Critically appraise the education provision available for people with Diabetes. Education on prevention of Foot Ulcers in Diabetes.

Introduction Currently I am working in a nursing home where the elderly residents have various illnesses including the after effects of strokes and dementia. Due to their age and particular care needs the education for health support workers, senior carers and nurses who are at the centre of this care provision is fundamentally important. The aim of this assignment will therefore be the appraisal of this education, meaning their training and ongoing monitored development, with a specific focus on the prevention of foot ulcers in patients who suffer from diabetes mellitus. This is an important area for consideration because at the moment health care support workers have no formal education in the prevention of foot ulcers in diabetes patients and can be ignorant of its symptoms. As with nurses it is reasonable to expect that they should have attained a certain level of knowledge in this area as the consequences of foot ulcers can be very serious and in cases can lead to amputation. This ultimately has a significant impact on the quality of life of the diabetes sufferer and the carer therefore has a duty of care to protect their patient against this preventable outcome. It should be noted that 85% of cases which end in amputation can avoided (Garay- Sevilla et al., 2002, 81-86). In order to carry out this critical appraisal the first step is to consider the causes of diabetic foot ulcers, it signs and symptoms, treatment and prevention. The assessment of these factors is necessary because it deconstructs the knowledge required by health care workers and subsequently allows the provision of education to be accordingly evaluated for its accuracy and comprehensiveness. The next point to discuss is the current state of education on offer. This will be assessed in terms of how far it provides the level of knowledge needed by people who are in the position of diagnose and treat diabetic foot ulcers. Recommendations for best practice will then be make. Causes of diabetic foot ulcer One of the effects of diabetes is decreased immunity and poor wound healing. In the absence of normal blood flow specific lesions of the arteries, particularly in the extremities, can occur. Diabetic foot syndrome is one such complication and occurs in 15% of all patients with diabetes. These changes are a consequence of the existence of diabetic neuropathy. Motor neuropathy in diabetes leads to muscle atrophy and impaired co-flexors and extensors whilst also effecting deformation rate. Sensory neuropathy, sensory disturbance of pain by temperature and touch, increases the risk of injury which in turn contributes to the formation of ulcers. Autonomic neuropathy results in the formation of arterial venous fistulas and impaired blood oxygenation which leads to disorders affecting the trophic ulcers (Rubin & Peyrot, 1998, 81–87). The syndrome occurs in the later stages of the disease and is one of its most severe complications as it can lead to death. It manifests itself in compl ex changes in the joints and foot nerves, limb deformation, and deep tissue damage. It is also associated with damage to blood vessels, nerves, skin and bones. The initial abnormality takes the form of a pressure point which can be caused by, for example, ill-fitting shoes which cause blistering, cuts, and bites caused by foreign bodies. Vascular disease, resulting in decreased blood flow, contributes to poor healing and infections can be caused by numerous microorganisms (Manson & Spelsberg, 2004, 172–184). Patients who experience sensory disturbances find that pain is suppressed and consequently they might not recognize the seriousness of their situation leading to a delay in treatment. The treatment that is required must be prompt and responsible but it can also be protracted (Lustman et al., 2000, 934–943). Foot problems can affect anyone who has Diabetes regardless of whether they are being treated with insulin, non-insulin, tablets, injections, a controlled diet or physical activity. Signs and symptoms of diabetic foot ulcer In order that treatment is successful it is necessary that health care professionals and care workers can recognize the signs and symptoms of diabetic foot ulcers especially when caring for the elderly who are unable to detect the signs and symptoms. The main features of the disease include explicit sores, prolonged healing sores, changes in the shape of limbs, and, in later stages, gangrene. In the early stages symptoms usually coincide with complaints of fatigue which is accelerated by walking and standing, a sense of gravity, and freezing feet due to the deformation problems with wearing familiar footwear. One of the most pressing reasons for a good standard of education in diabetic foot ulcers is the variety of forms it might take. This means that the health care worker must be able to recognize the condition in different scenarios. The neuropathic foot is the most common form with 70% of cases of diabetic foot falling into this category. It takes the form of a hot pink color with a palpable pulse and impaired deep sensation (Wysocki & Buckloh, 2002, 65–99). Another form is known as ischemic. This condition is caused by peripheral vascular occlusive. Diagnosis includes history (hypertension, hypercholesterolemia, smoking) and intermittent claudication. The foot assumes a cold bluish tinge and has no palpable pulse. The sufferer experiences a pain in motion and severe pain at rest (Lustman et al., 2000, 934–943). The final form is neuropatyczno-ischemic. This is characterized by the worst prognosis (Morisaki et al., 2004, 142–145). The main course of action is to preserve the integrity of the skin. This is because the main danger lies in the wounds and fractures where if infection takes hold the result will be purulent inflammation and necrosis. Severe pain or numbness, sores, blisters, and peeling require the most urgent medical intervention because these can lead to gangrene and ultimately amputation of the affected limb. As the only quantifiable sign of inflammation, which indicates tissue lesions, is skin temperature it is necessary to used infrared thermometers. These can be used to determine the temperature of the skin in different areas of the foot. Dermal thermometers are also useful in the interpretation of the different phases of Charcot foot and in determining the most appropriate orthopodologic treatment in each phase. However, these are specialised tools and are unsuitable for carers to use nursing homes. Methods There is very particular method which should be implemented for assessing the health of a diabetes suffer’s feet. It is this type of information which should be included in an educative strategy used to train health care workers. Before measuring the temperature of the skin in the feet, the patient should be barefoot for at least five minutes before the examination to avoid a rise in temperature due to footwear or hosiery. The result should then be recorded. The next step is to repeat the measurement in the same area of the contralateral foot and compare the results obtained. This should be done for all the high risk areas. A difference in temperature of less than 2? c can be considered normal. Once infection has been ruled out, differences greaterthan2? C in diabetic patients are highly suggestive of Charcot activity. When the examination is done in a patient with Charcot foot and the difference is less than 2? C it shows that the acute period has come to an end. If the patie nt observes a difference in temperature greater than 2?C in self-examination on two consecutive days, he or she should contact a healthcare professional to determine the cause of the difference (www.diabeticfootjornal.net). Unfortunately there is no effective treatment for diabetic ulcers but reducing the load on the feet does offer hope of saving the affected limb. Alternative treatments can involve the use of hydrotherapy and ulcer surgery to remove necrotic tissue. Algorithm for the treatment of infected feet includes glycemic control (insulin), strain rates (shoe inserts, crutches, plaster casts), antibiotics and surgical procedures (drainage, incision, removal of dead tissue). Prevention of diabetic foot ulcer One of the most effective treatments is preventative. All patients with Diabetes Mellitus should be screened when there is a sensation of numbness or pain exists even if there are no visible lesions or ulcers (Morisaki et al., 2004, 142–145). The education of health care workers in foot ulcers therefore needs also to take into account prevention. Inspection of the stop should be performed as often as possible. If the skin of the foot shows sign of a scratch or crack you cannot use adhesive, alcohol or fat-containing ointments as these tools lead to further irritation. Redness or paleness, the presence of edema, blunting of the sensitivity, fungal lesions, and the overall deformation of the foot should be examined for deviations from the norm. If identified treatment should start immediately. In addition, from time to time, it is desirable to perform a neurological examination to determine the tactile, thermal, and vibration sensation of the foot. Angiographic diagnosis of vasc ular leg reveals the presence of thrombus. Basic steps can also be taken to prevent the occurrence of gangrene. These include the maintenance of desired blood sugar levels, the monitoring of the hygiene of the feet, making regular visits to an endocrinologist and follow their recommendations. (Clement, 1995, 1204–1214). Good foot care Education is important because good foot care has lots of pitfalls. Using the wrong cream, overcutting toe nails, walking barefoot, wearing the wrong shoes or socks can increase the chances of foot ulcers. It is necessary that the carer should be able to advise diabetes sufferers in all the dos and don’ts when it comes to looking after their feet in the proper manner to decrease the chances of contracting a foot ulcer in the first place (www.patient.co.uk). Some of these dos and don’ts are as follows; In contrast to what might seem like common sense it is vital to avoid using items such as moisturising oils or cream designed for dry skin and the prevention of cracking. Look out for athletes foot (common minor skin infection) as it can cause flaky and cracked skin The space between toes can become sore and can become infected. It is essential to monitor this. Cut your nails by following the shape of the end of the nail. Do not cut down the sides of the nails as this may cause damage or lead the nails to develop an ingrown nail. It is important to wash feet regularly and dry them carefully, especially between toes. Do not walk barefoot even at home You right treads Always wear sole or shoes or other footwear however don’t wear too tight socks around the ankle as they may affect circulation Shoes, trainers and other foot wear should; Fit well to make into accounts any awkward shapes or deformities Have broad front and plenty of room for toes Heels to avoid pressure on toes. Have good laces, buckles to prevent movement and rubbing of feet in the toes When you buy shoes, wear the type of socks that you usually wear Avoid slip on shoes, shoes with pointed toes, sandals, or flip flops. Always feel inside foot wear before you put footwear on to check for stores, rough edges etc. Tips include avoiding food burns and water burns – checking the bath temperature with your hand before stepping in to it It important to avoid using items such as hot water bottles, electric blankets or foot spas. Do not sit too close to fires. Further measures include looking very carefully at the feet each day including between the toes. This involves examining the area for reduced sensation in order to not miss any vital signs of the inset of a foot ulcer. It is also necessary to look for any cuts, abrasions, bruises, blisters, redness or bleeding. If any of these symptoms are spotted carers should immediately inform the nurse who is in charge who should in turn carry contact a podiatrist or similar specialist. Existing education provision To date education in diabetic foot ulcers takes several forms. NICE recommends that all people with diabetes should be offered structured education as an integral part of their diabetes management (www.nice.co.uk). The purpose of this is to raise awareness of the side-effects and complications of diabetes in those who suffer with it. This increases the chance for early identification of foot ulcer symptoms. The XPERT Programme was launched in 2007 to provide education to all health care professionals across Wales so they are able to give structured advice to patients with type2 diabetes. In addition the National Service Framework (NSF) (2001) for diabetes set out a ten year programme for change. It outlined evidence-based standards for the planning, organising, and delivery of diabetes services. This programme represents the Welsh Assembly’s strategy for improving diabetes and through the progressive implementation of the NSF the quality of care and treatment for those living with diabetes (www.wales.gov.uk). However within this long-term plan there is little direct reference to patients in residential or nursing homes. This is also the case with the Desmond, Dafne and Bertie programmes which have little relevance for the care of the elderly. Clearly there is a significant gap within the education of health care professionals. This gap is apparent in the nursing home where I work as none of the staff have received any particular training specifically related to diabetes mellitus. This clearly puts the residents of the home in an at risk category because the chances of their carers recognising the early symptoms of foot ulcers are substantially reduced. Within the nursing home and home care system however there does exist a health care specialist with the expertise to assist in raising awareness about the causes and prevention of foot ulcers; the podiatrist. The work of a podiatrist is overseen by the Chiropody Code Of Conduct which states that chiropodists and podiatrists must be able to work, where appropriate, in partnership with other professional support staff, service users and their relatives and carers. They should also ‘be able to demonstrate effective and appropriate skills in communicating information, advice, instruction and professional opinion to colleagues, service users, their relative s and carers’ (Standards of proficiency, Health Professions Council, 2009). However, in practice this is frequently not the case. The health support workers are not currently included in visits and are not given the opportunity to learn or ask questions when the podiatrists are called to review residents. Neither do they pass on information about their findings to staff on duty. Evidently there is an issue of communication. The podiatrist is not the only person with a professional duty to assist health care workers with their treatment of foot ulcers. The NMC code of conduct states that nurses should work with others to protect and promote the health and wellbeing of those in their care, their families and carers and the wider community. Therefore, the nurse in charge should ensure that learning opportunities are facilitated and that staff have feedback from these specialist visits which help to inform and improve the care delivered to residents. Education – best practice The current provision of education demonstrates that the education of health workers is largely at the discretion of their employers. If individual employers do decide to provide their staff with training there is little in the way of advice to follow and this can result in poorly informed, ill-conceived or simply inadequate education. At the same time it creates a situation whereby health care workers have to rely on experience gained on the job to identify the symptoms of foot ulcers or their own inclination to acquire further knowledge. For new members of the staff who lack experience there might exist a worrying amount of ignorance on the subject. There is however much potential to improve this situation. In best practice education takes a variety of forms. This may include formal study sessions, workplace booklets or posters and online education programmes. Therefore there is potential for foot ulcer education to be flexible and made to suit the particular needs of a workplace. At my workplace none of these options have been made available. Ideally the best situation would be a formal study session where the expert knowledge of a specialist can be imparted and where full training can be given. The information gained should then be reinforced at the workplace through posters or leaflets. Conclusion Conclusively it is very important that diabetic foot ulcers are prevented at all times while treating patients with diabetes, especially in the elderly who might for other reasons associated with dementia and impaired movement find it harder to care for themselves. Education of health care professionals is key in achieving this. They should have the necessary knowledge to help prevent foot ulcers, to recognise the first symptoms of one, and to provide effective treatment. They must also be able to advise the diabetes sufferer on how to care for their feet and how to avoid the contraction of a foot ulcer in the first instance. Despite this clear need for knowledgeable clinicians the situation as it currently stands fails to provide health care workers who look after the elderly with the training they require to the provide the best standard of service possible. Whilst measures are in place for the education of both diabetic sufferers and nurses, more work needs to be done on identifyi ng the educational requirements of those who care for elderly patients. Best practice in education should be drawn upon and formal training sessions organised alongside the better provision of information within the workplace. The expertise of specialists such as podiatrists should also utilised more effectively so that staff within the nursing home are well informed and understand the treatment their patients are undergoing and their specific needs. Communication is at the heart of this.

Modern Relationships

The advancement of technology does not only change man’s way of doing things but also it changes some aspects of his personal life. One of these aspects is in the area of  Ã‚   building relationships.   According to Maslow, one of man’s basic needs is belongingness and love. He stated that man basically wants to find someone whom he can love and be loved.   Relationships add meaning to his life and gave him a sense of purpose ( Maslow, 1954). With the discovery of the internet, that purpose is going to be fulfilled in a new way. The quest for a mate had always been a complicated procedure for most. Some have list of qualities and requirements that they want to find in someone while others do not know what they are looking for. All they know and hoped for is that there is someone for them out there in the world. Whoever comes along they always hoped he will be the special one but unfortunately they are not always right the first time. And so the quest continues. One way that modern man had taken advantage of for the quest is using the internet.   What is interesting about the World Wide Web is that it provided modern man the chance to meet different people from different culture and religious background. With the use of   his fingers , he can easily   meet someone from anywhere in the world   at any time. It is because anybody can connect to any chatrooms or websites that advertises various individuals looking for someone to love. Others may be skeptical about this idea simply because you actually do not know the real person behind the face. And many (mostly conservative ones) would suspect that no lasting relationships can ever be established from internet dating. They feel that everyone was just out there to fool or take advantage of somebody. They also reasoned that if it is hard to make a relationship work with someone you personally know for years how much harder will it be if you commit to a relationship with someone you only know in the internet. And how more complicated will it be if that person came from another country and practicing another religion! While the above argument may have some truth in it, internet dating continues to become a popular means of modern man to find someone to love. Their reasons may vary. Others find communicating in the internet easier. Communication had always been a problem of any relationships. Some people just cannot express themselves to those who already know them for years. They cannot relate their disappointments, frustrations and broken dreams for fear of rejection or betrayal. So they pretended to be strong and able to conquer the world while in reality they are on the verge of collapsing.   But the internet had provided them a different scenario. In there they find people who do not know them and therefore had no basis to judge. And since the other person is so far away in the world to do them any harm, they freely began to talk about themselves and later they realized that they were accepted for who they were. They do not need to wear a mask. And because of that they were willing to take the relationship to the next level. Another reason why people go for internet dating is because they find it challenging to do so. They are mostly adventurous individuals who are curios to learn about other cultures and religion. They do not fear these differences because they have the capacity to accept people’s differences from their own. For example modern America is a place of diverse nationalities, and most Americans had been an eyewitness of successful relationships between two people of diverse culture and religion. They figure that if they possessed a heart of understanding and acceptance any relationship can work. 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The only thing that can really break their relationship now is if they really wanted to in the first place. Most people would never see themselves finding someone through the internet. They may utilize the net for an already formed relationship outside the internet (like the above example where one lover had to go away for some place) but to really find someone in the net is next to impossible for them. People who do this are usually very careful in life, they are afraid to make mistakes and for them it is a mistake to find someone in the net. But times had changed. In reality, there are many sensible people in the net. Decent modern men and women now take part in internet dating.   Their rule of thumb is to  Ã‚   use their head, be smart and stay away from suspicious people. It is true that many get fooled in the internet. But it is because they ignored the warning signs. People who do nasty things in the net and who request to see some private parts are not to be trusted. They do not possess any self-respect and will most likely make a mate’s life miserable. People that can be trusted are those who communicate respectfully and talk about wholesome matters.   But still in spite of that, a person should be watchful who he/she is talking or committing to. Even with the modern way of building relationships, using the head and lots of prayers are still the best means of finding the right person. Reference Maslow, Abraham H. (1954). Motivation and Personality. New York: Harper and Row Publishers, Incorporated   

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Americans in Poverty Cannot Eat with Integrity - Essay Example Many poor Americans cannot eat food with integrity because they do not like being seen as if they are poor yet they are poor. Even if they wish to eat with integrity, they do not know what to eat that will not affect their health. They want to associate themselves with the food taken by the high and the mighty in the nation (Ikerd). They decline from taking the best food that is free from intoxications brought about by preservation methods, processing and so many other processes food is passed through up to the point of being sold. In the process of transporting the processed food, there are various things done to the food which results in intoxication (Nielsen 31). The methods used to grow food also affect the quality of food hence making it harmful to the human health for instance, if genetically modified organisms were used. There are a lot of wastes from the industrial farming which affects the quality of the food people eat. This affects the conventions of producing integrity fo ods. The quality of food with integrity needs to be produced in consistent with the values of the community, beliefs and principles. This is not possible nowadays because there is a lot of inhumane handling of animal bred for food purposes. There are few people entrusted to handling food growth that is free from chemicals but none is focused to ensure they act upon the needs of the people. Americans shunned the foods with integrity because no fair treatment of food with integrity can be trusted. The people responsible for protesting or become citizen activists become silenced by the emerging giant industries producing such foods (Nielsen 30). The Americans have shown a preference for foods grown in the United States than from other regions. Most of the Americans capitalize on eating organic foods because they do not contain pesticide residues and other effects of farming effects but, it is hard to tell the difference with the GMOs. The genetically modified organisms (GMOs) are known to be harmful to the health or individuals (Ikerd). Whether the Americans are poor or not, they tend to be strict about the food they eat because they do not like contamination of the unhealthy food. They cannot eat food that have been killed humanely because they feel that meat from genetically modified organisms provide a means of maximizing exposure to the growth of antibiotics and hormones that are fed to animals. These antibiotics are given to animals under inhumane conditions and environment which is why they fear the meat even if it is killed in humane procedures (Eating with Integrity). American historical commitments into organic food influence how they consider the organic substances in relation to the inorganic or the genetically modified organism. They are committed to ensuring that the society has a healthy foundation by watching the food they take as well as the drinks (Ikerd). All this is done to build healthy communities and permanence within the society. The organi c movement that is rampant in the country emphasizes of the health more than safety of the food (Ikerd). Because of the fact that people want to watch their health, they advocate for safe eating habits than taking of food with chemicals that can intoxicate their health. There is an international slow food movement which provides tangible evidence of the new global culture of food. The slow food is a worldwide movement that has more than eighty thousand members in one hundred countries.

Exam Essay Example | Topics and Well Written Essays - 1250 words - 6

Exam - Essay Example The marketing process involves the following five steps: An evaluation of the marketplace to identify the consumers’ needs and wants. Consumers are rational; that is, they seek for products that will maximize their utility. Marketers need to conduct a market analysis to identify whether the consumer needs can be met through a new product or an advancement of the existing products. After sales services are also considered at this stage. Consumers would be influenced to purchase a product if the marketers offer significant after sales services. After identifying the consumers’ needs and wants, marketers should design a consumer driven strategy. The strategy formulated ought to be in line with the identified customer needs and wants. A comprehensive strategy is one which is formulated in line with the customer needs and wants. Marketers may also decide to segment the customers. This will ensure that similar consumer needs are grouped together for better attention. The third stage involves formulating a marketing mix, which matches the needs of the targeted market. The marketing mix involves; designing a perfect commodity, formulating favourable pricing decisions, distributing the products to the right places, and adopting the right promotional techniques: Products, place, price and promotions (4ps). These components of this stage will dictate the manner in which the company will penetrate the market; in terms of producing a product that matches the needs and wants of every consumer, charging a favourable price and adopting a suitable promotional strategy. A company should ensure that it builds and manages a profitable consumer relationship. Relationship management is an important component of contemporary marketing. This step focuses on gaining customer loyalty. This is only achievable through creating a positive and profitable customer relationship; referred to

Factors Determining the Information System Strategy for Global Firms Essay

Factors Determining the Information System Strategy for Global Firms - Essay Example ‘Factors determining the information system strategy for global firms’ identifies the strategies and issues that some prominent global enterprises have; classifies which organizational factors affect the decision making process of an organization when it is choosing an is strategy; gains knowledge on the impact of is on global business organizations and their role in tackling the market competition; carefully studies the factors that impact on the failures of is strategies in global business organizations. Numerous factors determine IS strategy, especially organizational characteristics. These are important, especially in terms of attitude, constraints, structure, system characteristics, â€Å"commonality†, size, technology, type, and criticality, IS department characteristics, and IS success factors. Quantitative results show that organizational factors such organizational attitudes and constraints and organizational structure have significant effect on IS strate gy decisions. Similarly, the results show that system characteristics such as â€Å"commonality, size, technology, and criticality† are important and are considered while making IS strategy choice decisions. Moreover, the results of qualitative analysis show that factors such as organizational structure and organizational attitudes and constraints are amongst the important organizational factors that need complete considerations while making IS strategy choices. Furthermore, system characteristics, such as the size of the project and criticality type of technology have been found to be important factors in IS strategy decisions. ... tem characteristics 19 Chapter 3: Research Methodology 21 3.1Research Approach 22 3.2 Positivist Paradigm 22 3.2 Interpretivist Paradigm 23 3.3Quantitative Research 24 3.4 Qualitative Research 25 3.5 Qualitative interview 25 3.6 Data Collection and Analysis 26 3.7 Regression Model 28 3.8 Research Ethics 28 3.9 Case Study Company: Projects System Holding Company 29 3.10 Summary 30 Chapter 4: Results, Analysis, and Discussion 32 4.1 Introduction 33 4.1.2 Regression Analysis 41 4.2 Organizational Characteristics and Is Strategy 46 4.3 System Characteristics and IS Strategy: 47 4.4 Summary of Quantitative Analysis 48 4.5 Qualitative Analysis 48 4.6 Questionnaire Research 50 Chapter 5: Discussion and conclusion 55 5.1 Discussion and Conclusion 56 Many companies are implementing innovative plans while dealing with various challenges that are initiated by globalization, and due to this reason, they started investing in other countries through different plans and strategies by adopting novel systems, tools and techniques for meeting customers’ needs world-wide. But the adoption of information systems (IS) has been one of the main sources to seek help in compensating for and countering the challenges, and thus organizations use various strategies to adopt IS. Previous literature suggests that many factors determine IS strategy such as Organizational characteristics in terms of attitude and constraints and structure, system characteristics, in terms of â€Å"technology, size, type, criticality and commonality, IS department characteristics, and success factors (Akmanligil & Palvia, 2004). However, this study, keeping in view the importance of organizational characteristics and system characteristics and lack of empiricism in the extant literature (Akmanligil & Palvia, 2004), uses

Paintings of Picasso during the Modernism Essay

Paintings of Picasso during the Modernism - Essay Example The essay "Paintings of Picasso during the Modernism " will help to understand the role of Pablo Picasso's art in the modernism. Art paintings that emphasizes material content and the social perception is perceivable as incomplete compared to art paintings in which the content is down played, and formal elements emphasized. The principles of modernism period are clearly visible in the works of Pablo Picasso, who perhaps can be considered as the most illustrious modern painter; conversely, the difference that exists between content and form is not one-sided or simplistic. Considerably, Pablo Picasso's paintings were not absolutely abstract; in most instances the paintings contained references, though unclear, to the material art world. Furthermore, while Pablo's paintings were characteristically concerned with the Cubism and universality, it helped shape and model abstract art. Social elements that were of interest then were incorporated in most of his works. Incorporation of social e lements in his works further complicated Picasso’s stature as a modernist artist. Consequently, though Picasso's art paintings encompass modernistic elements they are considerable as more complex in a modernistic sense because of all the elements incorporated in them. In the early 1900s, Picasso instigated his first unique style, which is referred to as the Picasso’s blue period. He restricted the color scheme he employed to blue, Picasso illustrated withered and solitude body forms whose figures and appearance signified the inferiority.

Social Movements Essay Example for Free

Social Movements Essay The black struggle for civil rights are tracing their origins back to the arrival of the first Africans in America and also to their work in manufacturing firms, plantations and homes of Americans Taylor, (2000). The civil rights were born as labour movements to fight for the alienated immigrants to have equal rights in America. Since then these movements in the United States have been primarily considered as nonviolent movements that struggle to bring equality and full civil rights for all the American people under the American laws. Most of these movements had long lasting impacts in tactics and increased social and legal acceptance of the civil rights movements because they brought abilities the exposure of the existing and persistent racism and its cost. The American civil rights movement has been made up of many movements though these movements have always been referred to as struggles between 1945 and 1970s. Many movements were initiated but they did not achieve much in terms of political legal social and economic liberations. This was due to their inability to mobilize people to join in their struggle for liberation. However there were two civil rights movements that achieved greater success and can be considered to be the most effective groups. In this case effectiveness of a movement would be defined as; the ability of a movement to mobilize people to join in its activities it’s capacity to make fundamental changes and it’s ability to leave behind legacies in cases of decline or when banned from operating in a state. The civil rights movements that achieved these were the NAACR and UNIA both which had their headquarters in the US and had large support from blacks and social democrats of white origin. The most effective civil rights movement in the USA in the 20th century was the National Association for the Advancement of Colored People (NAACP). This was and still is the most influential movement in the USA. A large group of people but from different races founded it on November 12 1909. The founding fathers of NAACP included DUBOIS and Ida Wells-Barnet who were African Americans, Henry Moskowitz (A Jew). Mary White Orrington (white) Oswald Carrison Villad (German born white) and William English Walling (white son of former slave owning family: In 1905 Du Bois advocated for a meeting in a Canadian hotel some meters from Niagara tells, to discuss the challenges facing â€Å"people of color†. People of color were the then used to refer to the blacks in America. 32 prominent African American people attended the meeting and this movement was called the Niagara movement. A year later, the whites that were against racism joined the Du Bois team. The Niagara movement then approached some 60 prominent Americans of the day to ensure that they broaden its membership to be more effective and have larger scope. It then changed from Niagara falls movement to NAACP in 1910 and the name was formerly adopted in may 30, 1910. NAACP was more viable reliable influential and diverse organization due to its mission. The mission of NAACP according to Mann (2000) was to promote equality of rights and to evaluate cost or value of racial prejudice among American citizens, to secure for the â€Å"colored people† importance suffering, to advocate for their interests, to increase their ability and opportunities for securing education for the children, justice in the courts, employment with accordance to their ability and complete equality before the American law. As Mann (2006) argues in his book; Katrina’s Legacy, he has identified the black-led movements to be more important than man-made disasters of Katrina as very important and significant to the possibilities of controlling imperialistic and capitalistic ways of life. They are also very vital in the transformation of a destructors and unstable imperialism and white supremacy. From Mann’s argument it is therefore very obvious that NAACP was effective in terms of democratic vision, ability to mobilize more members and ability to eradicate the racial prejudice. NAACP through Jim Crow’s states that were meant to legalize racial discrimination and by 1913s the people of color would go to the notes and any other restricted areas. NAACP’s president and board members were on in 1913 to oppose president5 Woodrow Wilson’s introduction of racial discrimination and segregation in the federal government policy. To be more effective the NAACP is having four departments within if; the department of education, legal office, health department and the local departments based in member colleges and towns. The legal department is entitled to legal maters. If facieses court cases with broad importance to minorities for instance, handles legal matters pertaining to systematic racial discrimination in employment, educational institutions, health institutions and recreational institutions. It is also entitled to pursuit legal cases involving government discrimination. The health division is endowed with the responsibility of advancing proper health care for minorities through public policy inanities and education. Through education the minorities are reminded about their rights to health care and all the legal frameworks that guides medical services and practitioners. The NAACP is having a Bureau in Washington DC which is responsible for lobbying for the US government. While the education department works in all the member states to improve the quality of education offered a t several atate4 and local levels. The local youth and college department are responsible for the organization of activities for individual members. In terms of mobilization of members NAACP has been able to recruit very many individuals since its initiation in the early 1900s. The headquarters of NAACP is based in Baltimore Maryland with regional offices in states of Texas, California, Georgia, New York, Missouri and Michigan. The regional offices are supposed to coordinate the efforts of state conferences and any other included within the region. 64 members board of directors runs NAACP with each coming from the member states. The Board elects their president and chief executive office for the organization, under the leadership of a chairperson of the board. Currently NAACP is approximately 400,000 people, this includes paying and non-paying members. The main political achievement of NAACP was its National Voter Fund to launch a major get-out-the vote offensive during the 200 US presidential elections. This saw about 10. 5 million African Americans cast their ballots in the presidential elections, a number which was estimated to be 1 million more people than four years before. This achievement was greatly credited by the international observers and they congratulated NAACP for playing a very important role in handling the Ai-Gore states as Michigan and Pennsylvania where elections were close. In the late 1970s Marcus Garvey found black liberation movement to fight against the oppressive rules against the blacks and non-blacks in Diasporas. Garvey’s movement was considered the most original innovative and important of all the movements of late 19th century. This movement was geared towards the struggle for black and African liberation and it provided a very powerful inspirations and valuable teachings for black and non-black member in the Caribbean countries. In early 1900s Garvey moved into the US and started an extremely successful movement known as The Universal Negro Improvement Association (UNIA). Thousands of UNIA chapters developed in the four continents, because it was viewed, as would be new and successful road to cultural, economic, political and social liberation for blacks and African nations. As NAACP, UNIA also proved very effective in liberation of the blacks through initiating several organizations and groups. The black women association was initiated to fight against racial prejudice among black women and was to advocate for their civil rights in the society. The musical group was aimed at fighting for the rights of the black musicians who had interest in the music industry. It opposed the limits set for the black musicians and called for participations from the ghettos to the gypsies and anybody who had interest and abilities. UNIA saw the initiation of the African Orthodox Church to carter for religious needs of the Africans. This saw the end of discrimination in the then missionary churches in Africa. To ensure that all the blacks and Africans got access to proper and reliable medical services the movement initiated ‘The Back Nurses’ Association to offer medical services needed by members of UNIA. Further on UNIA was able to initiate an internationally distributed newspaper ‘The Negro’ throughout the world. This was a means of education to the blacks stressing on self-reliance and critical evaluation of the books written by the whites about Africa and the blacks. The newspaper would also correct the overcritisism of the black movement and instead unveil the scenes of the whites associated with lynching of blacks. UNIA also developed black economic corporations for example the famous ‘Black Star Lines’ shipping company. Several ships were bought for this company and it was intended to bring back the Africans who were interested in going back to their original homeland. However during the period between 1920 and 1923 UNIA was faced with a decline because the US government for alleged fraud in the international transactions involving the ‘Black Star Lines’ imprisoned Marcus. Other African nations like Liberia refused to accept the blacks from Europe and the US. The movement also suffered persecutions from imperialists and capitalist governments. However UNIA is not dead as it would be for the US government it’s legacy still lives on to this century. Scholars like Mann (2000) are still advocating for the reinforcement of the historical perspectives, which are deeply rooted in centuries of struggle by black liberation. Mann thinks that capitalism, colonialism and imperialism have devastated environment and human lives, so struggle by the oppressed and the colonized is the main tool for liberation which in turn is the key to building new, more just, ecologically-sound and humane society. Though Garvey was jailed and later on released and deported to Jamaica his movement for the blacks UNIA still had great influence in the US. There are some movements that owe their origin to UNIA for example The Black Muslims Association and Neo-Garveyist Movements. He inspired numerous African leaders to fight for colonial liberation. For instance the first Ghanaian president Kwame Nkrumah appreciated the self-reliance calls made by Garvey in his books. Kenya’s first president who was a revolutionary leader Jimo Kenyatta was also inspired by Garvey’s works, Kenyata’s renown labour activist Tom Mboya also borrowed ideas from Garvey. On any occasions of independence attained in Africa scholars like Malcolm X would link it to Garvey’s colonial liberation. Malcolm argues that any independence attained kept the spirit of Garvey alive. UNIA’s legacy still lives on as all sided and the largest black movement with totality of cultural, political, economic and spiritual liberation. It is also the movement that achieved greatest strength internationalism, with membership of more than 25 nations with local chapters in each member country. UNIA also had approximately 2,000 delegates from all over the world. NAACP and UNIA were both civil rights organizations aimed at working on behalf of the African Americans and the blacks to fight for their rights. NAACP retained the name ‘Color People’ in accordance with the tradition of the last surviving users that is the few colored people still found in the US. UNIA on the other hand had advocated for self-reliance and critical analysis and evaluation of the literature by white people. The movement was virtually fighting for black liberations in issues related to land ownership, reparations, full democratic rights and the right of self-surficiency. Therefore it can be said that both NAACP and UNIA played a very important and significant role in black liberation because both contributed to the racial prejudice and disintegration as well as colonialism that were oppressive to the blacks. NAACP is still very vital in advocating for changes in the contemporary society. For instance it opposed election of president W Bush associating him with racism and other oppressions towards African Americans. President Robert Mugabe is still keeping the spirit of Garvey burning by insisting on a self-reliant Zimbabwe and he has locked out all the international aids to his people. It’s therefore evident that NAACP and UNIA have largely contributed to major radical changes in US. References Erick Mann (2006) Katrina’s Legacy; White Racism And Black Reconstruction In New Orleans and Gulf Coast, Frontlines Press, Los Angels. Jonathan B, Clevance Taylor, (ed) (2000), Civil Rights Since 1787;A Reader On The Black Struggle, NYU, Press, New York.

Survey of Satisfaction with College Facilities

Survey of Satisfaction with College Facilities Assignment 1 1. Plan for collection of Primary data and secondary data Primary data is the data which is collected directly from the field, i.e., it is first hand data and the secondary data is collected from some other source, i.e. second hand data. In this given problem primary data can be collected through interview to the Students and Staffs of the college. A Questionnaire will be prepared which will be filled up on the response of these individuals. Based on the information provided by them the database will be prepared and thus the primary data will be collected. In case of secondary data, the data could be collected from any organization / department which collects the school/college data or from any journal or from any Researcher. 2. Present the survey methodology and sampling frame used There are different areas in the college which are simultaneously used both by the Students of the college as well as the Staffs of the college. Considering those area alongwith few other he questionnaire is prepared. The survey will be then conducted on the basis of that and a selected sample will be chosen randomly from the students and from the staffs. Here since one has to plan a survey methodology, first thing which has to be done is to identify the sample members. For this purpose a total number of 50 individuals may be selected form70 students and 30 staffs taking 50% from each group (that is 35+15=50). Now, the Interview method will be used here for collection of data. Data on satisfaction level of each individual will be collected on different variables. Once the sampling units is finalized, sampling frame needed to be done. Sampling frame is basically the area/ space from where the sampling is to be done. Here one has to see whether all the units in the population are avail able in the sample. List of students and staffs must be representative of all classes and segments of the college. The level of satisfaction will be coded as 5= very good, 4= good, 3= average, 2= bad, 1= very bad, in five categories, following Likert scaling. 3. Design a questionnaire to know the opinion of students and staff on the matter Gender†¦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‚¬ ¦ Origin †¦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‚¬ ¦. Age†¦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‚¬ ¦.. Very good Good Average Bad Very Bad How much satisfied are you on the overall infrastructure of the college? How much satisfied will you be if Laundry facilities are available? How much satisfied are you with the Hostel facilities of the college? How much satisfied are you with the gym? How much satisfied are you with the parking facility of the college? How much satisfied are you on the toilet facilities? How much satisfied are you on the structure of labs in the college? 4. Information for decision making by summarizing data using representative values The data collected from the after the survey is recoded as per Likert scaling and is as below: How much satisfied are you on the overall infrastructure of the college? How much satisfied will you be if Laundry facilities are available? How much satisfied are you with the Hostel facilities of the college? How much satisfied are you with the gym? How much satisfied are you with the parking facility of the college? How much satisfied are you on the toilet facilities? How much satisfied are you on the structure of labs in the college? 1 4 2 2 5 2 2 4 2 5 4 4 2 3 4 2 3 3 2 2 4 2 2 4 4 5 1 1 2 4 3 4 5 4 2 2 1 2 5 4 6 1 4 2 2 1 2 4 7 2 2 4 4 2 4 2 8 5 3 2 2 4 5 5 9 3 5 1 3 2 2 4 10 4 2 2 5 3 2 2 11 4 4 4 4 5 4 4 12 5 5 2 5 2 4 2 13 2 2 3 4 4 1 4 14 4 2 2 2 2 2 4 15 5 4 4 4 4 3 4 16 3 4 2 4 2 2 4 17 2 1 1 4 1 1 2 18 4 2 2 5 2 2 5 19 5 3 4 4 4 3 4 20 1 2 2 2 2 2 2 21 4 1 3 4 3 1 2 22 5 2 5 4 5 2 2 23 2 3 2 4 2 3 4 24 5 2 4 4 4 4 2 25 4 1 2 2 5 4 3 26 5 2 4 5 2 4 5 27 4 3 2 4 4 2 2 28 3 4 1 2 2 3 4 29 5 4 2 1 1 5 5 30 4 4 4 2 2 2 2 31 3 4 2 4 5 4 2 32 4 2 3 2 2 2 4 33 5 3 5 3 4 4 4 34 3 2 2 2 2 2 1 35 5 4 4 4 1 1 2 36 4 3 5 2 2 2 3 37 3 2 2 1 4 4 2 38 4 4 2 2 2 2 1 39 5 4 4 4 3 3 2 40 3 2 4 2 5 5 3 41 5 5 1 3 4 2 2 42 4 4 2 5 5 2 1 43 5 2 3 4 4 1 2 44 3 4 2 2 2 2 3 45 5 4 1 4 4 2 4 46 4 4 2 4 4 1 2 47 5 4 3 4 4 2 4 48 3 2 2 4 4 4 2 49 5 5 4 2 3 2 3 50 4 4 3 5 3 3 5 5. For Analytical; purpose the variables are denoting as below: How much satisfied are you on the overall infrastructure of the college? How much satisfied will you be if Laundry facilities are available? How much satisfied are you with the Hostel facilities of the college? How much satisfied are you with the gym? How much satisfied are you with the parking facility of the college? How much satisfied are you on the toilet facilities? How much satisfied are you on the structure of labs in the college? overall infrastructure Laundry facilities Hostel facilities gym parking facility toilet facilities structure of labs Mean overall infrastructure 3.88 Laundry facilities 3 Hostel facilities 2.66 gym 3.26 parking facility 3 toilet facilities 2.7 structure of labs 3.06 The average of the Overall infrastructure is 3.88 which indicated that on average people are recognizing the overall infrastructure as almost â€Å"GOOD†. When it was asked â€Å"How much satisfied will you be if Laundry facilities are available?†, the mean response is 3 which is Average. This is quite sensible because this facility is yet to be there in the college. Regarding â€Å"Hostel facilities†, the average response is below averages which indicate that there is some urgent need to repair this sector. Gym facility is slightly more than the â€Å"Average†. The condition is better than â€Å"Average† but less than â€Å"Good† In case of â€Å"parking facility† the satisfaction level is exactly â€Å"Average† which indicates that there is scope to improve the sector. Satisfaction level on â€Å"Toilet facilities† is below average which also requires urgent attention of the college authority. Structure of Labs also requires some kind of attention. 6. Drawing valid conclusions based on information derived from the survey Laundry The above diagram shows that 36% are saying good to Laundry facility and also 36% is recognizing it as Bad. Only 8% is saying it â€Å"very Good† and 8% is saying very Bad. Some kind of symmetrical situation is observed here. It seems that the service provider is paying good attention to selected individuals. Hostel facilities In case of Hostel 46% saying it â€Å"Bad† and this is a matter of concern. While discussing with Average values, the data indicates the same urgency. But at the same time it can be observed that 24% , which is in 2nd position as far as percentages in concern, is saying is good. It may indicate that some portion of the Hostel is having better situation than the rest. Also 6% feeling their accommodation as â€Å"Very Good†. Gym While discussing about Gym, which is yet to be established, 48% is in favour of this, out of which 42% saying it as a Good facility and 6% as â€Å"Very Good† facility. Parking The above diagram shows that 38% are saying â€Å"Bad† to Parking facility and also 30% is recognizing it as â€Å"Good†. Only 8% is saying it â€Å"very Bad† and 12% is saying â€Å"Very Good†. Toilet In case of Toilet 44% saying it â€Å"Bad† and this is also a matter of concern. While discussing with Average values, the data indicates the same urgency. But at the same time it can be observed that 22% is saying is good. It may indicate that there is also some better situation. Also 8% feeling as â€Å"Very Good†. Lab In case of Lab, which is more related to education, 46% is in favour of this, out of which 36% saying it as a Good facility and 10% as â€Å"Very Good† facility. 7. Trend lines Now as per the given question, the trend lines have to be created in the spreadsheet graph. For this purpose , here the intercept is considered as zero(0) and then the equation is shown alongwith the scatter plot and the trend line. Here the first variable â€Å"Overall infrastructure† is considered as the Dependent Variable and there are other six independent variable. Taking each Independent variables separately, the trend line along with the graph will be created. Case 1. Overall infrastructure and Satisfaction on Laundry: As shown in the graph, the required equation is Y=.732x Case 2. Overall infrastructure and Satisfaction on Hostel: The required equation is Y= .659X Case 3. Overall infrastructure and Satisfaction on Gym : The required equation is Y= .787X Case 4. Overall infrastructure and Satisfaction on Parking facility : The equation here is Y= .740X. Case 5. Overall infrastructure and Satisfaction on Toilet facility : Here the equation is Y=.656x Case 5.Overall infrastructure and Satisfaction on Toilet facility : Here the equation is Y= .735x 9.Business Report All the equations are formed considering the variables separately. In each equation, if value of x is given, the estimated value of Y will be obtained by solving the equation with simple calculation. The dependent variable is considered as â€Å"Overall infrastructure:† which actually says whether there is really any need of ‘refurbishing the whole college† or not. This dependent variable depends on several other issues/ factors as considered as Independent variable. So, taking care or giving attention on those areas actually help the project to take decision whether or not this could be done. The above analysis tells which area needs utmost attention and which area is somehow okay up to this. Based on the analysis, one could say that the two issues .i.e. Toilet and Hostel need to be addressed seriously. Assignment 2 Question No.1 X = scores of a market survey regarding the acceptability of a new product launch by a company Frequency Table with a class interval of 5 Class interval 5-10 10-15 15-20 20-25 25-30 30-35 35-40 40-45 45-50 frequency 2 0 1 1 6 2 10 8 2 Mean, variance and standard deviation. Mean () = ,where N = and Variance = ÏÆ'2= 2 Standard Deviation = Square root of variance. And Xi here will be the mid value of the class interval. The following table is being constructed for the required calculations. Class interval mid value(xi) frequency 5-10 7.5 2 10-15 12.5 0 15-20 17.5 1 20-25 22.5 1 25-30 27.5 6 30-35 32.5 2 35-40 37.5 10 40-45 42.5 8 45-50 47.5 2 247.5 = 32 Here mid value(xi) frequency 7.5 2 56.25 15 112.5 12.5 0 156.25 0 0 17.5 1 306.25 17.5 306.25 22.5 1 506.25 22.5 506.25 27.5 6 756.25 165 4537.5 32.5 2 1056.25 65 2112.5 37.5 10 1406.25 375 14062.5 42.5 8 1806.25 340 14450 47.5 2 2256.25 95 4512.5 247.5 = 32 = 8306.25 = 1095 = 40600 Mean = = 1095/32 = 34.22 Variance = ÏÆ'2= (40600/32) – (34.22)2 = 97.83 Standard Deviation = Square root of variance =9.90 Score corresponding to 50% percentile. 50% percentile is also the median. Here the data set has to be written in increasing order 8 8 18 25 26 26 27 27 29 30 32 35 36 37 38 39 39 39 40 40 40 40 41 41 42 43 44 44 45 45 48 49 There are 32 observations in all => There will be two middle values. The average of those two middle values will be the value corresponding to 50% percentile or the Median. Now since both are 39 implies the average is also 39. So, it could be said that the score 39 corresponds to 50% percentile. Calculate the location of third quartile. Rewriting the data set in increasing order: 8 8 18 25 26 26 27

Gibbs reflective cycle

Gibbs reflective cycle Gibbs’ reflective cycle has 6 stages. They are usually given the following headings: 1. Description 2. Feelings 3. Evaluation 4. Analysis 5. Conclusion 6. Action Plan As part of my Overseas Nurse program, I am required to make a reflective essay. This essay is based on my experience in clinical placement in the Operating Theatre. The aim of this essay is to discuss my learnings about the importance of team briefing, principles of asepsis, and Surgical Handscrubbing, as well as experiences throughout my placement. I have come to select the Gibbs reflective framework for this for I feel that through this framework I can better express in a systematic manner the describe the incidents, feelings, and how I was able learn. Learning Outcome 1: Team Brief and WHO Surgical Safety Checklist In June 2008, the World Health Organization (WHO) implemented a second Global Patient Safety Challenge, ‘Safe Surgery Saves Lives’, to reduce the incidence of surgical deaths across the entire world. The initiative was developed to strengthen and improve the commitment of clinical staff to address safety issues within the surgical setting. This included improving anaesthetic safety practices, ensuring correct site surgery, avoiding surgical site infections and improving communication and teamwork within the team. The WHO Surgical Safety Checklist is a core set of safety checks, identified for improving performance at safety critical time points within the patient’s intraoperative care pathway. It is for use in any operating theatre environment, including interventional radiology with the expectation that it can be adapted to fit local practice. The three steps in the checklist (sign in, time out, sign out) are not intended as a tick box exercise, but as a tool to initiate meaningful and purposeful conversation between relevant members of the clinical team to improve the safety of surgery. According to the National Patient Safety Agency, NHS, there are five steps to safer surgeries. Namely Briefing, Sign in, Time out, Sign out and Debriefing. During my placement, I was assigned to circulate in theatre two. One of the five running theatres that our hospital has. The there was only one case. Patient Keiser (not the real name). 63 year old male consented for a Primary Total Knee replacement under general anesthesia using a Zimmer â€Å"NexGen† Knee system. I was nervous because it was a major case and I needed to be quick with my actions and be focused. I did my reading a day before so I had an idea of about the sequence of the operation. Before the patient was escorted to the theatre, the surgical team together with the anesthesia team had a team brief. In the briefing the patient details, laterality of site were confirmed as well as medication allergies, number of staff and availability of implants were all discussed. Everything went smoothly. The patient was then escorted to the anesthetic room and additional checks, verifications, and the sign in was done in the anesthetic room. The patient claimed that he had a nickel allergy and that he would get mild rashes when in contact with the metal property. The ODP (Operating Department Personnel) the person who is responsible for assisting the anesthetist and initiating the WHO Checklist was fully aware of this metal allergy as it was also reflected in the care plan and preassessment. The incident happened when the ODP and anesthetist failed to inform the scrub team about the specific allergy because they thought a nickel allergy had no significance. They were only conc erned with medication allergies. So they continued and put the patient to sleep with propofol and other anesthetic agents. The patient was then brought in the theatre with use of the trolley and placed safely on the Operating table. The scrub team on the other hand was almost done preparing the field and assembling equipment needed for the operation. When everything was ready. Being the circulating nurse, I then continued the WHO checklist and initiated the Time-out. The consent, patient verification and allergies were then reviewed but this time the ODP informed the team about the nickel allergy. The surgeon went ballistic! And ordered that the patient be woken up. There was a heated discussion between the surgeon and anesthetist and it they eventually had to wake the patient up. It was then explained to us by the surgeon that the System and implants to be used during the operation had a very small percentage of nickel present in its components which could cause a reaction if used to the patient. He was angry because it was the second time it happened to him and he did not want to go through all the paper works again. The patient was brought to recovery and woke up in a few minutes. The surgeon then explained the incident and unfortunately the operation was cancelled. The opened sterile instruments, supplies, and consumables were all put to waste. As I analyzed what happened, the mistake clearly rooted back to the team brief. There were vital information that the anesthetic team knew about the patient that was not shared to the scrub team because they did not see it as important. I personally think every allergy, be it medication, metal or objects should be taken into consideration. It was a major case and the team had to know everything relevant. I realized how important the team brief was. Often I would observe other teams not taking the team brief seriously. They would just breeze through it as if was just some unimportant routinely work. After the incident I learned a lot and the view I had on the team briefing and the importance of the WHO checklist drastically changed. It is a very important tool in ensuring a safe, effective and successful operation. I now plan to practice a thorough team brief as well as executing a proper WHO checklist. You never know, missing out on one important fact could mean a life of a patient. Learning Outcome 2: Principle of asepsis: Asepsis can be defined as the absence of pathogenic microorganisms that cause disease. It then can also be referred to as clean technique (Phillips, 2013). However, elimination of infection is the goal of asepsis, not sterility. (Ayliffe et al. 2000) suggest that there are two types of asepsis: medical and surgical asepsis. Medical or clean asepsis reduces the number of organisms and prevents their spread; surgical or sterile asepsis includes procedures to eliminatemicro-organismsfrom an area and is practised byhealth care workersand nurses in operating theaters and treatment areas. There are several principles of surgical asepsis. Although all are equally important, I have come to be more cautious and alert of specific principles more often than others. One principle I have chosen to share with is a principle stating that People who are sterile touches only sterile items or areas. (reference) It may seem as a very simple principle to follow but it could be at times difficult to imbed in our system. May it be a scrub role or circulating role this is one of the key things one should always keep in mind. I had one incident during placement relating to this. It happened during an early shift of a busy Friday. There were 52 operations to be done that morning. Everyone was on the go. For some time now I have been with an orthopedic team but this time I was assigned with my mentor to assist a list of over 6 cataract extractions with ocular lens implantation. She was to scrub and I was to assist with the circulating role. Coming into this list I had not assisted a cataract extraction in the last 4 years. My knowledge was very minimal although I knew the purpose and roughly the length of time needed to finish the procedure in general but I did not know much about the fine instruments needed, supplies and set up of the Centurion Vision. Everything was new to me and I felt much pressured to deliver and I was uncomfortable knowing I could make mistakes. As the operation began my mentor scrubbed in and she was too busy to guide me thoroughly at the moment. The surgeon and scrub started asking me to position the machine according to the surgeon’s preference. I was reprimanded for being slow and hesitant since the surgeon was ready to start. After finally connecting the plugs, foot pedals as well positioning the Centurion Machine above the patients head, the surgeon placed sterile plastic covers over each of the handles of the machine. These sterile plastic handles where used as a sterile field so that the surgeon can hold the machine. Like the principle states, only sterile people should touch sterile things and the other way around for unsterile. Already being reprimanded I was nervous that I would make another mistake and unfortunately I did. The surgeon wanted me to reposition the machine yet again to his preference but this time I unconsciously forgot my principles and touched the sterile handle and I compromised the sterility of the field. The surgeon requested for another sterile handle and the case was delayed. I felt very bad knowing that I knew the principle but still it just slipped my mind and I committed an error which compromised the operation someway. After the incident I knew what I needed to do and how to position the machine efficiently and quickly. I already knew the preferred position and supplies needed. I just needed to be more focused, less anxious and hesitant and be more confident this way I would not make mistakes of that degree. The first case finished and I was able to effectively circulate on the remaining cases with carefulness, confidence, focus and efficiency. Learning outcome 3: Surgical Hand scrubbing Microorganisms transfer from the hands of health care providers to patients; this is an Important factor with regard to health-care associated infections (i.e. nosocomial). Skin is a major source of microbial contamination in the surgical environment. Although the scrubbed members of the surgical team are wearing surgical gloves and gowns, their hands and forearms are to be cleaned preoperatively to significantly reduce the number of microorganisms (AORN 2006) According to the WHO Guidelines on Hand Hygiene in Health Care, Surgical hand scrubbing is the surgical hand preparation with antimicrobial soap and water performed preoperatively by the surgical team to eliminate transient flora and reduce resident skin flora (2009, World Health Organization). There are two methods of scrub procedure. One is a numbered stroke method, in which a certain number of brush strokes are designated for each finger, palm, back of hand, and arm. The alternative method is the timed scrub, and each scrub should last from three to five minutes, depending on facility protocol (Deborah Gardener 2011). In the operating theatres there are three most probable routes of infection transmission between successive/sequential surgical patients are via the air, from instruments, or from environmental surfaces. Journal of Hospital Infection (2002) I have always felt and understood the importance of keeping our hands clean even since I was a little boy. This was a practice taught to me by my parents. As I studied nursing in my country I got to know more about it and how it was properly practised in the wards and theatre settings. During my placement I would always observe my mentor thoroughly before gowning and gloving. I knew the importance of this. She would use repetitive strokes on the hands and arms to further remove any microorganisms. She would be very meticulous and patient while stroking her hands and arms with soap and an antimicrobial agent but as Ive observed, along with most of the scrub nurses, together with my mentor did not use brushes when doing surgical hand scrubbing despite brushes being available just at the side of the scrubbing area. This made a big question mark in my head and I was really confused. I wanted to know why they didn’t bother to use the brushes. So I decided to research about it. There was a study that compared surgical hand scubbing with and without the use of brushes. Two groups were involved during this study. One group to scrub without a brush and another group to scrub with brushes. According to Life Science Journal 2014, the result showed that the group which used brushes had slightly higher bacterial counts, this could mean that brushes traumatize the skin creating an environment where bacteria thrived. Whereas using no scrub brush resulted in no skin damage and significantly lower bacterial count. (AORN journal, 2004. 79: p. 225-30). Based on this research, I was amazed on how the United Kingdom healthcare setting applied evidence based practice. I applied this research findings to how I scrub. I learned more about because of research and from that moment on I have been scrubbing without using a brush. Surgical site infections (SSIs) are the second to third most common site of health care associated infections. When providing health services, it is es sential to prevent the transmission of infections at all times. (Engender Health 2001). I applied this research findings to how I scrub. I learned more about because of research and from that moment on I have been scrubbing without using a surgical brush.

Safety :: essays research papers

Health Safety Examination Summary of the Problems and Solutions of the New Product Line It is undoubtedly that the new product line is very important to my company. However, I found out that the new production line was not as safe as the way Engineer Oh described in his documentation. In this situation, Engineer Oh did not make provision for the safeguarding of life and health, and enforce safety regulations1. Actually, our new production line may cause serious injuries to our new production line workers. If I ignore these problems, I am also against  ¡Ã‚ §the Occupational Health and Safety Act ¡Ã‚ ¨ and  ¡Ã‚ §the Professional Engineers Act ¡Ã‚ ¨. In this summary, the three main problems of the new product line (with references to the acts) and the solutions are discussed. Problem 1  ¡V High-Voltage Equipment Not all the workers are familiar with our new high-voltage equipment. It may cause electric shock to the workers. Some of these workers even do not realize they are working in a high-voltage environment. My ethical responsibility is for the safety of the workers and also for the fairness to the workers2. The reason is that the workers can refuse to work with any equipment, which they think might endanger themselves3. It is their right to know what is their working condition. Solution First of all, I will suggest my company to put adequate warnings near the high-voltage equipment so that the workers know they are working in a high-voltage environment. If we have enough budgets, I will suggest my company to have equipment inspection and preventive maintenance on a regular basis and periodically test the equipment for electric shock hazards. Problem 2  ¡V Toxic Chemicals In producing our new product, we need to use a large variety of toxic chemicals (new to our company), that may cause skin irritation or corrosion to the workers. These chemicals are harmless when proper precautions, usually printed on the container, are followed. However, I found out that seldom of our workers read the instructions before using the chemicals and almost none of our workers wear protective clothing when using the chemicals. The Occupational Health and Safety Act states that any worker should use or wear the equipment, protective devices or clothing that the worker's employer requires to be used or worn4. In addition, we do not have a particular place to store the toxic chemicals, which is against the Occupational Health and Safety Act5.

Children With Autism Essay -- Papers Health Disorders Essays

Children With Autism Children with autism have the possibility to improve greatly, and some even overcome the effects of autism if appropriate therapies are begun early enough. A multifaceted disorder, autism has long baffled professionals and parents alike. At a point in time, doctors gave parents absolutely no hope for the recovery of their children. But recently, new treatments and therapies have shown that improvement is possible. With early intervention, intensive care, some children have if not fully recovered, improved, and have been integrated into schools, indistinguishable from their peers. Sandra L. Harris, PhD; Topics in Autism Siblings of children with autism, A Guide for Families â€Å"Children learn from children†. Siblings of children with autism focus on the often overlooked resource of brothers and sisters as effective playmates and teachers. Dr Harris offers a practical, easy-to-use plan; families can create to ensure possible positive interaction with autistic children and their families. This book focuses on the recurrent behavioral patterns characterized by autistic children. The book deals with the challenges and obstacles the families have to get through, but most importantly how to deal with this obstacles and how to overcome the challenges. Sandra L. Harris, Ph.D. & Mary Jane Weiss, Ph.D. Right from the start; Behavioral Intervention for Young Children with Autism A Guide for Parents and professionals Right from the start explains how the teaching method known as intensive behavioral interventions can benefit young children whose diagnosis fall within the broad spectrum of pervasive Devel... ...enior executives were concerned that infants under 6months were been exposed to mercury levels that were higher than the maximum levels approved by the FDA for mercury in the diet gotten by the consumption of fish. They said these infants were getting elevated doses of vaccines containing a high level of a widely used sterilizing agent. This memo was prepared at a time when U.S health authorities were aggressively expanding their immunization schedules by adding five new shots for children in their fist six months. Many of these shots along with some previously added to the schedule included thimerosal an antibacterial compound that is nearly 50% ethyl mercury, a neurotoxin. Bibliography Lynn M. Hamilton. Facing Autism; Giving Parents Reasons for Hope and Guidance For Help.1st ed. Waterbrook Press, Colorado, U.S; 2000

Conformity and Obedience in Society :: Social Roles Obedience Conformity Essays

Conformity and Obedience in Society The desire to be accepted and belong to a group is an undeniable human need. But how does this need affect an individual? Social psychologists have conducted numerous experiments and concluded that, through various forms of social influence, groups can change their members’ thoughts, feelings, and behavior. In her essay â€Å"Group Minds,† Doris Lessing discusses our paradoxical ability to call ourselves individuals and our inability to realize that groups define and influence us. We, as humans, hold individualism in the highest regard yet fail to realize that groups diminish our individuality. Lessing writes, â€Å"when we’re in a group, we tend to think as that group does... but we also find our thinking changing because we belong to a group† (p. 334). Groups have the tendency to generate norms, or standards for behavior in certain situations. Not following these norms can make you stand out and, therefore, groups have the ability to influence our thoughts and actions in ways that are consistent with the groups’. Lessing’s essay helps set the context to understand the experiments that social psychologists Solomon Asch, Stanley Milgram and Philip Zimbardo conducted to explain conformity and obedience. Solomon Asch’s experiment in â€Å"Opinions and Social Pressure† studied a subject’s ability to yield to social pressure when placed within a group of strangers. His research helped illustrate how groups encourage conformity. During a typical experiment, members of the group were asked by the experimenter to claim two obvious mismatched lines were identical. The single individual who was not privy to this information was the focal point of the experiment. Twelve out of eighteen times the unsuspecting individual went along with the majority, dispelling his beliefs in favor of the opinions of the group. Why did a subject conform in two-thirds of the tests? Influence causes us to think and act in ways that are consistent with our group, especially when we look to the group as a source of information. We also tend to assume that a large number of people can’t all be wrong. Asch writes, â€Å"the sheer weight of numbers or authority sufficed to change opinions, even when no arguments for the opinions themselves were provided† (p. 337). Stanley Milgram is well known for his work with obedience to authority. His work, â€Å"The Perils of Obedience,† studied whether average individuals would obey an authority figure, telling them to do something that harms another individual.

Sears V.S Walmart

1. What ratios are MOST important in assessing current and predicting future value creation for Sears? For Wal-Mart? Sears Sears grew up to the world’s largest retailer by expanding annual sales through diversifying sale products, such as apparel, cosmetics, jewelry, electronics, household appliances, cookware, bedding and hand-tools. This article shows that Sears suffered from a cost increase in 1997, including lawsuits, credit collectibles and sales in Mexico. Besides, the flexible payment facility that Sears offered is also a reason for cost increase. These problems brought Sears with bad debt and hence decreased the cash flow. The problems of the company came from the liquid market security, so I emphasize the flowing concepts: 1. Profit Margin, ( Net Income / Total Revenue) â€Å"It measures how much out of every dollar of sales a company actually keeps in earning. † This concept is effective to compare similar companies in an industry; a higher profit margin indicates a better leading position in the industry. It is an indicative factor for Sears to forecast its position in this industry 2. Asset Turnover rate ( Revenue/ Asset) This ratio can measure how efficient Sears uses its asset to chase for revenue. . DEBT to Equity Ratio ( Total liability/ equity) (5. 6 in 1997, 6. 3 in 1996) The ratio of debt to equity measures the risk of the corporation’s creditors and its prospective creditors 4. ROA (Net Income/Total Asset), Since the company has a higher sales in 1997 than the past 2 years but lower net income. To evaluate the performance of the company, we must know how profitable Sears is relative to its total assets. 5. ROE (Profit Margin * Assets Turnover * Leverage Ratio) which is more accurate way to evaluate the performance of Sears in the retailer industry. . Days of receivable Since Sears have a big issue about the credit collection, we need to think about the days of receivable. 7. Liquidate ratio * Cash ratio * Current ratio ( Current Assets / Current Liabilities) (1. 94 in 1997, 1. 90 in 1996) the current ratio is about 1. 9, it indicate Sears is using its liquidity to grow up. * Quick ratio Wal-Mart Wal-Mart was founded in 1962 and has the ROE of 20%. Wal-Mart also offers store Credit Card, but unlike Sears, it is Chase Manhattan Bank rather than its own credit company. Wal-Mart also boosts the annual sale by diversifying products as Sears does, but Wal-Mart also has different stores to target at the customers of various market segments, such as Wal-Mart Discount Store, Wal-Mart Supercenters and Sam’s Clubs. In order to measure how the performance of the Wal-Mart now and in the future, (Wal-Mart wants in low price and low cost) we need to analysis some financial ratio from the number on books. 1. Profit Margin, (Net Income / Total Revenue) 2. Asset Turnover rate (Revenue/ Asset) this ratio can measure how efficiency Sears to use its asset for revenue. 3. DEBT to Equity Ratio ( Total liability/ equity) . Leverage Ratio ( Long Term Debt / Shareholder) 5. ROA (Net Income / Total Asset), 2. Do you agree with Ravi Suria's analysis of the credit risks associated with Amazon bonds ? 1 In Ravi Suria’s analysis, â€Å"we believe that the current cash balances will last the company through the first quarter of 2001. † According to Exhibit 12c the cash flow statement, in contrast, the cash balance could last for the first quarter of 2001, when it suffered from 407 losses in operating activities, though positive in investing and financial activities. In summary, Amazon experienced 375 losses in the first quarter in 2001. Just from the number on the accounting book, we cannot see whether it is wrong or right. We must see the business strategy and where they spent the money, which is the key of the company for the long term. 2 I personal calculate the working capital of the 2000 and 2001 | Working capital ($M)2000| Working Capital 2001| March | 704| 205| Jun | 559| 87| Sep | 504| (21)| Dec | 386| (38)| His analysis was based on the working capital is shirking. The Working Capital table shows a decreasing trend since 2000. I don’t think amazon can still cover the cash flow in 2011 and use its capital efficiently. However, we cannot only use assumption of Working Capital to analysis a company, we need to look at the strategy, inventory, and so on. As this point, we will know Suria’s analysis is not proper. 3 Suria calculated the inventory as the stable mumble and use the revenue instead of Cost Goods Sold. But the revenue record as the market value, not as cost goods sold can indict the cost for the inventory. Amazon’s revenue varies season by season. We can use COG / average of the inventory to include the seasonal factor, instead of revenue/ inventory. 4 As for the inventory, I think, Suris is misleading by another point. He only thinks the inventory turnover is very low. However, amazon increases its inventory at the beginning year (from the case, the company only have 4000 books, but later on it run CDs, video, and movie. That’s why amazon has a very low inventory turnover at the beginning years. 5 Suria thinks the Amazon has low â€Å"cash flow per unit of product sold†, and he shows us some calculation about his conclusion on page 10. However, this is already a great business mode and strategy in the market. And it has already been proved from the success of Wal-Mart and Costco retailer, which is called â€Å"low gross margins†.