The Myth Of Mental Illness - 750 Words

Marquiel Dodson 12/10/15 Psychology 201 Dr. Streeter Final Exam I enjoyed every bit of this Introduction to Psychology class. I put together many things about myself and my own life that I didn’t notice before. Now that I have been introduced to the realm of psychology I have a much better understanding of the reasons of behavior that is around me every day. During this semester in Psychology 201 one very interesting thing we covered was The Myth of Mental Illness by Thomas Szasz. In this book Szasz states that mental illness has no physiological change. He is not judgmental at all, and discusses the advantages to the patient and the doctor. I totally agree with Szasz on his belief that autism is not a mental illness although autism is treated as a mental illness. Thomas Szasz stated this about autism, â€Å"With the passing of the years, my earlier conviction that conflict and disagreement are not diseases has only grown, and with it my conviction that listening and talking are not instances of medical treatment. This does not mean that I disparage listening and talking; quite the contrary. Attending to what another person tells us and being able to hear what is in his heart as well as on his lips is an exceptional skill, growing rarer by the day, especially among psychiatrists; the same goes for addressing another person and being ab le to tell him frankly, simply, and without humiliating him.† (The Ethics of Psychoanalysis, 1974) He is clearly trying to explain that mentalShow MoreRelatedThe Myth Of Mental Illness957 Words   |  4 PagesIn 1961 Thomas Szasz penned a book by the title The Myth of Mental Illness that would go on to cause quite the stir in the world of psychiatry. In the book, Szasz stated his belief that what most psychiatrists would label as mental illnesses are in fact not illnesses at all, but instead what he would go on to call â€Å"problems in living.† This article will take a critical approach at Szasz reasons for his belief in these â€Å"problems in living† including an objective outline of his argument, a discussionRead MoreThe Myth of Mental Illness2711 Words   |  11 PagesThe Myth of Mental Illness Mental illness has existed since the dawn of humanity, but has since been perceived and understood in various ways. This essay will examine the contemporaryç  ¾Ã¤ » £Ã¤ º ºdefinition of mental illness and how the definition is shaped more by the contemporary society that creates it rather than by real experience and understanding of the state itself. Unavoidably, this examination of a largely misunderstood subject leads to an investigation of the societal and philosophical influencesRead MoreThe Myth Of Mental Illness By Thomas Szasz Summary1472 Words   |  6 PagesReview of Thomas Szasz. M.D.,The Myth Of Mental Illness: Foundations of a Theory of Personal Conduct. Thomas Szasz was one of the first psychiatrist to criticise psychiatry and argue about the concept of mental illness. His book â€Å"The Myth of Mental Illness: Foundations of a Theory of Personal Conduct† highlights the fundamental flaws in the administration of psychiatry, with the aim of challenging the medical characteristics of the concept of mental illness and the wrongful treatment of patientsRead MoreMental Illness781 Words   |  4 Pageshead: MENTAL ILLNESS Mental Illness Natalie Maxwell March 8, 2010 Each year, almost 44 million Americans experience a mental disorder. In fact, mental illnesses are among the most common conditions affecting health today. The good news is that most people who have mental illnesses, even serious ones, can lead productive lives with proper treatment (www.yahoo.com). Mental illnesses are some of the most misunderstand afflictions in today’s society. Too many people think of mental illnessRead MoreThe Portrayal Of Mental Illness962 Words   |  4 PagesPortrayal of mental illness in media, films and television programmes is extensive and predominantly preserves myths and stereotypes about mental illness. People with mental illness are most commonly shown as being violent and aggressive, but they are also frequently depicted as tragic, tortured, genius, dangerous, eccentric, flamboyant, hysterical, sexual, jokers and rebels. Mental health professionals are variously portrayed as incompetent, sinister, unrealistically seductive or rationalist foilsRead MoreMental Health And The Media982 Words   |  4 PagesMental Health and the Media Mental illness in general carries an enormous stigma. People have respect for and take seriously physical ailments but when it comes to mental illness there is still immense discrimination. The stigma that comes from having a mental disorder such as, bi-polar depression, schizophrenia, or panic disorder comes with an enormous societal cost and can cause people not to talk about it. They may feel ashamed, embarrassed or fear stigma. Not seeking treatment causes people livingRead MoreAnorexia Nervosa: Nursing Interventions1326 Words   |  5 PagesAnorexia nervosa: Nursing interventions Anorexia nervosa has a higher mortality rate than any other psychological illness. Its primary clinical feature is extreme emaciation as a result of the patients refusal to maintain a healthy body weight. Weight loss may be achieved through caloric restriction or a combination of caloric restriction and purging behaviors (vomiting, laxatives, and exercise) (Understanding eating disorders, 2013, Australia Psychological Society). Besides self-starvation, otherRead MoreThe Portrayal Of An Issue Like Mental Illness1328 Words   |  6 PagesIt is easy for an audience to be manipulated by the media. The portrayal of an issue like mental illness is totally vulnerable to misrepresentation. Depending on who is writing and their viewpoint, it does not take much to make this issue sympathetic or demonized. If the author of a given piece wants his or her audience to demonize something, the author might use the word isolation†. If that same author wants a sympathetic response he might use the word loneliness†. As far as the New York TimesRead MoreThe Stigma Associated With Bipolar Disorder1448 Words   |  6 Pageseffects remain: often multiplied by individuals that have a limited understanding of the disorder. There are numerous myths related to individuals diagnosed with bipolar disorder. Hopefully a few of these myths will be put to rest after learning more about the disorder. What is bipolar disorder? As defined by the (NIMH 1), â€Å"Bipolar disorder, also known as manic-depressive illness, is a brain disorder that causes unusual shifts in mood, energy, activity levels, and the ability to carry out day-to-dayRead MoreClinical Diagnoses Of Bipolar Disorder1616 Words   |  7 Pagessymptoms that are related to mental illness have increased dramatically within the last several years, and treatment is becoming more specialized. But, unless you study these disorders, or have some degree in psychology, the basis of your knowledge of these disorders comes from media, movies and newspapers. Mass media is the public’s primary source for information so when they decide to present breaking news about some criminal felon who reportedly suffers from mental disorders such as bi-polar or

Shakespeares Presentation of Shylock in The Merchant of...

Shakespeares Presentation of Shylock in The Merchant of Venice In every play or story, you need a villain, someone you can hate - in Cinderella you have the evil stepmother, in Harry Potter you have Lord Voldermort, and in the Merchant of Venice you have Shylock. In this scene, I see Shylock not as the comical buffoon or villain but as the outsider. The scene opens with a conversation between Basanio and Shylock. Basanio wants to borrow three thousand ducats from Shylock for three months, but Shylock is reluctant. Antonio is then introduced into the conversation, and Shylock takes more interest in the proposition. Eventually, Shylock agrees to lend the money to Basanio, interest free, on one†¦show more content†¦He is especially bitter during his speech when he lets us know what Antonio had done to him in the past week. He is most calm and pleasant at the start of the scene, when he is thinking over Basanios request. As the scene goes on, he is reminded of what happened to him in the past and you can sense the bitterness in his voice. By the end of the scene you can get the impression that he is ready to kill Antonio. This is when he draws up the bond. Shylocks character develops with the scene from being, at the start, an innocent and vulnerable man who we (in modern times) feel sorry for, although the Elizabethans would have seen him as an evil murderous Jew; whilst we feel sorry for him, the Elizabethan audience would have hissed at Shylock and praised Antonio for what he did to Shylock. His character develops slowly until he becomes a bitter, hateful man until at the end of the scene the change in his character is more apparent. Shakespeares presentation of Shylocks character has not been typical of the way he is presented in the play as a whole until this point. It is only from the point in his speech where Shylock recollects Antonios wrongs that his character changes into the dangerous and obsessive villain that is typical of the rest of the play, although Shylock sees himself as the tragic hero. People are most likely to feelShow MoreRelated Shakespeares Presentation of Shylock in The Merchant of Venice831 Words   |  4 PagesShakespeares Presentation of Shylock in The Merchant of Venice This essay is an analysis of how the character of Shylock, in the play The Merchant of Venice, is presented to the audience, by Shakespeare, in different ways. The riveting play shows the best and worst aspects of human nature and contains one of Shakespeares most reviled, complex and compelling characters. Love and romance end this play, yet before that come bigotry, racism, hatred, death threats andRead MoreShakespeares Presentation of Shylock in the Merchant of Venice1458 Words   |  6 PagesShakespeares Presentation of Shylock in the Merchant of Venice In the Merchant of Venice, Shylock is continually involved in the bond plot. This plot is probably the most intense story-line in this Shakespeare play. Bassanio borrows money from Shylock in Antonios name in order to impress Portia, however after a tragic incident involving all of Antonios ships crashing; the money has failed to be returned. According to their bargain Antonio must now give Shylock a poundRead MoreA Study of Anti-Semitism in The Merchant of Venice Essay1540 Words   |  7 PagesA Study of Anti-Semitism in The Merchant of Venice ‘The Merchant of Venice’ was written by Shakespeare in 1596 and appeals to both audiences of comedy and tragedy. The play features anti-Semitism which is a response to 1500’s Britain as well as other literature of the time. Anti-Semitism is the term used to describe discrimination towards Jews and Judaism. ‘The Merchant of Venice’ has received both positive and negative comments over the centuries and throughout thisRead MoreShakespeare’s Presentation of Antonio in The Merchant of Venice1288 Words   |  6 PagesShakespeare’s Presentation of Antonio in The Merchant of Venice Shakespeare’s portrayal of Antonio in ‘The Merchant of Venice’ is decidedly open to interpretation, as his melancholic nature is revealed at the start of the play and foreshadows his later bad luck, but a specific reasoning behind it is never given. For an Elizabethan audience, Antonio provides the perfect Christian protagonist to Shylock’s evil Jewish antagonist, although our modern reception of him isRead More Justice and Prosperity in Shakespeares The Merchant of Venice1545 Words   |  7 Pages One of the strengths of good theater is its ability to mirror the problems and conditions shaping its time. In The Merchant of Venice, William Shakespeare reflects two important aspects of Elizabethan society: the corrupting influence of prosperity and the increasingly vengeful nature of Venetian justice. To address the former issue, Shakespeare downplays the importance of wealth by associating its involvement in romance with superficial and insubstantial advantages. He characterizes prosperityRead MoreEssay about Directing William Shakespeares The Merchant of Venice871 Words   |  4 PagesDirecting William Shakespeares The Merchant of Venice I am going to set my theatrical production of Merchant of Venice act 1 scene 3 in a building in a street in Venice. The building in which this scene is set should be lit by candle light creating a slightly dark, gloomy atmosphere to give the audience a sense of mischief and wrong doing on Shylocks part. Costume wise I would make a clear distinction between the clothes of Shylock and the Venetians. Shylock will wearRead More Merchant of Venice Essay: Antonios Love for Bassanio1721 Words   |  7 PagesAntonios Love for Bassanio in The Merchant of Venice  Ã‚     Ã‚  Ã‚   Antonio feels closer to Bassanio than any other character in The Merchant of Venice. Our first clue to this is in the first scene when, in conversation with Antonio, Solanio says, Here comes Bassanio, your most noble kinsman, / Gratiano, and Lorenzo. Fare ye well: / We leave you now with better company (i. i. 57-59). Once Antonio is alone with Bassanio, the conversation becomes more intimate, and Antonio offers an indebted BassanioRead MoreThe Way Shylock is Presented in William Shakespeares The Merchant of Venice1641 Words   |  7 PagesThe Way Shylock is Presented in William Shakespeares The Merchant of Venice The Merchant of Venice is about the conflict between a Jew and a Christian. This is not between one Jew and one Christian but between Shylock, who stands as a representative of the Jewish tribe, and between groups of Christians who greatly outnumber the Jew. The conflict between Jews and Christians is a historical one. The Christians hated the Jews because they made money from usury; this was Read MorePresentation of Hamlet in Act 2 Scene 2 and 3 in William Shakespeares Hamlet663 Words   |  3 PagesPresentation of Hamlet in Act 2 Scene 2 and 3 in William Shakespeares Hamlet It is hard to determine the intentions of William Shakespeare when he wrote Hamlet without looking at the social, historical and ethical context in which it was conceived. From the cover notes found within the Longman Literature edition, we can deduce that it is Shakespeares most well known play and, written during the year 1602, it was one of his later works. At this time, revenge was aRead MoreThe Presentation of Shylock and Antonio as Conflicting Opposites in The Merchant of Venice1123 Words   |  5 PagesThe Presentation of Shylock and Antonio as Conflicting Opposites in The Merchant of Venice Shakespeare personifies the juxtaposed themes of this play; justice and mercy, forgiveness and revenge. He contrasts characters of Shylock and Antonio to represent these key ideas. Shakespeare’s character representations of these themes certify that they are constantly played out against each other throughout the play. The play presents anti-semitic ideas, depicting Shylock, a Jew

Harmful Algal Blooms and Aquaculture Free Essays

string(171) " Algal Blooms Historically algal blooms are a naturally occurring phenomenon in earth’s oceans and have been observed throughout recorded history \(Hallegraeff, 1993\)\." Harmful Algal Blooms and how they are Linked to Aquaculture Abstract Harmful algal blooms cause a wide range of negative effects on aquaculture. These effects are come from the complexity of harmful algal species; the toxins they create and morphology they have adapted. Science still lacks a full understanding of factors that are envolved in blooms formation. We will write a custom essay sample on Harmful Algal Blooms and Aquaculture or any similar topic only for you Order Now Aquaculture and harmful algal blooms are directly related because it is one of many anthropogenic factors that unintentionally produce the conditions that promote harmful algal blooms. The methods of production, feeds used, waste produced can lead to nutrient loading and eutrophic conditions by releasing essential nutrients into water that are necessary for algal growth. Phosphorus and nitrogen compounds are two of the main byproducts or aquaculture that are associated with bloom formation. To minimize the effects of harmful algal blooms on aquaculture you must understand the diversity and complexity of harmful algal blooms and their relationship with aquaculture. Abstract Harmful algal blooms cause a wide range of negative effects on aquaculture. These effects are come from the complexity of harmful algal species; the toxins they create and morphology they have adapted. Science still lacks a full understanding of factors that are envolved in blooms formation. Aquaculture and harmful algal blooms are directly related because it is one of many anthropogenic factors that unintentionally produce the conditions that promote harmful algal blooms. The methods of production, feeds used, waste produced can lead to nutrient loading and eutrophic conditions by releasing essential nutrients into water that are necessary for algal growth. Phosphorus and nitrogen compounds are two of the main byproducts or aquaculture that are associated with bloom formation. To minimize the effects of harmful algal blooms on aquaculture you must understand the diversity and complexity of harmful algal blooms and their relationship with aquaculture. Andrew Blajda Introduction Over the last several decades harmful algal blooms events or HABs are believed to be increasing in frequency and geographic range. The reported increase is a major concern because of the wide scale impact they have on he environment and human activities. The effect of HABs on aquaculture can be very damaging with reduced growth, mortalities or accumulation of toxins. If aquaculture operations take place in the open bodies of water they have little or no way of avoiding incoming blooms. Harmful algal bloom events that come in contact with aquaculture operations often have negative effects that can include student growth, weakened immunity, mortalities, and on econo mic losses. One of the bigger concerns today is the apparent increase in harmful bloom events. Researchers have linked this increase with anthropogenic activities, aquaculture being one of them. Aquaculture operations adds additional nutrients to the system, this lowers nutrients that limits algal growth. A better understand of the dynamics and characters the form and make up a bloom combined with the a better understanding of nutrient loading of aquaculture could potentially help reduce the negative effects harmful algal blooms have on aquaculture. Single celled microscopic algae like phytoplankton are the most globally abundant species and one of the oceans’ most important resources. These autotrophic primary producers form the bottom of the food pyramid, acting as the primary source of food for larval finfish, crustaceans, filter feeding bivalves, and other species (Hallengraeff, 1995). In normal concentrations, these single celled algae work in balance with the ocean and its inhabitants, filling important roles in chemical and nutrient cycles. They act as primary producers, providing nutrients and food for variety of different species. These simple microscopic species are vitally important to the success of both fisheries and aquaculture, but in some situations they can also have detrimental effects on the marine and coastal environment and numerous terrestrial and marine species. A combination of physical, chemical, biological, hydrological, and meteorological events can generate appropriate conditions that allow these simple single celled microalgae can exhibit exponential growth and reproduction. These natural events create the opportunity for algal bloom formation with potential large scale negative effects throughout the area they cover (Graham, 2007). Algal blooms can be very diverse and differ from one another in many ways . How they form, the algal specie of causation, characteristics and dynamics of a blooms, the species they affect, and impacts they cause are some of the complex factors that are found in blooms (Zingone Enevoldsen, 2000). The specific characteristics used to define a harmful bloom vary by sources. Hans Paerl, among others, defined harmful blooms by using several characteristics. Paerl also defined harmful blooms at their most basic level by classifying them as having nuisance conditions, meaning ecological and/or economic impacts (Paerl, 1988). As harmful algal blooms move across the ocean, the observable effects they cause go beyond the ocean and marine species it covers. These events will also have wide spread negative impacts on costal terrestrial organism and both human health and activities. Algal species produce sevral different toxins that are detrimental effects to human health, causing various illnesses and mortalities. About 10% of foodborne disease in the United States results from algal toxins; worldwide they cause more than 60,000 intoxications a year. Van Dolah, 2000) Economic losses due harmful algal blooms have been estimated in the tens of millions of dollars, from costs of beach clean ups, decreased tourism, and closing or stopping sales of commercial fisheries and aquaculture (Van Dolah et al. , 2001). Over the past several decades there has been an apparent increase in the frequency and geographic range of harmful algal blooms. This apparent increase has been attributed to both increased observations and focus on harmful algal blooms and increased inputs from anthropogenic sources. Aquaculture is one of many anthropogenic activities that is believed to be hypernutrification and eutrophic conditions in surrounding bodies of water. This paper will attempt to gain a better understanding of diversity of harmful algal blooms and also the effect aquaculture has on the environment in adding in formation of harmful algal blooms. Algal Blooms Historically algal blooms are a naturally occurring phenomenon in earth’s oceans and have been observed throughout recorded history (Hallegraeff, 1993). You read "Harmful Algal Blooms and Aquaculture" in category "Essay examples" These events are often beneficial to bivalves by supplying an abundant food supply to these filters feeding that relay on microalgae for their source of nutrients. Algal blooms can quickly turn into detrimental to the environment and its inhabitants are various ways (Leverone, 2007). Sources from human history including the bible may contain the first documented cases of algal blooms. In Exodus 7: 20-21 referring to one of the plaques on Egypt â€Å"all the waters that were in the river turned to blood, and the fish that was in the river died†. Some historians and scientist now believe this biblical reference from 1,000BC could be the first written record of an algal bloom. (Hallegraeff, 1993) Other historical sources may have unknowing recorded written evidence on algal blooms, in China around 200AD general Zhu Ge-Ling documented sicknesses and losses of military personnel after drinking from a river that was stained green. (Chorus Bartram, 1999) Examination of fossil algal specimens and historical reference compounding evidence that these event are not a new phenomenon and have been occurring in earth’s oceans for thousands if not millions of years. Recent finding from numerous long term studies conducted around the world has brought a strong belief in the scientific community that algal blooms have been increasing in their frequency and geographic distribution. Even though most scientiest support the idea of a global increase of blooms and twith strong evidence supporting this theroy there is still a major dissagreement about what is causing the increase (Pelley, 1998). The apparent increase of algal blooms, along with the global impacts on aquatic organisms, the environment, human health, and activities has increased interest and research being done on these events (Li et al. 2002; Van Dolah et al. , 2001). The exact characteristics and descriptions that define an algal bloom are fairly broad and very from source to source. I was unable to find a universal definition of algal blooms. The description and definition I came across were similar but differed in many aspects; this included sizes, formation factors, impacts, and alga l species. Overall algal blooms are generally defined significant increase in biomass due to a rapid reproduction of a single microalgal species. The problem with this source is there can also be macroalgal blooms. Others described them as forming high density populations, with some species creating visible discoloration of the water. (Carstensen, Henriksen, Heiskanen, 2007; Diersing, 2009) Others define blooms by impacts they cause; displacing indigenes species, destroy habitat, oxygen depletion, and alter biochemical cycles. (Hoagland et al. , 2002) A more generalized definition was given by Hallegraeff, adding that a bloom must have at least million cells per liter (Hallegraeff, 1993). The defining characteristic that differentiates a bloom from a harmful algal bloom is when they takes on a destructive roll and causes environment impacts. The term harmful is defined more specifically as causing negative impacts on the environment and adverse effects on both aquatic and terrestrial organisms. This is due to factors such as toxins they produce, specie specific cell physical structure causing damage to aquatic organisms or by accumulation of biomass affect naturally occurring organisms causing alterations food web dynamics and biochemical cycles (Anderson et al. 2002). Depending on the species, some algae produce toxins that can affect crustaceans, fish, shellfish, birds and mammals including humans; nontoxic species can still causes damage by blocking light from penetrating the water column, clogging or damaging gills, and creating anoxic conditions from accelerated decomposition as they die off (Silver et al. , 2006; Sellner et al. , 2003) Harmful alga can also have impacts on shoreline coastal habitats, toxins can be transported onto the shore by sea spray (Hoagland et al. , 2002). There are over 5,000 know photoplanktonic algal species that inhabit the marine waters only a small portion, about 300 species are known to have blooming capabilities and even fewer, about 40-80 species or 2-3% of all photoplantonic algal species are known to have toxic chemicals producing capabilities; this includes members that form red tides (Hallegraeff, 1993; Smayda, 1997). Nontoxic red tides are not uncommon, today people often incorrectly or mistakenly refer to toxic algal blooms as red tides even when brown, green or colorless (Anderson, 1994). Toxic and other harmful algal species are ubiquitous throughout the marine and freshwater environment; the majority of the time they present at low population densities that cause few, if any and only minor impacts on the environment and its local inhabitants (Van Dolah, 2000). There are a variety of different phycotoxins algal species are able to synthesize; individual species will only produce one type of toxin. The evolutionary advantages of these toxins are not fully understood; they are believed to play a role in bloom formation and predator protecting (Nehring, 1993). The different phycotoxins vary from one another in terms of the impacts and degree of damage they have on marine and terrestrial organisms, depending on the toxicity, the concentration, and the organisms. Toxicity vary among algal species Dinophysis is one example, they have the ability to produce toxins that have negative effects at densities as low as 100 cells per L-1 (Sellner et al. , 2003). The most toxic algal species are mainly found in dinoflagellets (Table 1) with some having toxicity greater than venomous snakes. Table 1. Toxicity of several phycotoxins created different organisms including algae. (Van Dolah, 2000) The taxonomic algal groups’ dinoflagellets, raphidophyetes, cynobactria, and some diatoms are known to have the capabilities of phycotoxins production; these species are often the culprit behind harmful algal blooms. Phycotoxins are toxic chemicals created biologically by photosynthetic organisms. Dinoflagellets are one of the predominate species that forms red tides; members of this group also produce toxin that lead to foodborne illness and human mortalities (Li et al. , 2002; Hallegraeff et al. 1995). Human induced illnesses are not an uncommon result from consumption of seafood. Many algal toxins are potentially dangerous and even deadly to humans. Toxins accumulate in tissues of organisms like shellfish, finfish, and crustaceans that come in contact with a toxic bloom. These species are usually far less affected by algal toxins having adaptive mechanisms that lower the effects o n the organisms associated with toxic blooms. However toxins still accumulate within the tissues and detoxification can take weeks before they reach levels safe for human consumption. Algal toxins cause for concerns for humans not only because they maintain their toxicity long after the bloom but more importantly because they can withstanding heat from cooking. Algal toxin foodborne diseases are caused by various species or toxins and come from different vectors. Bivalve vectors can induce human illness that include (Table 2) paralytic shellfish poisoning (PSP), neurotoxic shellfish poisoning (NSP), amnesic shellfish poisoning (ASP), diarrhetic shellfish poisoning (DSP); other vectors can lead to various other diseases as well (Van Dolah, 2000). The popular term of red tide given to harmful algal bloom comes from compact, high densities of algal cells that containing red photosynthetic pigments, causing the water to appear red (Carstensen et al. , 2007). These toxic species can normally be found in low concentrations have no impacts on organisms and environment. The adverse effects on organism often deepened on cell concentration; in blooms toxic algae aggregate and are more dangerous (Van Dolah, 2000). Some toxic algal species have developed unique life cycles and morphological characteristics that allow them to occupy a specific niche that will be further examined. Table 2. Foodborne and environmental disease caused by harmful algal species, the toxin produced and the primary vector they inhabit. (Van Dolah, 2000) Harmful algal species have many adverse impacts on bivalves’ this includes a wide range of sub-lethal and lethal effects; some algal species are more detrimental than others (Leverone, 2007). It is believed that increase frequency of blooms is partially due to the introduction of non-indigenous algal species. Non-indigenous species potentially will create a specific niche, and/or out compete native species. Indigenous naturally occurring harmful algal species are far less direct effects on bivalves; this is because they have been able to naturally adapt to their presence over time. Native algal species in most case do not have as bad direct, detrimental impacts on shellfish and are usually not associated with large scale bivalve die off. The exception to this is in cases of intense blooms (Matsuyama Shumway, 2009; Nehring, 1993; Zingone Enevoldsen, 2000). It’s still hard to truly say many large scale die-offs and increase sub-lethal impacts are directly due to non-indigenous algal species because identification is sometimes difficult, longer term data individual algal species geographic ranges are limited combined, and the theory anthropogenic factors are causing an overall increase in blooms. In many circumstance of HAB mortalities it’s difficult to differentiate whether they resulted from the algal specie or unfavorable water quality that coincide with blooms (Anderson et al. , 2002; Leverone, 2007). Complex morphology are found in many harmful algal species that helps protect them from predation and the environment and help obtain nutrients. Diatom algae are members of the Bacillariophyceae class; they have been around for over 180 million years helping to create earth’s atmosphere and also play a major role in nutrient and chemical cycles. Over their evolutionary history diatoms have developed a variety of different exterior cellular morphology for protection from the environment and predation. They have a range of cell shapes and sizes and also form unique frustule cell walls made from silica. The frustule cell wall is made up of two over lapping overlapping silica bands forming a protective shell. The 100,000 diatom species have developed â€Å"seeming infinite variations† of cell wall micropatterns and structures; including ridges, spines and plates (Kroger Poulsen, 2008) These cellular morphological characteristics help protect them under adverse environmental conditions and restrict or prevent predation. Some species of diatoms have developed such strong cell walls with structural properties that enable them to survive ingestion and escape after passing through the digestive system. (Merkel, et al. 2003) The benefits of these structures do have negative effects and come at the expense of motile abilities, limits growth, and makes the cell very dense; motile restorations and high cell densities make diatoms much more likely to sink out of the high nutrient water column. Bloom Formation The intricacy of bloom formation is due to both the abiotic(environmental and anthropogenic factors) and biotic factors; these being the algae themselves. Adaptations of life cycle, morphology, and environmental conditions enable rapid reproduction of certain algal species that have developed specific niches (Sellner et al. 2003; Zingone Enevoldsen, 2000). Algal blooms formation driven by the complex relation between the environmental factors and algal species; although we understand the basics of formation there are still many unknowns. There are seemingly endless amounts of variables and factors that play a role in creating of a bloom. The main driving factors of when and where a bloom forms are a combination of environmental/anthropogenic factors (nutrient cycles and inputs) and algal morphology (Pinckney et al. , 1997; Sellner et al. ,2003). As simple as it sounds, there are countless variables including natural condition, anthropogenic effects, algal physiological and morphological characteristics that lead to the unpredictability and overall misunderstanding we still have on blooms. (Sellner et al. , 2003; Anderson, 1994) The belief that algal blooms are increasing in frequency and geographic range is a popular belief that is backed by numerous studies. The cause of this apparent increase has been attributed to the expanding human population (anthropogenic effects). Some still argue that the increase in blooms is due to the increase in observations from studies worldwide, a better understanding of blooms and better record keeping; but with overwhelming evidence supporting the lateral it’s hard to believe the human race is not playing a major roll. (Sellner et al. , 2003) Looking at the numer of literary reference to harmful algal bloom over 70 years(figure 1) shows a dramitic increase algal blooms from the 1920’s through late 1990’s (Hallegraeff, 1993). This also give arguments that increase research and technology contriubute to the increase ovserevd. Figure 1. Literary references of harmful algal blooms from Aquatic Sciences and Fisheries Abstract (AFSA) publications over about 70 years. The increase can be attributed to a combination of anthropogenic factors or increased observations and present arguments for both sides. (Hallegraeff, 1993) Today we have an understanding of the natural environmental processes and factors that lead to bloom formation; but the effects humans apply to the environment alter the natural cycles making it more difficult to predict blooms (Paerl, 1988). Blooms occur under irregular conditions that promote growth and reproduction allowing some species to flourish. The conditions found in blooms broad and often species’ specific adding to the complexity and unpredictability of blooms. In general the conditions associated with blooms are abundance (eutrophic), or an imbalance of nutrients, along with favorable water conditions (temperature, DO, salinity, etc. ). Natural processes like atmospheric deposition, water column turnover, upwelling, oceanic currents, storms, and anomalous weather events (El Nino) work together and fluctuate over time effecting mixing rates, water quality. Nutrients pools build up over time from organic decomposition in benthic sediment. Mixing of the sediment perelapses the nutrient pools and bring about eutrophic conditions or alter the water chemistry that enable specific species of algae to flourish (Sellner et al. , 2003; Van Dolah, 2000; Paerl, 1988). Natural mixing rates occur during regularly during temporal or seasonal with environmental fluxes or randomly from disturbances (natural anthropogenic). Sediment mixing are very important environment processes, releasing nutrients back into the water column allowing for increased primary producer growth. Seasonal and temporal sediment mixing produce lead to the specific conditions that form blooms. Eutrophication has been defined as â€Å"an increase in supply of organic matter to the ecosystem; in terms of algal bloom this refers to an increase in nutrients that allows an increase of primary production† (Bonsdorff et al. , 1997). Three key nutrients, nitrates ammonia and phosphates are associated with eutrophication and considered the driving forces behind bloom (Sheng, Jinghong, Shiqiang, Jixi, Dingyong, Ke, 2006). The levels found in marine waters are driven naturally based on natural events discussed above. Studies have found a correlation between anthropogenic actives leading to nitrogen and phosphorus nutrient loading and the apparent increase in frequency of algal blooms along with alteration of natural nitrogen/phosphorus ratio (Bonsdorff et al. , 1997; Paerl, 2009). There are various anthropogenic activities that have led to the both local and global increase of nutrients in fresh and marine waters. Aquaculture is just one of many of these activities. Many studies have shown that aquaculture operations have byproducts that can cause eutrophic conditions. Nutrient loading from aquaculture only has local effects and the amount of effects it causes is size dependent (Anderson et al. , 2002). Aquaculture and Nutrient Loading It is important to understand the relationship between aquaculture and harmful algal blooms. Additional nutrients from the feed used, effluent discharge, and waste products are some of the source that lead to nutrient loading (Tacon Forster, 2003). The amount of additional nutrients added to a system increases based on how intensive the operation is. HABs have wide spread negative impacts on aquaculture, the hope of significantly minimizing these impacts are still years away. To minimize the effects on aquaculture you must understand characteristics and dynamics of blooms, this includes the diversity of species involved and the factors associated with bloom formation. The apparent increase frequency and geographic range of harmful algal blooms is very important to aquaculture because aquaculture plays a role in helping create the conditions necessary for bloom formation. Aquaculture operations provided year round nutrient inputs in a local aspect, this eliminates nutrient limitations in those areas (Bonsdorff et al. , 1997). This section will discuss and review the relationship aquaculture has with nutrient loading and eutrophication of the surrounding water. Nitrogen and phosphors are to key elements that take on various forms necessary for bloom formation. Both nitrogen and phosphors in the forms of nitrates, ammonia, phosphates and other compounds are byproducts of aquaculture. Algal growth is limited by nutrient availability, mainly based on availability of nitrogen and phosphors in the environment. Nitrogen in the forms of nitrates and ammonia are water soluble and enter the system from either dissolved feeds, effluent discharge, or from waste produced by fish. Phosphates often accumulate mainly in the sediment and during mixing events are released into the water in high quantities (Karakassis, Pitta, Krom, 2005). Nutrient loading from aquaculture that leads to eutrophic conditions come from several sources. The amount and source of the nutrients depends on the operation. Location of farm (open ocean, ponds, raceways etc. ), what is being cultured (shrimp, finfish, bivalves), what are the inputs (feeds, fertilizer, etc. ) and how intensive the operation is. The source of local nutrient loading from aquaculture can be traced back to where the operation is taking place. Open ocean farming of finfish for instance causes eutrophic conditions right around the cages. On the other hand inland facilities such as pond systems and other flow through systems release effluent discharge causing nutrient in the and around the bodies of water they run into. The species being cultured also plays a major role. Bivalves for instance play a role in limiting algal growth by filter feeding, while finfish inputs and excreting essential nutrients in their waste is a major source of nutrients (Soto Mena, 1991). How intensive an operation is and the actual inputs into the system are directly related. The more intensive an operation the more inputs and the more inputs the greater chance of hypernutrification and eutrophic conditions. Different operations require different inputs and these inputs have different nutrient atios. Culture of some juvenile finfish require fertilization to promote phytoplankton growth for feed this puts the essential nutrients for algal growth directly into the system. The feeds used in aquaculture vary on the nutrients they are made up of, how stable they are and whether they float or sink. These factors are all in play in nutrient loading that come directly from aquaculture (Islam, 2005). The effects of aquaculture fe eds on nutrient loading depend on several factors. There are three main factors these include; 1) the amount of wasted feed. This is due to poor farming and management practice and floating Vs. sinking feeds. Poor management practices means over or an improper feeding technique that puts more feed in the water. Floating and sinking feed choices is also important. Sinking feeds may not be eaten by finfish if they go through the bottom of a net or cage, or if they sit on the bottom. On the other hand floating feeds may be less stable or uneaten if they are transported out of a system or to a place where they are unable to be eaten. 2) The actual quality of the feed. This poor stability and high solubility of feed pellets in water mean that once they are in the water they will be broken down and release more and nutrients and in less time. The final factor is deals is loosely related to the previous two. 3) Once the feed is ingested factors such as limitations of absorption and retention of the nutrients from the feed. This factor deals mainly with poor digestibility or metabolism of the species being culture to the feed they are given. The nutrients in the feeds many not be utilized to their full potential once ingested fish will excrete the excess nutrients (Soto Mena, 1991). Feed and nutrient inputs play a major role in nutrient loading and creating the conditions that promote algal growth either directly in the form of uneaten feeds or nutrients leaching or dissolving from the feeds, or indirectly from the digestion, metabolism and waste products from the species being cultured (Tacon Forster, 2003). The important of feeds in nutrient loading must not be overlooked one study estimated that 70% of phosphorus and 30-50% of nitrogen in feeds is not utilized by fish and is released into the environment (Soto Mena, 1991). This only shows two of the most essential nutrients associated with bloom formation and not the various other nutrients that are also released and are important for algal growth. This also shows the significance of feeds based on the large amount of nutrients that are not utilized and instead entering the environment, promoting algal growth. Over all aquaculture farm operations lead to excessive amounts of inorganic and organic fertilizer, feeds, and wastes that are put into local water bodies with high concentrations nutrient, that lead to nutrient loading and eutrophic conditions. Discussion and Conclusions Aquaculture over the last several decades has grown globally in both its production and popularity. In the future aquaculture will continue to grow in its importance to the human population as alternative food source to agriculture and wild fisheries, as well as helping with the depleted ocean stocks. As of now it appear that we will be seeing an increase in aquaculture around the world in the years to come. Although there are many benefits to aquaculture and the potential of increased production may have we must measure the benefits against the environment impacts they cause. Nutrient loading is just one of the environmental impacts associated with aquaculture and the effects of nutrient loading go beyond promotion of algal blooms. The global increase in aquaculture coincides with the apparent increase in harmful algal. Although there are many other anthropogenic factors that are at play in global nutrient loading aquaculture is a major local point-source form. We must understand the specific conditions that are associated blooms and the role aquaculture plays along with how complex and diverse blooms can if we hope to develop mechanisms that can significantly reduce the impacts on aquaculture. I choose the topic of harmful algal blooms and aquaculture effects of nutrient loading because it fits in perfect with our class: aquaculture and the environment. The purpose of this paper was to gain a general understanding of harmful algal blooms, and also to review the factors of aquaculture that lead to nutrient loading, eutrophic conditions, and the aid in bloom formation. This topic caught my attention because of similar topics I’ve cover and work I’ve done this semester in this class and others classes. Harmful algal blooms in general are very interesting because of the diversity of blooms, the range of effects they have, how unique the species involved are, and because of the complexity and over all lack of understanding have in factors of bloom formation. The purpose of this class included reviewing the impact of aquaculture on the environment and methods of reducing or eliminating those impacts. This paper focuses on harmful algal blooms and how aquaculture creates conditions that promoted bloom formation. I focused a great deal of this paper on harmful algal blooms because if you hope to minimize the impacts they cause you must appreciate and understand their complexity and also understand the relation they have with aquaculture. The purpose of this paper was not to examine direct ways in which to minimize nutrient inputs of harmful algal blooms but the information given on harmful algal blooms and the role aquaculture plays in promoting bloom formation is useful to future studies and reviews focusing on ways to minimize the impacts of HABs on aquaculture and help reduce the factors of aquaculture that promote harmful bloom formation. Bibliography Anderson, D. M. (1994). Red Tides. Scientific American Vol. 271, No. 2, 52-58. Anderson, D. M. , Glibert, P. M. , Burkholder, J. M. (2002). Harmful Algal Blooms and Eutrophication: Nutrient Sources, Composition, and Consequences . Estuaries Vol. 25, No. 4b, 704-726. Anderson, D. , Andersen , P. , Bricelj, V. , Cullen, J. , Rensel, J. (2001). Monitoring and Management Strategies for Harmful Algal Blooms in Coastal Waters. Paris: UNESCO. Bonsdorff, E. , Blomqvist, E. M. , Mattila, J. , Norkko, A. (1997). 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Journal of Plankton Research Vol. 23, No. 5, 447-461. Soto, D. , Mena, G. (1991). Filter Feeding by Freshwater Mussel, Diplodon Chilensis, as a Biocontrol of Salmon Farming Eutrophication. Aquaculture Vol. 171, 65-81. Tacon, A. , Forster, I. (2003). Aquafeeds and the Environment: Policy Implications. Aquaculture Vol. 226. Thouzeau, G. Chauvaud, L. , Paulet, Y. -M. (1998). Effects of Environmental Factors on the Daily Growthrate of Pecten maximus Juveniles in the Bay of Brest (France). Journal of Experimental Marine Biology and Ecology Vol. 227 Isu. 1, 83-111. Tran, D. , Haberkorn, H. , Soudant, P. , Ciret, P. , Massabuau, J. -C. (2010). Behavioral Responses of Crassostrea gigas Exposed to the Harmful Algal Alexandrium minutum. Aquaculture Vol. 298 Issues 3-4, 338-345. Van Dolah, F. M. , RoeIke, D. , Greene, R. M. (2001). Health and Ecological Impacts of Harmful Algal. Human and Ecological Risk Assessment: Vol. 7, No. 5, pp, 1329-1345. Van Dolah, F. M. (2000). 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Ocean Coastal Management. How to cite Harmful Algal Blooms and Aquaculture, Essay examples

Strength Leadership Coaching Organizations -Myassignmenthelp.Com

Question: Discuss About The Strength Leadership Coaching Organizations? Answer: Introduction During discharge, transition takes place from hospital to rehabilitation or home and this period is critical for the health and wellbeing of the patients. It is an intimidating event and improvements need to done with proper discharge planning improving the outcome of patients as they move to next level of care (Kearns et al. 2017). It is expected from healthcare providers including nurses to take active participation in discharge planning so that proper care is give to patients as they transit from hospitals to residential cares or homes. Similarly, in the given case study, Jim Karas, 70 year old is being discharged from hospital to home as well as his wife, Amara. Therefore, the following report involves the discharge and care plan of client, Jim taking all ethical and legal principles into consideration in decision-making and providing a culturally safe plan of care. Discharge and plan of care Proper post-discharge planning and caring is important for patients ensuring the continuity of care between hospital and communities. Healthcare professionals should take an active part in the discharge planning so that there is proper improvement of coordination of services following hospital discharge (Holland, Knafl and Bowles 2013). The main care core principles state that understanding and dignity is the central tenant of achieving high quality care and support (Mitchell et al. 2014). To provide the best quality of care, key values of respect, dignity, skills, attitude and knowledge is required providing the best possible care. In the given case study, Jim Karas is being discharged from hospital to his home and require appropriate plan of care ensuring fast recovery and continuity of high quality of care. For a nurse, discharge planning is critical, however one can undertake the following key procedure that is mix of pre-planning and post-planning steps: Evaluation: A discharge planning is not only undertaking discharge orders or taking physical exodus into consideration, but also evaluation of patient by nurse or other healthcare professional. In this case study, nurse should consider the present condition of Jim as well as ensuring that he is fit to travel home after discharge. Discussion: The healthcare professional should discuss with Jim and her daughter Angela to be sure of care that will be given to him after hospital discharge as Jim is leaving professional care. Planning: Planning is required for Jim and his family members so that proper treatment and post-discharge care is given to him until he recovers completely. Determining: In case of Jim, logistics like carer is required as he was the sole carer for his wife Amara and Angela son is suffering from Autism Spectrum Disorder (ASD). Referrals: For securing care, appropriate steps need to be taken by nursing faculty and Jims daughter; Angela should refer to a home care agency as he is unwilling to go to a residential care home. Arranging: Follow- ups, diagnostic tests should be arranged in advance for Jim prior to discharge. This would help to keep plan of care on track and ready for implementation in the coming days (Gonalves?Bradley et al. 2016). Care plan for Jim The immediate care plan required for Jim is to stabilize his hypotension condition. There should be regular monitoring of his blood pressure to avoid any kind of complications like weakness, dizziness, fainting and risk of fall injuries. To manage hypotensive condition, it is advisable for Jim to avoid strenuous movements or activities that it can cause drop in BP. Appropriate posture is required for him like avoiding prolonged standing and elevated head while going to sleep (American Diabetes Association 2016). Apart from posture, proper meals are also required like cutting down of carbohydrates and resting after meals. He should be advised to intake high salt in his diet and drink lots of fluid to avoid instances of dehydration (Shibao, Lipsitz and Biaggioni 2013). If required, elastic or compression stockings can be worn covering calf and thigh helping to restrict blood flow to legs and keep more blood circulation in the upper body (Mills et al. 2015). The second aspect of care involves the prevention further of CVC infection. It is important to teach Jim and his family members to practice good hygiene washing hands with soap and water or cleaning with hand gel that is alcohol based. The dressing should be kept touched only with clean and sanitized hands is crucial to avoid further central line infection (Blot et al. 2014). Medicine compliance is also important for Jim for fast recovery through antibiotics (Alkubati et al. 2015). As Amara is dependent on Jim who is suffering from COPD and heart failure, caregiver should provide appropriate aid to them in executing the activities of daily living like dressing, bathing, eating and compliance to medications. In addition, Angelas son is suffering for ASD, so the caregiver should be properly trained to care for the family members and helping them in their daily tasks. Utmost care should be taken by caregiver regarding their diet and in providing safe environment for fast recovery and in avoiding further complications. The nurse should contact the agency in Campbelltown, new South Wales, Australiafor hiring caregiver or home carer for supporting his family through local services. In this community, Baptist Care Organization provides support for Jim like family support and aged care. They also provide financial support that can contribute to life-transforming care for Jim and Care Cell Emergency Response providing alarm for emergency call support enhancing independe nce of Jim and his family. This organization offers services in Greek language supporting his family. This organization also offers training to carers for learning skills in caring and gain access to resources and services that can help them to provide better care to Jim and his family. Effective transition from acute care to community care is an important part of high quality care of patients and is one of the core duties of the hospitals. This activity is more effective when the hospital nurses, community providers and primary care physicians act together and communicate effectively to provide the required care interventions for the patients and the family members. The acute care nurses should not only provide references to Jim about local care but should themselves communicate with the local care providers and engage in discussion sessions. This would ensure that all the healthcare requirements that Jim and Amara need are met properly. Not only that, both should curve out detailed planning and engage in decision making about the approaches that both the patients would need at home ensuring that proper resources are provided to them on time. They should maintain the autonomy and dignity of both of them and engage them in all decision making. The acute care nurse s hould also aware the community nurse about their cultural backgrounds and help the local service in meeting the preferences of Amara specifically as she is not comfortable with English. Ethical and legal principles The ethical principle of autonomy suggests that patients should be allowed to make their own decision and take an active part in decision-making process. In the given case study, Jim wants to remain in his own home and strongly objects the option of residential care for him. In addition, he believes that he can take better care of Amara and they decided to stay in their own house instead of any residential home care or a small house or unit. In such instances, the nurse cannot go against his decision and force him to seek professional assistance. The nurse has to respect his decision complying with principle of respect for autonomy and dignity. Moreover, while respecting Jims decision, the nurse need to comply with principle of beneficence and non-maleficence. This can be explained in a way where the nurse should work towards promoting good health for the family members and fast recovery. The care plan should be focused on providing a safe environment for the family directed towards benefit and fast recovery (Pope, Hough and Chase 2016). Through effective communication skills (interpersonal skills), the nurse should explain Jim and his family members for seeking professional support as apart from Angela, other family members including Thomas who is suffering from ASD (Kourkouta and Papathanasiou 2014). The nurse should advocate strength-based approaches concentrating on strengths of Jim and his family members aiding empowerment and recovery. A qualified home carer should be appointed by the nurse from the local community who can support the family members needs and preferences (Jones 2017). This approach in nursing is based on the fact that all individuals have their own strengths and while focusing on their interests and skills through empowerment. Through this, Jim and his family members would be able to overcome their emotional, physical and emotional trauma that they are facing in turn improving individual outcomes like health and quality of life. Strength- based nursing leadership can be helpful where Jim and his family members should be encouraged to take in charge of their health and responsible for healing and recovery. Through collaborative relationship between nurse and family members, the overall goal of health and wellbeing can be achieved (MacKie 2016). Culturally safe care While providing care to Jims family, nurse should develop care in a culturally competent manner. The family is originally from Greece and migrated to Australia. Therefore, the cultural differences can influence the plan of care for the family. Moreover, Amara is not comfortable speaking English and carer should be aware of their personal cultural beliefs and their perceptions towards health and illness. Culturally competent nursing can promote efficient care by discovering cultural beliefs and values of patients and being culturally aware in providing safe care while planning care for Jim and his family (Douglas et al. 2014). Conclusion For planning discharge and plan of care for Jim, utmost care should be taken advocating ethical principles of respect for autonomy and maleficence. Proper discharge planning should be done for his hypotension, central line infection due to CVC for Jim and his family members including Amara. Moreover, while planning care, proper care should be given their culture and maintain cultural sensitivity as they are originally Greek. As Jim does not want to go to residential care with his family, carer should be appointed who provide culturally sensitive care with respect for autonomy. Therefore, nurse should plan care helping Jim and his family to improve their health and quality of life with proper haling and recovery. References Alkubati, S.A., Ahmed, N.T., Mohamed, O.N., Fayed, A.M. and Asfour, H.I., 2015. Health care workers' knowledge and practices regarding the prevention of central venous catheter-related infection.American journal of infection control,43(1), pp.26-30. American Diabetes Association, 2016. Standards of medical care in diabetes2016 abridged for primary care providers.Clinical diabetes: a publication of the American Diabetes Association,34(1), p.3. Blot, K., Bergs, J., Vogelaers, D., Blot, S. and Vandijck, D., 2014. Prevention of Central LineAssociated Bloodstream Infections Through Quality Improvement Interventions: A Systematic Review and Meta-analysis.Clinical Infectious Diseases,59(1), pp.96-105. Douglas, M.K., Rosenkoetter, M., Pacquiao, D.F., Callister, L.C., Hattar-Pollara, M., Lauderdale, J., Milstead, J., Nardi, D. and Purnell, L., 2014. Guidelines for implementing culturally competent nursing care.Journal of Transcultural Nursing,25(2), pp.109-121. Gonalves?Bradley, D.C., Lannin, N.A., Clemson, L.M., Cameron, I.D. and Shepperd, S., 2016. Discharge planning from hospital.The Cochrane Library. Holland, D.E., Knafl, G.J. and Bowles, K.H., 2013. Targeting hospitalised patients for early discharge planning intervention.Journal of clinical nursing,22(19-20), pp.2696-2703. Jones, A.K., 2017. Oncology Nurse Retreat: A Strength-based Approach to Self-care and Personal Resilience.Clinical journal of oncology nursing,21(2), pp.259-262. Kearns, M., Curran, M., Collier, D., Burke, M. and Lawler, M., 2017. The Community Intervention Team as a means of improving the transition from hospital to home for patients.International Journal of Integrated Care,17(5). Kourkouta, L. and Papathanasiou, I.V., 2014. Communication in nursing practice.Materia socio-medica,26(1), p.65. MacKie, D., 2016.Strength-based Leadership Coaching in Organizations: An Evidence-based Guide to Positive Leadership Development. Kogan Page Publishers. Mills, P.B., Fung, C.K., Travlos, A. and Krassioukov, A., 2015. Nonpharmacologic management of orthostatic hypotension: a systematic review.Archives of physical medicine and rehabilitation,96(2), pp.366-375. Mitchell, P., Wynia, M., Golden, R., McNellis, B., Okun, S., Webb, C.E., Rohrbach, V. and Von Kohorn, I., 2014. Core principles values of effective team-based health care. Institute of Medicine of the National Academies. 2012. Pope, B., Hough, M.C. and Chase, S., 2016. Ethics in community nursing.Online Journal of Health Ethics,12(2), p.3. Shibao, C., Lipsitz, L.A. and Biaggioni, I., 2013. ASH position paper: evaluation and treatment of orthostatic hypotension.The Journal of Clinical Hypertension,15(3), pp.147