How Autism Spectrum Disorder ( Pecs ) Essay - 1697 Words

Erena Cabal SPA 3472 November 1, 2016 Using Pictures to Communicate There are many different obstacles autism spectrum individuals have to overcome in their daily lives; social insecurities, eye contact, appropriate spatial awareness etc. But in most cases, their biggest hurdle is mostly their communication skills; it’s been shown that communication impairment is at the heart of autism spectrum disorder (ASD) and that children with ASD can show a wide range of communication skills as discussed by Agius and Vance (2015). According to Agius and Vance, there is up to a 30% positive diagnosis of children with ASD who will forever remain nonverbal (no consistent verbal communication). With such a high percentage of ASD children it is recommended that their communication and learning needs are to be addressed by using the Picture Exchange Communication System (PECS), it has been shown as an effective intervention that addresses individuals with ASD and their learning and communication needs (Ogletree, Morrow-Odom, West ling, 2015). PECS has helped children and young adults with ASD communicate with those around them; their teachers, peers, parents etc. Autism is most commonly described as a developmental disability that is diagnosed over a broad spectrum of impairment and identifiers; and within the first three to five years of life. The number of cases of ASD have steadily grown over the past several decades and can be seen in 1 in every 88 births (Ogletree, Morrow-Odom, Show MoreRelatedAugmentative and Alternative Communication in Children Essay1545 Words   |  7 PagesAugmentative and alternative communication (AAC) provides a way for children with autism to communicate. According to DeBonis and Donohue (2008), AAC is a communication option for individuals who have difficulty or inability to express themselves verbally. Children with autism who display difficulty in social situations and verbal communication may benefit from AAC use. AAC systems provide a way for children with autism to communicate, enhance verbal language, and participate in social interaction.Read MorePervasive Development or Autistic Spectrum Disorders Essa y1056 Words   |  5 PagesDefinition of Pervasive Development Disorder: Any of a group of disorders of infancy, childhood, or adolescence that are characterized by distortions in the development of the basic psychological functions such as language, social skills, attention, perception, reality testing, and movement. http://dictionary.reference.com/browse/pervasivedevelopmentaldisorder Pervasive developmental disorder was first used in the 1980’s to describe this class of neurological disorders that can impair social and communicationRead MoreThe Role Of Communicative Intent For Communication Essay1276 Words   |  6 Pagescommunication include, but are not limited to, gestures, body language, sign language, picture exchange communication systems (PECS), and augmentative-alternative communication devices. It is important that we recognize the differences in each form of communication and their applications to learning. Research suggests between 25 and 61% of children who are diagnosed with autism use little or no functional speech to converse with others (Carson, Moosa, Theurer, Oram Cardy, 2012). The emergence of communicativeRead MoreA Research Study On Autism Spectrum Disorder Essay1686 Words   |  7 PagesAutism Spectrum Disorder The autism spectrum is very wide ranging and includes many symptoms. It goes from one or two mild developmental abnormalities all the way up to a person needing a lifetime of care. There are many contributors for autism however, researchers have not found the single cause of autism, and with that, they have not found a cure or accurate prevention methods. It has been found that children who have a sibling with ASD are much more likely to have it, which gives researchersRead MoreEngaging : Promoting Autism Wellness1746 Words   |  7 PagesEngaging in Promoting Autism Wellness Introduction When one thinks of autism, many people do not fully understand the disorder, this is due to lack of research, media perception, and lack of involvement with these individuals. Hillman (2006) describes autism as, â€Å" a devastating developmental disorder in which children have core deficits in verbal and nonverbal communication, social interaction, and pretend or imaginative play.† These difficulties prevent the child from interacting with individualsRead MoreAutism Spectrum Disorder And Autism1492 Words   |  6 Pageslife there are several different disorders that have been well known from many years ago. There is one disorder that was diagnosed in the early 1800’s but it wasn’t until a few years ago that it gained lots of attention. What used to be known as Autism was later renamed in the DSM to Autism Spectrum Disorder meaning, a neurodevelopmental disorder rather than a pervasive developmental disorder (Gargiulo, 2015). Autism spectrum disorder is a dev elopmental disorder characterized by abnormal or impairedRead MoreLiterature Review. Autism Overview. Autism Spectrum Disorder1496 Words   |  6 PagesLiterature Review Autism Overview Autism Spectrum Disorder (ASD) is a widely known disability that, as of 2012, affects about 1 in 68 of children in the United States (Centers for Disease Control and Prevention, 2016). The exact cause of the disability is unknown, however individuals with ASD exhibit some common characteristics. â€Å"Autism belongs to heterogeneous categories of developmental disabilities where neurological disorders lead to deficits in a child’s ability to communicate, understandRead MoreIs Autism Spectrum Disorder? Essay1335 Words   |  6 PagesWhat is autism spectrum disorder? Autism spectrum disorder is a diagnosis which describes a group of individuals with a common cluster of symptoms, though it is important to note that the degree of severity of these symptoms vary greatly amongst individuals (Speaks, 2011). Autism is a lifelong developmental disorder affecting our communication, our interactions, and processing abilities which co-occur with motor coordination, attention, and physical health conditions which include but are not limitedRead More547 Marie Jevon1 Understand How The4585 Words   |  19 Pagesï » ¿547 – Marie Jevon 1. Understand how the different and evolving theories about autism reflect the complexity of autistic spectrum conditions Since it first identified as a distinct disorder by Leo Kanner (1943), autism studies continued in order to explain its causes. Many theories and clinical studies evolved. However, none of them seems to be conclusive. Although it was interchangeably considered as part of schizophrenia, recently it is defined as a distinct disorder that has its own characteristicsRead MoreAutism Spectrum Disorder ( Autism )1450 Words   |  6 PagesAutism Spectrum Disorder Many of us have heard about Autism, also knows as Autism Spectrum Disorder (ASD). Some have a family member, a friend, or know someone who has ASD. Increasingly it is becoming a more common disability. â€Å"Autism is one of the fastest-growing developmental disorders in the U.S† (Autism Speaks). Autism has no respect for gender, race, social class and or ethnicity. â€Å"Autism is a pervasive developmental disorder that involves abnormal development and function of the brain.† (Autism

A Conflict in Interest Essay - 633 Words

A Conflict in Interest The year 1910 marked the beginning of reform within the Mexican political order. Proposals such as Francisco Madero’s Plan of San Luis Potosi and The Plan de Ayala by Emiliano Zapata denounced the rigid control of dictator Porfirio Diaz, stating that the existing government offered no concessions to the Mexican people. In an effort to overthrow Diaz, Madero’s plan for revolution declared the current government nonexistent beginning at six o’clock on the evening of November 20, 1910. Emiliano Zapata, however, developed a plan resulting from his own lost faith in Madero’s goals and unfulfilled promises. On November 25, 1910, Zapata offered his own proposal to â€Å"continue the revolution begun by (Madero)† until†¦show more content†¦Emiliano Zapata, however, made no effort in his proposal to designate a position of power to himself or anyone else, stating that representatives will designate an interim President once the revolution is ac hieved. Through these statements, Madero seemed anxious to take control of the government, while Zapata focused on serving the needs and rights of all the Mexican people. In maintaining an illusion of democracy, Madero stated in his Plan that the new government would collect loans (forced and voluntary) to pay the debt caused by the revolution, and that these loans would be carefully documented and repaid. Just as Diaz had done in his dictatorship, Madero took from the poor in order to pay for the actions of an elite group, all while upholding the image that he was carrying out his plan with the Mexican people in mind. His Plan stated, â€Å"The most severe penalties will be applied to the soldiers who sack a town or who kill defenseless prisoners.† This statement was one of few that demonstrate concern for the â€Å"defenseless† peasants. Madero addressed the taking of the indigenous peoples’ land by declaring that the land shall be returned to its for mer owners, and if this is not possible, they will receive indemnity from those who stole theirShow MoreRelatedConflict of Interest in Research2203 Words   |  9 PagesConflict of interests in research Everyone must deal with conflict of interest. Conflict of interest exist in every walk of life, including education, business, government, finance, and research. It can affect our thoughts, judgments, choices, and decisions. There is nothing inherently unethical in recognizing oneself in a conflict of interest. Rather, the main point gear toward whether one discovers his conflict of interests and how does he deal with this situation. Definition of conflict ofRead MoreConflicts Of Interest And Its Impact On Research1440 Words   |  6 PagesConflicts of interest appear in all aspects of life, yet in research the potential consequences of these conflicts may be disastrous. Allowing conflicts of interest to exist in science has a negative impact on research – they could damage public opinions of science and slow the progression of research. Scientific disciplines have the potential to harm society, highlighting the need to conduct ethical research free from conflicts of interest. In epidemiology, conflicting interests may have seriousRead MoreConflict Interest Case Essay696 Words   |  3 PagesSubject: Chief employee bonus: Conflict Interest. To: Ethics for Accountant From: Kyungwon Kwak Date: 03/07/2011 1. Ethics Case-Chief employee bonus The WGN Company has a bonus arrangement, which grants the financial vice president and other executives a $15,000 bonus if the net income exceeds the previous years by $1,000,000. Noting that the current financial statements report an increase of $950,000 in the net income, Vice President Jack Brickhouse asks Louise Boudreau, the controllerRead MoreEthical Dilemm Conflict Of Interest901 Words   |  4 PagesI - Conflict of Interest A conflict of interest exists when an employee’s duty to give his or her individual business loyalty to the Company may be prejudiced by actual or potential personal benefit arising from another source. While not presuming to restrict the right of individuals to passively invest or participate in other business ventures, the Company is concerned where those interests might lead to conflicting interests on the part of the individual. For example, a conflict of interest mayRead MoreA Conflict Of Interest Policy For The Board1618 Words   |  7 Pagesof Issues and Topics to address when establishing a Conflict of Interest Policy for the Board. As a tax exempt organization the presence and enforcement of a Conflict of Interest1 in a Board will: A) Protect the Healthcare System’s interest in transactions or arrangements that may also benefit a director’s private interest. B) Ensure that the Board can make decisions in an objective manner without undue influence by persons with a private interest. c) Help protect its Tax exempt status as the BoardRead MoreDuty to Avoid Conflicts of Interests1559 Words   |  7 Pagesarguments. Outline for â€Å"Duty to avoid conflicts of interest†: (Practice question about Agrico) Consider the company Agrico Limited, discussed last week. Jenny Smith is the managing director of Agrico, and she is also a director and shareholder of 50% of the shares in Telegenics Pty Ltd – a small IT company founded by her husband (he is the other director and 50% shareholder of the company). The other directors of Agrico are not aware of Jenny’s interest in Telegenics. Telegenics is tenderingRead MorePrincipals-Agents Conflict of Interest1798 Words   |  8 PagesCynthia Claude Nkono Moanang 1009040 CORPORATE GOVERNANCE AND BUSINESS ETHICS ASSIGNMENT TOPIC: Principals (shareholders) – agent (managers) problem represents the conflict of interest between management and owners. For example, if shareholders cannot effectively monitor the managers’ behaviour, then managers may be tempted to use the firm’s assets for their own ends, all at the expenses of shareholders. Discuss the pros and cons of this statement with regard to duties of Board of DirectorsRead MoreConflict Of Interest And How It Was Resolved846 Words   |  4 PagesConflict of interest is a â€Å"situation in which a person has a private or personal interest sufficient to appear to influence the objective exercise of his or her official duties as, say, a public official, an employee, or a professional.† (Chris MacDonald, Aug 2002) If left unchecked conflict of interest can put an individual in ethical and legal trouble. Conflict of interest usually occurs when a person’s personal interest is in conflict with his/her duty or employmen t. Conflict of interest is commonRead MoreConflict Of Interest Between Employer And Workman Essay951 Words   |  4 PagesThere is and will be an on-going conflict of interest between employer and workman. On one hand employer looks for more and more investment opportunity while on the other hand workman demands for better standard of living. Though there can be mechanism to reduce the tension but we don’t see a permanent answer to the issue. One of the very strong mechanisms identified is in the form of Industrial dispute act. The prime objective of the Industrial Disputes Act is to ensure industrial peace and harmonyRead MoreEffective Regulation And Conflict Of Interest Relational Guidelines880 Words   |  4 Pageswith the financial institutes and It s also something we can stop, through effective regulation and Conflict of interest relational guidelines. Contribution of New Points...(Backing) Extremely concerning is the fact as recent as 2015, several high-level leaders and investors have lost millions of investors’ money and our elected officials still haven t taken appropriate action, even after the financial crisis in 2008. Several acts of unethical behavior by upper-level Management large organizations

Night World Dark Angel Chapter 1 Free Essays

Gillian Lennox didn’t mean to die that day. She was mad, though. Mad because she had missed her ride home from school, and because she was cold, and because it was two weeks before Christmas and she was very, very lonely. We will write a custom essay sample on Night World : Dark Angel Chapter 1 or any similar topic only for you Order Now She walked by the side of the empty road, which was about as winding and hilly as every other country road in south-western Pennsylvania, and viciously kicked offending clumps of snow out of her way. It was a rotten day. The sky was dull and the snow looked tired. And Amy Nowick, who should have been waiting after Gillian cleaned up her studio art project, had already driven away-with her new boyfriend. Sure, it must have been an honest mistake. And she wasn’t jealous of Amy, she wasn’t, even though one week ago they had both been sixteen and never been kissed. Gillian just wanted to get home. That was when she heard the crying. She stopped, looked around. It sounded like a baby-or maybe a cat. It seemed to be coming from the woods. Her first thought was, Paula Belizer. But that was ridiculous. The little girl who’d disappeared somewhere at the end of this road had been gone for over a year now. The crying came again. It was thin and far away-as if it were coming from the depths of the woods. This time it sounded more human. â€Å"Hello? Hey, is somebody in there?† There was no answer. Gillian stared into the dense stand of oak and hickory, trying to see between the gnarled bare trees. It looked uninviting. Scary. Then she looked up and down the road. Nobody. Hardly surprising-not many cars passed by here. I am not going in there alone, Gillian thought. She was exactly the opposite of the â€Å"Oh, it’s such a nice day; let’s go tramping through the woods† type. Not to mention exactly the opposite of the brave type. But who else was there? And what else was there to do? Somebody was in trouble. She slipped her left arm through her backpack strap, settling it on the center of her back and leaving her hands free. Then she cautiously began to climb the snow-covered ridge that fell away on the other side to the woods. â€Å"Hello?† She felt stupid shouting and not getting any answer. â€Å"Hi! Hello!† Only the crying sound, faint but continuous, somewhere in front of her. Gillian began to flounder down the ridge. She didn’t weigh much, but the crust on the snow was very thin and every step took her ankle deep. Great, and I’m wearing sneakers. She could feel cold seeping into her feet. The snow wasn’t so deep once she got into the woods. It was white and unbroken beneath the trees-and it gave her an eerie sense of isolation. As if she were in the wilderness. And it was so quiet. The farther Gillian went in, the deeper the silence became. She had to stop and not breathe to hear the crying. Bear left, she told herself. Keep walking. There’s nothing to be scared of! But she couldn’t make herself yell again. There is something weird about this place†¦ Deeper and deeper into the woods. The road was far behind her now. She crossed fox tracks and bird scratches in the snow-no sign of any-l thing human. But the crying was right ahead now, and louder. She could hear it clearly. Okay, up this big ridge. Yes, you can do it. Up, up. Never mind if your feet are cold. As she struggled over the uneven ground, she tried to think comforting thoughts. Maybe I can write an article about it for the Viking News and everyone will admire me†¦ Wait. Is it cool or uncool to rescue somebody? Is saving people too nice to be cool? It was an important question, since Gillian currently had only two ambitions: 1) David Blackburn, and, 2) To be invited to the parties the popular kids were invited to. And both of these depended, in a large part, on being cool. If she were only popular, if she only felt good about herself, then everything else would follow. It would be so much easier to be a really wonderful person and do something for the world and make something important of her life if she just felt loved and accepted. If she weren’t shy and short and immature looking†¦ She reached the top of the ridge and grabbed at a branch to keep her balance. Then, still hanging on, she let out her breath and looked around. Nothing to see. Quiet woods leading down to a creek just below. And nothing to hear, either. The crying had stopped. Oh, don’t do this to me! Frustration warmed Gillian up and chased away her fear. She yelled, â€Å"Hey-hey, are you still out there? Can you hear me? I’m coming to help you!† Silence. And then, very faintly, a sound. Directly ahead. Oh, my God, Gillian thought. The creek. The kid was in the creek, hanging on to something, getting weaker and weaker†¦ Gillian was scrambling down the other side of the ridge, slithering, the wet snow adhering to her like lumpy frosting. Heart pounding, out of breath, she stood on the bank of the creek. Below her, at the edge, she could see fragile ice ledges reaching out like petals over the rushing water. Spray had frozen like diamond drops on overhanging grasses. But nothing living. Gillian frantically scanned the surface of the dark water. â€Å"Are you there?† she shouted. â€Å"Can you hear me?† Nothing. Rocks in the water. Branches caught against the rocks. The sound of the rushing creek. â€Å"Where are you?† She couldn’t hear the crying anymore. The water was too loud. Maybe the kid had gone under. Gillian leaned out, looking for a wet head, a shape beneath the surface. She leaned out farther. And then-a mistake. Some subtle change of balance. Ice under her feet. Her arms were wind-milling, but she couldn’t get her balance back†¦ She was flying. Nothing solid anywhere. Too surprised to be frightened. She hit the water with an icy shock. How to cite Night World : Dark Angel Chapter 1, Essay examples

Mary, Where are U Essay Example For Students

Mary, Where are U Essay The debate over whether or not the United States government shouldgrant tuition vouchers to the parents of children who attend private schools hasgone on for many years, and has included many powerful arguments on bothsides of the issue. Those who support the private school vouchers believe thatthey are beneficial to everyone because they promote productivity in both publicand private schools alike, and they also give low-income families the chance togive their children a quality private school education. Those in opposition to thevouchers say that they will drain money out of the public schools, and that theyonly truly help a small population, mainly the wealthy and advantaged. Opposers also believe that the vouchers interfere with the Separation of Churchand State, since many private schools have a religious affiliation. This issue hastruly been a controversial one, with many people fighting arduously. Afterreading through the various arguments for each side, one can not help but c ometo their own conclusion about private school vouchers. There have been many school voucher programs proposed in the past,but they all seem to share one common theme. This similarity between them isthat they all promote giving households that send their children to private schoolsa tax dollar-funded voucher that would cover all or most of the cost of theschools tuition. Many of the proposals also include the right for parents to chosewhich private school their child will attend. The vouchers allows students to usethe money that would be subsidized for them in a public school to go toward aprivate school education. This system redirects the flow of educational funding,bringing it to the individual family instead of the school district. The idea of school vouchers first became popular after Milton Friedman,an economist, released two publications, in 1956 and in 1962, that supported thevoucher plan. In his 1962 book, Capitalism and Freedom, when Friedmandiscusses education, he turns to public education criticizes it for beingunresponsive because it has been free from competition (Lieberman, 120). Vouchers would provide this much needed competition, since public schoolswould now have to contend with the private schools that were receiving the samepayments they were. Friedman believes that,most dissatisfied parents have only two options. They can enroll theirchildren in private schools, in which case they have to bear the costs inaddition to paying taxes to support public schools. Or they can resort topolitical action, an option Friedman regards as ineffective. (ibid.)After Friedman publicly showed his support for school vouchers, a debate beganin America, with fellow supporters and the opposers announcing their views onthe issue. People on both sides of this issue have been very vocal over the years,explaining why they think school vouchers should or should not be implementedin American schools. In arguing about the same point in the debate, like thedecline in the quality of public schools or the separation of church and state,each group has found a way to make it fit into their beliefs. Therefore, nothing isever accomplished because the groups blame each other for any problemsinvolved with the vouchers that may arise. Besides the two points listed above,minority education and low-income student education have also been used aspowerful arguments both for and against private school vouchers. The

10 Years Old Children Prefer to Watch Cartoons Rather free essay sample

10 years old children prefer to watch cartoons rather than other TV shows Marcela Reyes Quintana Claudia Arteaga Gomez Jessica Morales Martinez Danaee Jimenez Guevara Sebastian Ortega Uribe Sebastian Diaz Carvalledo Universidad del Valle de Mexico Professor: Sergio Bautista 31 / 05 / 2010 Prologue: Since the last decades, mass media has taken a big role on any society that exists nowadays. It is of great importance because of many reasons. One of them being because thanks to them information can be spread throughout the world in a matter of seconds. In a way this type of media unites the world more than anything, especially when we talk about the TV. For sure in most houses of every country, there is a TV present. And as in most families, there are also children present. Now, what happens if you unite both, TV and children? Well what you get is an excellent way of distracting a kid. For some reason (or reasons) kids are always really curious about TV, you will always see a child watching it maybe even for hours. We will write a custom essay sample on 10 Years Old Children Prefer to Watch Cartoons Rather or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page What interests us the most is to know the reasons why this little kids love to watch TV, but not any type of program, but particularly cartoons. For sure cartoons are really entertaining; many people (even adults) still enjoy watching a cartoon every now and then. By watching this type of shows that aren? t really complex to understand, full of colors, movements, and many other stimulus for the senses, it helps kids to relax, feel comfortable and even laugh. Thing which they can? t do when watching for example a novel, because they are more full of drama and real-cases type of stories which they are just too young to understand and since they are in contact with reality when they aren? t watching TV, what they less want to see on TV is what they see in their everyday lives. Index:

How Most Parents In Middle East Country Decide A Babys Name Essay

How Most Parents In Middle East Country Decide A Babys Name Essay How Most Parents In Middle East Country Decide A Baby's Name – Essay Example Naming conventions in the Middle East: Introduction: The naming conventions in the Middle East and in Islamic culture in general strictly adhere to the Prophets suggestion. According to the Hadith, the parents are required to give meaningful and religious names to their children since the Muslims believe that the childs name reflects their personality and also because they believe that individuals will be called by their names on the day of judgement. Hence the names such as Abdullah or Abdur Rehman which are closer to Allah are suggested by the Prophet. With regard to naming a child the Prophet says "Keep the names of the noble Prophets, Allah loves most the names Abdullah and Abdur Rehman. The most truthful names are Harith and Humam, while the most disliked are Harb and Murrah (war and bitter)" (Isconline.org). Structure:In the Middle East, the child is perceived as a critical generational link within the family unit and hence the name given to the child is of crucial significance . All traditional Arabic / Middle Eastern names are comprised of five key components each signifying the childs past and present familial ties and status in the family unit. These include Ism- which refers to the personal name given to the child. The personal names are mostly adjectives which indicate the desired character or trait that the parents wish for the child. Such as Karim - which means generous, or Mahmud- meaning praiseworthy. This is followed by a Nasab which is the name of one or more of the child’s ancestors. It is indicated by the male prefix ibn which means son of and binte which means daughter of. The kunya is used to connect the father or mother to their decendants; the Iaqab traditionally was title or a nickname and lastly the Nisbah which is the last name of the family or ancestors tribe or city. This last name is mostly used by the family through several generations (Palls, 2008: p. 277).Figure:Source: Basis Technology: Government Users ConferenceReferenc es:Palls, B. P., (2008). Cultural portraits: A synoptic guide. Bloomington, IN: Author House PublicationBasis Technology (2000). Government Users Conference [Online] Available at: [Accessed: Feb 12,2014]Isconline.org (2014). Naming babies [Online] Available at: lsconline.org/naming-babies.html [Accessed: Feb 12, 2014]

Apple Company Analysis Essay Example | Topics and Well Written Essays - 2250 words - 1

Apple Company Analysis - Essay Example The paper tells that Apple Inc. is the producer of the iTunes software program that is used to store and play music in one place. The company’s clients are varied with respect to the variety of products, for instance, educators, business organizations, and daily basis customers. Owing to its wide range of products, the company has the capability to target a wide range of customers, with most sales being conducted online and a host of others from direct sales, retailers and the company’s retail shops. The company has current operations distributed all over the world; in the United States, Japan, Europe, Asia Pacific and some parts of Africa. On April 1, 1976, three men, Steve Jobs, Steve Wozniak, and Ronald Wayne co-founded Apple Inc. The company did not receive immediate attention in the market but until 1984 when the company introduced the Macintosh computer. Jobs and Wozniak left the company in 1985 in pursuit of other goals. The company went ahead with the release of new computer models that were unique in style and more portable as opposed to other computer models. Even with these improvements, the company could not cement its position as a dominant computer manufacturing company across the globe and in 1997, one founder Steve Jobs rejoined the company when it was losing huge sums of cash. Apple released the iMac in 1998 and immediately gained profits with increasing market share thus turning the downward spiral of the company around. Apple’s revolution of the digital music distribution came with the introduction of the iPod in 2001 along with iTunes and in 2007, the company expanded its scope of production and entered the smart-phones world when it released the iPhone. Today, Apple is among the leading innovators in computer hardware and software, phones and a host of digital portable devices.

Critique of a research paper Quantitative design Essay - 1

Critique of a research paper Quantitative design - Essay Example The researchers aimed at examining the progress of the Motivate Programme; an exercise, behaviour change and nutrition guided management programme, in terms of how it could help the select group of overweight and obese participants improve their cardiovascular risk factors (Rutherford et al, 2014). The aims lay out what the reader has to expect, and provide a basis to evaluate consistency in a research process (Boaz and Ashby, 2003). Highlighting the credentials of authors proves their experience in a field, and offers credibility to research (Vance et al, 2013). The institutional affiliations of all participants were clearly indicated in the article. Credibly, they were all affiliated to leading institutions in the United Kingdom. However, the educational attainments of the authors were not listed. The article was published in the journal Soccer and Society, a relatively new, peer reviewed journal database with a growing readership and specific focus on sociological, financial and scientific matters of soccer. A database that does not offer peer reviews has lower regard in the scholarly world, since evidence for clarification of the research process is a necessity for quality control (Rafols et al, 2012). Rychetnik et al. (2002) noted that the abstract should clearly summarize the main sections of an article. The abstract is clearly and systematically outlined to provide highlights of every major part of the article; the background, aims, methods, results and conclusion. A strong justification was offered to explain why they carried out the research, noting that the unique approach of the research (soccer-based exercises, unlike mere walking and running used in many research studies; and the location of recruitment). No clear research questions were provided to guide the research. Research questions are an important step in guiding readers of an article through the transition from the aims to the results. As such, sufficiency of research

Engineering The palms in Dubai aka 8th wonder of the world Essay

Engineering The palms in Dubai aka 8th wonder of the world - Essay Example The Islands add about 1, 600 km to Dubai’s coastline and have already been termed as the eighth wonder of the world. The three islands facilitate over 100 luxury hotels and a large number of residential and entertainment centers [1]. This report presents an analysis of one of the best engineering marvels, the Palm Islands project. The report will first give a background of the project, including the construction process, and then discuss the challenges faced by the engineering team. The impacts of this mega project on the local environment and the coastal eco system will also be discussed in detail. Table of Contents Abstract 1 Table of Contents 2 Introduction 3 Reasons for construction of the Palm Islands 4 Construction Process 4 Curving the land 5 Engineering Challenges 6 Environmental Impact 8 Project Result 9 Conclusion 9 References 11 Introduction The UAE is one of the world’s largest and fastest growing economies. This country has witnessed immense investments in the construction industry hence becoming the largest construction market in the GCC [2]. According to Noack [3], the country’s construction industry managed to record a strong development between 2007 and 2009 despite the global financial distress. In 2009, the industry contributed approximately 8% to the country’s GDP. ... An island is made up of piles of lava rising above the water level. Technically, the Palm islands are manmade peninsulas made of sand dredged from the Persian Gulf [4]. Among the three islands, the Palm Deira is the largest and is also the largest artificial island in the world. Construction was commissioned by Sheikh Mohammed bin Rashid Al Maktoum. The islands were constructed by Jan De Nul and Van Oord, the former being a Belgian company and the latter a Dutch company, with each settlement shaped like a palm tree. Palm Jumeriah was the first island to be constructed. Its construction commenced in June 2001. Also situated on an artificial island in Dubai is the Burj al Arab. This is a luxury hotel standing 280 meters from Jumeriah beach. It is the world’s fourth tallest hotel and has a private curved bridge connecting it to the main land [5]. Reasons for construction of the Palm Islands The Palm Island is unquestionably one of the most ambitious and enterprising ventures to h ave ever been imagined and constructed. The core purpose of the entire construction of the islands was to increase the tourism sector in Dubai. This was to be achieved by providing a tourist destination that stands out from the rest, brimming with world class hotels, upscale amenities and hundreds of miles of beaches all in one unique place [2]. The other objectives of the construction project were to complete reclamation of land and as a result, achieve pioneer status as well as fame. The reclamation would then allow for construction of hotels and housing facilities. This would involve many foreign investors and hence improve Dubai’s international recognition [3]. Construction Process Construction of The Palms began in mid 2001 [5]. The Islands are made of sand

Pathophysiology of Skin Alterations

Pathophysiology of Skin Alterations Skin Alterations Beverly Phelps Abstract Human skin is the largest multifunctional organ of the body, and knowledge of its structure and function is essential to clinicians and researchers. The skin has two layers, the epidermis and dermis, separated by a basement membrane zone. It provides protection, sensation, thermoregulation, biochemical/metabolic, and immune functions. Key and emerging concepts important to understanding pathophysiological mechanisms for practicing clinicians are: knowledge of differences between acute and chronic wounds; ability to evaluate depth and extent of injury; and understanding stages of healing versus zones of activity. Discussion: Explain pathophysiology of broad categories of skin alterations (e.g., minor, traumatic, burns, benign, parasitic, pressure ulcers, cancerous, infectious, and inflammatory). Also discuss causative agents, assessment data (what it looks like, pathophysiological changes, and presenting symptoms). Skin Alterations This paper will cover minor wounds, burns, pressure injury, and cancer with variations in skin color, as well as the causative agents and assessment data. Minor Wounds Minor skin wounds occur as the result of unanticipated trauma and may include lacerations, abrasions, blisters and more serious wounds such as skin tears and bites. Lacerations are often irregular shaped wounds with ragged skin edges and typically have deeper skin damage and bruising noted. Abrasions are known as grazes and are more superficial wounds in which the top layer of the skin is remove by sliding across a rough surface and usually contains some dirt and sometimes even particles of what scraped it. Blisters are the result of friction of between the top two layers of the skin, or coming in contact with something hot, removing the top of the blister, puncturing the blister, or draining the fluid will cause the area to heal more quickly, and will require a protective dressing afterwards. A cut or incision usually has clean edges as a result of the cause of injury, for example a sharp knife. If it is a deep wound it can bleed profusely and nerve and muscle damage can occur. Human and animal bites are of special concern, especially in puncture wounds, as bacteria from the mouth can enter the wound resulting in an increased risk of tetanus an d infection. Most animal bites are from pets, usually dogs and cats, and can cause abrasions, deep scratches, and lacerations as well as puncture wounds. Cat bites and scratches are considered more serious due to the high incidence of infection due to the germs that are in their mouth and under their claws. Infection is the largest risk of minor traumatic wounds as they often contain debris and bacteria from the cause of the injury. The treatment from a minor traumatic wound is to clean the wound and surrounding skin, removing any debris and other foreign material. Abrasions require thorough irrigation as ground dirt is frequently embedded in these wounds. Apply an antiseptic solution to cleanse the wound using chlorhexidine, povidone-iodine and normal saline. Surgical wounds that have been stitched together, just clean the old blood prior to the application of a dry dressing. The most important thing is to try to determine the cause of the injury or the object which caused the injury and when the injury occurred. Wounds greater than six to eight hours old have an increased risk of infection. With all traumatic injuries assess the patient’s tetanus status and ensure they have adequate coverage. Following this an assessment of the wound can be made for the location, size, and depth and any additional trauma to underlying structures such as muscle, tendon, nerve, vascular and bone. Animal bites must be monitored for 24-48 hours for signs of infection. Precautionary antibiotic may be administered. Burns Burns can be sustained in a number of ways with children and the elderly where it is the most common. Scalds involving hot liquids are the most common type of burns. In adults, flame burns are more prevalent and other causes can include chemical contact, electrical, friction damage, and sunburn. The seriousness of a burn injury depends on several factors including the size, depth of the burn, the location of the burn, and the age and general medical condition of the burn patient. Clinical studies suggest that about 95% of all burns are relatively minor, however about 5% require hospitalization and highly specialized treatment. The severity of a burn determines the type of treatment it requires. There are 5 recognized grades of burns, minor/superficial, superficial partial thickness, mid dermal partial thickness, deep dermal partial thickness, and full thickness, which has replaced the first, second and third degree terminology used before. Minor/Epidermal is characterized by red, painful, usually not blistered, and will heal within approximately 7 days with no scarring. Superficial dermal is characterized by blistered with pale pink base, very painful and usually heals by epithelialization in 10 – 14 days with no scarring. Mid – Deep dermal is characterized by blotchy, red or white base +/- blisters, no capillary return, predominantly painless, prolonged healing with possible scarring and contracture, and heal in 14 – 28 days. Full thickness is characterized by leathery, white or charred, painless, and prolonged healing with scarring and possible loss of function. The clinical objectives for management of burns are stabilize the patient, cool the wound, debride devitalized (necrotic) tissue, protect from infection, and close the wound by first or second intention healing or by grafting. The impact of first aid cannot be overemphasized with rapid, effective first aid helping to prevent further damage and deeper tissue loss. Burn wound conversion refers to the process whereby tissue damage can extend to deeper layers resulting in prolonged healing. This increases the risk of complications post healing such as contraction and keloid or hypertrophic scarring. Pressure Ulcers . A Pressure Injury is a wound caused by unrelieved pressure of tissue compressed between a bony prominence and an external surface which is classified according to the extent of tissue damage. Synonymous terms include pressure sores, bedsores, and decubitus ulcers. As a result of unrelieved pressure, the network of vascular and lymph vessels supplying oxygen and nutrients to the tissues can be occluded. Several factors are involved in determining if a Pressure Injury will develop and include: duration of pressure, intensity of pressure, and the ability of tissue to tolerate pressure (tissue tolerance). However, there is no universal agreement as to the length of time and the intensity of pressure before tissue damage occurs. Other major factors include: shear, friction forces, and moisture. Pressure Injuries affect people who are largely immobile. They are most common amongst the elderly, but can effect anyone who is confined to a bed or wheel chair. On average 10% of hospitalized p atients can develop a pressure ulcer during their stay. Recent prevalence studies undertaken in several major Australian teaching hospitals identified the prevalence rate of pressure ulcers as being between 5.4% and 15.6%. The most common positions for pressure ulcers are Sacrum/tail bone, Heel, Ischia/buttocks, and Greater trochanters/hip Pressure injury classification are classified according to the level of tissue damage that has been sustained and staging system is used. There are 4 stages of pressure injuries, and are as follows. Stage one is described as intact skin with observable changes including areas of persistent redness. Stage two is described by partial thickness skin loss involving epidermis and or dermis. Stage three is described by full thickness involving damage or necrosis of subcutaneous tissue that may extend down to, but not through, underlying fascia. Stage four is described as full thickness skin loss with extensive tissue destruction to muscle, bone, or supporting structures, tendon, and joint capsule, and may have undermining or sinus formation. The primary treatment and objective for management of pressure injuries are: reduction of pressure and shear forces, management of exudate, prevention of contamination leading to infection, creation of a moist wound environment, and to minimize the frequency of dressing changes, which is generally more cost effective, and provide more rapid healing and less disruption to the patient. Skin Cancer. Skin cancer occurs when errors occur in the DNA of skin cells. The mutations cause the cells to grow out of control and form a mass of cancer cells. Cells involved in skin cancer begin in your skin’s epidermis. The epidermis provides a protective cover of skin cells that your body continually sheds. The epidermis contains three main types of cells: the squamous cells that lie just below the outer surface and function as the skin’s inner lining, the basal cells, which produce new skin cells, sit beneath the squamous cells, and melanocytes which produce melanin, the pigment that gives skin its normal color, and are located in the lower part of your epidermis. Melanocytes produce more melanin when you’re in the sun to help protect the deeper layers of your skin. Where skin cancer begins, is determined by its type and will also determine the treatment options. Skin cancer is the abnormal growth of skin cells that most often develops on skin exposed to the sun. But th is common form of cancer can also occur on areas of your skin not ordinarily exposed to sunlight. There are three major types of skin cancer — basal cell carcinoma, squamous cell carcinoma and melanoma. You can reduce your risk of skin cancer by limiting or avoiding exposure to ultraviolet (UV) radiation. Checking your skin for suspicious changes can help detect skin cancer at its earliest stages. Early detection of skin cancer gives you the greatest chance for successful skin cancer treatment. Skin cancer develops primarily on areas of sun-exposed skin, including the scalp, face, lips, ears, neck, chest, arms and hands, and on the legs in women. But it can also form on areas that rarely see the light of day like your palms, beneath your fingernails or toenails, and your genital area. Skin cancer affects people of all skin tones, including those with darker complexions. When melanoma occurs in people with dark skin tones, its more likely to occur in areas not normally exposed to the sun Ultraviolet light and other potential causes Much of the damage to DNA in skin cells results from ultraviolet (UV) radiation found in sunlight and in the lights used in tanning beds. But sun exposure doesnt explain skin cancers that develop on skin not ordinarily exposed to sunlight. This indicates that other factors may contribute to your risk of skin cancer, such as being exposed to toxic substances or having a condition that weakens your immune system. Risk factors Factors that may increase your risk of skin cancer include: Fair skin.  Anyone, regardless of skin color, can get skin cancer. However, having less melanin in your skin provides less protection from damaging UV radiation. If you have blond or red hair and light-colored eyes, and you freckle or sunburn easily, youre much more likely to develop skin cancer than is a person with darker skin. A history of sunburns.  Having had one or more blistering sunburns as a child or teenager increases your risk of developing skin cancer as an adult. Sunburns in adulthood also are a risk factor. Excessive sun exposure.  Anyone who spends considerable time in the sun may develop skin cancer, especially if the skin isnt protected by sunscreen or clothing. Tanning, including exposure to tanning lamps and beds, also puts you at risk. A tan is your skins injury response to excessive UV radiation. Sunny or high-altitude climates.  People who live in sunny, warm climates are exposed to more sunlight than are people who live in colder climates. Living at higher elevations, where the sunlight is strongest, also exposes you to more radiation. Moles.  People who have many moles or abnormal moles called dysplastic nevi are at increased risk of skin cancer. These abnormal moles — which look irregular and are generally larger than normal moles — are more likely than others to become cancerous. If you have a history of abnormal moles, watch them regularly for changes. Precancerous skin lesions.  Having skin lesions known as actinic keratosis can increase your risk of developing skin cancer. These precancerous skin growths typically appear as rough, scaly patches that range in color from brown to dark pink. Theyre most common on the face, head and hands of fair-skinned people whose skin has been sun damaged. A family history of skin cancer.  If one of your parents or a sibling has had skin cancer, you may have an increased risk of the disease. A personal history of skin cancer.  If you developed skin cancer once, youre at risk of developing it again. A weakened immune system.  People with weakened immune systems have a greater risk of developing skin cancer. This includes people living with HIV/AIDS and those taking immunosuppressant drugs after an organ transplant. Exposure to radiation.  People who received radiation treatment for skin conditions such as eczema and acne may have an increased risk of skin cancer, particularly basal cell carcinoma. Exposure to certain substances.  Exposure to certain substances, such as arsenic, may increase your risk of skin cancer References http://www.sh.lsuhsc.edu/policies/policy_manuals_via_ms_word/wocn/wocn_08.pdf http://www.medscape.com/viewarticle/562489_4 http://annonc.oxfordjournals.org/content/16/9/1425.full http://www.ncbi.nlm.nih.gov/pubmed/17523178 http://www.mayoclinic.com

Technology and Individualization in Education Essay -- Technological I

Technology and Individualization in Education Technology is a major influential factor in the progression of education. Technology has allowed for many positive advances in education, allowing for more efficient, more individualized learning. The introduction of computers in education has provided countless benefits to students, and enhanced learning greatly. Students now have a much broader wealth of information in which they can get knowledge from, and more specialized learning. Education will continue to be benefited by technology as progression continues. Individualization in education should be an ultimate goal, and this can only be achieved through technology. Technology should continue to be an influential factor in education. Computers have been the most influential form of technology to affect education. Many experts are critical of computers in the classroom. Dennis Gooler suggests that computers institute a gender gap, and that serious questions need to be addressed before computers are allowed in classrooms. He says that boys are much more inclined to use computers, and that girls will be left behind in the technology craze. I think that the way to solve this problem is to have computers in schools and promote their use by both genders. Computers allow for students to learn individually, and to gain access to a plethora of knowledge that has recently become accessible. There are many ways that computers have benefited learning. Studies have proven that computers in the classroom cause students to get better grades, because their learning is based on personal learning styles. Before computers were invented, all papers had to b e typed out in typewriters. Computers have made typing papers much easie... ...ucation. Our society is in a constant state of progression through technology, and it is only right that education is included. Education is positively effected by technology in many ways, and will continue to be benefited, until individualized education is achieved. Advancement occurs all throughout the Bible, and the importance of education is stressed. I believe that God is pleased when the two come together for an advantageous outcome. Works Cited 1) Gooler, Dennis D. â€Å"Computers in the Classroom: What is the effect on the Gender Gap?† Stanford March 1998: 1-10. www.Google.com. 9 November 2001.

Sarbanes Oxley Act 2002

Anna Hendryx September 14, 2010 Acc. 201 Sarbanes-Oxley Act 2002 Extra Credit Report Frank Huber Introduction The Sarbanes-Oxley Act of 2002 was a piece of legislation that came into effect in 2002 which introduced major changes to the regulations of the many financial practices as well as corporate governance. This particular piece of legislation was named after Senator Paul Sarbanes and Representative Michael Oxley. In this paper I will be discussing the overview, intended purpose, and whether or not SOA was a success or failure. OverviewThe Sarbanes-Oxley Act of 2002 has been deemed as being the most significant change to securities laws since the 1934 Securities Exchange Act. The Sarbanes-Oxley Act was signed by President George W. Bush in 2002, and became effective on July 30th of that year. The Sarbanes-Oxley Act, which is often times referred to as â€Å"SOX†, was an act that set forth records management as well as retention policies for all public companies. This parti cular act was enacted in response to corporate scandals that involved large corporations, the Enron scandal being one of the more popular. Anand, 2004) The Sarbanes-Oxley Act requires all financial reports to include an internal control report. What an internal control report is designed to do is to show the company’s financial data accurately. Companies have confidence in these particular reports because its adequate controls are in place at all times in order to safeguard financial data. All year-end financial reports must always contain an assessment of the effectiveness of all internal controls. (Anand, 2004) Intended Purpose The intended purpose of the Sarbanes-Oxley Act was passed in the spot light of major corporate scandals.What a lot of these scandals had in common were that they engaged in skewed reporting of selected transactions. For example companies such as Enron, Tyco, and WorldCom misrepresented a variety of questionable transactions which ultimately resulted in very large losses for the stakeholders, of the companies, as well as a crisis in investor confidence. (Green, 2004) It was thought of by Congress that the Sarbanes-Oxley Act would address the problem by aiming to enhance corporate governance as well as to strengthen corporate accountability.Some of the ways that the Act does this is; it formalizes and strengthens internal checks within corporations. It has instituted various new levels of control and sigh-off which is designed to ensure that financial reporting exercises the full disclosure and that corporate governance is transacted with full transparency. (Green, 2004) Has the Sarbanes-Oxley Act been a success or a failure? This particular question is very debatable among different people. I would like to include both sides those who think that SOA has been a failure, and those who feel that SOA has been a success.Those who tend to criticize the Act, often times claim that the Act is unnecessary, and is too expensive to impleme nt. The most overbearing of all the criticizers of the bill claim that not only did the Sarbanes-Oxley Act fail, but also with its so called mission to ensure honest financial record keeping and disclosure but that it has also stifled new business development in the United States. Those who have deemed the SOA as being a success believe that more precise financial statements that are now being prepared for public companies allow the shareholders a greater confidence in regards to their investments. Green, 2004)Conclusion In conclusion having the opportunity to do this paper, has really taught me a lot about the Sarbanes-Oxley Act. Before doing the research I can honestly say that I had no idea what it was. My feelings on this Act is that I would more so deem it a success more than a failure for the simple fact that it allows shareholders of large corporations that added confidence and comfort when it comes to dealing with their investments. Also, it helps the internal controls of co mpanies which ultimately provides them more tools to stop fraudulent activity.References: Anand, S. (2004). The Sarbanes-Oxley guide for finance and information technology professionals: by Sarbanes-Oxley group. Clifton, New Jersey: CLA Publishing. Green, S. (2004). Manager's guide to the Sarbanes-Oxley act: improving internal controls to prevent fraud. Hoboken, New Jersey: John Wiley and Sons Inc.

buy custom Advance Accounting Research Case essay

buy custom Advance Accounting Research Case essay One of the codes of practice that are to be met by companies listed in the New York Stock Exchange is to prepare their financial statements based on the United States Generally Accepted Accounting Principle (US GAAP). Notably, the companies listed in the New York Stock Exchange include foreign and non-foreigners corporations that trade their shares. As it is recommended for all companies to produce financial statements that will give appropriate information to the stakeholders with interest in the company. As there is need information in order for shareholders, invest in locally and internationally owned companies it is critical to regulate the financial reporting standards in order to enhance uniformity in application of Generally Accepted Accounting Principles. The United States Securities and Exchange Commission oversees the companies adherence to reporting their financial statements under the US GAAP. For this reason, foreign companies have to oblige to the regulations by reconci ling their financial statements into the US GAAP. Sony Corporation is an international company that manufactures electronic goods and trades its shares in the New York Stock Exchange although it is a Japan based corporation. Sony Corporation is international companies with its subsidiaries based in Japan maintaining their records besides preparing their financial statement in accordance with Japan GAAP. On the contrary, the foreign subsidiaries of Sony Corporation maintain their records and prepare the financial statements with conformity to its domicile country GAAP. In order to come up with uniformity, certain adjustments and reclassifications have to be incorporated with regards to the consolidated financial statements such that they can conform to the US GAAP. This, however, does not include all the details in the financial statements as there are certain disclosures that are omitted from complying with the United States GAAP. The main reason behind the conversion is to ensure uniformity and consistency while giving final report s of the holding company f Sony Corporation. Japanese GAAP applies to most of Sonys subsidiaries in Japan in a different form as that used by the holding company as it applies the United States GAAP that is totally different in their rules and regulations in maintenance and preparation of financial statements. Differences in the Japan GAAP and US GAAP in Net Income Measure The difference in the net income of a financial statement maintained and prepared using the United States GAAP, and Japanese GAAP is brought about by the way the items found in the books of accounts are accounted for respectively. The books of accounts that are prepared at the end of the year give the final report through the cash flow statement, balance sheet beside the profit and loss account. Major difference arises in terms of accounting for the subsidiaries in the consolidated financial statement where according to Japanese GAAP, it is based on the control that the company has over its subsidiaries. On the other hand, the US GAAP recognizes the subsidiaries while preparing the consolidated financial statement depending on the majority voting interest by shareholders. Besides, the convertible bonds value differs when accounted for under the US GAAP and the Japanese GAAP. This is because Japanese GAAP converts changes in market bonds as net unrealized gains or losses under the net assets in the balance sheet whereas the change in market value in the US GAAP is reflected under the income statement. Accounting treatment of new policies under the Japanese GAAP is charged to the costs as soon as it is incurred unlike US GAAP where the insurance acquisition cost is amortized in order to be evenly distributed. Treatment of the actuarial gains or losses in retirement benefits according to Japanese GAAP amortizes the whole amount without a corridor unlike US GAAP that applies the corridor of amortization based on the value of the retirement benefit. Treatment of goodwill as the Japanese GAAP advocates for strict amortization with impairment whhereas the US GAAP advocates for impairment only and not aromatization. Where there is pooling of interest in business combinations the US GAAP uses purchase method while the Japanese GAAP ensures that it is exceptionally used when strict criteria have been met. Another difference arises in the measure of impairment of assets whereby Japanese GAAP takes the higher value between the net selling value and the value in use in order to determine the recoverable amount. On the other hand, US GAAP gives the measure of impairment of assets in terms of the fair value. Companys Profitability in Japan GAAP and US GAAP Companys profitability differs when US GAAP or the Japanese GAAP is applied when preparing the financial statements. Significantly, the difference extremely comes about due to the different currencies used in different countries. Whereas Sony subsidiaries use Japanese Yens, while maintaining and preparing the financial statements, an increase in the Yen value leads to lower profits as Sony Corporation reports low sales considerably. On the contrary, when compared to the use of US GAAP the translation of the values from Japanese Yen into the United States dollar in order to have uniformity is marked by differences in the exchange rates. As a result, of unfavorable exchange rates, Sony Corporation operations report an increase in the operating loss. In the long run, lower profitability levels led to, lower dividend returns and poor profitability performance of the Sony Corporation in the New York Securities Exchange as it trades its share to investors. However, the United States Securities and Exchange Commission has overseen that the use of US Generally Accepted Accounting Principles is not favorable they stipulate for the use of the Internationally Financial Reporting standards reinforcement by 2015. As a result, there will be uniformity in the application of accounting standards as most countries just like the Japan GAAP oversee its regulation adherence to the IFRS. Buy custom Advance Accounting Research Case essay

Free Essays on Computer Advnaces

People always tend to seek the easy way out looking for something that would make their lives easier. Machines and tools have given us the ability to do more in less time giving us, at the same time, more comfort. As the technology advances, computers become faster and more powerful. These new machines are enabling us to do more in less time making our lives easier. The increased use of computers in the future, however, might have negative results and impact on our lives. In the novel, Nine Tomorrows by Isaac Asimov often criticizes our reliance on computers by portraying a futuristic world where computers control humans. One of the images which Asimov describes in the book is that humans might become too dependent on computers. In one of the stories, Profession, Asimov writes about people being educated by computer programs designed to educate effortlessly a person. According to the Profession story people would no longer read books to learn and improve their knowledge. People would rely on the computers rather than "try to memorize enough to match someone else who knows" (Nine Tomorrows, Profession 55). People would not choose to study; they would only want to be educated by computer tapes. Putting in knowledge would take less time than reading books and memorizing something that would take almost no time using a computer in the futuris tic world that Asimov describes. Humans might begin to rely on computers and allow them to control themselves by letting computers educate people. Computers would start teaching humans what computers tell them without having any choice of creativity. Computers would start to control humans’ lives and make humans become too dependent on the computers. Another point that is criticized by Asimov is the fact that people might take their knowledge for granted allowing computers to take over and control their lives. In a story called The Feeling of Power, Asimov portrays how people starte... Free Essays on Computer Advnaces Free Essays on Computer Advnaces People always tend to seek the easy way out looking for something that would make their lives easier. Machines and tools have given us the ability to do more in less time giving us, at the same time, more comfort. As the technology advances, computers become faster and more powerful. These new machines are enabling us to do more in less time making our lives easier. The increased use of computers in the future, however, might have negative results and impact on our lives. In the novel, Nine Tomorrows by Isaac Asimov often criticizes our reliance on computers by portraying a futuristic world where computers control humans. One of the images which Asimov describes in the book is that humans might become too dependent on computers. In one of the stories, Profession, Asimov writes about people being educated by computer programs designed to educate effortlessly a person. According to the Profession story people would no longer read books to learn and improve their knowledge. People would rely on the computers rather than "try to memorize enough to match someone else who knows" (Nine Tomorrows, Profession 55). People would not choose to study; they would only want to be educated by computer tapes. Putting in knowledge would take less time than reading books and memorizing something that would take almost no time using a computer in the futuris tic world that Asimov describes. Humans might begin to rely on computers and allow them to control themselves by letting computers educate people. Computers would start teaching humans what computers tell them without having any choice of creativity. Computers would start to control humans’ lives and make humans become too dependent on the computers. Another point that is criticized by Asimov is the fact that people might take their knowledge for granted allowing computers to take over and control their lives. In a story called The Feeling of Power, Asimov portrays how people starte...

Strategic Human Resource Management (SHRM) Essay - 2

Strategic Human Resource Management (SHRM) - Essay Example This paper will examine various functions of human resource management in relations to APS business objectives and evaluate the human resource management aspects of the company. Strategic human resources management, alignment with mission achievement, strategic alignment these terms are some of the phrases, which are being used to explain the latest, evolving function of human resources management (HRM). Different people will give different meaning for these terms. Consequently, it is imperative to ascertain from the starting what we are really talking about. Human resources management alignment implies integrating decisions concerning employees with decisions regarding the outcomes a business is attempting to reach the objective of the company in relations to its business targets. (Hunger & Wheelen, 2003) This report will address strategic human resource management in APS Company. The report will take a critical evaluation of the human resource and offer the best strategy to follow. With human resource rising as the primary asset of an organisation, human resources (HR) management are being faced with new challenges to come up with strategic approaches that can add value to the organisations when sourcing for new employees. To address this issue the human resource have to formulated strategies that will add value to an organisation in pursuit of identifying, recruiting, developing and retaining highly talented employees who can take the company to new heights and provide a competitive advantage to the company (Armstrong, 2006) Recruitment and retention Beardwell & Holden (1997) states that; employee recruitment is very important in an organization. It consists of administration, performance and staffing. All these are interrelated activities that are carried out in an organization. Management and staffing activities help in ensuring that employees with right or desired skills are recruited. The employees have also to be in the right numbers desired by the organization. Employee recruitment aims at ensuring that employees are at the right place at the right time. Human resource manager in this case is concerned with ensuring that employees perform their best. Best recruitment processes insure that the organizations get the best staff that can improve and add value to the company. The human resource has to provide better employment terms to retain employees who are experienced in the organization. This will highly help the restructuring processes. (Beardwell & Holden, 1997) Training and development Each employee requires more learning in order to improve his /her skills, no matter how best a candidate is, he/she can not be 100% percent qualified. Thus, the human resource management should implement learning management system (Beardwell & Holden, 1997) In general the human resource management is supposed to come up with training and education programs for its employees. Training can be termed as systematic enhancement of knowledge, skills and attitudes of the needed by an employee in order to perform a given task. Development is the growth of an employee in terms of capability, understanding and awareness. In an organization training and development is important in order to; 1. Develop a workforce that can perform higher-grade assignments 2.

Environmental Factors Paper Essay Example | Topics and Well Written Essays - 1000 words

Environmental Factors Paper - Essay Example Toyota is one of the world’s leading car manufacturing companies which produce and market more than 8 million cars every year. It has a global presence with manufacturing units in more than 27 countries and vehicles sold in more than 170 countries and regions (Toyota, 2010). This paper discusses how various environmental factors affect the marketing decisions of Toyota. Influence of global economic interdependence and the impact of trade practices and agreements It is quite important that Toyota understand the importance of economic interdependence and the impact of trade practices since the current economic situation calls all the countries in the world to be highly interdependent. Toyota can efficiently procure the vehicle parts from specific countries and strategically increase the market share in the countries where they do business. On May 2009, Toyota reported a record loss of $4.2 billion due to the global financial crisis. This shows that the performance of the firm is highly related to global economic conditions. Differences in tariffs, taxes and trade agreements between different countries need to be considered while pricing the products. A high import duty will make a country less attractive to do business with. On the other hand a subsidy on international trade will make a country more attractive to trade. Importance of demographics and physical infrastructure Demographics and physical infrastructure are both macro environmental factors that affect the marketing decision of any firm. The marketing decisions of Toyota are shaped by the demographic factors of human population such as size, location, gender, occupation, race, etc. For example, Toyota cannot supply vehicles to a location where it does not get a cost advantage. So it has to decide on the feasibility of opening a manufacturing unit in that location if the consumer demand is high. The demographic environment can also be classified on the basis of generations. They are Baby Boomers, Generation X and Generation Y. The needs and aspirations of these different generations are different in the form of vehicle design, performance, mileage, pricing etc. Promotional measures should also be made in order to give the right appeal for each of these segments. Physical infrastructure also plays a major role in designing the marketing decisions of Toyota. The vehicles marketed in one country may not be apt for some other countries due to the infrastructure those countries have. In such cases, there needs to be a structural redesign on the vehicle before it can be marketed to such countries. Also the availability of good physical infrastructure will help determine whether it is beneficial to open up manufacturing units for reasons of easy availability of energy, water supply, telecommunication facility, etc. Influence of Cultural Differences Toyota has over the years developed an image of trust and value among the minds of the customers. The marketing strategies will be aime d at making people associate themselves with these qualities in order to affect their purchase decision. People perceive Toyota as a lifestyle brand in some countries whereas in some other countries they consider it as a quality brand. It is the ability of the marketing department that enables Toyota to position the vehicles in the minds of the

Assignment 4 Essay Example | Topics and Well Written Essays - 1000 words - 1

Assignment 4 - Essay Example So pick a card, any card. Wouldnt you think that your odds of finding a number starting with 1 would be the same as finding a number starting with 9? Or 3? Or 7? (See Figure 1) After all, you gathered as many different numbers from as many different locations as possible, so they should all be evenly distributed, right? Wrong!!! Here comes Benfords Law, bitch! Benfords law says that the odds of obtaining 1 as the first digit of a number are much higher than obtaining any other digit. (See Figure 2) And nobody can really explain why! Creeeepy. But the coolest thing is that the broader the sampling of numbers, the more accurately they conform to Benfords law. For example, if you only examined the numbers in a New York City phone book, it wouldnt fit with Benfords law because your data would favor 2s and 7s (because of the popular area codes 212 and 718). But mix a phone books numbers with an almanacs numbers with an encyclopedias numbers and without a doubt youll start seeing a "Benfordian" distribution. Didnt I tell you this shitd freak you out? But the most important part of Benfords law (and partially why its so fascinating) is that it only works with numbers observed and gathered from the real world. So if you were to randomly generate a list of numbers with a computer, or by simply making them up, their first digits would most likely be evenly distributed from 1-9 and NOT in accordance with Benfords law. (See Figure 1 again). For this reason, Benfords law is used by the IRS to spot defrauders who make up phony numbers, because if the numbers dont follow Benfords law, they werent from real transactions. Fascinated by all this, I decided to test it for myself. Rather than spend years gathering numbers from all over the world, I decided to turn to Google - arguably the broadest source of data in existence. Seeing how many results Google finds for a number is a surefire way to judge how many times

Ethnicity in Sociology Essay Example for Free

Ethnicity in Sociology Essay -Much greater levels of police stop and search on young black African-Caribbean males, than whites. -After attack on World Trade Center in 2001 and London Underground bombings in 2005, a new discourse has emerged regarding Muslim Youths. -The new image of them is of being dangerous- a threat to British culture. Offending -There are 3 ways on gathering statistics on ethnicity and crime: official stats, victimization studies and self-report studies. -According to Home Office statistics, about 9. 5% of people arrested were recorded as ‘Black’ and 5. 3% ‘Asian’ (similar rating to white). This means that, relative to the population as a whole, black people are 3x more likely than whites to be arrested. -However, these stats could be seen as a comment on the actions of the police. – some sociologists argue there is institutional racism in police. -Offenders are most likely to be young males aged between 14 and 25. Any ethnic group with a high proportion of this age group within it will have relatively high arrest rates. The British black pop has high rates, and so it would be expected that they’d have high arrest rates too because of this. -Stats show that Black Youth are more likely to be unemployed or in low paid jobs. Victimizing studies -Victim-based studies (British Crime Survey) are gathered by asking victims of crime for their recollection of the ethnic identity of the offender. -According to the British Crime Survey, the majority of crime is intraracial, with 88% of white victims stating that white criminals were involved, 3% claiming offenders were black, 1%Asian, 5% mixed. -About 42% of crimes against Black victims were identified as black offenders and 19% of crime against Asian were Asians. -The figure of white crimes AGAINST ethnic minorities are much higher – 50% (though 90% of pop is white). -However only 20% of survey-recorded crimes are ‘peronal’ such as theft, where the victim may actually be able to identify the offender. Bowling and Phillips argue that victims are influenced by racial stereotypes and ‘culturally determined expectations’ as to who commits crime. Their research shows that where the offender is not known, White people are more likely to describe those of African-Caribbean background. Self-Report Studies- asked in anonymous questionnaires to see what offences people commit -Graham and Bowlings study for the Home Office of 14 to 25 year olds, found that the self-reported offending rates were more or less the same for the White, Black and Asian respondants. However, Blacks are 3. 6 x more likely to be arrested (Jones and Singer). Sentencing -After arrest, Affro-Carbs are slightly more likely to be held in custody and to be charged with more serious offences than Whites. But they are more likely to plead, and be found ‘not guilty’ -Bowling and Phillips state that these stats indicate that that both direct and indirect discrimination (types of charges laid, accsess to bail etc) against members of ethnic minorities do exist. -For example, Those of African-Caribbean backgrounds have a 17% higher chance of imprisonment than whites. Punishment -According to Jones and Singer the proportion of Black British background took 19% of total prison population. Racist Policing -Most sociologists ie Mayhew et al a rgue that most crime is committed by young males who come from a poor background. -The ‘canteen culture’ approach argues that police officers have developed distinctive working values as a result of their job. The core characteristics of this culture according to Reiner include a thirst for action, cynicism, macho values and racism becasude they often feel pressure/work long hours/face public scrutiny etc. -Studies by Smith and Gray (who himself was a policeman) showed racist views by the police force and they targeted blacks. Institutional Racism -After the racist murder of Stephen Lawrence, the Macpherson Report was set up to look at the circumstances of his death and handling of the situation by the police. Sir William Macpherson said ‘police had procedures, practices and a culture that tended to exclude or disadvantage non-white people’. Left-realist approach -Lea and Young accept that there are racist practices by the police but argue that despite this, the statistics do bear out a higher crime rate for street robberies and associated ‘personal crimes’ by youths of Affro-carb backgrounds. -They explain this by suggesting British society is racist and that young ethnic minorities are economically and socially marginalized (pushed out of society), with lesser chances of success than majority of population. Cultures of Resistance -Because minority groups have been discriminated against (colonialism etc) leaving them in a lower socioeconomic position compared to whites, a culture of resistance formed. -COF = organized resistance that has its origins from anticolonial struggles. Ie when young offenders commit crime they are doing it as a political art rather than a criminal act. -However Lea et al argues that this doesn’t account for the high proportion of Black on Black crime. -Fitzgerald et al = street crime is caused by deprivation, lack of community -Higher crime in lone-parent fams -Justifications among crime such as l=bad education, alienation from schools etc.

Assisting In Endotracheal Intubation Nursing Essay

Assisting In Endotracheal Intubation Nursing Essay An ETT is an advanced measure of airway management, where a catheter is inserted in the trachea generally through the mouth. This creates a direct passage between mechanical ventilator, which simulates breathing, and the lungs, where gaseous exchange occurs. ETT is most commonly used in unconscious or sedated patients, where the patient may lose spontaneous breathing, also bringing about benefits like protection from aspiration of gastric contents into the lungs, which lead to infection and complications. Considerable amount of attention is given to the intubation procedure, avoiding trauma and infection. Preparing a patient for intubation requires the patient to be positioned in the sniff in the morning, that being body straight with head slightly tilted to the front to obtain a straight airway. An anaesthetist will perform this procedure and the nurse prepares the necessary: an intubation set including an Ambu with face mask and other connectors and a laryngoscope with different blade sizes and muscle relaxant (Atracurium) and sedation (Propofol) medication are prepared. Once everything is checked that is in perfect working order, the anaesthetist, positioned behind the patients head, starts by giving the first IV bolus of Propofol later followed by the Atracurium. From this point onwards sedation will be administered by the nurse, and the anaesthetist will keep the head in position to maintain an open airway and bag the patient for 1-minute using the soft Ambu attached to the mask with 100% oxygen at 10-15l/min to hyper-oxygenate. After this 1-minute the first try for intubation is began and this should be no longer than 30secoonds. A laryngoscope is then inserted from the right side pushing the tongue to the side and lower, this will create physical space to see the epiglottis and the laryngoscope will be advanced slightly more to see the larynx. Once identified, the ETT is carefully advanced from the right side over the laryngoscope and straight between the larynxes. Then the tube is advanced up to 21-24cm from its markings, laryngoscope withdrawn and the soft Ambu is now connected with a specific connector to attach to the ETT. The anaesthetist will now bag and auscultate over the chest to check position of ETT, and to check that air is going into both sides of lung, or only a single side or worse the stomach. During the process the nurse may be requested to give more boluses of sedation, depending on what the anaesthetist encounters. Once the position is confirmed, the ETT is secured using a tie or a facial adhesive. The patient is then connected to the ventilator, where the anaesthetist gives the initial setting and liaises with the nurse on the aims and guidelines needed to safeguard the patients health and especially avoid unnecessary complications. Continuous sedation is as well started as now the patient is preferably left unconscious to stabilise, as a patient may extubated once semi-conscious and agitated. Parameters post-intubation are checked and charted, blood gases are taken and analysed. Shortly after insertion a chest X-ray is performed to verify positioning thanks to the radio-opaque strip incorporated in the ETT. Indications for intubation may vary from hypoxemia, loss of consciousness, airway obstruction or manipulation of the airway. In one of the cases I had the opportunity to observe clearly, the patient was suffering from pneumonia and was losing consciousness as she could not maintain a decent pO2 via a non-rebreather mask and started to get agitated and therefore continue lowering her oxygen saturation level. I took a blood gases sample and it resulted in a low enough result that the nurse decided to advise the anaesthetist to try intubation, apart from the fact that she was definitely in need to be sedated to reduce her agitation. In a pneumonia case a sedated patient may benefit more from care and obtain a healthier outcome as consciousness is then resumed when infection has started to clear. Intubation as like all the other invasive procedures carries numerous risks for the patient. To start with is the high risk of infection, which may come from lack of attention to asepsis during the procedure, and there can even be trauma to the lungs if the anaesthetist goes in too far with the ETT, or can even cause trauma to the buccal cavity, where with the use of the laryngoscope, leverage over the teeth may be exerted leading to the breaking of teeth. Moreover, if the patient takes too long to be intubated hypoxia may result, since the patient is not breathing at all. Single-sided or stomach intubation may occur as well. In the intubation procedure, precautions to prevent complications include patient sedation and muscle relaxation at the start of the procedure to avoid movements of any muscles. The patient is positioned to help the anaesthetist have an improved visualization of the larynx while using the laryngoscope. A measurement of the length of the airway is taken, to avoid inserting the ETT too much further down into the lungs. A patient is bagged for 1-minute prior to trial of intubation and no try takes longer than 30seconds, and ultimately a chest X-ray is performed to confirm ETT position. Blood sampling through an arterial catheter An arterial catheter is one of the most common lines required in ITU, indispensable for continuous intra-arterial blood pressure which is essential in a critically ill patient supported by vasoactive drugs. Moreover it aids in arterial blood sampling, being routines or ABG of an intubated patient, where if a patient doesnt have an arterial line would be pricked countless times during a single day, therefore is a benefit for the patient as well. Taking a blood sample through an arterial line requires following step by step instructions, while always keeping in mind asepsis, as although it is not actual invasive procedure, we are dealing with arterial blood and colonising a cannula imposes great risks of infection. To start with, perform hand hygiene and prepare essentials within easy reach, including alcoholic 2%chlorohexidine wipes (clinell), a packet of sterile non-woven swabs, pair of non-sterile gloves, luer lock stopper, 5ml syringe, ABG syringe, appropriate vacutainers and luer lock adaptor. Once everything is prepared and patency of line is checked by using the flushing device, perform hand hygiene once again and wear gloves. Place the open packet of sterile swabs under the area you will be working around, i.e. the 3-way tap on the arterial line. Wipe the stopper locked port at the 3-way tap for 15seconds using a clinell wipe. Now the 3-way tap OFF position should be facing the port that has just been disinfected, remove the stopper and attach 5ml syringe using a non-touch technique, turn the 3-way tap to OFF from flushing device and aspirate the first 3-5ml which will contain mostly heparinised saline. Turn the tap back to OFF from the port being used. Now, remove the 5ml syringe and start from collecting blood sample for ABG, using the same non-touch technique attach the syringe to the port, turn the stopper OFF from the flushing device. Withdraw small sample of blood (up to half of ABG syringe, approximately 1ml), if you require more blood samples turn the tap OFF to port again and remove ABG syringe while attaching its stopper at its end, connect luer lock adaptor for vacutainer use. Now turn the tap OFF to flushing device and start pressing each vacutainer until it stops filling, always changing the vacutainers using non-touch technique. It is suggested to leave for last any blood test sample that its result is affected by the amount of heparin in the sample, eg. APTT/INR. Once finished from taking the necessary blood samples, turn tap OFF to patient and flush using flushing device onto the packet of swabs. Once clear from blood, close with luer lock stopper using non-touch technique. Now turn the tap OFF to port and flush the remaining part of the arterial line. Avoiding leaving blood traces in the lines will ensure longer lifetime and patency of the arterial line itself. Patients in a critical care setting most often need several blood sampling every day, one indication may be ABG monitoring due to the patient being supported by a mechanical ventilator. ABG sampling is also needed in the weaning off process, but can also be used to monitor any acidosis or alkalosis the patient may be suffering from, due to his admitting condition. Other blood samples are mostly taken routinely in the morning and more investigations may be required throughout the day. The withdrawal of blood via an arterial line is not an invasive procedure, though it is still a manipulation of a catheter leading to the bloodstream, therefore it exposes the patient to a high risk of acquiring a nosocomial infection through the line if asepsis is not maintained throughout the procedure. The colonisation of the line without adequate disinfection may eventually lead to life-threatening septicaemia. Prevention of infection was applied using universal precautions like hand hygiene, disinfection using alcoholic 2%chlorohexidine wipes (clinell) and non-touch technique. This minimised drastically the chances of nosocomial infections. Section B INTERPROFESSIONAL COLLABORATION IN THE CRITICAL CARE SETTING Describe the role of the nurse in each of the following units: Intensive Therapy Unit (ITU) Neonatal and Paediatric Intensive Care Unit (NPICU) Burns and Plastic Surgery Unit Renal Unit Intensive Therapy Unit (ITU) An Intensive Therapy Unit (ITU) nurse is required to work in a setting where patients are experiencing or at-risk of experiencing life-threatening conditions, thus require complex assessment, high-intensity therapies and interventions, continuous nursing care and high-tech monitoring. Critical care nurses trust upon a particular organization of knowledge, skills and experience to provide care to patients and families and create healing, humane and caring environments. Patient advocacy is a major role in ITU nursing, as usually the conditions of a patient may be poor to the extent that the patient is unconscious or else is induced into unconsciousness. Therefore the nurse has to act on behalf of and in the patients best interest as the patients advocate and ensuring that the patients family are well informed about the care that the patient is receiving. The necessary information needs to be given to help make highly personal decisions about the patients care, and that the patient and familys decisions are respected in the development of any treatment plan for the patient. Advanced and continuous assessment needs to be carried out to verify patients health status; physical assessment may include Glasgow Coma Scale, eye sensitivity test, cardiac auscultation, abdominal palpation and more. Leading then to high-tech monitoring from highly specialised bedside monitors, requires critical nurses to be trained in telemetry. Telemetry is a computerized monitoring system that transmits essential information about the condition of the patient (heart and lung activity), and the nurse using this information can make healthcare judgements. Therefore with the help of telemetry in conjunction with the extensive knowledge of pathophysiology of illnesses, nurses assess the need to perform any intensive interventions that the patient might need. For instance, take arterial blood gases of a patient if oxygen saturation are getting lower, or perform suctioning if certain breathing sounds are noticed. More assessment may be done after certain interventions and therefore prevention of degrading in the patients condition is another main responsibility of the ITU nurse. This requires the nurse to be able to interpret any result and respond with an appropriate intervention, these may include; titration with inotropic substances to maintain a pre-determined arterial pressure, increase oxygen supply through the mechanical ventilator or change the mode it is set to wean off from extra support. ITU nursing in certain large-scale hospitals may be split in specialized sectors, like for instance the Cardiac Intensive Care Unit (CICU) in Mater Dei Hospital is a post-surgery intensive unit mostly dedicated to open heart surgery, leaving the ITU to take care of mostly post-laparotomy patients, serious trauma and other life-threating cases, including severe infections. Neonatal and Paediatrics Intensive Care Unit (NPICU) Nurses working in Neonatal and Paediatrics Intensive Care Unit (NPICU) require being extremely careful and vigilant, as this field requires working with neonates which may have some sort of complication from birth (or even before) to kids up to four years. As with all patients of this age group, symptoms and conditions change drastically, due to the frailty of the neonates, therefore continuous assessment is of extreme importance. As cases can differ from premature babies to post major operation neonates, the care is split into three: Intensive, High-Dependency, and Special Care. Caring for this type of population, care is adopted to support the patient medically and physically, assess and monitor but a great input in supporting psychologically the parents is a major requirement in these cases as they will be going through a really rough period, especially in the most serious cases like complications. Necessary time and information is given to the parents to understand what is going on with their child, involvement in the babys needs in special care. In intensive and high dependency cases, the patients will be connected to high tech bedside monitors; monitoring vital signs like arterial blood pressure, ECG traces, respirations, oxygen saturation and pulse. Most often patient with such frailty will be in a temperature controlled and humidified incubator to keep a stable environment, promoting recovery. The need of certain accesses may be essential as well, an umbilical line (usually arterial) is needed in cases of drug and fluid therapy, intubation may be needed in some of the cases as well. Inputs and outputs are strictly monitored throughout all levels of care provided in the unit, but as blood gases and other blood investigations may also be essential in certain intensive cases, keeping the blood volume withdrew as low as possible is of extreme importance as too much blood withdrawal in neonate may lead to serious complications. For special care there is more the usual care of a baby, therefore involving basic feeding, bathing and nappy changes, but need some extra care especially in calculation and handling due to the their small structures. Naso-gastric or oro-gastric tubes may be necessary in patients premature enough not to have a fully developed swallowing reflex or those too frail to suckle all the milk they need to maintain themselves. In this type of care, parents (especially the mother) are encouraged to handle and take care of the baby themselves as this has positive effects on both the mother and babys health. The nurse is responsible to liaise with the mother to set appointment regarding washing her baby or nappy changes which the mother may wish to do herself. Monitoring of daily weight, measurement of Occipitofrontal Circumference (OFC) and nappy weighting are some of the documentation taken by the nurse apart from the regular vital sign like temperature and heart rate. Plastic Surgery and Burns Unit Nurses working on the Plastic Surgery and Burns Unit (PSBU) may encounter the extremes of wounds through skin layers, since those present in burns cases could involve from only skin to muscles, nerves, blood vessels and even bones. On the other hand, plastic surgery is more related to the surgical grafts done post-recovery from a burns accident, or superficial level surgery like the removal of melanomas and other skin disorders. Burns nurses are responsible in fluid resuscitation given through wide-bore IV lines in severe cases of burns. In conjunction with fluid resuscitation, is a strict input and output charting to assess renal perfusion due to large volume loss from interstitial spaces due to loss of skin. Haemodynamic monitoring is another essential role, as the fluid loss from wounds may lead to hypotension, inotropic substances may be needed to support the heart muscle in extreme cases. Furthermore, the importance to keep sterility over wound and to aseptically cover using a special type of dressing containing paraffin oil, which does not allow water to transpire, is stressed in burns cases, as once the skin layer is lost, all the infection and water loss prevention which the integumentary system was responsible for, are now absent. In the plastic surgery cases, nurses are mostly responsible in post-op wound reviews and change of dressings. The nurse also advises the patients to protect fresh wounds and prevent infections. Renal Unit Dialysis Nurses on the Renal Unit work with a patient population of solely End Stage Renal Disease (ESRD), therefore their insight into the illness and its treatment needs to be well-defined. Dialysis treatment, which is the process of removing waste from the blood of a patient whose kidneys lost this function, is available in two modalities, namely; Haemodialysis (HD) and Peritoneal Dialysis (PD). Nurses in charge of PD patients conduct periodical reviews to collect blood, peritoneal fluid and swabs for investigations. Their main responsibility though, is to check progress from the personal log that the patient is encouraged to keep from the start of the treatment, this includes daily weight, oral intake, dialysate input (type and amount), dialysate output (colour/consistency and amount). Since PD is a self-care treatment at home, a high-quality nurse-patient relationship is required to assess for adherence to treatment. The nurse is responsible to liaise with patient and relatives if they are encountering any challenges during treatment. Advices about the necessity of any treatment changes and the importance of asepsis during treatment, to avoid unnecessary exposure to infection, i.e. peritonitis, are one of the key responsibilities of a PD nurse. On the other hand, nurses responsible of HD patients, unlike PD, have a more direct responsibility with the patients infection prevention. The nurse first responsibility is to inspect equipment, ensuring it is in perfect working order before use and all lines are new and sterile to minimize chance of infection. Review of the patients previous session handover and preparation of any treatment needed during the dialysis is carried out by the nurse. A typical dialysis treatment starts with morning weighting and then, the nurse, using strict aseptic technique, inserts two wide bore cannulas into the patients AV access. Finally the patient is connected to an HD machine for 4 hours, set to target weight calculated by the physician, to remove excess water and waste products from the bloodstream. Before, during and after these 4 hours, vital signs are checked and charted. Routine blood investigations are also taken and any indicated medications from previous investigations are administered and documented. The patient is advised of the possible complications and suggested to notify as soon as any abnormal feelings set on. Any pain complaint reported by the patient during the dialysis is reported in the documentation for hand over and physicians are contacted in view of treatment changes requirements. Moreover, as HD patients have to attend these sessions 3-4 times weekly, the need of a quality nurse-patient relationship is essential. The dialysis nurse spends time with the patient assessing any psychological or physical ill effects of the illness and documents an adequate handover to obtain successful treatment of this condition. Compile a list of the different types of health care workers whom you encountered during this entire placement. Physiotherapists Anaesthetists Midwives Nurses Nursing Aides Care workers Radiographers Speech Language Pathologists Occupational Therapists Audiologists Electrocardiogram (ECG) Technicians Describe the role of THREE other (non-nursing) members of the ITU team. Include key responsibilities of these persons for the patient. From your observation, what is the nature of their interaction, if any, with the critical care nurse? Physiotherapists Physiotherapists in an intensive care setting are mainly responsible for clearing secretion from chest walls using positioning, percussion, manual hyperinflation and vibration. These methods clear the peripheries of the lungs and mobilize secretions to the central airways to be easily suctioned and therefore re-establish a larger lung capacity. Apart from chest-physio, they also work with conscious patients on the early movement of limbs to resume physical function and avoid muscle waste due to being sedated and bed-bound. Whilst encouraging the patient to do these exercises on his/her own initiative as needed, the physiotherapist reports to the nurse any result of his/her actions and reminds the nurse to encourage and observe the patient doing the exercise needed for further improvement in recovery. Radiographers Radiographers in the ITU setting are not mainly responsible for diagnosis, as in critically ill patients usually the underlying conditions of illness are discovered prior to admission. Though, with the use of portable X-ray machines, their help is essential in confirming the positions of any tubes or lines inserted in the unit or theatre, whilst minimizing discomfort of unnecessary transport to the Medical Imaging. Moreover through radiography any degradation of the ITU admission health insults may be identified, for example comparisons of previous chest x-ray to analyse if consolidations increased or decreased. The radiographer-nurse relationship is usually more concerned in helping to position the patient well to get a clear shot, giving the possibility to take the most out of the X-ray taken. Once published, X-ray are seen by medical staff to verify placement of any newly inserted central venous line or endotracheal tube, and the progression of the condition is also assessed. Electrocardiogram (ECG) Technicians ECG Technicians are indispensable in cardiac related admissions in ITU, this usually would be a post-MI patient with recurrent arrests. Their main responsibilities are into attaching leads at specific sites on the patients body to the ECG machine, which in turn prints the signal it receives onto an ECG strip. Although patient in an ITU setting are generally attached to a continuous ECG monitor, this type of ECG gives a better picture of any arrhythmias and axis deviations of the pulse. The technician then analyses the result, identifies any emergencies and liaises with nursing staff and medical staff. Most often this involves cardiology staff as well, since decisions regarding treatment are usually deducted from these types of ECGs. Section C DOCUMENTATION Why is documentation important in a critical care area? Documentation in critical care, as in the all nursing field, is an essential role which enables a better continuation of care and assessment of progression or regression of the patients condition. That said, the importance of precise information in the critical area is exponential to the fragility of the critically-ill patient, therefore this gives a valid reason for the necessity of hourly vital signs, urine output, continuous IV pump rate and more. Along the various types of documentation, comes in the rationale for certain actions taken leaving a pattern to be followed and leave good ground for recommendations to be given during handover. For instance, low oxygen saturation is monitored and the nurse decides to perform suctioning and an improvement is visible in the forthcoming readings, therefore one can suggest the following nurse to try this method as it has shown good results. Moreover, importance of documentation increases as the risks for the patient increase leading to a more responsible practice. This helps to improve quality of care provided and safeguard the patient from malpractice. Documentation is critical not only for nurses in this setting, but plays quite an enormous part in any of the doctors actions, as strong and consistent rationale is needed to back up certain decisions taken in critical life-threatening moments to improve care given and obtain healthier outcomes. List all forms of documentation which nurses perform in each of these units: Intensive Therapy Unit (ITU) Neonatal and Paediatric Intensive Care Unit (NPICU) Burns and Plastic Surgery Unit Renal Unit Intensive Therapy Unit Chart (incl. Hourly Parameters, Investigation Results, I.V./Oral Intake, Ventilation (via type of Mask or Ventilator Mode (SIMV, CPaP, BiPaP) FiO2), Continuous I.V. Treatment, Output via N.G./Drains/Urinary Catheter), Handover Sheet Neonatal Abstinence Scoring System, Investigation Flow Chart, Parameters + Intake/Output Chart, Fluid Prescription Chart, Apnoea Chart Parameters + Intake/Output Chart, Chart for Estimating Severity of Burn Wound, PSBU 24hrs. Drain Output Chart Haemodialysis Chart (incl. Parameters, Actual + Target Body Weight, Blood Test Results, Handover for next session) Section D ITU PROCEDURES During your ITU placement, select one of the following procedures which you have observed and in which you have taken part: Admission of a patient to ITU Transport of a patient to the operating theatre or the medical imaging department Discharge of a patient to another ward/unit (a) DESCRIBE the nursing observations, actions and documentation during the procedure. Include a rationale for these activities. (b) How did YOU participate in this event? (c) REFLECT on what was done properly and what could have been done better. Transport of a patient to the operating theatre or the medical imaging department The transport of a critically ill patient is one of the most challenging and requires a lot of preparation, but thanks to the portable X-ray and Ultrasound (US) technology this occurs in only a few cases like Magnetic Resonance Imaging (MRI) or Computed Tomography (CT) scan, or else an essential need to transfer back to the operation theatres in case of complications. In a case I had the opportunity to take part in; we had to take a patient to MRI for a brain and C-spine scan. The nurses I was with started from contacting an anaesthetist as the patient was intubated, contacted a radiographer to take girth measurements, since the patient was obese, to check if the patient would go through the scanner and contacted the family that their relative will go for a scan and may not be there when they come. Afterwards the nurse extended IV tubing to obtain enough length during the scan, while I started to collect all the portables needed for the transport including; oxygen cylinder, portable ventilator, crash pack, Ambu bag and monitor stand. Preparation of extra sedation, other IV treatments and necessary flushing solutions was done to prevent running out of medications during this transportation. The nurse checked that the patient was stable enough on the current inotropic support and sedation. The nurse also checked the oxygen tank pressure, ventilator function and just before we left connected to portable machinery and evaluated condition of the patient again and charted the parameters. The anaesthetist gave a dose of muscle relaxant to avoid any unexpected movements from the patient while doing the transportation, which could lead to lose the airway if the patient would extubate. Extra muscle relaxant was prepared as well. Leaving off from the ITU, we continuously monitored the patients parameters on the monitor, arrived securely at the medical imaging and started discussing what needs to be removed or replaced from the patient before we enter the MRI room. Certain machinery is not MRI-compatible, therefore the exposure to that magnetic field would damage it or cause malfunction. Following advises given by the radiographer, anything that needed to be removed was removed, leaving only essential monitoring to be removed and re-attached to appropriate machinery once in the MRI room. Patient was then transferred from the bed to the MRI table going straight into the MRI room, back on essential monitoring assessment of condition was done and we aligned MRI table to the scanner to start the procedure. During all this time the nurse and anaesthetist gave necessary amount of sedation and muscle relaxation bolus to prevent accidental alertness of the patient and unexpected extubation. The moment when we were getting the patient inside the scanner, we realized he wouldnt get in because of his hands had to pass over his already enormous girth and he simply wouldnt fit. At that point we realized we made a lot of effort, but unfortunately we were still unsuccessful. Therefore all the process had to be reversed, and once out from the MRI room, settled the patient with adequate monitoring for transportation back to ITU. Once back in ITU, we removed any unnecessary tubing, placed all transport equipment back in place and documented parameters post-transportation. A note was added in the documentation regarding the failed MRI; the family was let in to see the patient and was given an explanation of what was done during the day. Looking back and reflecting on the event, I realise the amount of things that are taken in consideration prior to leaving the ITU. The importance given to sedation and muscle relaxation to avoid extubation, Ambu bag for manual ventilation in case portable ventilator stops working or needs to be disconnected. The extension of the IV tubings was something, that actually didnt even cross my mind and though so important. Preparation of extra medication, not too run without during transport. These are all things that require effective thought as if omitted, the repercussions can be terrible. I dont consider the unsuccessful try of getting the patient into the MRI has anything to do with being unprepared or unaware of something, as this fact was taken in consideration from the beginning. I do consider it as an unfortunate event, which left us all with another important lesson learned. I believe it is imprinted enough that, from now onwards when I hear that a patient is for MRI will be the first I will consider. Section E PATIENT CARE IN A CRITICAL CARE SETTING In this account I will be focusing on a case I followed during my placement on the Renal Unit at Mater Dei Hospital. The case study involves an interview with a 27-year old male patient suffering from End Stage Renal Disease (ESRD). This gentleman is to date known to have lost renal function due to Focal Segmental Glomerulosclerosis (FSGS) with onset of illness symptoms started at 17 years of age. Due to ethical reasons the patient involved in this account will have the pseudonym Mr. Frank Abdilla. Mr. Abdilla has been treating this illness for slightly more than 10 years now and is currently following haemodialysis (HD) 3 times a week. I started this interview with getting to his medical history, and to tell me more about the onset of the illness and its treatment to date. Frank expressed that he suffered from nothing prior to the onset symptoms, which he referred to them as a silent killer symptoms. I only know that I started to feel less the urge to urinate and my breath had a foul smell, then after a couple of days I had an episode of loss of consciousness,