St Jude Childrens Research Hospital

St Jude Childrens Research Hospital St. Jude Childrens Research Hospital is a not-for-profit hospital located in the heart of Memphis, Tennessee. It is an internationally recognized hospital that pioneered research finding cures and saving children with cancer and other catastrophic diseases. It treats patients from all 50 states and around the world, without regard to ability to pay, never requiring families to pay for treatment not covered by insurance (St. Jude Childrens Research Hospital, 2010). St. Jude remains the first and only pediatric cancer center designated as a Comprehensive Cancer Center by the National Cancer Institute (St. Jude Childrens Research Hospital, 2010). It is currently ranked first in Childrens Hospitals for cancer care (U.S. News and World Report, 2010). St Jude Childrens Research Hospital encompasses an extensive and impressive mission, vision, and set of values. The mission of St. Jude Childrens Research Hospital is to advance cures, and means of prevention, for pediatric catastrophic diseases through research and treatment. Consistent with the vision of our founder Danny Thomas, no child is denied treatment based on race, religion, or a familys ability to pay. (St. Jude Childrens Research Hospital, 2010) St. Jude has a vision to be a world leader in the treatment and prevention of catastrophic diseases in children (St. Jude Childrens Research Hospital, 2010). They aim to meet this by providing exceptional patient care and extensive clinical research to better understand the catastrophic diseases of childhood, enhance outcomes of treatment, prevent diseases, minimize deleterious consequences of treatment, and educate healthcare and research professionals on such findings (St. Jude Childrens Research Hospital, 2010). The overall goal of these tasks is to find a cure and enhance the quality of life for the children they treat. To reach a larger portion of the affected population, they work to expand and share this knowledge to enhance the treatment of children with catastrophic diseases worldwide, working towards a strategy for disease prevention (St. Jude Childrens Research Hospital, 2010). St. Jude highly values their patients, families, and donors that enable them to act out their Mission. To adequately espouse their Mission and vision, the organization has outlined an explicit set of values and standards to guide their daily actions and decisions. To ensure adherence, ongoing training and evaluation is conducted (St. Jude Childrens Research Hospital, 2010). The values include: promoting ethical behavior, providing the highest quality of medical and supportive family-centered care, respecting ethical, cultural, religious, and lifestyle differences of all those involved in the hospital, promoting wise spending of every dollar donated back to the care and research for the patients it treats, maintaining a commitment to a culture of excellence, innovation, and creativity in all that they do, having a drive and sense of urgency to succeed, being honest and accountable for actions and decisions, and cultivation of an environment of trust, teamwork, and respect (St. Jude Ch ildrens Research Hospital, 2010). St. Jude does a fantastic job adhering to their Mission, vision, and values as noted through their increased survival rate of all pediatric cancers, high quality care, repeated ranking of the number one hospital for pediatric cancer care, and meeting financial requirements of the establishment with never asking families to pay for treatments that insurance fails to cover. This last portion has remained extremely important to the hospital since first opening as most patients who enter through hospital doors have already maxed out their lifetime insurance caps and lack the funding to continue paying for the seemingly endless hospital bills (St. Jude Childrens Research Hospital, 2010). To be accepted as a patient at St. Jude, a child must have a diagnosis specific to a current disease in study and be referred by physicians. The patient must be no older than 18 and generally not have received extensive treatment elsewhere. (St. Jude Childrens Research Hospital, 2010). While the St. Jude Childrens Research Hospital campus is an independent health care system, their top-notch research integrates them with childrens hospitals throughout the world (St. Jude Childrens Research Hospital, 2010). St. Jude conducts all research and primary studies within their campus but freely shares this research with hospitals throughout the world (St. Jude Childrens Research Hospital, 2010). Because of this cooperation, there is minimal competitiveness from other facilities but rather a system that works together for the sake of the children suffering from catastrophic diseases. St. Jude is the national coordinating center for the Pediatric Brain Tumor Consortium and the Childhood Cancer Survivor Study (St. Jude Childrens Research Hospital, 2010). On top of the exceptional research and care provided for pediatric cancer, St. Jude is a leader in sickle cell disease research and has become a primary research center for influenza throughout the world (St. Jude Childrens Research Hospital, 2010). St. Jude is internationally recognized for pioneering the research and treatment of pediatric patients suffering from cancer and other catastrophic diseases (St. Jude Childrens Research Hospital, 2010). Because of the work St. Jude has done, research protocols have helped to push overall survival rates of childhood cancer from less than 20 percent when the hospital opened, to over 80 percent today (St. Jude Childrens Research Hospital, 2010). They have treated patients from across the globe that are accepted and respected without regard to ethnicity and cultural differences (St. Jude Childrens Research Hospital, 2010). St. Jude has impacted the families by providing hope to families with a grim prognosis, lack of financing, and nowhere else to turn. St. Jude is the sole pediatric cancer research center that accepts patients without regard to ability to pay. Families are never asked to pay for treatment not covered by insurance, and no child is denied treatment because of inability to pay. (St. Jude Childrens Research Hospital, 2010). The American Lebanese Syrian Associated Charities (ALSAC) has been the exclusive fund-raising organization of St. Jude since 1957, helping raise funds to build the establishment with founder Danny Thomas and his vision (St. Jude Childrens Research Hospital, 2010). In the 2009 Fiscal Year, ALSAC raised $682 million through volunteers, corporate partners, and donors to meet the daily St. Jude operating cost of $1.5 million a day (ALSAC/St. Jude Annual Report, 2009). These operating costs include patient care services, research expenditures, education, training, and community services to accommodate staff and administration of the hospital. Patient care services include all care needed for active patie nts. This can include medical care and living expenditures for patients and families. Most patients are treated on an outpatient basis in the St. Jude clinics and are housed at one of the three housing organizations in Memphis affiliated with St. Jude (Target House, Grizzly House, Ronald McDonald House). Once remission is achieved treatment can be transferred to a doctor in the patients home community in collaboration with St. Jude protocols (ALSAC/St. Jude Annual Report, 2009). In addition to ALSAC, St. Jude has over 60 corporate partners including: Target, the NFL, The Memphis Grizzlies, Kay Jewelers, and Chilis, (St. Jude Childrens Research Hospital, 2010). In addition to their corporate partners, individual donors and organizations help financially support the work of St. Jude (St. Jude Childrens Research Hospital, 2010). Additional influences on St. Jude Childrens Research Hospital include the American Medical Association and American Nursing Association who serve to guide the doctors and nurses employed by the hospital. The policy and regulation of St. Jude is in accordance with research policies nationwide to ensure the safety of patients with the potential benefit of treatment outweighing the risk. The hospital adheres to set protocols in study and only deviates from them should extensive research prove the deviation to be more beneficial and scientifically supported (St. Jude Childrens Research Hospital, 2010). The system at St. Jude is highly supported by having the research institute under the same roof as the patients with the scientists actively involved in the patient plan of care. In addition to these regulations, St. Jude has policies in place to prevent infection spread to patients who are immunocompromised. These include not allowing visitors under the age of 12, screening for illness prior to visiting, proper hand-washing education, and not allowing visitors who have recently received the nasal flu vaccine or oral polio vaccine within the past four weeks. These policies ensure the safet y and overall well-being of their patients (St. Jude Childrens Research Hospital, 2010). The organization of St. Jude Childrens Hospital is based on the vision of founder Danny Thomas to create a hospital treating children with catastrophic diseases so no child has to die in the dawn of life (St. Jude Childrens Research Hospital, 2010). In partnering with ALSAC, Danny Thomas was able to obtain funding necessary to create this hospital from the ground up and work to create an environment welcoming to all who enter. His vision included a hospital where children didnt feel threatened by care providers, where doctors and researchers ate alongside of patients, a hospital where patients were allowed to continue their childhood while battling catastrophic diseases (St. Jude Childrens Research Hospital, 2010). According to Henry Mintzberg, an organization can consist of a maximum of six parts including the strategic apex (top management), the middle line (middle managers), the operating core (primary workers), the technostructure (workers who standardize and improve work), the support staff (those who work outside of the primary flow), and the ideology (beliefs, traditions, norms, values, and culture) (Value Based Management, 2010). The following diagram depicts the Mintzberg organizational structure of St. Jude Childrens Research Hospital and is explained below. (Proven Models, 2010) The strategic apex of St. Jude consists of the Boards of Directors and Governors for ALSAC-St. Jude Childrens Research Hospital. The Board is responsible for governing the organizations by establishing policies and objectives, selecting, appointing, supporting, and reviewing the performance of the Chief Executive Officers, insuring the availability of adequate financial resources, approving annual budgets and strategic planning, and accounting for the ethics, compliance, and performance of the organizations (St. Jude Childrens Research Hospital, 2010). Below them St. Jude has the middle line operations consisting of the Chief Executive Officers, Senior Management Team, and the Executive Committee that directly oversee the operating core. At the heart of the hospital are the operating core of physicians, research and development team, advanced practice nurses, nurses, certified nursing assistants, child life specialists, psychologists, and families who collaborate to provide adequate family-centered care. The Support Staff of St. Jude consist of ALSAC as the primary fundraising organization, the administrative body, the environmental service employees, the cafeteria, the public relations department helping advocate for ALSAC fundraising endeavors, the Target, Grizzly, and Ronald McDonald houses and staff people, the ethical and legal committees, and volunteers who help throughout the hospital. The technostructure of St. Jude consists of the specially named Faculty and Adjunct Faculty that standardize research in collaboration with care provided to patients. It also includes the external advisory boards that help to standardize protocols and ensure they are accessible and clearly stated to be shared worldwide. St. Jude has a surprisingly large technostructure of employees who work to standardize care throughout the hospital with regard to uniqueness of each patient in the research studies. Any deviations from standardized care are backed through the research cond ucted on the St. Jude campus. Because of this, the hospital would be classified as a Machine Bureaucracy that has all components present and strong in their functioning and enactment towards the campus. The nursing role that will specifically be analyzed is the role of the Pediatric Acute Care Nurse Practitioner. Unfortunately, this role is not currently available at St. Jude Childrens Hospital and therefore no specific job description or title is available for the specific role at St. Jude. According to the National Association of Pediatric Nurse Practitioners (NAPNAP), the Pediatric Acute Care Nurse Practitioner (PNP-AC) would function to provide direct patient care management, perform in-depth physical assessments, interpret lab and diagnostic tests, order mediations, and perform therapeutic treatments for children who are acutely, chronically, and critically ill (NAPNAP, 2005). The PNP-AC would be licensed as a registered nurse in the United States with a graduate degree in nursing through an accredited program, and certified by the Pediatric Nurse Certification Board as a Certified Pediatric Nurse Practitioner Acute Care (PNCB, 2010). To become certified one must meet certain competencies and pass a board examination that meets the National Council of State Boards of Nursing APRN criteria (PNCB, 2010). To maintain certification, one must complete continuing education hours and/or re-certification every three to five years, or as deemed by the organization and state board of nursing (PNCB, 2010). The role of the PNP-AC would fall within the operating core of the hospital. They would work in collaboration with other Physicians and Researchers at St. Jude to create a comprehensive plan of care for the patients. This would keep everyone working towards the same goal and ensure overall patient well-being. They would also work with the nurses, nursing assistants, child life specialists, and other therapists to keep them informed of progress or hardships the patient may encounter, and help them understand the cares that need to be provided to ensure success of treatment protocols. They would also work with unit managers and nursing directors should problems or questions arise. They will be able to consult with the middle line management or technostructure personnel should questions or concerns arise. They would also work with varying support staff members for outreach, dietary consults and education-oriented tasks. This role would directly interact with patients and families throug h their everyday tasks. They may do outreach into the community, and conduct education for consumers and payers on current advances the hospital is making. They would also indirectly work with human resources and the finance department to obtain their paycheck. The role of the PNP-AC is very autonomous in impacting patient care and outcomes. They can diagnose and treat conditions, prescribe medications, obtain necessary consults and interpret results of ordered tests. They would oversee the progress of care and intervene should any alarming findings be made in response to the protocol under study. The role would be strong in the sense that they are an autonomous and an independent member of the healthcare delivery team that is capable of providing a high-level of care to patients. They have strong patient interaction skills and a comprehensive knowledge of care that should be provided by the nurses. They are best able to understand the role of the nurse and delegate appropriate tasks to other members of the healthcare team. The role weaknesses include the chance that they may not be as highly respected as physicians or physician assistants, and the lack of advanced training specifically in pathology and the physiology like physicians and ph ysician assistants often have. Overall, the role of the PNP-AC would be a highly functioning advanced practice role that can provide comprehensive and thorough care to his or her patients and work as a productive member of the healthcare delivery team.

French and idian war Essay

The French and Indian War alter the political, economic, and ideological relations between the Britain and its colonies by being in debt that lead to tax laws, mercantilism and the way people felt about Britain’s control over its colonies. ***After the French and Indian War, the colonizing of the North America changed greatly. The English took over most of the North America land. English colonies had dominated the new world(Doc. A). This took a toll on the political relationship between the American colonists and Britain because this lead to the Proclamation of 1763. Britain believed they owned every land that they touched and this made conflict with the Native Americans. The Native Americans believed that they â€Å"had no right to settle† and they must † insist on removing them†(Doc A). The Britain created the Proclamation of 1763 thinking of decreasing the conflict but this added on to resentment in colonists’ hearts. ***Some political changes that included Britain’s abandonment were their salutary neglect policy. After the French and Indian War, England was seriously in debt and needed new ways to increase their status. England began to regulate trade and create tax laws on commonly used items. Even though Britain made these changes to ‘increase in territory†(Doc F), the colonists felt as if they were treated unfairly. *** Since of the taxation, the colonists and Britain’s relationship decreased rapidly. Some Acts that the Britain created forced the Americans to ship their raw materials to Britain and also buy the finish products only from their mother land. This encountered mercantilism which made Britain rich. At this point, colonists were fed up and decided to fight back. The Stamp Act was the last straw for the colonists. As Benjamin Franklin claims, the colonists wanted to â€Å"set it repeal’d’ which meant the colonists were eager to put a stop in Britain’s footsteps. As the colonists practiced non- consumption and non- importation and boycotted destroyed the economic relationship between the Britain and its American colonies even more. ***Colonial ideological values changed enormously toward the Britain because of their greed and the colonists proven that they could unite as one during their boycotting rival and stand up for what they believed in. As a soldier wrote, â€Å"we are debarred Englishmen’s liberty†(Doc D). From this dairy, this showed that Americans had resentment in their hearts toward Britain. ***Britain’s greed of land, controllment, and royalty destroyed many relationships along the way. The Native Americans feelings toward Britain were if they should’ve not been there in the first place. The American colonies felt as if Britain needed a stop in their footsteps and unite as one to fight off Britain’s crown.

Ankle Sprain

An Ankle Sprain of a Female Colligate Basketball Player Objective: To introduce a case study about a mild ankle sprain. Background: The most common way to sprain an ankle in basketball is to step on someone else’s foot, or to plant and to turn the wrong way. Differential Diagnosis: Could be an injury to the deltoid ligament, CF, or the ATF ligament. Treatment: Ice, High volt, Theraband, Towel scrunches, Towel stretches, Whirlpool Conclusion: Rehab will help her get her strength back in her ankle as long she continues to work hard. Keywords: Ankle sprain, High volt, Medial and Lateral Malleolus Objective The ankle joint is the most commonly injured part of the lower leg. It happens from an unusual twisting action when the foot is planted awkwardly or when running on uneven ground. An unbearable amount of force is placed on the joint itself. Such injuries occur all the time in athletics or just by running. The ankle is made up of bones, tendons, and ligaments. The major bone of the lower leg is the tibia; it holds most of the body’s weight. It is made up part of the medial malleolus, which consist of the inside up hump of the ankle. The fibula is the next largest of the ankle bone in the lower leg. It forms the lower leg end form the lateral malleolus, the outer hump of the ankle. The smallest ankle bone is the talus which completely makes up the bone on the top of the foot. The tendons connect the muscle to the bones. There are several muscles that help control motion at the ankle. The tendon connects one or more of the bones to the foot. Tendons can be stretch to torn when a great amount of tension is placed upon it. They can also be pulling away from the bone, such as the Achilles tendon rupture. Ligaments provide connections between the bones. Ligaments are mostly sprained. The ankle has many bones that comes together to form the joint. The most commonly injured ligament is the anterior talofibular ligament that connects the front of the fibula to the talus bone on the front outer rim of the ankle joint. Ligaments are sprained when a great than normal force is placed on it. This is done when the foot is inverted most of the time. This happens when the foot is awkwardly planted or is stepped upon during activities. Stepping in a surface that is irregular, such as in an athletic event when one player steps on another player foot a sprain can result. Background A twenty-one year old female, basketball player experienced an ankle sprain by accidentally stepping on another player’s foot. The player was going up to make a shot landed on the opponents foot when she came back down, which made her ankle invert. The head athletic trainer evaluated her then taped her ankle to provide support and keep the swelling to a minimum at that time, so the player could return to play. Immediately after the game, the player’s ankle was iced down to control the swelling and was receiving NSAID’s to help with the pain or discomfort she was feeling. The player was referred to the team physician for x-rays and MRI to help rule out fractures. Treatment was started to help relieving the swelling and pain. Treatment In the first couple of days of rehab, she received high volt, and ice to help with the swelling she also did ankle pumps that also help with moving out the inflammation. As each day went by, towel scrunches, towel stretches were performed as three set each. Compression pumps were administered for 15 minutes several times a week, rhythmic stabilization, and aquatic therapeutic exercises were added as she got closer to the sub acute phase. The sub acute phases are about six days to until six weeks. In this stage she was allowed to jog straight ahead, trying wide figure-eight at first. Eventually the player was either on the bike or the stair stepper for 10 minutes a day. After the bike she was moved to the shuttle press with four cords, and three sets of ten, after the shuttle she did calf raises. The farther she progressed, the whirlpool was introduced, and both hot and cold water. Two set of tens, in all four directions using Therband was the next step of treatment; ultrasound was done to help break up scar tissue that had started to form. As her ROM improved along with other tests, she was moving closer to the return to play phase. The return to play phase this is when functional test and sport specific drill can be started. Functional testing is important along with continuing with other exercises and modalities. She moved to three set of fifteen with a Therband in all direction, hot pack assisted with high volt was added. Following the Therband the shuttle with the dynadisc, doing three set of fifteen along with four cords, she also did towel scrunches five times; wobble board, marbles and exercise. ROM exercise was done to increase plantar flexion and dorsiflexion. Differential Diagnosis There are many kinds of ankle injuries that can be present in variety of ways. The calcaneocuboid joint injury is a kind of inversion ankle sprain that involves the ligament overlying that joint. Which cause immediate swelling, pain and tenderness to the touch? The pain is localized to that region of the joint. The deltoid ligament resists abduction and lateral rotation of the ankle. However sudden forceful motion of the ankle may tear the ligament or stress it. The ligament may avulse that is attacked to the malleolus; a vast majority of case, there will be a tear through the ligament. The tear could be associated with compression of the talar joint. There could be an injury also to the ATFL and the CF ligament. Conclusion The player went through all the appropriate phases to get back in to the return to play phase. She will continue to do rehab so that her ankle with improve and get stronger.

Defining and Understanding Literacy

Simply put, literacy is the ability to read and write in at least one language. So just about everyone in developed countries is literate in the basic sense. In her book The Literacy Wars,  Ilana Snyder argues that there is no single, correct view of literacy that would be universally accepted. There are a number of competing definitions, and these definitions are continually changing and evolving. The following quotes raise several issues about literacy, its necessity, its power, and its evolution. Observations on Literacy Literacy is a human right, a tool of personal empowerment and a means for social and human development. Educational opportunities depend on literacy. Literacy is at the heart of basic education for all and essential for eradicating poverty, reducing child mortality, curbing population growth, achieving gender equality and ensuring sustainable development, peace, and democracy., Why Is Literacy Important? UNESCO, 2010The notion of basic literacy is used for the initial learning of reading and writing, which adults who have never been to school need to go through. The term functional literacy is kept for the level of reading and writing that adults are thought to need in a modern complex society. Use of the term underlines the idea that although people may have basic levels of literacy, they need a different level to operate in their day-to-day lives., David Barton, Literacy: An Introduction to the Ecology of Written Language,  2006To acquire literacy is more than to psychologically and mechanically dominate reading and writing techniques. It is to dominate those techniques in terms of consciousness; to understand what one reads and to write what one understands: It is to communicate graphically. Acquiring literacy does not involve memorizing sentences, words or syllables, lifeless objects unconnected to an existential universe, but rather an attitude of creation and re-creation, a self-transformation producing a stance of intervention in ones context., Paulo Freire, Education for Critical Consciousness, 1974There is hardly an oral culture or a predominantly oral culture left in the world today that is not somehow aware of the vast complex of powers forever inaccessible without literacy., Walter J. Ong, Orality and Literacy: The Technologizing of the Word,  1982 Women and Literacy Joan Acocella, in a New Yorker review of the book The Woman Reader by Belinda Jack, had this to say in 2012: In the history of women, there is probably no matter, apart from contraception, more important than literacy. With the advent of the Industrial Revolution, access to the power required knowledge of the world. This could not be gained without reading and writing, skills that were granted to men long before they were to women. Deprived of them, women were condemned to stay home with the livestock or, if they were lucky, with the servants. (Alternatively, they may have been the servants.) Compared with men, they led mediocre lives. In thinking about wisdom, it helps to read about wisdom, about Solomon or Socrates or whomever. Likewise, goodness and happiness and love. To decide whether you have them or want to make the sacrifices necessary to get them, it is useful to read about them. Without such introspection, women seemed stupid; therefore, they were considered unfit for education; therefore, they weren’t given an education; therefore they seemed stupid.   A New Definition? Barry Sanders, in A Is for Ox: Violence, Electronic Media, and the Silencing of the Written Word (1994), makes a case for a changing definition of literacy in the technological age. We need a radical redefinition of literacy, one that includes a recognition of the vital importance that morality plays in shaping literacy. We need a radical redefinition of what it means for society to have all the appearances of literacy and yet to abandon the book as its dominant metaphor. We must understand what happens when the computer replaces the book as the prime metaphor for visualizing the self.It is important to remember that those who celebrate the intensities and discontinuities of postmodern electronic culture in print write from an advanced literacy. That literacy provides them the profound power of choosing their ideational repertoire. No such choice or power is available to the illiterate young person subjected to an endless stream of electronic images.