Neil Postman's view on either religion, politics, or education in Essay

Neil Postman's view on either religion, politics, or education in Amusing Ourselves to Death - Essay Example This is certainly true, as many local cable shows make religion to be some kind of spectacle and not much else. However, even off the television religion is not all that great and in fact many of the things Postman talks about have been carried out long before television existed. According to Postman, when religion is put on television, "Everything that makes religion an historic, profound and sacred human activity is stripped away; there is no ritual, no dogma, no tradition, no theology, and above all, no sense of spiritual transcendence" (Postman). He says that what happens instead is that the preacher becomes more important than God himself, and that essentially the religious experience becomes some kind of cult of personality where the audience is enthralled with the preacher who owns the television show. Postman cites a number of television shows which proves his point. His three main examples are Jim Swaggart, Pat Robertson, and Reverend Terry. Reverend Terry "offers a "prosper ity Campaign Kit," which appears to have a dual purpose: As it brings one nearer to Jesus, it also provides advice on how to increase one's bank account" (Postman). Pat Robertson is not quite so bold about it but his 700 club still charges people "fifteen dollars per month" to belong to it and to keep running (Postman). Jim Swaggart is in the old style but his preaching is still television-ized, his sermons are "theatrical, emotional, and in a curious way comforting" (Postman). Indeed, there are plenty of television shows like the ones Postman mentions. Local cable stations abound in just the sort of preaching that he is talking about. In fact, things have gotten worse since Postman's writing. Figures like Glenn Beck, who has a television show as well as a radio show, actually just spread hatred and spectacle on their show purely for ratings. Glenn Beck is a reat example of the preacher being more important than God, like Postman says. Postman, though, says television "is not congen ial to messages of naked hate" (Postman). Figures like Beck show this is not the case, and suggest that religion has become even more degraded by television now. Postman believes that television automatically changes the message of anything, and that this is why religion becomes cheapened on television. Unlike the thrill of being there in person, where the preacher can speak more directly to you, television makes this impossible because you do not know who is watching and have to take care of the ratings. Basically he says that "on television, religion, like everything else, is presented, quite simply and without apology, as an entertainment." Postman compares several pre-television evangelists to the three TV preachers he brought up. He says that men "such as Jonathan Edwards, George Whitefield and Charles Finney, ... were men of great learning, theological subtlety and powerful expositional skills" (Postman). He says that what makes the real difference though, is that the medium o f television is not as effective as the medium of being there in person. The problem with moderrn evangelists is that they do not "the truth, if they think about it at all, that not all forms of discourse can be converted from one medium to another" (Postman). He says this is like translating poetry, where the message remains but the meaning is lost. While Postman does make a good point about ratings, it is not necessarily true that all pre-television evangelists were better at their job. For instance there must have been many who were just in it to make money by entertaining people, and in a time when television was not available there was not any other sort of entertainment. For this reason

How Do Abiotic Factors Influence the Rate of Photosynthesis?

How Do Abiotic Factors Influence the Rate of Photosynthesis? Table of Contents (Jump to) I. Background Research Design II. Research Question III. Hypothesis IV. Variables V. Apparatus VI. Safety Aspects/Animal Welfare Issues VII. Method Data Collection and Processing Conclusion and Evaluation Evaluation Conclusion Bibliography I. Background Research Photosynthesis is the process in which green plants, algae and cyanobacteria use the energy of sunlight to form carbohydrates from carbon dioxide and water in the presence of chlorophyll. Organisms need complex carbon compounds to build the structure of their cells and to process essential and vital procedures. Some organisms are able to form all the carbon compounds they need using only light energy and simple inorganic substances such as carbon dioxide and water (Alott Mindorff). Photosynthesis can be described by a chemical equation. The overall balanced equation is: Plant cells use carbon dioxide and water for photosynthesis. To finish this process, plants also need light energy captured from the sun, which they gain using a separate process. The usable end product the plant produces through photosynthesis is glucose, which the plant uses as food. The oxygen produced as an outcome of this process is a byproduct and is consequently released back into the environment. Animals and plants both construct fats and proteins from carbohydrates; therefore glucose is an essential energy foundation for all living organisms. The oxygen released as a photosynthetic byproduct provides most of the atmospheric oxygen essential to respiration in plants and animals, and animals in turn produce carbon dioxide vital to plants (Lagassà ©). The rate of photosynthesis in a plant can be determined by three external factors: temperature, light intensity, and available carbon dioxide concentration. In any given situation any one of these may become a limiting factor if they are below the optimal level (Alott and Mindorff). According to the concept of limiting factors, under any combination of light intensity, temperature and carbon dioxide concentration, only one of the factors is essentially limiting the rate of photosynthesis. This is the factor that is farthest from its optimum. As the limiting factor is moved closer to its optimum, while keeping the other factors constant, a point will be reached where this factor is not the one that is furthest from the optimum anymore and another starts acting as the limiting factor. An increase in the carbon dioxide concentration increases the rate at which carbon is incorporated into carbohydrate in the light-independent reaction, and so the rate of photosynthesis generally increases until limited by another factor. Increasing carbon dioxide concentration causes a rapid, significant increase in the rate of photosynthesis, which eventually plateaus when the optimal level is reached. E. canadensis is a submerse macrophyte, an aquatic plant immersed in water. It has bright green, translucent and oblong leaves which are borne in whorls of three round the stem (Rose and Reilly) (see fig. 1). It is easily available in aquarium shops or pet shops that have aquarium sections. Fig. 1: Elodia canadensis (Fischer). Design II. Research Question How do different concentrations of carbon dioxide (CO2) solution affect the rate of photosynthesis in Elodea canadensis? III. Hypothesis As the concentration of carbon dioxide increases, the rate of photosynthesis will increase until a certain point where it reaches the optimal level and plateaus. IV. Variables Table 1: Dependent Variable Dependent Variable Photosynthesis rate Table 2: Independent Variable Table 3: Controlled Variables V. Apparatus 25 samples of E. canadensis 500 ml of pre prepared dilute sodium carbonate solutions with the following CO2 concentrations: 1% 2.5% 3% 5% 10% 50 test tubes (used as containers to make a respirometer, not for measurements) 25 x 100 ml 25 x 150 ml 5 x 300 ml beaker (used as containers, not for measurements) 30 cm ruler ) Compact fluorescent lamp as light source 100 ml graduated cylinder ( ± 0.5 ml) Stopwatch ( ± 0.01s) Scalpels Thermometer ( ± 0.01C) VI. Safety Aspects/Animal Welfare IssuesScalpels are sharp and should be used with caution. The glassware involved in the experimentation may lead to injuries if used without caution and broken. Use of liquids may also lead to some risks if spilled because the floor may become slippery. The lab did not lead to any animal welfare issues.VII. Method Label the five beakers with the following: 1% CO2 2.5% CO2 3% CO2 5% CO2 10% CO2 Set up the light source. Place the beakers in a spot that is 20 cm away from the light source. Place one E. canadensis sample into a 100 ml test tube and fill the test tube with 100 ml of the 1% CO2 dilute sodium carbonate solution. The tube should be filled as full as possible. Carefully invert a larger tube and place it over the smaller tube containing the sample plant and the 1% CO2 dilute sodium carbonate solution.   Push the smaller tube all the way into the larger tube using your finger or a pencil and then invert both tubes so that the opening of the larger tube is up. Be sure that the small tube is pushed to the top of the larger tube before inverting it (see fig. 2).   Mark the water level on the test tube with a marker. Place this set up in the beaker which was previously labeled as 1% CO2. As soon as the set up is ready place it under the light source and start the stopwatch. With time, the distance between the water level and the top of the test tube will increase because of photosynthetic activity, which will produce O2 gas. Photosynthetic activity by E. canadensis samples will cause the water to displace and increase the space at the top of the test tube. The volume of fluid displaced will equal the volume of the gas produced. Run the trial for and monitor it for 20 minutes. After every 2 minutes, check the test tube and measure how much of the dilute sodium carbonate solution has displaced with a ruler. Each time after taking measurements, use a marker to mark the new liquid level for the future measurements you will make. Repeat steps 5 to 14 for 4 more times. At the end of this, there should be 5 trials done in total for the 1% CO2 dilute sodium carbonate concentration. Repeat steps 5 to 15 for the remaining 2.5%, 3%, 5% and 10% CO2 dilute sodium carbonate solutions. The process described in the previous steps should give 10 raw data points for each trial with a total of 250 data points. Record this data in a â€Å"Raw Data† table. All the lab work is completed for this experimentation. The lab and the apparatus can be cleaned if necessary.   Data Collection and ProcessingFigure 3: Raw Data for Liquid Displacement over Time in Different CO2 ConcentrationsFigure 4: Processed Data with Means, Standard Deviations and Average RatesFigure 5: Processed Data: Average Photosynthesis Rate in Different CO2 ConcentrationsConclusion and EvaluationEvaluationThe collection of data was an easy process. My results match my predictions. But the uncertainties in the data, which I sh.ould have considered before processing the experiment, are preventing me from making clear and strong statements. One uncertainty preventing me from making clear statements derived from this lab is the fact that I ran the trials for 20 minutes only. It was unfortunately not possible to see any changes in such a short time with low concentrations such as 1% CO2 . If I had run the experiments for longer, I could have seen the photosynthesis rate reaching it’s limit and becoming constant, but because I ran it for a short time, I am not able to understand if , for example 0,3 mm/minutes is the maximum photosynthesis rate the plant Elodea can reach in 10% CO2 concentration. I needed to do it for a longer time to say it has reached a limit or not.Second thing I should have considered is the fact that although they belong to the same species, the plants used in the experiment were still not the same in terms of leaf sizes. If I could use the exact same plant in each tube (take Elodea from one tube and place it in other), results might have changed because plants might be doing photosynthesis at different rates. This is also something I should have searched before starting the experiment, while doing my background research so that I could be sure about it.If I was doing the same experiment again, I would avoid these uncertainties and that would help me make clear statements about my results saying that they match every prediction I made and are strong justifications. Right now, they still match some of my predictions. For example, the photo synthesis rate in 10% CO2 was 0.3 mm/minute while it was 0.2 mm/minute in 5% CO2. This shows that the rate of photosynthesis is greater when higher concentrations of CO2 are present. But like I have stated above, this can be caused by other factors such as the difference in plants or anything I have not considered. Therefore, I should have run more trials.ConclusionMy aim was to see the effects of CO2 concentration on photosynthesis and although I was not able to see them, I was able to make predictions about the effects. I have listed everything that has caused uncertainties in the experiment, and these uncertainties are unfortunately preventing me from making clear statements. If I could do this again, I would avoid all of these uncertainties. The results meet my predictions but one should not say that these results are clear and direct justifications of the background research. Some other factors were involved in the experiment, therefore I would not consider this experiment as s uccessful, and I would do it again.BibliographyAlott, Andrew and David Mindorff. IB Biology Course Book 2014 edition: Oxford IB Diploma Programme. Oxford University Press, 2014.Lagassà ©, Paul, ed. Columbia Electronic Encyclopedia. 6th Edition. New York: Columbia University Press, 2013.McGinley, Mark. Differences between aquatic and terrestrial environments . 5 February 2009. 1 March 2015 http://www.eoearth.org/view/article/151726/>.Rose, Francis and Clare Reilly. The Wild Flower Key: How to identify wild plants, trees and shrubs in Britain and Ireland. London: Frederick Warne, 2006.

Death of a Salesman vs The Simpsons :: essays papers

Death of a Salesman vs The Simpsons Each of the characters in "death of a Salesman" can be compared in some way to a character in the Simpsons. Linda Loman has a lot in common with Marge Simpson. Both love their families very much and are always the first to defend their husband's actions. Each wife is unappreciated and and does not receive much respect from her family. They try to instill good values onto their children: Marge reprimands Bart for stealing, and Linda tells Willy not to encourage the boys to steal. They attempt to steer the boys away from their fathers' influence, since Willy and Homer are not always the best role models. An example is when homer tells Marge "don't discourage the boy! Weaseling out of things is important to learn. It's what separates us from the animals! Except the weasel." Biff (before he find's himself) is a lot like Bart. The two are always getting into some kind of trouble; Biff for stealing, while Bart is constantly wreaking havoc in the school. Biff is unable to hold down a job, and Bart cannot be productive at school. Both lie and cheat their way through life. Charley can be compared to Lenny as both are friends of the protagonist and care about his welfare. Charley aids Willy with his financial needs, giving him money and offering him a job. Lenny helps Homer in the nuclear plant, always covering for him and giving advice. Although he is not an evil monster, Howard's character resembles that of Monty Burns. They are both business men, more concerned about money than people. Howard does not care about Willy; he fires him after he had worked for the company for so long. Mr. Burns does not even know who homer is even though they've often had a chance to interact. Bernard, Biff's brainy friend, is similar to Milhouse, Bart's geeky friend. Each one is teased about their appearance; Bernard is called an anemic by Willy, and Milhouse is called a geek by pretty much everyone. Bernard used to idolize Biff, he was proud to be carrying his elbow pads. Milhouse is also a sidekick to Bart. He knows his job is to stay hidden while Bart wows everybody with his talents.

A Report On LVMH HR Policies Education Essay

Lvmh HR policies are in surplus of required and implement on the concern groups and companies. Through flexible regulation, it besides provides organisation. The map of corporate HR is to normalise certain ways, to exemplify program and to give force to companies ‘ HR squads. In connexion with scheme, HR offers other than hardly of all time oblige. An employee work reciprocally with the concern group which study to corporate central office. Approximately 55 to 60 % of advancements are controlled by companies, the else managed by the concern groups or corporate. There are four types of HR directors at Lvmh. Subsequent the group ‘s construction, they operate on four degrees: corporate, regional, concern group and company degree. The subordinate HR Director or the individual moving as such, studies to the subordinate ‘s President. The subordinate ‘s HR Director gets recommendation and shore up from his company. The concern group ‘s HR Director organizes his companies ‘ HR Directors through monthly meetings. The intent of these meetings is to place vacant places throughout the universe and to analyze the list of possible campaigners for these places, between which are the Ready to Move. Lvmh has ready internal mobility – both geographic and functional – a footing of their human resources policy. This cross-fertilisation of experience within their ecosystem under the consolidative umbrella of the group creates matchless cause of proficient and personal fulfillment. International mobility is indispensable portion of every prospective calling way. It targets to make planetary directors many of them have far above the land cardinal practical move. As an illustration the caput of HR development remember the instance of a Gallic insurance specializer in the manner concern unit who was sent to Romania to head a shoe mill. LVMH be on familiar footings with they could make with hazards to develop likely impending. It needs to set them in new fortunes to assist them develop new accomplishments and set up their bravery. Lvmh actively supports the professional development of its employees. The decentralised organisation of the Lvmh group encourages single enterprise. Half of Lvmh ‘s senior executives and over 40 per cent of managerial staff are Gallic, whereas the Gallic history for 37 per cent of the group ‘s planetary work force. HR needs to develop more planetary concern directors so they can be a portion of globalized top direction. Lvmh mobility procedure works on the web of HR squads who largely staffed with locals. Lvmh did non direct out any experts because non hold local gift. Generally their experts fit two profiles: those sent out by the corporate HQ to command its subordinates and protect its involvements and sent out to develop their accomplishments. To back up the international concern growing relocate is lifting. Though, it non means that increasing figure of Gallic exiles will coerce this disposition. Lvmh lake of planetary directors creates their order adverse in footings of deploying adept director to company ‘s desire program or task given to that director. Lvmh did non pull experts by giving them higher fringe benefits in footings of their degree. The group is motivated for cost effectivity. They know that a good bundle is indispensable, but that it non the chief encouragement to travel abroad. The primary balance-sheet move in the way of bundle is based on the benchmark that proficient should neither lost nor turn from their reallocate. Lvmh ‘s C & A ; B section has connected this draw near as a direct for it does remunerate bundle policy. Specific state based salary is evident for international mission. Salary will acquire hire during the period of mission. That is used as a vital for work out of societal security and pension payments. The mobility rewards are mean comparison to local labor market. Lvmh distinguishable two types of high potencies, HP1 and HP2 is an single likely to accomplish a top direction place such as member of Board commissions, Regional president or Subsidiary president. An HP2 is an employee probably to travel up one or two stairss in the hierarchy. For corporate HR this word picture of high potency is excessively wide and is more relevant for level constructions. It is now sing contracting it. It would retain the definition of HP1 and include those who are considered to be experts in their field. Lvmh is giving specific undertaking or mission to the planetary director in their working content for specific period and give him or her full authorization to take determination for the company, besides they want to larn from this sort of freedom to make new or dare things. Undertaking 2To fit the planetary demand of concern working form Lvmh has to deploy local people instead than experts from the Gallic, because they do non hold know the local civilization or local market how they react in new or old section for their merchandises or what is the tendency among them for Lvmh ‘s merchandises. If they select local director with relevant expertness for their desire undertaking or purpose to accomplish. In this status they can acquire director with accomplishment which they want and besides acquire betterment from his cognition about their merchandise fiting the local public positions and if possible implement them for acquiring better consequences. For LVMH operates in all over universe so, they have to believe globally and move locally for their operations. For illustration they have decided same regulations and ordinances for the all employee universe broad like their rewards and benefits. In France they have decided to give 6500 ˆ per month wage to the planetary director for giving his or her services to the company as per same wage may non be pay in other continent like Asiatic states China or India. Populating criterion in all continents is different so, their policies should be different than headquarter and subordinate in footings of rewards. Lvmh has to take attention for the different civilization base for their scheme in HRM for illustration in Japan they can non deploy younger director on the employee who is senior in footings of age so him or her, because Nipponese have cultural usage that they respect elder individual and do non traverse their words of all time so, in that manner Lvmh has to be specific about cultural differences. Like in South East Asia India is a populated state and have more knowledge base potency campaigners are available to fit their standards but they have to maintain in head that Indian civilization is a versatile and full of festivals. If they want to establish the new merchandise there they have to look frontward for the appropriate gay season for their merchandises and the director who familiar with the usage of this festival and achieve company ‘s end. Before directing the planetary trough on his or her assignment they has to be given developing about linguistic communication which is locally spoken over at that place and have good bid over at least 3 linguistic communications other so French. Looking frontward the HRM policies of Lvmh is to follow divergency in footings of local environment like in UK people like to imbibe Beer while in USA and France prefer to imbibe Wine. Such things keep in head and develop their program for act in a planetary market through their planetary directors who really implement their policies to their concern. Undertaking 3Lvmh has created his name in the planetary universe so they have to choose planetary linguistic communication like Good English talking individual because in the yesteryear they select staff from the France merely, they ca n't talk English fluently for that they have to larn English as a preparation and development undertaking which is programmed by HR section and educate them to cover in English at planetary degree.

Asvance Care Planning Essay

Assessment Criteria 1.1. Describe the difference between a care or support plan and an Advance Care Plan Advance care planning (ACP) is a process of discussion between an individual and their care providers irrespective of discipline. According to NHS guidlines the difference between ACP and planning more generally-which sets out how the client’s care and support needs will be met- is that the process of ACP is to make clear a person’s wishes. 1.2. Explain the purpose of advance care planning It usually take place in the context of an anticipated deterioration in the individual’s condition in the future, with attendant loss of capacity to make decisions and/or ability to communicate wishes to others. In that case Advance care planning can ensure that all of those concerned with the patient’s care and well-being kept informed -with the patient’s permission-of any decisions, wishes or preferences which impact upon her care when she has no ability to communicate these any more. 1.3. Identify the national, local and organisational agreed ways of working for advance care planning The main principles are covering the agreed ways of working: The process is voluntary. No pressure should be brought to bear by the professional, the family or any organisation on the individual concerned to take part in ACP ACP must be a patient centred dialogue over a period of time The process of ACP is a reflection of society’s desire to respect personal autonomy. The content of any discussion should be determined by the individual concerned. The individual may not wish to confront future issues; this should be respected All health and social care staff should be open to any discussion which may be instigated by an individual and know how to respond to their questions Health and social care staff should instigate  ACP only if in the context of a professional judgement that leads them to believe it is likely to benefit the care of the individual. The discussion should be introduced sensitively Staff will require the appropriate training to enable them to communicate effectively and to understand the legal and ethical issues involved Staff need to be aware when they have reached the limits of their knowledge and competence and know when and from whom to seek advice Discussion should focus on the views of the individual, although they may wish to invite their carer or another close family member or friend to participate. Some families may have discussed their issues and would welcome an approach to share this discussion Confidentiality should be respected in line with current good practice and professional guidance Health and social care staff should be aware of and give a realistic account of the support, services and choices available in the particular circumstances. This should entail referral to an appropriate colleague or agency when necessary The professional must have adequate knowledge of the benefits, harms and risks associated with treatment to enable the individual to make an informed decision Choice in terms of place of care will influence treatment options, as certain treatments may not be available at home or in a care home, e.g. chemotherapy or intravenous therapy. Individuals may need to be admitted to hospital for symptom management, or may need to be admitted to a hospice or hospital, because support is not available at home ACP requires that the individual has the capacity to understand, discuss options available and agree to what is then planned. Should an individual wish to make a decision to refuse treatment (advance decision) they should be guided by a professional with appropriate knowledge and this should be documented according to the requirements of the MCA 2005 1.4. Explain the legal position of an Advance Care Plan Mental Capacity Act 2005 which came into force in October 2007 along with the supporting Code of Practice. Chapter 9 of the Mental Capacity Act (MCA) 2005 Code of Practice refers specifically to Advance Decisions to Refuse Treatment and will be used as a guide to sections within this document that refer to advance decisions. According to NHS guidelines for individuals with capacity it is their current wishes about their care which needs to be  considered. Under the MCA of 2005, individuals can continue to anticipate future decision making about their care or treatment should they lack capacity. In this context, the outcome of ACP may be the completion of a statement of wishes and preferences or if referring to refusal of specific treatment may lead onto an advance decision to refuse treatment. This is not mandatory or automatic and will depend on the person’s wishes. Alternatively, an individual may decide to appoint a person to represent them by choosing a person (an ‘attorney’) to take decisions on their behalf if they subsequently lose capacity. A statement of wishes and preferences is not legally binding. However, it does have legal standing and must be taken into account when making a judgement in a person’s best interests. Careful account needs to be taken of the relevance of statements of wishes and preferences when making best interest decisions. If an advance decision to refuse treatment has been made it is a legally binding document if that advance decision can be shown to be valid and applicable to the current circumstances. If it relates to life sustaining treatment it must be a written document which is signed and witnessed. 1.5. Explain what is involved in an ‘Advance Decision to Refuse Treatment’ The MCA 2005 provides the statutory framework to enable adults with capacity to document clear instructions about refusal of specific medical procedures should they lack capacity in the future. An advance decision to refuse treatment: Can be made by someone over the age of 18 who has mental capacity Is a decision relating to refusal of specific treatment and may be in specific circumstances Can be written or verbal If an advance decision includes refusal of life sustaining treatment, it must be in writing, signed and witnessed and include the statement ‘even if life is at risk’ Will only come into effect if the individual loses capacity Only comes into effect if the treatment and circumstances are those specifically identified in the advance decision Is legally binding if valid and applicable to the circumstances. 1.6. Explain what is meant by a ‘Do Not Attempt cardiopulmonary resuscitation’ (DNACPR) order In England and Wales, CPR is presumed in the event of a cardiac arrest unless a do not resuscitate order is in place. If they have capacity as defined under the Mental Capacity Act 2005 the patient may decline resuscitation, however any discussion is not in reference to consent to resuscitation and instead should be an explanation. Patients may also specify their wishes and/or devolve their decision-making to a proxy using an advance directive, which are commonly referred to as ‘Living Wills’. Patients and relatives cannot demand treatment (including CPR) which the doctor believes is futile and in this situation, it is their doctor’s duty to act in their ‘best interest’, whether that means continuing or discontinuing treatment, using their clinical judgment. Learning Outcome 2: Understand the process of advance care planning Assessment Criteria 2.1. Explain when advance care planning may be introduced ACP may be instigated by either the individual or a care provider at any time not necessarily in the context of illness progression but may be at one of the following key points in the individual’s life: Life changing event, e.g. the death of spouse or close friend or relative Following a new diagnosis of life limiting condition eg. cancer or motor neurone disease Significant shift in treatment focus e.g. chronic renal failure where options for treatment require review Assessment of the individual’s needs Multiple hospital admissions 2.2. Outline who might be involved in the advance care planning process Advance care planning centres on discussions with a person who has capacity to make decisions about their care and treatment. If the individual wishes, their family, friends and health and social care professionals may be included. It is recommended that with the individual’s agreement that  discussions are documented, regularly reviewed, and communicated to key persons involved in their care. 2.3. Describe the type of information an individual may need to enable them to make informed decisions Statements of wishes and preferences can include personal preferences, such as where one would wish to live, having a shower rather than a bath, or wanting to sleep with the light on. Sometimes people may wish to express their values e.g. that the welfare of their spouse or children is taken into account when decisions are made about their place of care. Sometimes people may have views about treatments they do not wish to receive but do not want to formalise these views as a specific advance decision to refuse treatment. These views should be considered when acting in a person’s best interests but will not be legally binding. A statement of wishes and preferences cannot be made in relation to any act which is illegal e.g. assisted suicide. 2.4. Explain how to use legislation to support decision-making about the capacity of an individual to take part in advance care planning The Mental Capacity Act says: Everyone has the right to make his or her own decisions. Health and care professionals should always assume an individual has the capacity to make a decision themselves, unless it is proved otherwise through a capacity assessment. Individuals must be given help to make a decision themselves. This might include, for example, providing the person with information in a format that is easier for them to understand. Treatment and care provided to someone who lacks capacity should be the least restrictive of their basic rights and freedoms possible, while still providing the required treatment and care. The MCA also allows people to express their preferences for care and treatment in case they lack capacity to make these decisions. It also allows them to appoint a trusted person to make a decision on their behalf should they lack capacity in the future. The MCA sets out a two-stage test of capacity. Does the individual concerned have an impairment of, or a disturbance in the functioning of, their mind or brain, whether as a result of a condition, illness, or external factors such as alcohol or drug use? Does the impairment or disturbance mean the individual is unable to make a specific decision when they need to? Individuals can lack capacity to make some decisions but have capacity to make others, so it is vital to consider whether the individual lacks capacity to make the specific decision. Also, capacity can fluctuate with time – an individual may lack capacity at one point in time, but may be able to make the same decision at a later point in time. Where appropriate, individuals should be allowed the time to make a decision themselves. MCA says a person is unable to make a decision if they cannot: understand the information relevant to the decision retain that information use or weigh up that information as part of the process of making the decision If they aren’t able to do any of the above three things or communicate their decision (by talking, using sign language, or through any other means), the MCA says they will be treated as unable to make the specific decision in question. Before deciding an individual lacks capacity to make a particular decision, appropriate steps must be taken to enable them to make the decision themselves. For example: Does the individual have all the relevant information they need? Have they been given information on any alternatives? Could information be explained or presented in a way that is easier to understand (for example, by using simple language or visual aids)? Have different methods of communication been explored, such as non-verbal  communication? Could anyone else help with communication, such as a family member, carer, or advocate? Are there particular times of day when the individual’s understanding is better? Are there particular locations where the individual may feel more at ease? Could the decision be delayed until a time when the individual might be better able to make the decision? 2.5. Explain how the individual’s capacity to discuss advance care planning may influence their role in the process Example by NHS: Caroline has dementia and lives at home with the support of carers from a domiciliary care agency. Over the last two days, she has become very confused and unable to make decisions about the care she receives. The care worker has suggested that the GP be called. Caroline is adamant that she does not require the GP. It is clear that Caroline is unwell and the care worker, having consulted the family, assesses that Caroline lacks the capacity to make the decision about whether or not to call the doctor. So the care worker calls the GP and records her actions in the care plan. The GP visits Caroline and diagnoses a urinary tract infection. He requests a urine sample for analysis and commences treatment with antibiotics. Within three days, Caroline has regained her capacity, for this decision. 2.6. Explain the meaning of informed consent Informed consent is a process for getting permission before conducting a healthcare intervention on a person. For consent to be valid, it must be voluntary and informed, and the person consenting must have the capacity to make the decision. These terms are explained below: Voluntary – the decision to either consent or not to consent to treatment must be made by the person themselves, and must not be influenced by pressure from medical staff, friends or family. Informed – the person must be given all of the information in terms of what the treatment involves, including the benefits and risks, whether there are reasonable alternative treatments and what will happen if treatment does not go ahead. Capacity – the person must be capable  of giving consent, which means they understand the information given to them, and they can use it to make an informed decision. If an adult has the capacity to make a voluntary and informed decision to consent to or refuse a particular treatment, their decision must be respected. This still stands even if refusing treatment would result in their death, or the death of their unborn child. If a person does not have the capacity to make a decision about their treatment, the healthcare professionals treating them can go ahead and give treatment if they believe it is in the person’s best interests. However, the clinicians must take reasonable steps to seek advice from the patient’s friends or relatives before making these decisions. 2.7. Explain own role in the advance care planning process Under the MCA, anybody making a decision about the care or treatment of an individual, who has been assessed as lacking the capacity to make that decision for himself, will be required to take any statement of wishes and preferences into account when assessing that person’s best interests. Part of assessing best interests should include making reasonable efforts to find out what a person’s wishes, preferences, values and beliefs might be. This is likely to involve contacting the person’s family or other care providers. They may be able to advise whether any statements of wishes or preferences exists or for help in determining that person’s wishes. This will not always be possible, e.g. if an individual is admitted as an emergency, is unconscious and requires rapid treatment. 2.8. Identify how an Advance Care Plan can change over time Person’s views may change over time. If they wish to make any changes they should let their doctor or nurse know as well as their family and friends. When their Advance Care Plan is completed they are encouraged to keep it with them and share it with everyone involved in their care. What has been written in their Advance Care Plan will always be taken into account when planning their care. However sometimes things can change unexpectedly, such  as their carers (family, friends and neighbours) becoming over tired or ill- these are unforeseen circumstances. 2.9. Outline the principles of record keeping in advance care planning According to NHS guidelines: Healthcare professionals cannot make a record of the discussion without the permission of the individual The individual concerned must check and agree the content of the record Information cannot be shared with anyone, unless the individual concerned has agreed to disclosure. Where the individual refuses to share information with certain individuals the options should be explained to them and the consequences made clear Any record should be subject to review and if necessary, revision and it should be clear when this is planned. Review may be instigated by the individual or care provider, can be part of regular review or may be triggered by a change in circumstances A clear record of who has copies of the document will help facilitate future updating and review Copies in notes should be updated when an individual makes any changes Where an advance decision is recorded, it should follow guidance available in the Code of Practice for the MCA http://www.dca.gov.uk/menincap/legis.htm#codeofpractice and be recorded on a separate document to that used for ACP The professional making the record of an advance decision must be competent to complete the process Where this is part of a professional’s role, competence based training needs to be available and accessed If the individual agrees for their record to be shared, it should be ensured that systems are in place to enable sharing between health and social care professionals involved in the care of the individual, including out of hours providers and ambulance services For an individual who has lost capacity disclosure of a statement will be based on best interests There should be locally agreed policies about where the document is kept. For example, it may be decided that a copy should be given to the individual and a copy placed in the notes 2.10 Describe ci rcumstances when you can share details of the Advance Care Plan The advance care plan is a document that goes into effect only if the  client is incapacitated and unable to speak for herself. This could be the result of disease or severe injury—no matter how old is she. It helps others know what type of medical care she wants. In that case it is really important to make sure that everybody who is involved in her care knows everything about her preferences and wishes-thus the Advance Care Plan’s details should be shared. That could explain her feelings, beliefs and values that govern how she make decisions. They may cover medical and non-medical matters. They are not legally binding but should be used when determining a person’s best interests in the event they lose capacity to make those decisions. Learning Outcome 3: Understand the person centred approach to advance care planning Assessment Criteria 3.1. Describe the factors that an individual might consider when planning their Advance Care Plan The wishes are being expressed during advance care planning are personal and can be about anything to do with the patient future care. They may want to include their priorities and preferences for the future, for example: how they might want any religious or spiritual beliefs to hold to be reflected in their care, the name of a person or people they wish to represent their views at a later time, their choice about where they would prefer, if possible, to be cared for, for example at home, in a hospital, nursing home or hospice their thoughts on different treatments or types of care they might be offered, how they like to do things, for example, preferring a shower instead of a bath or sleeping with the light on, concerns or solutions about practical issues, for example, who will look after their dog should you become ill 3.2. Explain the importance of respecting the values and beliefs that impact on the choices of the individual Sometimes people will want to write down or tell others their wishes and preferences for future treatment and care, or explain their feelings or  values that govern how they make decisions. Statements of wishes and preferences or documented conversations the person has had with their family or other carers may be recorded in the person’s notes. A statement of wishes and preferences can be of various types, for example: A requesting statement reflecting an individual’s aspirations and preferences. This can help health and social care professionals identify how the person would like to be treated without binding them to that course of action if it conflicts with professional judgment A statement of the general beliefs and aspects of life which an individual values. This might provide a biographical portrait of the individual that subsequently aids deciding his/her best interests. Your beliefs and values are what make you a unique individual. They are based upon past experiences as well as present circumstances. Many of them were learned from parents as well as other respected individuals. While some people may have values and beliefs that are deemed to be â€Å"wrong† according to society, unless your values and beliefs cause harm to others, they cannot be considered wrong. While some beliefs and values may change from time to time, they remain your own. 3.3. Identify how the needs of others may need to be taken into account when planning advance care A person assessing an individual’s best interests must:- Not make any judgement using the professional’s view of the individual’s quality of life Consider all relevant circumstances and options without discrimination Not be motivated by a desire to bring about an individual’s death Consult with family partner or representative as to whether the individual previously had expressed any opinions or wishes about their future care e.g. ACP Consult with the clinical team caring for the individual Consider any beliefs or values likely to influence the individual if they had capacity Consider any other factors the individual would consider if they were able to do so Consider the individual’s feelings 3.4. Outline what actions may be appropriate when an individual is unable to or does not wish to participate in advance care planning Many patients with early or slowly progressing disease, and some with advanced disease, will not wish to discuss end-of-life care. However, they should still receive the opportunity to discuss other aspects of their future care. If the patient does not have capacity for making future plans, then the clinical team will need to make choices based on the patient’s best interests as defined in the MCA. 3.5. Explain how individual’s care or support plan may be affected by an Advance Care Plan If an individual wishes, ACP may be an integral part of the care and communication process and of their regular care plan review. The difference between ACP and care planning more generally is that the process of ACP will usually take place in the context of an anticipated deterioration in the individual’s condition in the future, with attendant loss of capacity to make decisions and/or ability to communicate wishes to others.

The Crappy Side of Writing

The Crappy Side of Writing I’m staring at a screen, after an extremely frustrating, full day of writing and editing. Mostly editing. Without going into details, I fought with a full manuscript edit for almost eight hours one day this week. I edited an entire novel only for the edits not to save properly. There’s a long story about a corrupted file. Needless to say, I cursed and shed a few sloppy tears on my napkin beside the dinner hub On top of that, I learned my deadline was changing a little bit for Tidewater Murder, which really crimped my style pertaining to a certain speaking engagement. That change sucked the wind right out of my sails for a while. Maybe I shed a couple more tears. Hub So, once I reached a stopping place, and settled down, I made myself write this editorial. Why? Because I’m frustrated and wanted to know how I’d write in that frame of mind . . . and to show those of you who aren’t writing full time that writing for a living can have some seriously catastrophic days that make you want to throw up your hands and simply say â€Å"WHY DO I DO THIS?† I’ve sat at conferences watching the speaker smile, chuckle, and talk about how hard writing is, but then preach/lecture/instruct the audience to just stick it out. (finger snap) Just like that you’re supposed to decide that nothing will stop you. No emotion in the lesson. All tell and no show. I want to wipe that smile off that successful face and ask them to SHOW me. Quit TELLING. I want them to show me through detailed anecdotes. . . 1. How they almost quit one night over a rejection;2. How they wanted to strangle an editor;3. How they behaved when they lost an entire story on the computer;4. How, after ten chapters, they realized the story had no purpose. Or how about answering these questions: 1. How much money did they really make on that self-pubbed book? 2. Did they ever make a fool of themselves with an editor/agent?3. When did they make a bad decision on selling rights?4. After expenses, how much money do they really net after a traditional publisher kept 92% of the print proceeds and 75% of the ebook gross earnings?5. Was there ever a time he was a bad writer?6. How did that one-star review REALLY make him feel? Give me the dirt . . . all of it. Why? Because I need to know what’s coming at me. I need to understand that there will benights like this, where I doubt myself and crave an easier life. We write for the satisfaction. But no one tells us about the nights we feel like our writing sucks, or that the planets are aligned against us. Those are the times that define us in this profession. Coming out on the other side of those bad nights intact, with the shards of our wits swept up off the floor, with lessons painfully learned leaving deep scars behind, makes us decent writers. No pain, no glory. Okay. Big sigh. Excuse me while I return to beat up my keyboard.

Bar to Atm - Converting Bars to Atmospheres Pressure

Bar to Atm - Converting Bars to Atmospheres Pressure These example problems demonstrate how to convert the pressure unit bar (bar) to atmospheres (atm). Atmosphere originally was a unit related to the air pressure at sea level. It was later defined as 1.01325 x 105 pascals. A bar is a pressure unit defined as 100 kilopascals. This makes one atmosphere nearly equal to one bar, specifically: 1 atm 1.01325 bar. Helpful Tip Convert bar to atm When converting bar to atm, the answer in atmospheres should be slightly lower than the original value in bars. Bar to Atm Pressure Conversion Problem #1 The air pressure outside a cruising jetliner is approximately 0.23 bar. What is this pressure in atmospheres?   Solution:1 atm 1.01325 barSet up the conversion to the desired unit will be canceled out. In this case, we want atm to be the remaining unit.pressure in atm (pressure in bar) x (1 atm/1.01325 bar)pressure in atm (0.23/1.01325) atmpressure in atm 0.227 atmAnswer:The air pressure at cruising altitude is 0.227 atm. Check your answer. The answer in atmospheres should be slightly less than the answer in bars.bar atm0.23 bar 0.227 atm Bar to Atm Pressure Conversion Problem #2 Convert 55.6 bars into the atmosphere. Use the conversion factor: 1 atm 1.01325 bar Again, set up the problem so the bar units cancel out, leaving atm: pressure in atm (pressure in bar) x (1 atm/1.01325 bar)pressure in atm (55.6/1.01325) atmpressure in atm 54.87 atm bar atm (numerically)55.6 bar 54.87 atm Bar to Atm Pressure Conversion Problem #3 You can also use the bar to atm conversion factor: 1 bar 0.986923267 atm Convert 3.77 bar into atmospheres. pressure in atm (pressure in bar) x (0.9869 atm/bar)pressure in atm 3.77 bar x 0.9869 atm/barpressure in atm 3.72 atm Notes About Units The atmosphere is considered to be an established constant. This does not mean that the actual pressure at any point at sea level actually will be identical to 1 atm. Similarly, STP or Standard Temperature and Pressure is a standard or defined value, not necessarily equal to actual values. STP is 1 atm at 273 K. When looking at pressure units and their abbreviations, be careful not to confuse bar with barye. Barye is the centimeter-gram-second of CGS unit of pressure, equal to 0.1 Pa or 1x10-6 bar. The abbreviation for the barye unit is Ba. Another potentially confusing unit is  Bar(g) or barg. This is a unit of gauge pressure or pressure in bars above atmospheric pressure. The units bar and millibar were introduced in 1909 by the  British meteorologist William Napier Shaw. Although the bar is still an accepted unit by some European Union countries, it has largely been deprecated in favor of other pressure units. Engineers largely use a bar as a unit when recording data in pascals would produce large numbers. The boost of turbo-powered  engines is often expressed in bars. Oceanographers may measure the  pressure of seawater in decibars because the  pressure in the ocean increases roughly 1 dbar per meter.

How to Make a Thesis

How to Make a Thesis How to Make a Thesis How to Make a ThesisYou can make hundreds of attempts to formulate a thesis statement, still, fail to do it. The reason is that it is difficult to make a thesis from scratch. Developing a thesis statement is not the outburst of inspiration but rather a task that requires some time to accomplish it successfully. So, if you want to know how to make a thesis statement, you have come to the right place. In this article, you will find some tips on how to make a thesis successfully. While PhD thesis writing is not easy and you must follow specific thesis format. How to make a thesis: Tip 1. Develop your personal position on the problemReading what others think about the question you are researching may turn out to be rather useful in case you know a little about the matter. Your position may coincide with someone elses or may differ cardinally from already adopted viewpoints. The key point is that you should truly believe in what you are talking about. Do not be inclined to others point of view only because you cannot shape your own position. This will only make it more difficult for you to support it. How to make a thesis: Tip 2. Formulate your main ideaTry to make your message specific rather than vague or general. What is more, do not make it too long. One or maximum two sentences will be quite enough. Write it somewhere on a sheet of paper. This thesis is not final yet. You will come back to it as soon as your paper is completed.How to make a thesis: Tip 3. Conduct researchWhile researching the topic, some information that yo u may find in the sources may turn out much useful. They can help you in formulating and improving your thesis statement. So, make notes on the information that can be included into your thesis statement.How to make a thesis: Tip 4. Come back to your thesis and think what might be changedIt is important to keep your thesis flexible until the investigation is actually finished. If you do it, you will not have any difficulties with rewriting it later. So, after you finish researching the topic, come back to your thesis statement and think what can be changed. A thesis statement is an important element of any paper, it is the framework that every paper is based on. So, it is extremely important to know how to make a thesis correctly. Follow our guidelines and you will learn writing a research paper without any problems!

Barriers to Literacy Essay Example | Topics and Well Written Essays - 1500 words

Barriers to Literacy - Essay Example Over the years different legislations have been passed by government to facilitate the literacy and learning environment but at times these laws become a barrier as laws are difficult to understand and implement. Also, there could be administrative barriers at school, college, university, and district and state levels. Multicultural environments pose barriers to learning and literacy as students seek companionship with the people of same background and language. Interactions among classmates who are from vastly diverse linguistic backgrounds are different from the students with mainly same ethnic or linguistic background. â€Å"Traditionally, some of the factors that restrict access to full literacy for language-minority students have included (a) xenophobic English-only movements (Donahue, 1995); (b) limited resources and personnel within ESL (August & Hakuta, 1997); (c) controversy about bilingual education (Faltis & Hudelson, 1998; Krashen, 1996); (d) differences about the durati on and type of language services children should receive (Collier, 1987); and (e) cultural and linguistic deficit models (Luke, 1986)† (Grant & Wong, 2003). Motivation of individuals for stirring the process of literacy and human development is considered one of the main barriers to learning. â€Å"For adult learners, however, learning is not usually an externally imposed, secondary role, but one that they freely choose. Adults learn to achieve both intrinsic (Bruner, 1966) and extrinsic rewards† (Dinmore, 1997).

The Entrepreneur I Most Admire Essay Example | Topics and Well Written Essays - 3000 words

The Entrepreneur I Most Admire - Essay Example The first part of the essay gives a brief outline of the profile of Warren Buffet and tracks the path of his career as an entrepreneur. The reason for the selection of this person has been explained in detail. In the later parts of the essay the strategies and models adopted by Warren Buffet has been analysed. Finally a reflection has been provided on the learning from the business model and strategies of the person and how it can be implemented in the present day scenario as a starter. Discussion Warren Buffet, the CEO of Berkshire Hathaway is also a stock market investor whose net worth is estimated at $58.5 billion as on 2013. Considered to be the most successful investor of his time, he is the largest shareholder of Berkshire Hathaway and has been ranked as the richest man of the world for many consecutive years. The person has remained loyal to the philosophy of value investing that he believed in throughout his life and followed meticulously. Along with the materialistic part o f his life it must also be mentioned that Buffet is a well acclaimed philanthropist. He had taken up a motto of donating 99% of his profits to the charity in form of donations. The person has been chosen for the discussion in this essay chiefly because his story would motivate a large number of entrepreneurs who are in the making. Buffet reached the heights even from a very humble background chiefly because of his hard work, his ideas, his will power and his ability to understand the field in which he operated. Since childhood Buffet has the passion for making money which he continued to pursue throughout the rest of his life. Buffet was lucky to have the securities analyst Benjamin Graham and David Dodd as his mentors in Columbia Business School and the education that he gathered from these two maestros helped him in his later phases of life (Hagstrom, 2005, p. 29). People like Warren Buffet act as inspiration for the entrepreneur who want to start their own business. Not only that Buffet reached the heights from the grass root levels and therefore he had enough foresight about the future and experience of the practical aspects of life. Being a person who is continuously dealing with money, Buffet never avoided the ethical and moral aspects of life. He always believed that whether human relations or business, values are important for long term sustainability. Warren Buffet as an Entrepreneur Various types of Entrepreneurship models are used by the businesses in the present day. The types of businesses have been depicted in the chart below. (Source: MIT Sloan Management Review, 2007, p. 77) The kind of ownership of the management in the organisation would determine the entrepreneurial style. On the other hand the source of the resources whether come in an ad hoc manner or through a pool of resources created by individuals in the corporate world determines the type of entrepreneur. Warren Buffet would come under the enabler model because the employees of Berksh ire Hathaway are provided with a lot of flexibility and support when they come up with their new ideas. They are encouraged to pursue their personal goals as long as they remain aligned with the goals of the organisation. Buffet has pursued this kind of model chiefly because of the fact that he himself has moved along in the path of freedom in the thought process and pursuing the field of

Im not sure about the topic Essay Example | Topics and Well Written Essays - 250 words - 3

Im not sure about the topic - Essay Example Both exercises emphasize a the mental aspect of exercise that requires focus and strong discipline to gain good results. In yoga, which is an Eastern cultural practice, meditation is utilized to relax the mind and relieve the body of stress caused by worry, anxiety, depression, grief and other negative emotions. A number of physical ailments have been linked to stress such as diabetes, hypertension, asthma and even certain types of cancer. Yoga is one popular method of mind-body awareness that in a way helps to heal the body because the mind and the body is only one unit (Siegel 60). While yoga is spiritual in nature, pilates is more on flexibility and strengthening the muscles of the body, especially the torso (core of the body), the back muscles and also on the abdominal muscles, that greatly improves lung capacity and results in better blood circulation. Pilates was originally developed to rehabilitate immobilized or wounded soldiers; it is made up some 500 different exercises divided into two general types: mat exercises and resistance exercises using some special equipment. Both yoga and pilates offer the same benefits of the mind-body awareness due to connection of nerves, molecules, antibodies and

Information sources and services Assignment Example | Topics and Well Written Essays - 3000 words

Information sources and services - Assignment Example In this context, it can be affirmed that libraries are the centre of academic activities, as they serve educational organisations along with the students, teachers and administrators with miscellaneous information necessities (Bhatia & Vohra, 2007). It is in this context that the characteristics of information have transformed significantly in recent times. Most striking characteristics of today’s knowledge-oriented generation are the propagation of huge quantity of data, especially in the digital format. Thus, the major challenges for libraries in 21st century are to search, address and use information effectively in order to satisfy the varied groups of people. Based on this perspective, the discussion will intend to develop strategies and options for a large vocational education library which serves almost 30,000 students. With the changes in the requirement of information, the library services are facing significant pressure in terms of the number of services with the reduction in the traditional information counter tasks in library. Considering this aspect, the discussion intends to reform the information service of library which can reflect the requirements of large and varied user groups comprising young and mature students belonging to various cultural and economic backgrounds, professional interns and trainees along with immigrants, tutors and community workers. Reference and Information Services Reference and information services denote individual support delivered to the people in order to satisfy their information requirements. It is based on high level of communication between guiding members and individuals. Providing such custom-made support can be thus regarded as a major objective of library occupation in the modern day phenomenon. In the 21st century, the constant growth of accessibility for digital databases has altered the characteristics of reference services in library. Undeniably, the upsurge of internet and increasing number of contributions for accessing online information and free online materials has also made the improvement of library services more critical (Australian Library and Information Association, 2011). Today, librarians are generally confronted with broad ranges of information alternatives which must be assessed for genuineness and accurateness. It is in this regard that new technologies act as streams leading t o vast torrent of knowledge for people. Thus, providing users with personalised facilities in sensible way can ensure excellence in library information and reference services (Bopp & Smith, 2011). Models of Reference Services In the current day scenario, the digital age has changed the tasks of reference librarians by a certain extent. Although the central task remains the same, i.e. to provide professional support in addressing beneficial information to the users, the new world of accessible electronic databases has developed new ways to manage information in modern day libraries (Lamolinara & Grunke, 1998). The delivery modes of services have also changed in recent days. Where traditionally, users were required to attain services through face to face interactions; in virtual model, the key modes has transformed to electronic modes such as e-mails and chats among other means of communication. Furthermore, traditionally, reference work included arranging and publishing academic info rmation which were principally assimilated from commercial salespersons. However, in the current day phenomenon, the reference tasks have grown to select, store, manage and organize information in a standard format. Therefore, it can be affirmed that the roles of librarians have moved from custodial role to more communication role (Breitbach & DeMars,

Anthropology of humor Assignment Example | Topics and Well Written Essays - 1250 words

Anthropology of humor - Assignment Example Grandparents and grandchildren are expected to fill this role. The worst choice of local mediator would be anj-umba who has a bukangandu (cold, distant) relationship with both Anji and Ego. The anj-umba would likely sit and stare into space, having no eye contact with either Anji or Ego. Obviously, this strategy would not settle any disputes; and more tension would occur. The worst choice of mediator would be the Western marriage councilor. The Western therapist would have no idea what the issues were or how resolution works among the Ndake. The Westerner would try to delve into root causes and common ground when the Ndake resolve the hurt feelings, not the topic of conflict. The Western African conflict resolution technique is intriguing. The core conflict is less important than the relationship resolution. This form of therapy actually mirrors the Golden Rule well; do you want others to forgive your transgressions, if so, then forgiving others now sets that precedent. Ethnic humor is disturbing when used to target a group for ridicule. It is a common form of toxic humor. Some groups choose to joke about themselves as a form of therapy. The danger is separating those who laugh â€Å"with† and those who laugh â€Å"at†. Jewish humor serves to teach, explain and maintain dignity among the Jews. The Talmud Law teachings could be so complex, traditional Jewish humor used absurdity to define limits of these laws. Throughout history, Jews have been in the entertainment business disproportionately. Vaudeville acts would go to the Catskills and the Borscht Belt circuit. Now television has a large Jewish entertainer population. Saul Bellow, famous Jewish author, claims the oppressed must be witty as a survival skill. (BrainyQuote.com) The Jewish humor is based on religious belief, of course, assimilation into society, self deprecation and wits. Laughing with your peer group helps understand the human comedy that is that group. From

Chapter 8 Assignment Example | Topics and Well Written Essays - 500 words

Chapter 8 - Assignment Example They still stay at home because they can be easily being managed in the home environment. This is also called the day treatment (Simpson, 2004). This is a resource-intense high level of care, for those patients with high levels of addiction who need 24 hours of care because of their mental health, addictive behavior, and medical needs. This is to make recovery possible and take less time. They may be unable to avoid substance abuse due to the home environment or psychiatric (Simpson, 2004). This program includes the residents and staff and all members of the community and teaches social responsibilities and coping skill. A case manager’s role is to ensure that an individual reaches his optimum level of wellness and functionality within his environment. They assess the needs of patients and family and coordinate care services. This includes counseling, education, rehabilitation, nutrition and transportation. Case managers also to ensure that provision of care is in the most comprehensive and cost-effective manner for the individual family and his insurance providers (Zehner, 2012). They monitor the continuity of care and serve as an advocate for the individual. A counselor serves as a therapist to family groups, individuals, and couples. Counselors do not plan and coordinate care but are part of the care plan for those seeing a case manager. They do not treat mental illness or provide medication but provide advice and tools for coping with certain situations, for example, health challenges, disabilities, and relationships (Zehner, 2012). A national review of state alcohol and drug treatment programs and certification standards for substance abuse counselors and preventive professionals. The standards used are the client’s rights, governance of the program, and payment to the program, environmental sanitation, statistical reporting, client’s case reports and quality of care reviews (Zehner,

Anthropology of humor Assignment Example | Topics and Well Written Essays - 1250 words

Anthropology of humor - Assignment Example Grandparents and grandchildren are expected to fill this role. The worst choice of local mediator would be anj-umba who has a bukangandu (cold, distant) relationship with both Anji and Ego. The anj-umba would likely sit and stare into space, having no eye contact with either Anji or Ego. Obviously, this strategy would not settle any disputes; and more tension would occur. The worst choice of mediator would be the Western marriage councilor. The Western therapist would have no idea what the issues were or how resolution works among the Ndake. The Westerner would try to delve into root causes and common ground when the Ndake resolve the hurt feelings, not the topic of conflict. The Western African conflict resolution technique is intriguing. The core conflict is less important than the relationship resolution. This form of therapy actually mirrors the Golden Rule well; do you want others to forgive your transgressions, if so, then forgiving others now sets that precedent. Ethnic humor is disturbing when used to target a group for ridicule. It is a common form of toxic humor. Some groups choose to joke about themselves as a form of therapy. The danger is separating those who laugh â€Å"with† and those who laugh â€Å"at†. Jewish humor serves to teach, explain and maintain dignity among the Jews. The Talmud Law teachings could be so complex, traditional Jewish humor used absurdity to define limits of these laws. Throughout history, Jews have been in the entertainment business disproportionately. Vaudeville acts would go to the Catskills and the Borscht Belt circuit. Now television has a large Jewish entertainer population. Saul Bellow, famous Jewish author, claims the oppressed must be witty as a survival skill. (BrainyQuote.com) The Jewish humor is based on religious belief, of course, assimilation into society, self deprecation and wits. Laughing with your peer group helps understand the human comedy that is that group. From

Motivating Assignment Example | Topics and Well Written Essays - 1000 words

Motivating - Assignment Example It is otherwise an abstract term, highlighting an inner human feeling emerging out of a churning of physiological, psychological and social component processes for energizing an individual in â€Å"selection of pursuits for maintaining a sustained, goal-directed performance amidst competing alternatives, intensity of effort and persistence of exertion† (Bandura, 1991, p.158). It tends to become complex when different individuals, groups and cultures acquire very different beliefs about what exactly defines control, success and effectiveness at work. Aided by the right level of positive emotions like humour and happiness to induce commitment towards their goals, supported by their cherished values of interest, skill or utility with the right blend of self-belief for facing challenges is what motivating individuals is all about. The factors motivating individuals are realistic levels of self-confidence, positive emotional climates and strong personal values for work related task s. A personal intention to succeed at assigned goals is very motivating for individuals. Against the outdated early theories treating humans as machine-like entities driven by internal or external factors beyond their control, contemporary motivation theories handling issues such as incentives, drives, needs and the like, influencing and tapping human capabilities through self-direction and self-regulation to an extent appear short sighted. Life Systems Framework approach is aimed at a more rational integrated analysis and appreciation of the unitary and component parts of an individual, both in isolation and in unison for assessing the stability and change in the functioning of the component parts of the person and the person as a whole. Coming under the more recent Motivational Systems Theory, a realistic study of all aspects of the characteristics of people in general, and the organisation and the actualisation of these characteristics in persons for assessing motivation in indiv iduals has become meaningful for going into the subject in depth in recent times. The belief that no one can motivate another person leads to individual motivation being invoked always from within. The degree of motivation is governed by the external environment in which individuals function and the demands made of them. The level of involvement that they feel and the degree of interest they have in what they are doing, is directly linked to the individual’s advancement through an organisation. Open business cultures are increasing transparency. We are living in an ‘aware’ culture of work-life harmony with no security of employment. Individual motivation is undergoing a change in tune with the contemporary requirements of fast changing organisations. Modern manager’s role lies in creating the conditions and encouragement that enable individuals to motivate themselves, despite the pulls and pressures. It is important to have self esteem and mutual respect a mong teammates. They must have a collective belief that, they are capable of succeeding as a team. It is of prime importance in motivating teams, as one can see â€Å"in pressure-packed overtime matches where contestants are evenly matched and a mistake brings sudden death defeat ...perceived group efficacy emerges as the sole determinant of overtime performance† (Bandura, 1997, p.383). An environment helping the team members

Effect of Unit of Analysis in Political Research

Effect of Unit of Analysis in Political Research Units of Analysis In social or scientific research, the definition of units of analysis is similar since it is the unit that the researcher will focus on while making his inquiry. According to (Lewis-Beck, Bryman, Liao, 2003), the appropriate definition of the term as developed in research is that it is the basic unit that is to be investigated. This statement implies that the unit of analysis can be defined in the hypothesis of a study or within the topic of the research. In a case where the research is based on an investigation about the truth of a hypothesis, the unit of analysis becomes the main actors in the hypothesis. In political science, it simply implies the level of actors at which a researcher will aggregate the data. In any study, the choice of actors or the unit of analysis has a bearing on the final generalization that is given by a study. In this perspective, the emergence of fallacies on the conclusion of a study will be as a result of not properly identifying the unit of analysis. In a study about the geopolitics of a country, for instance, the focus of the research could be trade relations. The selection of the actors in this study due to the interest and ideas about the actor could lead to a level of complications like cross referencing or fallacies (Babbie 2013). This article examines the possible set of units that relate to a research question about the geopolitics of China and its international partners in trade. Specifically, the units of analysis that relate to the research are discussed in details. It also observes the relevance of the units of analysis that will be selected for the investigation on the topic. Depending on the research question and the motivation of the researcher, the development of the appropriate actors or even the units of analysis could be difficult or just impossible. In this case, the use of cross-referencing is used to create a correlation of the available information to the unit of analysis that has been selected. The difficulty in obtaining the data about the unit of study may also lead to the absence of this ambiguity which seldom happens, the choice of the unit of study is simplified. Problems like the ecological fallacy that results from using data that is meant for a group to make generalization is avoided. In the case of geopolitical analysis of China and the trade relations, the major unit of analysis is the country which is China. This choice is provoked by the fact that much of the data that will be collected on the topic for purposes of analysis will have to do with a perspective of the geopolitics of China or even its partners. Data about international trade of China and the politics that govern regions like the South China Sea are potential units of analysis in this study. The ecological fallacy (Babbie 2013) can also be possible in the development of this study by making generalizations that are not about the group that is the overall country China. For instance, in a study about the preference of the wealthy Chinese businessmen and their preferred destinations of investment, a study could use the country data. In this study if the generalization of the research argues that the businessmen prefer to make trade deals with the west as opposed to the African or Asian counterparts, an ecological fallacy is given in the study. The ecological fallacy in this study will be as a result of observing the overall government bilateral trade agreements and generalizing this at the personal preference level. It is highly likely that the wealthy Chinese business persons can have interests in the African or Asian continents as well. The specific units of study, in this case, are related to the constituents of geopolitical studies or the major aspects that contribute to the subject domain of geopolitics. These units of study could be related to the concepts like demography and trade that is the main area of study. Other units of analysis can be linked to the climate of the regions, the region, natural resources, the use or imbalance of technology, and politics of the region being evaluated. For a study about the geopolitical aspects of trade relations of the Chinese especially if the comparison is inclined towards the American-Sino relations, all these factors are potential actors of the units of analysis which is the country. An imbalance of technology, for instance, is likely to trigger trade to favor the country that is in the possession of a high level of technology. Factors like efficiency could be the silent driving forces behind the success of the high technology countries. Ideas like climate could play a role like in the tourism sector. But while noting that the two countries are subcontinents there is a possibility that the overall impact of the climate more or less remains a constant factor. Despite this great mix and variety of the actors, the main actor therefore in this study remains the regional and global politics and the effects of demographics (Riegl In LandovskyÃÅ'  2013. Justification of the actors The politics of the region being evaluated in a study has a strong relation to the main actors of the economy that is the unit of study. Particularly, aspects of politics include the ability to dominate the regional bodies in a continent and the control of the same. For instance, in a regional union like the European Union, the decisions are negotiated by the members. The ability to martial the allies to vote for the interest of a country in economic affairs would have to do with the regional political influence of the country. In a case like this interests also play a major role. The role of interest is that member states will have to consider their position on the global front and the need to progress. In many instances, the interests of a nation are driven by the fact that there is need to achieve economic growth in the nation. As such any progress that is considered to have a negative impact on the economy is taken as an unwanted position by the block. Therefore aspects of politi cal ideologies and intention have an effect on the geopolitical relations. In demographics, the profligacy of the United States has come under sharp criticism. This idea has become a central potential of exploitation of the Chinese in dealing with the trade with the American public. Leonard (2006) examines the roles of this demographic factor in the relations of trade created between the two partners. Its findings indicate that the American public has become extremely uncaring of their spending habits in the past that even led to the recession that occurred in the nation. As a result, this actor is a significant variable in examining the geopolitical relations that have to do with trade between the nations. The reason for its importance is related to the level of debt that China holds for the United States. This research study also claims that the height of debt that America hold in China is substantial and a major driver in the trade relations between the two states. The selection of the two main actors in this type of research is based on the ability to take a validity assessment and the reliability of a study. In any research, before making a generalization, the review of the measurement is taken. For instance, it would be important to review if all measurements of the information that is contained in the study is properly within the context and requirements of the same study. In this case, main geopolitical factors in the study will have to be tested for their validity and reliability in making generalization of the subject of discussion. This factor means that the actors will have to be listed within the sub-factors that indicate their face or content validity. The face validity of the actors includes factors that the researcher envisions in their study (Babbie 2010). The content validity is deeper in meaning and will cover the major conventional attributes that build or indicate the actor in research. Reliability, on the other hand, deals wi th the replication of the same study (Kibble 2011). Therefore, the selection of these two actors which are important aspects of the unit of study will be a stronger block in generating the sub-factors that will point to a more reliable and valid study. Selected case study The unit of analysis, in this case, is at country level. It would be important to select case studies with the same level of units of analysis. In looking at the geopolitical factors and their effects on the international trade with China, this study will select a case study based in the United States and a Scandinavian country or a developing country. This selection will aim at unveiling the difference in the geopolitical factors that favor or does not favor trade in the two countries. At a more specific level, a comparison of the main actors that are involved will be the main factor. This will aim at unveiling if the two main actors that have been identified by this research are valid or not. The choice of the United States in the geopolitical study is made mainly because the United States is a major trading partner of the Peoples Republic of China. Therefore, a study in the geopolitical aspects of the relation could make conclusive on the facts relating to the same. Another important aspect is to do with the Chinese economic system that is communist and the inclination towards the western democratic nations. It would be important here to see if the political aspects have anything to do with the level of trade that is generated between the United States and the Chinese counterparts. In conclusion, the choice of a unit of analysis has a significant bearing on the outcome of a research process. The main contribution of the fact is based on the identification and selection of the units. In a case of improper selection, the problems that are likely to arise are related to the fallacy of the outcome of the study. In ecological fallacy, the generalization of the outcome and the drivers of the same is the main concern. It would be inappropriate to make group conclusion of results as a representative of individual units of analysis and vice versa. In a study of this character, it is also important to review the validity and reliability issues. References Babbie, E. (2013). The basics of social research. Cengage Learning. Babbie, E. R. (2010). The practice of social research. Belmont, Calif: Wadsworth Cengage. Kibble, B. P. (2011). Reliability in Scientific Research: Improving the Dependability of Measurements, Calculations, Equipment, and Software, by IR Walker: Scope: review. Level: postgraduate, early career researcher, researcher, scientist, engineers. Contemporary Physics, 52(6), 615-616. Lewis-Beck, M., Bryman, A. E., Liao, T. F. (2003). The Sage encyclopedia of social science research methods. Sage Publications. Leonard, Andrew (2006), No More Treasury Bonds, Thank You, I’m Full: Is China Tired of Propping up the U.S. Economy?, 6 January, online: www.salon.com/technology/how_the_world_works/2006/01/06 /china_bonds> (17 May 2015). Riegl, M., In LandovskyÃÅ' , J. (2013). Strategic and geopolitical issues in the contemporary world.

My Philosophy of Teaching Essays -- Philosophy of Education

Philosophy of Education Throughout the history of education, there have been many different philosophical views. The views have varied from Plato's "The Republic," to Rousseau's "Emile". Plato believed that the purpose of education was to create a perfect city-state, while Rousseau believed that the purpose was to develop people, who freely choose good. Both of these philosophies cooperate with my beliefs; however, my beliefs do differ in some aspects. Through my philosophies covering the nature of humans, curriculum, and teaching methods I hope to better educate the students and America a better place to live. First, I believe that humans are naturally good. The environment that a child grows up in affects the way that they act. Children are easily manipulated and I believe that the people in their early years are the ones that influence them the most. I believe the most important influences in a child's life are his parent and his teacher. In my own experience, I remember my kindergarten teacher spanking me when I was younger for no apparent reason. I could not figure out why she was doing this to me and it hurt my self-esteem, which made me not even want togo to school. However, my parents helped me Iovercome these problems. My parents influenced me to work harder and be myself no matter what. I would have to say that my parents were the biggest ~nfluence of my life; the things they taught me will stick with me the rest of my life. Secondly, I believe that everybody is born in certain classes. Like Plato, I believe there are classes with into which you are born. I believe that there are born leaders and then the children who do not have the same opportunities. I think you have to separate the two as soon as po... ...uate assistant on the Baseball field, while getting my masters in sports management. After that, I plan to coach college or high school baseball and teach physical education, hopefully for my alma mater Southeast High School. My goal is to become an athletic director, teacher, and coach at the same time because we all know that is where the money is. If a graduate assistant job does not open up, I plan to coach high school baseball and take night classes at Kent State for my masters. Furthermore, all aspects of teaching are important. As teachers, we hold the future of America in our hands with educating the youth. All aspects of teaching are important in shaping the youth of America. With the philosophies of some of the worlds greatest thinkers ever and with some philosophies of our own, I hope we can bring theeducation of America's youth to a higher level.~

The Club :: essays research papers

In The Club, friendship and loyalty are forgotten. The characters in this play sneak around behind each other’s backs, trying to achieve one thing; they are trying to hold onto their position. They want to replace some members of the Club so that they can start a new and better club, without the interference of â€Å"busy-body’s†. Although Laurie shows loyalty to his team, and Ted shows loyalty to the club, Jock and Gerry are continually stabbing Laurie and Ted in the back. Gerry, the career administrator, seems to be on everybody’s side but he is actually the one who makes the bullets for all the other bunnies to fire. Ted, the Club president, means well but can’t help sticking his nose into other people’s business. Geoff is the new recruit and could not care less about the game of football. Laurie is the coach of the team and as they are not doing the best, he finds out that at the end of the play that he is going to be sacked. Danny is the captain and long-time club champion of the team. He too is about to get the axe after years of charitable service. And then there is Jock, who is an interfering ex-president. He is also the holder of the Club’s longest player record.  â€Å"Ted’s going to have to resign soon. He’s got himself into real trouble. I can guarantee that he won’t be around in a month or two.†   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  [Page 17]  â€Å"We’re not going to renew Laurie’s contract at the end of the year.†  â€Å"We’re going to try and not renew his contract at the end of the year.†   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  [Page 18] The above quotes show Gerry Cooper, the clever manipulator that he is, in action. First, Gerry talks to Laurie and tells him that Ted will have to resign soon. Laurie is unaware of the fact as to why he will have to resign but he knows that Ted is about to go bankrupt. Gerry leaves Laurie, leaving him thinking that he is safe and that Ted will go. The second quote shows Ted and Gerry talking. Ted tells Gerry that he does not want Laurie’s contract renewed at the end of the year. Gerry agrees with Ted by saying that he will try not to renew it, only after he told Laurie that Ted was going to have to resign. By now, Gerry has convinced Laurie that Ted will be quitting the club.

Language Barriers for Non-Speaking Citizens

The Language Barrier for Non-English Speaking Citizens Lynne Lilley Com/150 University of Phoenix Com/150 March 8, 2010 The Language Barrier for Non-English Speaking Citizens â€Å"No Habla English†. â€Å"21 million people living in the United States cannot speak English. Citizens are not just speaking Spanish, but Chinese and Russian are rising fast. † (U. S. Bureau of Census, 2009) To force a citizen to speak a new language is discrimination. Non-English speaking citizens and immigrants that are without good English skills will fall academically, in the judicial system and when receiving proper medical care. 47 million Americans five years and older used a language other than English. The children that have no English skills will not be able to understand what the teacher is trying to teach. Children will not be able to do their assignments correctly and will eventually fail the class. †Some illegal immigrants are raising their children without teaching them English, hoping that the school will do that job. The Washington Post recently reported that as many as two-thirds of the children in suburban Arlington County, Virginia, receiving language assistance from kindergarten through second-grade born in the United States to non-English-speaking parents who don’t read to them, talk to them, or provide them a background in any language. (Not Speakiing their Native Tongue, 1996) A child being educated in English opens many doors of opportunities. English as a Second Language learner has more benefits than those of native English. Native speakers tend to speak in slang or use cliches and have bad grammar skills. There are even laws to wanting to learn another language as opposed to not knowing another language. In Albany, Georgia, they are trying to pass a law that students no longer have Spanish classes in schools and parents need to hire a tutor to come in to their home and teach the child a foreign language. Learning English will benefit a child not knowing the language and prevent barriers as an adult. Since the first amendment is freedom of speech, why do so many non-English speaking citizens run into barriers in the judicial systems? A citizen cannot explain an emergency to a police official such as; ho attacked them, who they were victimized by or the nature of the emergency they are having. There are just not enough bilingual employees in the judicial system whether it is police, courthouse officials, or translators. If an officer does not speak the language of the victim, the officer has to call a hotline service that will provide the correct language and that could take some time. Attorney’s that have non-English speaking clients recognize initially that such representation will be time consuming. They must begin their representation carefully, making sure a basis foundation for communication exists. Another problem that occurs when the client and attorney waste time because the attorney, court clerk, or other individual fail to identify the correct name of the represented individual. Often times when a non-English speaking citizen has problems with the judicial system it occurs because the person cannot read the notices sent or end up having no counsel or able to consult with their counsel. Defendants end up doing lengthy jail sentences because they did not tell the court they needed an interpreter. â€Å"In Virginia, a convenience store clerk was fired for complaining about the employer’s unwritten English-only policy. In Florida, two hotels faced on AFL-CIO boycott because they reportedly insisted they use English only. In New York, Long Life Home Care has been sued by EEOC on behalf of two workers who allege that the company prohibits employees from speaking Spanish only during breaks, lunch in the cafeteria and within one city block of their office building† (Lost in Translation, 2006). Judicial systems are not the only ones who have problems with language barriers; the medical field are affected too. Non-English speaking citizens and immigrants are receiving improper medical care because of the miscommunication. The people who cannot speak English well are misunderstood, when they go to free clinics or hospital emergency rooms and attempt to explain their symptoms and illness or cannot understand the doctors or medical profession that are trying to help them. † Interpreters are omitting questions about drug allergies. Patients are not telling nurses the correct symptoms. A mother misunderstood by putting oral antibiotic into the ears of the child instead of the mouth. The Puerto Rican word for mumps is not the same in Central America, so a child was mistreated. A doctor mistakenly told a parent to put a steroid creme on entire child instead of just the face† (Yolanda Prtida, 2005). Language barriers in the medical field are dangerous and some times even fatal. There is definitely a need for more translators in hospitals and doctors office. Clear communication is essential for safe quality healthcare. Poor communication can lead to disastrous outcomes, especially for patients with limited or no English ability. Working together with non-English speaking citizens and immigrants would help eliminate some barriers. When you call any bank or financial institute, public utility, or government agency, you can hear a prompt stating if you want to proceed in English press 1. That shows that we are working on a bilingual nation. A language barrier is not a disability, while those who cannot communicate are, of course, handicapped in our society. The inability to speak English is not a handicap in the physiological sense. † Let’s face—English is a crazy language, and English was invented by people, not computers, and it reflects the creativity of the human race (which, of course, isn’t a race at all). That is why,-when-the stars are out, they are visible, but when the lights are out, they are invisible. And why, when I wind up my watch, I start it, but when I wind up this essay, I end it† (unknown). Works Cited Lost in Translation. (2006, January 17). New York Times , pp. 1-2. Not Speakiing their Native Tongue. (1996, May 14). Washington Post , p. A1. U. S. Bureau of Census. (2009). Retrieved March 2, 2010, from U. S Bureau of Census website: http://factfinder. census. gov unknown. (n. d. ). Yolanda Prtida, M. D. (2005). Language Policy and Practice in Healthcare. Fresno: Center for Medical & Eduacation Research.

Abdominal Aortic Aneurysm Health And Social Care Essay

This instance survey is about an 80 old ages old male with symptomless abdominal aortal aneurism who presented to his GP with other symptoms unrelated to abdominal aortal aneurism. The writer will analyze the diagnosing of his aneurism, the mode used, the intervention and direction. Diagnosis and intervention tracts shall be followed ; analysis and comparing to other tracts shall be done to see which is the most effectual and accurate in the diagnosing and intervention of abdominal aortal aneurism. Patient confidential information shall be maintained throughout this essay, therefore in line with the codification of professional behavior, Nursing and Midwifery Council ( 2008 ) . Case study 80 old ages old, Mr X, of height 5 pess 8 tall who weighted 50 kilograms presented to his GP on the 6th of February 2010 with 6 yearss history of irregularity. During physical scrutiny a throbing mass was noted in his venters. The patient had no symptoms related to aneurysm, such us back or abdominal hurting. The GP discovered during conversation with Mr X that his brother died from rupture AAA a twelvemonth ago. Mr X smokes 3 battalions of coffin nails daily. His past medical records showed that, he had chronic clogging pneumonic disease, high blood pressure, ischemic bosom disease which he had a beltway surgery 15 old ages ago. He besides had an MI 2 old ages ago holding had transdermal conary intercession ( PCI ) to circumflex and right coronary arterias. The GP suspected that Mr X had an AAA and referred him for ultrasound scan to govern out the size of AAA. The ultrasound scan was conducted two hebdomads after seeing the GP. The scan revealed an aortal aneurism below the degree of the nephritic arterias mensurating 5.99 cm A-P diameter. Mr X was referred to a vascular sawbones who recommended a CT scan to look into the extent and anatomical construction of the aneurism to see Mr X ‘s suitableness for endovascular repai Computer Tomography Angiogram aorta was performed a hebdomad after the ultrasound scans. CT angiogram with contrast showed a big infra-renal abdominal aortic aneurism which measures maximally 6 centimeter in diameter. It besides demonstrated good infra-renal cervix. Ultrasound of the venters showing an infrarenal aortal aneurism steps 5.99 centimeter. ( Local NHS Trust 2010 ) Axial CTA with contrast of the venters demoing infrarenal aortal aneurism mensurating 6 centimeter ( pointers ) with partial calcified integral wall ( Local NHS Trust 2009 ) The sawbones so referred Mr X for an elected vascular surgery because his aneurism was big and carried a high hazard of rupture and decease. One hebdomad before his surgery, Mr X had a chest X ray, blood trial and EKG which were all normal. On the twenty-four hours of admittance, his pulsation was 68BP/min and regular with a blood force per unit area of 140/80 mmHg. The below tabular array shows pre-assessment blood probes done. Blood Test Mr X ‘s consequence Normal Laboratory Test Values Entire white blood cell count 6.56 M/mcL 3.8 M/mcL to 5.6 M/mcL hemoglobin 14 g/dL 11 g/dL to 18 g/dL Platelet count 160 150-400 Red blood cell count 5 M/mcL 3.8 M/mcL to 5.6 M/mcL Bureau of intelligence and research 1.1 0.9-1.2 Blood urea N 6.86 mg/dL 6 mg/dL to 23 mg/dL Creatinine 98 mg/dL 0.6 mg/dL to 15 ng/dL ( Tinkham 2009 ) Preoperative appraisal was done to give Mr X ‘s sawbones a image of his overall wellness position. A complete blood count was performed to look into for the presence of infection, ensured an equal ruddy blood cell volume and regulation out serious haematological abnormalcy. Electrocardiography ( ECG ) was performed to measure cardiac arrhythmias and diagnose cardiac upsets such as myocardial infarction. Chest X ray was done to measure the presence of infection, bosom failure, emphysema and other status that may act upon surgical result. Creatinine and urea were performed to place job with nephritic clearance preoperatively.INR trial was done to guarantee coagulating ability before surgery. The International Normalized Ratio ( INR ) was done to guarantee blood coagulating ability before surgery On the 30/ 4/2010, Mr X underwent an endovascular aortal fix and was transferred to intensive attention unit while proctor his status for 3 yearss. He was discharged and had a wholly recovery after a month. Mr X had a follow up postoperative ultrasound and field movie x beam of venters. X beam and ultrasound was conducted at 1and 6 months to look into the place of the stent transplant and endoleaks. However, the scan and ten beam showed no grounds of any complication. Plain skiagraphy of venters at 1 month the unity and migration of Zenith stent transplant Raad ( 2010 ) Discussion AAA is a comparatively common and potentially dangerous status associated with old age. The bulk of abdominal aortal aneurisms do non do any symptoms and hence diagnostic is frequently missed. In many instances, the exact cause of aneurism is still ill-defined. However, harmonizing to Baker ( 2009 ) , the primary cause of aortal aneurism is atherosclerosis and other factors for case, male over 65 old ages, smoke, a positive household history, COPD and high blood pressure contribute to the hazard. An probe of Mr X ‘s AAA was done during a physical scrutiny of the venters which was conducted for other grounds. Approximately 75 % of abdominal aortal aneurisms are symptomless and are found by the way during abdominal physical scrutiny or radiographic probes ordered for other conditions, ( Anderson et al 2001 ) . Aneurysm tactual exploration on physical scrutiny has merely been shown to be sensitive in thin patients and those with abdominal aortal aneurism & A ; gt ; 5 centimeter with an overall sensitiveness and specificity of 68 % and 75 % , severally for sensing of AAA, ( Fink et al 2000 ) . The primary mode used to corroborate Mr X ‘s aneurysm size was made by ultrasound. Ultrasound is a standard image mode for an probe of suspected symptomless and surveillance of abdominal aortal aneurism. Ultrasound is safe, non-invasive, comparatively cheap, widely available and does non expose patient to radiation. It is the best option for observing and mensurating the size of aneurism. However, harmonizing to Sparks et Al ( 2002 ) ultrasound can non accurately specify the extent of the aneurism as it can be altered by intestine gasses, and hence is unequal for preoperative planning of endovascular fix. Computerized Tomography Angiogram ( CTA ) of the venters was the 2nd mode to be used to look into the extent of Mr X ‘s abdominal aortal aneurism and the aneurysmal cervix for preoperative planning. CTA is going the diagnostic imagination mode of pick in the preoperative appraisal of patients with an abdominal aortal aneurism. However it has some disadvantages for case, it uses high doses of radiation, cost effectual and requires endovenous contrast but it is faster and extremely accurate in finding the size and extent of the aneurism, and its relation to the nephritic arterias. ( Hafez 2009 ) . The other mode that could hold been used for preoperative planning for Mr X ‘s abdominal aortal aneurism is magnetic resonance angiogram ( MRA ) . Harmonizing to Aburahma ( 2007 ) , MRA is merely used for surgical planning fix when CTA contradicts with patients with contrast allergic and nephritic failure. However, both computerized imaging and magnetic resonance imagination are effectual for preoperative planning fix. CTA and MRA imaging provide high-resolution imagination of the aorta and find proximal and distal boundaries of the aneurism, says ( Upchurch 2009 ) . MRI scan is comparatively clip devouring, really expensive and may be distorted by gesture artifact, extended calcified plaque and metallic surgical stents Upchurch ( 2009 ) . Hence, MRA is non used for preoperative appraisal of endovascular fix. Mr X ‘s preoperative mode was good as he did non hold any contraindication such as contrast allergic reaction or nephritic failure for him to undergo a magnetic resonance angiogram scan. With magnetic Resonance Angiogram, endovenous dye is non required and it does non expose the patient to radiation as compared to Computer Tomography Angiogram, ( Truijers 2009 ) The primary end of intervention depends on the size of the aneurism, the possibility of rupture and the patient ‘s status. The purpose of surgical intervention is to forestall aneurism from rupture for patients with symptoms such as back hurting, or symptomless aneurism greater than 5.5 centimeter in diameter, ( Hakaim 2006 ) . When sing intervention of abdominal aortal aneurism there are two types of fix ; unfastened fix and endovascular aneurism fix. Endovascular aortal fix ( EVAR ) was recommended as the most appropriate intervention for Mr X taking into history short and long term hazards and the benefits of both processs in relation to his age and co-morbidity every bit good as anatomical suitableness. This Endovascular aortal fix is a safe process and can be efficaciously performed in a patient with the suited anatomy for illustration, a individual with infrarenal aortal diameter no larger than 26 millimeters and aortal cervix length at least 15-20mm without inordinate angulations, ( Hallett 2009 ) . However, in such patients with a suited anatomy and surgical expertness, increasing the usage of endovascular aortal fix is likely justified based on its better preoperative result informations ( Hallett 2009 ) . EVAR relies to a great extent on nomadic C-arm image intensive. This enables the sawbones to utilize x-ray images to visualize the interpolation of stent transplant through the femoral arteria up to the site of the aneurism while being imaged. However, this it exposes patient to radiation during the process and in subsequent follow up EVAR is a less invasive process with a potentially reduced morbidity, mortality of 1.6 % , intensive attention, entire infirmary stay and a rapid recovery clip comparison to open fix with morality of 4.6 % , ( Tinkham 2009 ) . In the prospective randomized controlled tests, EVAR has been shown to hold a signifi ­cantly better preoperative result, ( Tinkham 2009 ) . In contrast to EVAR, unfastened fix requires a surgical exposure of the aorta clamping. Open fix was non recommended for Mr X because of hapless province of wellness due to his medical co-morbidities which limit his day-to-day activities. Harmonizing to Anderson ( 2009 ) , unfastened fix is non suited for patients with co-morbidity including terrible chronic clogging pneumonic disease or myocardial misdemeanor which places at high hazard. EVAR carries a higher hazard of complications which would necessitate farther surgery to rectify. This requires postoperative long-run follow-up imagination as the long term lastingness of the stent transplant remains unsure, ( Liaw et al 2009 ) . Mr X underwent a postoperative follow up obviously abdominal x beam and ultrasound at 1 month to look into the stent transplant unity and migration. Plain skiagraphy is easy to obtain and widely available. It still plays a utile function in measuring the metallic unity of the stent transplant but the truth of endoleaks is limited. However, the field movie can be used in concurrence with ultrasound as a method of follow up, ( Mattes et al 2011 ; Ginter et al 2009 ) . Duplex ultrasound imaging is non-invasive compared to CT. Studies show that duplex ultrasound had a sensitiveness of 90 % while CT had of 58 % in sensings of endoleaks, ( Badri et al 2010 ) Contrast-enhanced CT is another imaging mode that could hold been used for Mr X ‘s postoperative endovascular aortal fix. This image mode is expensive, less accurate in sensing of little endoleaks and it exposes patients to radiation and is. However, the major concern sing the frequent usage of contrast-enhance CT including additions cost and cumulative radiation doses which leads to lifetime malignant neoplastic disease hazard to patients have shift toward color semidetached house ultrasound, ( Mattes et al 2011 ) . MRA is alternate mode could hold been used for postoperative rating of Mr X ‘s stent transplant fix. Mr X can non undergo MRA as his aneurism was treated with Zenith stent transplant which may be distorted by gesture artifact in the magnetic field. Harmonizing to Liaw et Al ( 2009 ) , MRA is every bit accurate as CTA for sensing of endoleaks but is really expensive and can non be usage to image ferromagnetic stent transplants such as Zenith. Hence, MRA is non utile for postoperative rating of patients with stent transplants Decision I think the tract taken to name Mr X ‘s abdominal aortal aneurism was right and besides the most current pattern taken in many infirmaries. Endovascular aortal fix is a less invasive process with a potentially decreased morbidity and mortality. Endovascular aortal fix has been widely performed and it is an effectual option to open fix, peculiarly for patients with medical comorbidities. However, the mandatary follow up after is a disadvantage of this technique. Despite the disadvantages, CT remains the most widely used mode in preoperative planning for abdominal aortal aneurism and postoperative surveillance after endovascular aortal fix. In contrast to computing machine imaging, ultrasound is the simplest, cheapest, mode used for suspected and surveillance of AAA. It is a standard mode used in concurrence with field movie in some infirmaries for follow up after endovascular aortal fix. Overall, imaging provides an spread outing aggregation of tools, leting progressively accurate probe of AAAs and patient choice for endovascular aortal fix. Surgeons and radiotherapists in this field should be cognizant of the technological betterments in each imagination mode, to do the right picks before, during and after endovascular aortal fix