second century BC. In England, a violent rugby type game was even played to settle feuds between villages. With the development of the industrial revolution and the creation of the first public schools, sports decreased in violence and were played more recreationally and constructively. Basketball was invented to help the youth in New England spend their energy in the winter months. Since the early 1900Ã¢â¬â¢s sports have been a key experience in the United States (Ã¢â¬Å"History of SportsÃ¢â¬ ). I have playedÃ¢â¬ ¦show more contentÃ¢â¬ ¦The experiences of failing and trying again provide a learning process that can translate to greater achievement in school. Ã¢â¬Å"A controlled longitudinal study found that adolescents who participated in sport s showed improved grade point averages, had increased attachment to school, and were more likely to attend collegeÃ¢â¬ (Larson, Reed, and Sean Seepersad). The persistence children learn while playing sports will carry on in other parts of life, such as learning in school, leading to continual success. While playing basketball, I began to grow more mentally and socially. I stayed more active in the games and reacted faster; I would be ready to block a sudden dash to our hoop. In other activities, such as math, I began solving equations quicker and was more focused. Also, as a child I was a quiet and shy. When playing the game, I could not just stand back; I had to get into the action by challenging the ball or trying to get a pass. As my confidence developed, I became more bold and outgoing in other parts of my life. Sports can be a unifying force, too. Parents of high school students who participate in sports have higher expectations for their children. They will drive their children to work harder and achieve more potential. Girls find participation in sports to be a way to break gender stereotypes, enhancing their sense of possibility. Also, playing team sports can minimize feelings of difference and isolation.Show MoreRelatedCompetitive Sports Essay800 Words Ã |Ã 4 Pagesknow that sports and regular exercise provide physical and mental stress relief, which can help certain mental health disorders like depression and anxiety. There has been a long disagreement about whether kids should be able to play sports or not. I believe that they should be able to. I do know that sports can cause problems, but I believe the benefits overweigh these problems. Competitive sports can help deal with varieties of these discomforts including physical, social, and mental health. InRead More1 Student 1 Sp ort Policy1750 Words Ã |Ã 7 PagesPolicy (1M 1S) Sports should be integral to a personÃ¢â¬â¢s life. This is due to the benefits in health that can be derived from it and also skills such as strategic thinking and teamwork can be learnt. Most pupils have benefitted from participation in various sports, but most voluntarily participated in the sport activities of their choice. Sports serve as an excellent physical exercise. Those who play sports have a more positive body image than those who do not. Sports often involve physical activitiesRead MorePlaying Sport Is Better Than Video Games-Speech817 Words Ã |Ã 4 PagesDo you prefer to play sport than video games? Not everyone agrees but recent and continuous research has shown that more than half of Australians prefer to play it because of the physical and mental health benefits and an opportunity to socialise more with new friends. Playing video games however, hardly uplifts these standards. First of all, itÃ¢â¬â¢s obvious for a fact that the reason why playing sport is better than video games is because it helps us become physically stronger. Our health improvesRead MoreSports And High School Are Beneficial848 Words Ã |Ã 4 PagesSports in High School are Beneficial Students are people who study at school or college. At school students, lives are divided into two sections such as academic and athletic. During high school, sports become a good portion of studentsÃ¢â¬â¢ lives. Some parents send their children to study at school and considers sports a distraction to studies. A true sport requires energy, time, and determination..There are a few disadvantages to playing sports in High School but there are even more benefits to playingRead Morebenefits of youth sports1111 Words Ã |Ã 5 Pagespositive effects of youth sports Athletics can have a very major impact on a childÃ¢â¬â¢s life. Students who participate in youth athletics learn many life skills that can positively affect their lives. Athletics benefit children in physical, psychological, and social development. Studies show that youth who participate in organized sports during middle and high school do better academically and are offered greater job prospects than children who do not partake in sports activities (Marilyn Price-MitchellRead MoreVideo Games : An Unhealthy Lifestyle1289 Words Ã |Ã 6 Pagesdays who are more focused on playing video games are at risk of having an unhealthy physical lifestyle. Video games play a part in a childÃ¢â¬â¢s health in that it could be the reason they do not get enough physical activity. This could lead to an unhealthy lifestyle in which they could become overweight and continue to be overweight as young adults. 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The main reason for this is that either the schools do not have enough facilities to organize sports or the management does not realize the importance of sports and other physical activities. In schools, the break time is hardly o f 20 to 30 minutes. Children can either play games with friends or have their lunch during this short time. They do have games session, but that is just once in a week. Even on that day the children cannot play sports as there is nothingRead MoreWhat Role Did British Colonisation Play On Developing Indian Cricket?1534 Words Ã |Ã 7 Pagesthrough colonisation in the 18th century. The British considered cricket to be more than just a sport. They regarded it as a Ã¢â¬ËgentlemenÃ¢â¬â¢s gameÃ¢â¬â¢ that embodied key values of English Victorian Society, such as, sportsmanship, strength, good temperament and polite conversation. The British, therefore, had ulterior motives for introducing cricket into India. 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