Risk Management Evaluation And Avoidance Methods

Risk management deals with the detection, assessment and avoidance methods, to cut down the adverse effects of risk on the organizations. There are different kinds of risk management techniques like risk avoidance, loss control, risk retention, risk transfer. Depending on the type of project’s involvement one can have several different risk management models to consider. If you don t know for sure what will happen, but you know the odds, that is risky. If you don t even know the odds, that is uncertainty. (Frank Knight, 1921). If a senior artist retires before the movie is complete, the production of art renderings will be delayed and will result in slipping the project schedule. This is a case where risk mitigation step involves the development of the project. It can have a range of effects on achievement of project objectives, from the total failure to the unexpected welcome surprise. Identifying the risk there are several likely- Project delay, projections hold-up, project cancellation, etc. In the risk mitigation plan, the senior artist who is retiring could be requested to continue till the completion of current projects. Another approach may be to curtail the role of the actor and manipulate the story of the movie. But, if the reason of retirement for the actor is sound, then in that case the project delay is indispensible and other mitigation plan has to be considered. Among all such plans, we have to contemplate on the one which could minimize the losses. IfShow MoreRelatedRisk Management Plan For A Company1333 Words   |  6 PagesRisk Management The process that helps project managers follow when they need to calculate, identify, and manage risk in a company is defined as Risk Management. When a company faces risk, risk management would be the ideal solution to use that to solve the known and unknown risks. Risk management plans should be ready to help reduce and prevent those risks because most risks in a company are uncertain. When a company is facing risks that are uncertain, these risks come up very fast and they couldRead MoreThe Facility s Risk Management Program1127 Words   |  5 Pages Describe and discuss the facility s Risk Management program. Do you feel their Risk Management program is adequate? Compare and critique the subject facility s Risk Management program to that of a model facility and whether the facility adheres to the recognized standard for risk management. Identify areas for improvement in the facility s Risk Management program, if any, and any recommendations you think should be implemented to lower risks in the facility. Give valid reasons for yourRead MoreSteps Risk Management Process ( I- Preparation )1318 Words   |  6 PagesSteps risk management process I- Preparation: It includes planning process and maps the scope of work and the foundation which will be adopted in the risk assessment as well as the definition of a framework for the process and the agenda for analysis. II- risk identification: At this stage, it is to identify the importance of risk. A risk is an event when access leads to problems and it can begin to identify the risks of the source of the problems, or the problem itself. When you know the problemRead MoreInformation Data Backup Challenges At The High Level Management1507 Words   |  7 Pages3. Available options for Risk Mitigation ..................................................................................................................................4 3.1 Risk hedging†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.4 3.2 Risk avoidance†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.4 3.3 Risk control†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.4 3.4 Risk assumption†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.4 3.5 Risk reduction†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.4 3.6 Risk Sharing†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.4 3 Possible Strategies for Risk Mitigation..............Read MoreRisk Management At Germantown Hospital1647 Words   |  7 Pages Risk Management When the term â€Å"Risk management† is mentioned, those that are not familiar with it may not be fully aware of the seriousness of it. 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Women s Search For Selfhood - 2169 Words

Women’s search for selfhood, for self-discovery or identity are themes that are represented in Kate Chopin’s work. Chopin was on the same regular path as other women in her era. She got married at the age of twenty and had six children. When her husband passed away Chopin wanted to support herself so she decided to start writing which was also an outlet for her feelings. During the nineteenth century women were getting sick of the rules that were forced on them and Chopin expressed her feeling towards it through her writing. Her feelings led her to freely comment on society which successfully demonstrated the movement of feminism. Chopin was a big influence for women who wanted to be treated equal with men and have the same opportunities they had. Chopin s stories contain much mental understanding of deep things that draws attention to her characters and plots. Important themes in her writing were female sexuality, inequality of men and women, male dominance. Chopin can use the physical setting in her stories to bring attention to important themes, affect the way of thinking of the characters, and add to the mood of her stories. Kate Chopin’s work displayed the difficulty of women living in a society where women were dealing with so many restrictions. The Awakening and â€Å"The Story of an Hour† were her best work and became very popular. Her stories will sometimes involve a death of a character because she experienced many tragic deaths in her life. Her father died when sheShow MoreRelatedThe Instituition of Marriage748 Words   |  3 PagesInstitution of Marriage In the story â€Å"The Yellow Wallpaper†, by Charlotte Perkins Gilman, I will discuss how women were oppressed by the institution of marriage in the nineteenth century while making comparative references to â€Å"The Story of an Hour† by Kate Chopin. Women were treated as second class citizens during the 1800’s, which under rule of their husband weren’t allowed to be a person of their own, but live in the shadow of their husband. The narrator in â€Å"The yellow Wallpaper†Read MoreThe Double-Fold Oppression Of Intersectionality. The American1642 Words   |  7 Pagesexplanation for its deep roots in American society, especially works by women such as Alice Walker and Toni Morrison. Despite the severe racism and poverty Alice Walker faces as the daughter of sharecroppers in Georgia, the memory of her being forced to move to the back of a segregated bus inspires her to write The Color Purple. By tracing the life of a young black woman named Celie, Walker encapsulates the despairing situation of black women in the 1940s, who struggle to escape from the command of whiteRead MoreUsurpation of Identity in ‚Äà ºThe Yellow Wallpaper‚Äà ¹1096 Words   |  5 Pagesbizarre wall-covering has been used as an early example of post-partum depression. In the latter part of the 1800’s women were seen as inferior subordinates to men who could not be trusted due to the effect of the female organs on their brains. The narrator is almost certainly a victim of the lack of medical knowledge of the day, while the prevailing attitudes in the medical field of women as childlike and the social pressure of male domination contribute to the narrator’s illness. The husband’s roleRead MoreKate Chopin s Life And Feminism1281 Words   |  6 PagesPontellier, a radical feminist, and Adele Ratignolle, a subtle feminist, demonstrate to the reader the desire for equality for women. The actions of these characters critique on the social problems of the time period while at the same time advocating for women’s rights and independence. Edna’s words and actions often comment on the unfair nature of marriage and the right for women to challenge this unfairness. While Edna is very radical about her feminist values, Adele is more subtle, but still effectiveRead More Themes Discussed in Joyce Oates Where Are You Going , Where Have You Been1551 Words    |  7 Pagesin the world. They are on a quest to find themselves, and in search of a path that will lead them to future happiness. â€Å"Where Are You Going, Where Have You Been,† is a short story written by Joyce Oates .In her short story Oates shows how easily susceptible one is in this stage of life. Oates shows in her story how the quest of finding one’s self, gives one a false sense of knowledge. It is this false sense of knowledge and the search for self and identity that produces the tragic outcome of theRead MoreDavid Herbert Lawrence s Moral And Mental Issues1438 Words   |  6 Pagesthat there is no contact between his autobiography and writings. 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Chronicity And Co Morbidity In Healthcare †MyAssignmenthelp.com

Question: Discuss about the Chronicity And Co Morbidity In Healthcare. Answer: Introduction: The health care industry has advanced considerably in the past few decades and what used to be an incurable morbidity, taking hundreds of lives; now there are different treatment options for it. However, it also needs to be considered that despite all the technological revolution in the health care industry, there still is a number of emerging public health concerns that mortality rates are increasing rapidly (Lisspers et al., 2014). One of the most common of these health priorities can be considered the chronic obstructive pulmonary disorder that targets more than 34% of the global population and this particular health disorder contributes to a large proportion of mortality to the health care sector. Chronic obstructive pulmonary disorder or COPD is a respiratory disease which can be characterized by the blocked respiratory airways, shortness of breath and excessive sputum or cough production. The patient suffering with COPD can be cared for optimally if a multidisciplinary team having different experts belonging to different care sectors; ho can address differential care needs of the patient. This assignment will attempt to evaluate all aspects associated with caring for a patient suffering with COPD taking the help of a case study. Interrelationship of complexity, chronicity and co-morbidity in healthcare COPD is the chronic illness and is associated with various comorbidities such as diabetes mellitus, cardiac disease, osteoporosis, hypertension,muscle weakness and other psychological disorders (Mellado et al., 2016). Chronicity of the illness refers to the condition that is difficult to be cured. Comorbidities are the medical condition that are associated and occur together with the main illness. These comorbidities add to the complexity of the chronic disease. COPD is the complex disease, as the patient had to cope up with various other comorbidities, which increases the length of the hospital study and exacerbation of COPD symptoms (Donner et al., 2017). Therefore, it mandates the need of more than one drug to fight the comorbidities along with COPD. Risk factors such as smoking, medication interaction, aging and lack of treatment of comorbidities add to the complexity of the comorbidities and outcomes in the patients with COPD. The complexity of the presentation of the symptoms makes it challenging for the clinicians to mage the chronic disease (De Lucas-Ramos et al., 2017). Thus, the complexity, chronicity and the comorbidity is interrelated in the health care and this concept must be clear to the health care providers to rightly handle the upcoming challenges. In the given study, Angela (COPD patient) was presented to her GP with increasing shortness of breath, increased sputum production, which has changed to dark yellow with green staining. Her condition is worsening daily. She is feeling unwell since several days. Her SaO2 is 84% on room air, temperature 38.4 C, She is significantly dyspnoeic, struggling to say more than 5 words without a breath. Her pulse is 104bpm and her BP remains elevated at 162/102mmHg. Due to inadequate intake of the medication, her symptoms have exacerbated. Consequently, she had to increase her antibiotics, nebulisers and oxygen therapy to maintain SpO2 above 92%. Due to hospitalisation, her mental well-being is affected. She is more upset due to burden of illness, inconvenience caused to her family, and at unable to care for daughters. Thus, chronic illness and associated comorbidities makes treatment more complex that ultimately affected both the physical and mental wellbeing. Pathophysiology of COPD COPD is characterised by airway inflammation, structural changes in the airway and mucociliary dysfunction. As a consequent of exposure to the inhaled irritants such as polluted air, tobacco smoke a chronic inflammation of the airway and lung tissues occurs along with the inflammation in the blood vessels (Celli, 2014). When the irritants are inhaled, it stimulates the lymphocytes, neutrophils, CD8+T-lymphocytes, and other inflammatory cells such as macrophages, and B cells. These stimulated cells are activated to trigger a cascade (Celli, 2014). Firstly, the inflammatory mediators are released such as interferongamma, tumour necrosis factor alpha, C-reactive protein, and interleukins (IL-1, IL-6, IL-8). These mediators can sustain the inflammatory process. They induce range of systemic effects and leads to tissue damage (Rodrguez-Roisin, 2014). Secondly, the chronic illness leads to various structural changes in the lugs that limit the airflow. The airway inflammation remain associated with the COPD due to airway remodelling. The narrowing of the airway is caused by the peribronchial fibrosis, over multiplication of the epithelial cells of the airways, damage of the airway and build-up of the scar tissues (Mitchell, 2015). This results in the loss of lung tissue elasticity. It is caused by the damage of the structures that support alveoli. It results in collapse of small airways on exhalation. It causes trapped air in the lungs and impedes airflow. This reduces the lung capacity (Pouwels et al., 2017). Thirdly, the mucous glands are enlarged by smoking and consequent inflammation. These glands line the lung airway and upon enlargement, it leads to goblet cell metaplasia. Ultimately, the region is filled with mucous secreting cells. COPD inflammation damages the mucociliary transport system that cleans the airway mucus. Eventually mucous is accumulated in the airways that blocks and worsen the airflow (Rogers, 2014). The pathophysiology of COPD detailed above can be related with the case study. Angela experiences dyspnoea and shortness of breath. Dyspnoea results due to airflow obstruction and exertion. The damage caused to lungs makes it hard to breath as the airflow is limited. It takes more efforts to make air travel. The breathing irritants may have damaged the tiny air sacs within the lungs. Therefore, the COPD patients develop emphysema. The shortness of breath is also related to irritants and mucous that cause swelling and inflammation. In case of Angela, shortness of breath can also be the sign of flare up or exacerbation. It may be also be caused by the infections, Flu or pneumonia (Mitchell, 2015). The elevated blood pressure in Angela can be related with the pulmonary hypertension due to arteries that transfer blood to lungs. It forces a patient to breath faster (Rodrguez-Roisin, 2014). Nursing intervention for COPD: Nursing diagnosis Care goals Interventions Rationale Expected outcome Shortness of breath or dyspnoea. The patient will retain normal breathing pattern The patient will maintain normal respirator rate. The oxygen saturation limit of the patient will increase. Placing the patient in the semi-fowlers position. Performing CPT or chest physical therapy to the patient. Increasing the fluid intake of the patient considerably. Maintaining a patent airway technique, and secrete suctioning is also performed as per the discretion of the medical practitioner. Providing respiratory support to the patient in case of aggravated dyspnoea (Punekar, Shukla Mllerova, 2014). Administering cough suppressant medicines and analgesics if the patient experiences pain and discomfort in the chest or airway. This will allow the patient to have maximum lung expansion and the breathing rate will subsequently increase. Increasing the fluid intake of the patient will liquefy the secretions as soon as possible (van der Molen Cazzola, 2012). As dyspnoea is characterized by the blocked airways due to the accumulation of sputum, the suctioning will remove the excess cough and clear the airways. In case the dyspnoea of the patient is aggravated and the patient cannot breathe on her own, respiratory support will help in stabilizing her condition. The cpugh suprresants will liquefy the accumulated cough and the mild analgesics will help the patent feel comfortable. The patient experience easier breathing exercise. The patient no longer experiences dyspnoea and the breathing rate of the patient returns to normal. Ineffective airway clearance Maintaining the airway patency of the patient with the breathing sounds getting clearer. Demonstrating breathing interventions to the patient to improve airway clearance by the means of effectively coughing and secretion removal. Auscultation of the breathing sounds of the patient checking for wheezes, crackles or rhonchi. Assessment of respiratory rate taking into accounts both the inspiratory and expiratory ratio. Assessing the presence of air hunger in the patient, characterized by restlessness, respiratory distress, and excessive usage of respiratory muscles. Providing a comfortable, safe, warm environment for the patient which is absolutely devoid of any environmental pollution (van der Molen, Miravitlles Kocks, 2013). Administration of intervention techniques like oral bronchodilators, pursed lip breathing exercises, suctioning, bronchial tapping while coughing, etc. It will indicate if the patient is expressing any indication of bronchospasm. It will assess whether the patient has tachypnea (van der Molen, Miravitlles Kocks, 2013). Presence ofb air hunger i9n the patient will indicate at the onset of severe respiratory dysfunction in the patient aggravated by any infection of allergic reaction. A warm and comfortable environment will help the patient relax, and the absence of any polluter like dust, smoke will help in minimizing the infection. These intervention techniques will help the patient breathe more effectively and facilitate better airway clearance (Glaab et al., 2012). The airway of the pati9ent will be effectively cleared. The patient will face no difficulties in maintain normal breathing pattern. Risk for infection The patient will communicate the probable risk factors or grievances. Identificatioj and administration of interventions that reduce the risk for infection. Facilitating changes in the lifestyle of the patient to promote safe and comfortable environment Monitoring the temperature of the patient Observing the nature, colour and odour of the sputum (Davis et al., 2015). Engaging the patient in effective and hygienic disposal of sputum and handwashing . Administration of oral antibiotics if presence of infection is confirmed. The fever might be indicative of the onset of infection in the patient. Presence of odor, or yellowish to greenish coloration in the sputum is indicative of pulmonary infection. Will reduce the risk of infection. Antibiotics will effectively combat the spreading infection (Lisspers et al., 2014). The patient will not acquire any infection while staying in the facility and will attain a speedy recovery. Health coaching, self-management, empowerment and advocacy: COPD is the leading cause of death in many countries and most people are not aware of the factors that exacerbate the symptoms. It is necessary for the patients to learn the COPD conditions and factors of exacerbations. Learning about the comorbidities makes the patient take better care of health. Therefore, coaching is necessary to aware patients on the indoor and outdoor air pollutants that can block the airway. It will help the patients to avoid the risk factors. Coaching the patient will help in the early detection, prevention, improved treatment and care (Baker Fatoye, 2017). In case of Angela, she must be taught about the side effects of medications (oral prednisolone, salbutamol) and signs that need immediate attention of the GP. She must be educated on the self-management skills. Self-management of COPD includes smoking cessation, self-care of exacerbations, participating in physical activities, performing breathing exercises, maintaining proper diet, adhering to the medications prescribed by the GP (). It will reduce the exacerbations as Angela is repeatedly admitted in hospital due to poor medication adherence and delayed intervention. According to Lenferink et al. (2017) comprehensive self-management is possible by coaching the patients and it has been found effective to some extent in improving the quality of life. Reducing the exacerbation will relive a Angela of anxiety and stress due to frequent hospitalisation. It will empower her to have faith in her medication. It will increase her self-efficacy and participate actively in treatment process. Collaboration by registered nurse: Registered nurses are in the key position to manage the COPD patients. The nurse must collaborate with the patients and her family members to enhance the care. The nurse must be able to initiate life style management plan for Angela. The nurse must consult with the dietician to develop appropriate diet plan for Angela. The nurse must collaborate with social worker to help Angela deal with any other psychosocial factors hampering her health such as caring for her daughters (Efraimsson et al., 2015). On addition addressing the funding issues and recognising other barriers is necessary to improve the patient wellbeing. Since COPD involves comorbidities, the registered nurse must collaborate with the pulmonologists (optimising treatment), respiratory therapists (ventilator support therapies, inhaler training), case managers (coordinate care needs after discharge) and information system specialists (for designing the medication reconciliation plan) (Flinter et al., 2017). Conclusion: On a concluding note, it can be said that chronic obstructive pulmonary disorder or COPD is a respiratory disease which can be characterized by the blocked respiratory airways, shortness of breath and excessive sputum or cough production. There can be a varied reasons contributing to the formation of this disease although the most common risk factors associated with this disease are excessive smoking, past medical history of chronic asthma, and genetic inclination towards developing this disease. COPD is associated with a highly specialized yet diverse care planning and interventions must be aligned to the specific needs and requirements of the patient in order to avoid any further complication. References: Baker, E., Fatoye, F. (2017). Clinical and cost effectiveness of nurse-led self-management interventions for patients with copd in primary care: A systematic review.International Journal ofNursing Studies,71, 125-138. Celli, B. R. (2014). Pathophysiology of chronic obstructive pulmonary disease. InMechanics of Breathing(pp. 339-352). Springer Milan. Davis, K. J., Landis, S. H., Oh, Y. M., Mannino, D. M., Han, M. K., van der Molen, T., ... Muellerova, H. (2015). Continuing to Confront COPD International Physician Survey: physician knowledge and application of COPD management guidelines in 12 countries.International journal of chronic obstructive pulmonary disease,10, 39. De Lucas-Ramos, P., Gonzalez-Moro, J. M. R. (2015). Aging, chronicity and pulmonary care.Arch Broncroneumol,51, 369-370. Donner, C. F., Carrozzi, L., Maio, S., Baldacci, S., Pistelli, F., Viegi, G., ... ZuWallack, R. L. (2017). Integrating the care of the complex COPD patient.Monaldi Archives for Chest Disease,87(1). Efraimsson, E. ., Klang, B., Ehrenberg, A., Larsson, K., Fossum, B., Olai, L. (2015). Nurses Flinter, M., Hsu, C., Cromp, D., Ladden, M. D., Wagner, E. H. (2017). Registered Nurses in Primary Care: Emerging New Roles and Contributions to Team-Based Care in High-Performing Practices.The Journal of Ambulatory Care Management,40(4), 287. Glaab, T., Vogelmeier, C., Hellmann, A., Buhl, R. (2012). Guideline-based survey of outpatient COPD management by pulmonary specialists in Germany.International journal of chronic obstructive pulmonary disease,7, 101. Lenferink, A., van der Palen, J., Van Der Valk, P., Cafarella, P., Van Veen, A., Quinn, S., ... Effing, T. W. (2017). Self-Management Action Plans For COPD Patients With Comorbidities Reduce Exacerbation Duration And Respiratory-Related Hospitalizations-The COPE-III Study. InD13. THE REVOLVING DOOR: COPD HOSPITALIZATION AND READMISSION(pp. A7003-A7003). American Thoracic Society. Lisspers, K., Johansson, G., Jansson, C., Larsson, K., Stratelis, G., Hedegaard, M., Stllberg, B. (2014). Improvement in COPD management by access to asthma/COPD clinics in primary care: data from the observational PATHOS study.Respiratory medicine,108(9), 1345-1354. Mellado, M., Mercadal, A., Matarrodona, M., Navazo, I., Moya, F., Gracia, Y., ... Puerta, N. (2016). Social Health Diagnosis as a complementary tool in the clinical diagnosis for the integrated approach of the CCP in a FUCP addressed to the direct attention of CCP with heart failure (HF) and chronic obstructive pulmonary disease (COPD).International Journal of Integrated Care,16(6). Mitchell, J. (2015). Pathophysiology of COPD: Part 1.Practice Nursing,26(4), 172-178. Pouwels, S. D., Van Geffen, W. H., Jonker, M. R., Kerstjens, H. A., Nawijn, M. C., Heijink, I. H. (2017). Increased neutrophil expression of pattern recognition receptors during COPD exacerbations.Respirology,22(2), 401-404. Punekar, Y. S., Shukla, A., Mllerova, H. (2014). COPD management costs according to the frequency of COPD exacerbations in UK primary care.International journal of chronic obstructive pulmonary disease,9, 65. Rodrguez-Roisin, R. (2014). The Airway Pathophysiology of COPD: Implications for Treatment.[Internet] 2005.COPD. Rogers, D. F. (2014). Mucus pathophysiology in COPD: differences to asthma, and pharmacotherapy.[Internet] 2000.Europe Pubmed General. van der Molen, T., Cazzola, M. (2012). Beyond lung function in COPD management: effectiveness of LABA/LAMA combination therapy on patient-centred outcomes.Primary Care Respiratory Journal,21, 101-108. van der Molen, T., Miravitlles, M., Kocks, J. W. (2013). COPD management: role of symptom assessment in routine clinical practice.International journal of chronic obstructive pulmonary disease,8, 461.

JOHN F. KENNEDY IN VIETNAM Essays - Vietnam War,

JOHN F. KENNEDY IN VIETNAM There are many critical questions surrounding United States involvement in Vietnam. American entry to Vietnam was a series of many choices made by five successive presidents during these years of 1945-1975. The policies of John F. Kennedy during the years of 1961-1963 were ones of military action, diplomacy, and liberalism. Each of his decision was on its merits at the time the decision was made. The belief that Vietnam was a test of the Americas ability to defeat communists in Vietnam lay at the center of Kennedy's policy. Kennedy promised in his inaugural address, Let every nation know...that we shall pay any price, bear any burden, meet any hardship, support any friend, oppose any foe to assure the survival and success of liberty. From the 1880s until World War II, France governed Vietnam as part of French Indochina, which also included Cambodia and Laos. The country was under the formal control of an emperor, Bao Dai. From 1946 until 1954, the Vietnamese struggled for their independence from France during the first Indochina War. At the end of this war, the country was temporarily divided into North and South Vietnam. North Vietnam came under the control of the Vietnamese Communists who had opposed France and aimed for a unified Vietnam under Communist rule. Vietnamese who had collaborated with the French controlled the South. For this reason the United States became involved in Vietnam because it believed that if all of the country fell under a Communist government, Communism would spread throughout Southeast Asia and further. This belief was known as the domino theory. The decision to enter Vietnam reflected America's idea of its global role-U.S. could not recoil from world leadership. The U.S. government supported the South Vietnamese government. The U.S. government wanted to establish the Southeast Asia Treaty Organization (SEATO), which extended protection to South Vietnam, Cambodia, and Laos in case of Communist subversion. SEATO, which came into force in 1955, became the way which Washington justified its support for South Vietnam; this support eventually became direct involvement of U.S. troops. In 1955, the United States picked Ngo Dinh Diem to replace Bao Dai as head of the anti-Communist regime in South Vietnam. Eisenhower chose to support Ngo Dinh Diem. John Fitzgerald Kennedy was born in Brookline, Mass., on May 29, 1917. Kennedy graduated from Harvard University in 1940 and joined the Navy the next year. After recovering from a war-aggravated spinal injury, Kennedy entered politics in 1946 and was elected to Congress. After a hard primary battle, Kennedy won the Democratic presidential nomination on the first ballot at the 1960 Los Angeles convention. With a majority of 118,574 votes, he won the election over Vice President Richard M. Nixon and became the first Roman Catholic president. Kennedy was inaugurated January 20, 1961. January 19, 1961 was President Eisenhower last full day in office. He met with President elect Kennedy to lay out pressing national issues he would have to face. Tensions between the United States and the USSR had mounted after World War II, resulting in the Cold War. JFK would have to deal with that problem. There was an intense discussion about Laos and Vietnam between Kennedy and Eisenhower. Another problem JFK had inherited was Diem from Eisenhower. Kennedy's cabinet members were made up of many different thinkers. Dean Rusk, the Secretary of State believed that there was a communist plot to take over the world and it must be stopped. Walt Rostow, the presidential advisor believes that we should use military force to cut off supplies to the Vietcong, have large scale bombings of North Vietnam and accelerate modernization in South Vietnam. General Maxwell Taylor criticized Eisenhower's conventional training efforts. McGeorge Bundy, the NSC advisor wanted to attack the Vietcong and North Vietnam if necessary. George Ball believed that Diem regime was corrupt and to create democracy in Vietnam was impossible. Kennedy first role as president was to focus on issue involving the dangerous crisis over Berlin, on Cuba, and on the future of Laos. JFK first sends advisors to Vietnam to recommend a course of action during May 1961. Lyndon B. Johnson, Vice-President, visits South Vietnam and recommends strong commitment. In June 1961, the State Department report had three