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Nursing theory informs nursing practice, and especially evidence-based practice. Theory offers a framework for decision-making and policy. Neuman's systems model provides the perfect theoretical framework with which to conduct my research and inform best practices. My PICO question is as follows: "For hospitalized patients who are susceptible to catheter associated Urinary Tract infection (CAUTI), if nurses and other assistive personnel develop an action plan with a systematic team approach of evidence-based infection control practices, compared to current practices, could it reduce or eliminate incidences of CAUTI?"
Developed by Betty Neuman, Neuman's systems model has a variety of applications in the workplace. Although it is a broad mid-range theory, Neuman's systems model also has specific applications for daily nursing practice. According to Neuman (2011), the systems model "provides a unifying focus for approaching a wide range of international health concerns." One of these concerns regards the correct use of catheters…… [Read More]
intervention for my PICO problem is changing the policies and procedures in hospital with the goal of reducing instances and severity of catheter-related urinary tract infections among affected patients. Although it is an administrative intervention, the outcomes are related to patient data.
The independent variables in the research include structure of nursing staff teams; the specific policies that are implemented including catheter insertion and removal procedures and regulations; and finally, the materials that are used in catheterization. Specific independent variables are listed in Appendix A.
Dependent variables include overall number of instances of CAUTI, tracked according to patient population and why the patient was catheterized. In addition to rate of CAUTI infections, the costs associated with the infection can also be a dependent variable. The material used to measure dependent variables is listed in Appendix B of this report.
Written guide related to catheter removal, with express role…… [Read More]
Summations by Supreme Court Justices Brennan and Blackmun clearly express why the court voted in favor of the plaintiffs in this important case. First of all, Justice Brennan maintains that the case "does not involve textbooks, or indeed any books that... students would be required to read. The only books at issue are library books (which) are optional rather than required reading." What Brennan is attempting to say is that the students at Island Trees were not being forced to read the so-called "filth," but if they chose to read these books, their rights as protected under the First Amendment allowed them to read as much or as little as they pleased.
Similarly, Justice Blackmun asserts that the books in question may not be removed from library shelves "for the purpose of restricting access to the political ideas or social perspectives" of the authors. Also, these books cannot be removed…… [Read More]
Patient Falls and Nursing
PICO Question -- Among acute care patients on a Medical-Surgical Unit, does hourly rounding, as opposed to only setting the bed alarm, significantly reduce patient falls (at least by 50%)?
Modern healthcare and nursing are more complex than ever before. The nurse's role is far more than simply an assistant, and requires the understanding and application of a large toolbox to deal with many different situations within the course of any given time period. (Borkowski, 2011). More often than not, nurses tend to act as the "moral agents" within the system because they are the locus of communication between the physician, the patient, and the family. The modern nurse leader must act with moral courage and conviction since "nursing leaders are responsible for creating cultures that support acts of courage in nursing… [because] these acts have the potential to increase nurse retention, promote patient comfort, relieve…… [Read More]
Giovanni Pico della Mirandola asks the question as to what is man's highest calling. He finds it in the deepest of religious beliefs and offers rational spirituality as the way to perfection. He believed that man was the greatest of God's creations, the highest form of life, even rivaling the angels. His reason was based on his firm belief in God and man's relationship with God as the creator and father of all men. He pointed out that man was the intermediary between God and the lower animals. He based this on the fact that Man has reason and intelligence. He is the one to interpret nature, and use nature. Giovanni writes from the premise that man is created by God, and that there is a Divine order to the Universe. His belief is agreement with other religious leaders including the writings of Teresa of Avila, and Saint Augustine.…… [Read More]
Evidence-Based Practice using PICO
The question posed for this search activity will be, "Does early referral of terminally ill patients into a hospice program results in better patient outcomes, in particular, with regard to pain management?" The patient group in this question is terminally ill patients. The intervention is terminally ill disease. The comparison is time entered into hospice care. The outcome is reduced pain. The primary search terms for this search are hospice and pain management. ynonyms for the search are in-home care, bereavement care, critical condition, deathbed, palliative, and anesthesia. The Meh terms are Hospices, Terminal Care, Pain management and Chronic Disease.
Based on the located synonyms, the better phrasing of the question may be, "Do early admitted hospice patience have a better outcome regarding pain management?" The reason for shaving the question slightly is that only terminally ill patients can be admitted into hospices. o, the term…… [Read More]
In the study, patients attending an asthma clinic were instructed during a two-hour educational session on asthma, its potential triggers, the appropriate use of medications, proper inhaler techniques, and the self-management of their disease. This study was more dramatic in its findings regarding the improving benefits of education. 230 patients were recruited for the study, and 83% completed the study. The group demonstrated significant improvements in lung function. There were also significant improvements in inhaler technique, asthma knowledge and patient's self-rating of the severity of their asthma symptoms. There were also reductions in the numbers of hospitalizations, visits to family physicians and accident and emergency room attendance during the study period. Patients with moderate to severe asthma were most likely to benefit from the program, thus the study concluded that patient education was beneficial.
Defense of Choices
These studies are useful, because while both examine educational initiatives targeting adult asthmatic…… [Read More]
Both Luther and Pico believe that human nature is duplicitous and binary, and that human beings have the ability to choose between the two poles. Those two poles are also framed similarly by Pico and Luther, who claim that a human being is both body or animal as well as spirit or soul. In "Concerning Christian Liberty," Luther claims that human beings have a dual nature, comprised by the body and the soul. In "Oration," Pico states that human beings exist between two worlds, the divine world and the mundane one. The goal of human life is to reach the highest potential of human nature, which is to aspire toward God. Luther and Pico differ regarding their suggested methods by which a human being aspires toward God, but not in a significant way. For Luther, a human being need only have faith in Jesus. Pico believes a human being…… [Read More]
2010). While there is of course a mandate for emergency departments to provide necessary care to any individual that requires it, more efficient and effective care can be proved when crowding in the department is kept to a minimum and releases of boarded patients are made as soon as possible (McCarthy et al. 2009; Bair et al. 2010). Crowding itself was seen to have an effect on waiting room and boarding times, and though treatment was not typically delayed due to crowding -- at least not nearly to the same levels as boarding times -- but the efficacy of treatment and the overall efficiency of a given emergency department's operations were greatly enhanced by a lack of patient crowding, which can be conversely affected by decreasing boarding times (McCarthy et al. 2009).
The desired outcomes as stated is the improvement of safety and health outcomes for boarded emergency department patients,…… [Read More]
It is also quite possible that there is a significant "placebo effect" when dealing with GI (or other) treatments. The patients may be truly relaxing, but may also believe that they are managing their pain through breathing and imagery, meaning they are, in fact doing just that (resler; Menzies).
Evidence-ased Practice Analysis -- Clearly, the use of GI techniques to supplement and help wean patients off pharmaceutical pain management solutions is not only positive, but cost-effective and more efficient. The research shows that not only is GI helpful for pain management, it can also be an effective technique to lower blood pressure, reduce anxiety, work in a pre- and post-op setting, to help prevent patients from "test or exam" panic, and to increase pain tolerance. Physicians could help disseminate this technique by supplying their patients with a disk or zip-drive with several different (length, style, etc.) GI scenarios. Giving the…… [Read More]
This ahs some relevance to the PICO question in the ability of individuals to provide proper self-care, but it does not address the issues of diet or exercise at all.
The Two Best
The two most relevant articles that were uncovered during this research process in regards to the specific PICO question identified above were Gulve's 2008 article concerning the effects of different exercise types on glucose levels, and the Mayo Clinic's 2009 general information article on developing a healthy eating plan. These two articles have very different approaches both in collecting their information and in presenting it to the reader, but both also came the clsoest to directly answering the PICO question, or at least specific portions of the PICO question, and had highly reliable information.
In the case of the Mayo Clinic's article, the dietary plan was directly and explicitly linked to changes in glucose levels, aiding the…… [Read More]
Adults with congestive heart failure requiring hospitalization
Heart Failure education (signs, symptoms, pathophysiology), self-care interventions (diet, fluid restrictions, sodium dietary restrictions, review of medications, exercise recommendations, weight monitoring), patient support (telephone support, increased clinic visits, home visits, social support, psychological support, multidisciplinary care).
Usual care vs. intervention, one intervention vs. another intervention
eadmission rates (all causes), length of hospital stay, health care utilization, mortality rates (all causes), quality of life.
One Month follow up
In congestive heart failure patients 50 years and older, what is the effectiveness of interventions to support post-discharge care compared with the usual care to prevent readmission?
How can we prevent readmissions for patients with congestive heart failure?
Congestive Heart Failure (CHF) occurs when the heart is unable to pump enough blood flow to meet the needs of the body. It can cause a number of symptoms, including shortness…… [Read More]
PICO Question: Bariatric Surgery
As the obesity rate continues to be an issue of great concern in America, the question arises as to the best ways to reduce the BMIs of individuals already suffering from the condition, as well as how to enact preventative means. Although the ideal is for people to never become obese at all, the fact remains that there is a need to develop proactive measures to facilitate weight reduction. For most patients, modifications in diet and exercise is recommended but, as even people who have attempted casual weight loss know, deploying such techniques in an effective and consistent fashion is far easier said than done.
The PICO question for the purpose of this study is, from the perspective of a family nurse practitioner, when treating patients with type 2 diabetes and obesity, can bariatric surgery be more effective than standard medical therapy at increasing…… [Read More]
Treatment to Patients
The main objective of providing treatment to patients is to relieve symptoms along with decreasing the progression of the disease as well as the mortality or morbidity. However, in some cases, this objective is not fully achieved, especially in the case of the patients who are admitted to the ICU with some serious and almost always a terminal stage of the disease. For example, when old patients are admitted in the ICU, their immunity is extremely low and this is the perfect time for the opportunistic infections to make matters worse for these patients. There are many infections that are specifically associated with patients admitted in the hospitals. Pseudomonas Aurigeonosa is a micro-organism that is well documented to cause bacterial pneumonia and bacteremia in the patients who are terminally ill and are receiving treatment in the hospital setting. Since most of the patients in the ICU are…… [Read More]
The findings yielded a direct correlation between poor inhaler use and poor literacy: Poor inhaler technique was found in 89% of patients reading at less than the third-grade level compared with 48% of patients reading at the high-school level (Nowlan, illiams, Baker, Honig, Lee 1991).
This study's result would have a direct impact upon traditional patient educational efforts, as health education still tends to rely heavily on printed materials. These materials might also be written at too high a level. Making use of pictorial materials and personal demonstrations, the authors concluded, might be more effective than using traditional verbally-based media. The study suggests that different approaches are needed, and more personalized intervention may be required for asthmatics, at least during early stages of treatment. However, there is an issue of correlation vs. causation -- individuals with low levels of literacy may have difficulty learning in general, regardless of the medium,…… [Read More]
Progressive Mobility Protocol
This paper is a project based on PICO. The clinical question that serves as the foundation for this data-based design is; for immobile critical care patients, does the use of a nurse driven progressive mobility protocol reduce ICU LOS compared to every hour of repositioning? In this paper, the adult patients admitted to an ICU represent the population (P) of interest. The nurse driven progressive mobility represents the intervention (I), the comparison (C) is the critical care patients repositioned every two hours, and the reduction in LOS represents the result.
Most hospitals place critically ill patients on bed rest and reposition them every two hours in the intensive care unit. Some literature reviews provide evidence in favor of progressive mobility protocols. In addition, the paper also reviews the safety of mobilization of the critical patients and the negative effects bed rest may have on…… [Read More]
Ethical Aspects in esearch Studies
The essential aspects of research are the concern and respect that the researchers offer to the participants. esearch is aimed at producing insights that are beneficial to the society. However, the research should be conducted ethically. The ethical concern in research adduces that it should not advance a society at the detriment of others especially the participants in the research. Ethics in research is vital because it guides the working principles of the researcher for the research to conform to the required standards. This is the case especially when research subjects in health or medical research are often human beings. Therefore, it is vital to respect these individuals. The guiding principles in research ethics focus on preserving the rights and dignity of the research participants. In this regard, ethics focus on ensuring consent is obtained, no harm is done, the participant's privacy is respected, and…… [Read More]
search I intended to use various keyword searches in order to find the relevant literature regarding how lifestyle modification compared to no modification in liver transplant patients, with a view to the impact on quality of life over 4 months post-operation. I was utilizing an intervention PICO and the reviews that I deemed relevant were systematic, reviews with meta-analysis of randomized control trials, case control studies, qualitative studies, and articles in which expert opinion was pronounced. Thus the purpose of these searches was to find literature which represented the extent of academic work on the subject in recent years.
The purpose of this review was to discover primary sources in various databases such as Medline, Cinahl, Embase, PsychINFO, and PubMed. Secondary sources were also targeted using Cochrane Database of Systematic Reviews and Cochrane Central Register of Controlled Trials.
Strengths and Weaknesses
Medline was utilized primarily because it is…… [Read More]
Still, the concept of guided imagery tends to stray far from traditional methods of pain management. Pharmaceuticals have long been a major method of treatment for pain, but have resulted in major backlashes in regards to patients becoming addicted, especially in long-term and chronic cases of pain. If guided imagery could be a successful method, it may reduce pain or increase pain tolerance, without the threat of chemical dependence.
There are a number of benefits which are seen in the ongoing discourse today. As such, the expected improvements include things like drops in blood high blood pressure, lower heart rates, and reduction of chronic pain symptoms, lessoning of headache pain, and increasing overall pain tolerance (Cornelius, 2010). In situations were patients going into a major surgery were coached with guided imagery, it was "shown to decrease stress and anxiety before and after surgery," thus helping reduce additional pain issues during…… [Read More]
interest, an identification of the problem that you have selected, and an explanation of the significance of this problem for nursing practice
My research question: Among acute patients on medical surgical units does hourly rounding as opposed to only setting the bed alarm help decrease patients falls by 75%.
Falls are a major problem amongst acute patients, particularly amongst the 65+ population and can lead to so many related problems, occasionally to fatal results, that this essay considers it a crucial topic for nurses and caregivers to look into and investigate.
The fall is traumatic aside from which consequences of falling can also include post-fall anxiety, fractures, head injuries and loss of independence through falling, each of which has far wider ramifications impacting physical, social, mental, emotional, and behavioral spheres of the patient's life. The ramification of falling, therefore, for the patient has a wider and far-reaching impact that touches…… [Read More]
According to Waryasz & McDermott (2009), the global prevalence of diabetes among people aged between 20 and 79 rose to 6.4% affecting 285 million people in 2010 and the rate will rise to 7.7% affecting 439 million people by 2030. Amid 2010 and 2030, the rate of individuals with diabetes will increase by 69% in developing nations, and a twenty percent rate in developed nations. In 2011, the number rose to 366 and it is expected to rise to 552 by 2030. The pervasiveness of diabetes is advanced in males compared to females, yet the number of women with diabetes is more compared to that of men.
Diabetes affects any part of the human body and people with diabetes are likely to die of heart-related problems or stroke. Seventy-percent of individuals with diabetes show signs of high blood pressure which a risk factor for heart-related diseases. The majority of…… [Read More]
Suicide rates are remarkably high worldwide and nationally, making suicide one of the leading causes of death (Schwartz-Lifshitz, Zalsman, Giner et al, 2012; Tillman, 2014). Although most suicides do not occur in the hospital setting, psychiatric disorders—especially mood disorders and psychotic disorders—are risk factors that increase the likelihood of a suicidal event (Appleby, 1992; Sarzetto, Delmonte, Seghi, et al, 2017). Suicide not only affects the patient, but reverberates throughout the patient’s family and social circle, also causing distress and potential performance issues among clinical staff (Tillman, 2014).
Therefore, it is important that psychiatric nurses understand how to recognize risk factors, and establish a clinical practice environment that prevents suicide. Minimizing suicidal tendencies requires different types of treatment interventions individually tailored for at-risk patients, as well as implementing best practices for creating a clinical environment that reduces risk. Best practices may also include preparing, teaching, and training nursing staff, especially when…… [Read More]
These individuals promoted the belief that it was in people's best interest to concentrate on putting across thinking that reflected positively on the world and that moral thinking played an essential role in changing the way that the social order functioned. Humanist writers wanted people to learn to enjoy life's pleasures without focusing on material values.
Even with the fact that Castiglione partly agree to Pico by stating that reason and knowledge were essential factors in this process, the former actually seems to focus on a more profit-motivated attitude while the latter is apparently interested in having people acknowledge the need for more moral values.
Castiglione, Machiavelli, and Pico all had different perspectives concerning the attitudes that the Renaissance man needed to employ in order to experience positive results as he was trying to discover his personal identity. In contrast to both of them, Machiavelli did not hesitate to emphasize…… [Read More]
Despite major medical advancements over several decades, nearly 10 percent of births in the US continue to occur prematurely each year (Martin, Hamilton, Osterman, Driscoll, & Matthews, 2017). Creating a significant socioeconomic burden, preterm birth is one of the leading causes of infant morbidity and mortality in the United States resulting in approximately $16.9 billion in medical care costs annually (Institute of Medicine [IOM], 2007). After days, weeks, or even months of intensive care, weight gain becomes a major criterion for hospital discharge. Feeding intolerance (FI) is a common complication among these preterm infants, which disrupts enteral feeding, resulting in feeding advancement delays, prolonging adequate weight gain and growth, and increasing hospital stays (Carter, 2012). Additionally, FI is associated with necrotizing enterocolitis (NEC), a gastrointestinal emergency and a leading cause of morbidity and mortality in this group of patients (Moore & Wilson, 2011). The underlying cause for these problems…… [Read More]
Feeding intolerance has been identified as a significant problem for infants in the Neonatal Intensive Care Unit (NICU). Inquiry has revealed massage therapy as a possible nursing intervention for the problem (Shaeri et al., 2017). Additional knowledge is desired to determine if new research findings present clinically significant evidence for use of the intervention in the NICU patient population. Toward this end, a PICO question has been formulated: does massage application given to infants born at less than 37 weeks gestation reduce feeding intolerance?
Given the increased prominence of theory-based nursing, identifying an applicable nursing framework is important. One model that can be used in addressing the identified problem is Roy’s adaptation model (RAM). Indeed, RAM is one of the most common nursing models. Essentially, the model emphasises patient adaptation to the environment (Saini et al., 2017). As per the model, the nurse focuses on improving the patient’s ability to…… [Read More]
Post Traumatic Stress Disorder and isk of Dementia among U.S. Veterans
According to Yaffe et al. (2010), Post Traumatic Stress Disorder is a prevalent psychiatric syndrome linked to increased mortality and morbidity rates. This condition is among the most prevalent amid veterans returning from combat. Among veterans returning from Afghanistan and Iraq, the prevalence of post traumatic stress disorder is estimated to be about 17% (Seal et al., 2009). Veterans returning from Vietnam have a twenty to thirty percent rate. Past studies have confirmed that PTSD is linked to increased health care consumption and an augmented danger of developing a variety of other medical conditions among veterans such as dementia. The risk factors that link PTSD to increased rates of dementia include head injuries, depression or medical comorbidities.
This work highlights the findings of the study carried out by Yaffe et al. (2010). The project specifically focuses on the conclusions…… [Read More]
Confessions of Augustine, The Life of Saint Teresa of Avila by Herself, "On the Oration and Dignity of Man," Petrarch's poetry, and Shakespeare's drama "King Lear" are both products of societies in which the dominant religious ethos was Christian rather than pagan. However, although all texts share this similar historical feature, fundamentally opposing views of the self are articulated through the theological texts in contrast with the works of lyric and dramatic poetry.
This may seem counter-intuitive to a casual reader, as both Augustine's Confessions and "King Lear" makes use of pagan and Christian modalities of selfhood. A closer reading suggests that while the former does so to validate the Christian concept of the supreme value of the inner life of the self as illuminated by God, the latter does so in a way that ultimately expresses a view of human inner life that is nihilistic, confusing, and cannot necessarily…… [Read More]
Foreign key fields (i.e. The key that represents the value of a primary key in a related table) may exist in the case of CLEBSI speciment: date of diagnosis, date and time of specimen (where latter may replicate). Under 'Patient', CLEBSI line is a foreign key, too.
V. Atomic-level data
Atomic data would be the most reducible element of information (without elaboration). So for instance for hand hygiene it would be Chlorhexidine Skin Antisepsis Antimicrobial Dressing Placement
VI. Schemas of the database will be:
Patient with the attributes of name, age, medical record number (MN), diagnosis, central line; Central line with the attributes of medical record number, date of insertion, insertion site, date of removal, line days, inserting provider, the components Central Line Bundle compliance, antimicrobial dressing placement; and CLABSI infections with attributes of MN, date of diagnosis, date and time of specimen, organism detected. Central Line Bundle compliance will…… [Read More]
I completely understand the agency's chain of command, rules, and protocols. Frankly, I also appreciated the camaraderie that I enjoyed at the LCSD because it made it an absolute pleasure to come to work everyday and I look forward greatly to the opportunity to rejoin the team. Naturally, I missed the annual picnic provided by Director Strout, as well.
It would be my most sincere pleasure to have another opportunity to work for Director Dean Strout, Lou Mackoler, John Carillo, Tray Strout, and Ruben Verillo again and I am confident that they will be able to confirm my suitability for the advertised position. I look forward tremendously for the opportunity of an interview and genuinely appreciate the chance to return to the Los ngeles County Sheriff's Department as an electrician because my previous employment in that same capacity has been my career highlight to date.… [Read More]
Q2. From an American perspective, it is tempting to look out at the world and to assume that American culture now dominates and reigns over all, given the seeming ubiquity of American movies, television, and music. However, a cultural analysis of many regions of the world yields the finding that culture is far more regional and pluralistic in nature.
For example, in Mexico, soap operas known as telenovelas captivate almost the entire population. They often give voice to Mexican fantasies about transgressing economic borders. One such soap opera, Ugly Betty, has actually been appropriated by U.S. culture. Mexican culture has changed the U.S., as well as vice versa, despite the U.S.'s greater economic power in the region. And within India, Bollywood films are far more popular than Hollywood films because of the way they speak to unique Indian culture needs. Within this densely-populated and fantastically diverse nation, the fascination with…… [Read More]
On the other hand, a motive of debate was whether or not the Court should be intervening on issues that, ultimately, belong to daily operations in schools. The Court judged, however, that this was a breech to "basic constitutional values" (as in Epperson vs. Arkansas) and, in this sense, the judicial system's intervention becomes a necessity.
Additionally, the Court decided that the school board's decision could not be justified by the sole means of "educational suitability," which would have made it permissible, but that it was based on a purely partisan, political approach (some of the 9 titles clearly suggest this).
Petitioners rightly possess significant discretion to determine the content of school libraries. But that discretion may not be exercised in a narrowly partisan or political manner."
In Board of Education vs. Pico, the Supreme Court affirmed, with a 5-4 vote an order from the Second Circuit Court of…… [Read More]
Nurses are well positioned to identify clinical problems and use existing evidence to improve practice and make care more effective (eyea, 2006). Evidence-based practices enables nurses to provide high quality care based on current evidence. The potential impact includes better patient outcomes, contributions to the science of nursing, keeps practice current and relevant, increases confidence in decision making, and keeps policies and procedures current, supporting JACHO readiness.
Some common practices in disseminating to a broader audience includes poster presentations, presentations, such as paper presentation, speaking, and presenting to the organization (Mauk). Other ways can include presenting to nursing journals for publication. Still another way is to implement a nursing research council that shares in the processes of researching current research studies, collecting evidence, and sharing at their individual organizations.
To implement a strategy for developing a collegiate EP network, goals and mission first need to be defined. Processes, then, need…… [Read More]
riters such as Pico Iyer, Richard Pells, and Joseph Nye are in fact correct that the world culture has not and will not be Americanized. These writers are correct in asserting that American culture is ever forceful, but still America remains just one influence in a multicultural world: a manifestation of globalization. ith such a supreme focus on America, it can seem like America is the dominant force; however, this is just a result of a skewed perspective. It is true that other cultures have also spread outwards and that local cultures cannot and will not be destroyed.
The phenomenon of culture shock is direct evidence of the fact that American culture is not as pervasive as many people would like to assert that it is. As centers for study abroad programs in various universities explain, culture shock is a logical reaction to the body and mind in…… [Read More]
Qu'an simila to and diffeent fom the Holy Bible? Give examples fom each wok to illustate thei similaities and diffeences
The Qu'an is the holy book of Islam, the eligion established by Muhammad while the Holy Bible is the saced book of Chistianity. Thee ae a numbe of ways in which the Qu'an is simila as well as dissimila to the Holy Bible. Fo states, both of them consist of chonicles, teachings, poety, and epimanding. Seveal chonicles encompass the simila basic occasions and individuals. The Qu'an and the Bible both teach the ceation of the wold by a distinct almighty, all-knowing God who commands human beings to follow the moality set out fo them. Fist of foemost, one of the key simila doctine is that God, efeed to as Allah in the Qu'an, and Yahweh in the Bible, is the only ceato of all things in the univese and whose…… [Read More]
Rudolfo Anaya grew up in the New Mexico and much of his work reflects this upbringing. A popular theme in his fiction is the background of the state and the introduction of factors that can lead to human destruction: greed, lust, self-righteousness, deception, and connivance (Garcia 2000, p. 11). His short story "The Apple Orchard" is not exception to this. This is the story about a young boy named Isador who is in seventh grade as he struggles to come of age in his community. The first-person narrator has a father who values education. The themes of education and its importance is integral in Chicano literature. According to Hector Colderon (1999), it is extremely difficult to finish education in the Hispanic community, particularly if English is not your first language. He says, "Out of some thirty-plus students, three of us graduated from high school on time, a few others had…… [Read More]
In Italy, the Counter-eformation had a great deal of effect on enaissance works. As an example, Michelangelo's Cristo della Minerva in the church of Santa Maria sopra Minerva, in ome, fell victim to these actions. Just as the bonfires of the vanities saw artwork in various forms destroyed by fire, Michelangelo's sculpture was not safe from harm. The nakedness of Christ was seen as obscene, and as such, a girdle was added to the sculpture to cover his genitals ("Cristo della Minerva"). This is in contrast to enaissance works in Northern Europe that although they experienced the troubles of religious division with the eformation, Counter-eformation and events such as the formation of the Church of England..
German enaissance artist, Albrecht Durer, also is instrumental in illustrating the differences between the Southern and Northern enaissances. Durer captures his views of the 'condition of man' eloquently in his print Melencolia I.
Many…… [Read More]
(Busch, Barber, Overend, Peloso, and Schachter, 2007, p. 8)
esults from this study relate a moderate quality evidence that aerobic-only exercise training at recommended intensity levels produces positive effects "global well-being (SMD 0.44, 95% confidence interval (CI 0.13 to 0.75) and physical function (SMD 0.68, 95% CI 0.41 to 0.95) and possibly on pain (SMD 0.94, 95% CI -0.15 to 2.03) and tender points (SMD 0.26, 95% CI -0.28 to 0.79)." esults noted that flexibility and strength and flexibility remain under assessed. (Busch, Barber, Overend, Peloso, and Schachter, 2007, pp. 11-13)
According to criteria Melnyk Fineout-Overholt (2005) present, this study is a Level II study. From the Cochrane review, the following relates what research notes regarding the effect of exercise for FMS:
moderate intensity aerobic training for 12 weeks may improve overall well-being slightly and physical function.; moderate intensity aerobic exercise probably leads to little or no difference in pain…… [Read More]
The Pope's purpose, of course, was to emphasize the concept of original sin and the importance of the Church's priests in reconciling sinful man with God's mercy. In order to do this, he downgraded the condition of man in his writings, emphasizing how demeaned, pitiful and degraded is the state of the human soul, which could only be saved from eternal damnation by the pardon obtained by prayers and petitions offered through the Catholic Church. Mirandola's viewpoint, synthesizing the Platonist view with Aristotelianism, Averroism (a form of Aristoteleanism) and mysticism (the Kabbalah and the Hermetica), which elevated the concept of humankind, in religion, as well as in other ways, believing that religious truth was freely available and "in part revealed to all, both Christian and non-Christian." (Hooker 1)
Hooker, Robert. (6 Jun 1999) Pico Della Mirandola. orld Civilizations. Retrieved January 15, 2007 at http://www.wsu.edu/~dee/REN/PICO.HTM… [Read More]
Paediatric, pediatric, infant
How would you describe your Participant, Patient, or Population group?
Female hospital worker age 20 to 45
What characteristics of your Patient/s are important? Age, gender, condition, etc. can all be significant.
What Intervention are you interested in?
Work shift 8 hours long
Defining the Intervention is often the central part of PICO.
What alternative or different option do you want to Compare your intervention to?
Work shift 12 hours long
You might want to Compare the chosen intervention to usual care, to another intervention or to no intervention.
What measurable Outcome/s are you interested in?
Outcome is the final aspect of PICO. Some examples include: symptoms of asthma, accuracy of diagnosis or mortality.
2. eformatted (PICO) Clinical Question
In healthcare providers working in a hospital (nurses) (P…… [Read More]
Renaissance humanism refers to a period of history where there was a move away from the ideas of State and religion as the basis of society and a move towards human experience and interaction. It was a rebirth in that it rejected the ideas of the Middle Ages and reinvented the ideas of the ancient philosophers. The basis of it was a return to the study of the humanities which included music, art, poetry, science, and virtue. The one thing that underlined both the ideas of the ancient philosophers and the ideas of the Renaissance humanists was that the importance of humans lay in their ability to interact as individuals with the world around them and extract meaning from it. Man himself became the measure of all things.
It is first worth noting that the humanist ideas were the ideas of scholars. For this reason, much emphasis was put on…… [Read More]
Strategies for Dissemination
The key stakeholders in the implementation of the PICO project include patients, their families, health care team members including physicians, hospital administrators, insurers, suppliers, and investors ("Who are the Stakeholders in Health Care"). A broad and diverse group of stakeholders like this one requires a complex and multifaceted approach to project dissemination.
Different dissemination strategies will be used for different stakeholders. For patients and their families, the dissemination strategy will consist of the distribution of educational materials and access to educational resources. The educational resources will help patients to be empowered, so that they can ask questions related to their catheterization. Knowing what questions to ask, and what the answers mean, will help patients and their loved ones make responsible health care choices. For example, the study will show patients that they do not have to keep the catheter in, just because the nurse has…… [Read More]
In fact, when it comes to terrorism, strangers are, generally, the ambit of their activities.
There have been some activities, however, that have targeted innocent civilians and the motives and actions, in these cases, have ominously paralleled terrorist stratagems and motivations. A case in kind occurred in December, 2004, when an intercity bus in Honduras, Central America was intercepted and sprayed with machine gunfire and 28 passengers, mainly women and children, were killed first by the gunfire then by the assailants climbing abroad the bus and methodically executing the passengers17. The objective was a protest against the Honduran government who had recently reinstated the death penalty.
Another similarity is in their pattern of operation where, like al-Quida, they operate in a form of loose, unstructured cells that form a global dispersed network. Similarly, too, their individual ceils are devoted to similar activities and some are quite sophisticated. These include activities…… [Read More]
Indeed the Germans, the French, and the rest looked back to an antiquity in which their ancestors had been subjugated by the legions. Nothing is more remarkable therefore than the rapid and irrevocable penetration of Italian ideas and practices among the "barbarians," as the Italian writers referred to them, some of whom were currently invading the peninsula." (Wiener, 124) it's also important to note that influence of antique classicism typical for Italian architecture of the 14-16th centuries is not observed in the north. Classical style of Italian cathedrals and churches, typical for Ancient Greek and oman pagan temples is usually not observed in buildings of enaissance epoch in Germany, Britain or France, where architecture was influenced by Gothic style, which got earlier spread in Europe.
eformation and Counter eformation
The spread of Protestantism over Europe, which is considered to be one of the most historically significant achievements of enaissance and…… [Read More]
After the completion of the design and development of satellites, the systems are normally subjected to waiting periods that span for several years before the identification of an appropriate launch opportunity.
Design and Implementation Cost:
The third major problem in the development and implementation of satellite communication is the software development costs. This includes money spent on all bus systems, ground support equipment, systems engineering, communication payloads, program management, and integration and test. In most cases, the development and implementation costs are difficult to estimate since there are recurring and non-recurring cost drivers in the process. The non-recurring cost drivers include heritage, number of prototypes and engineering models, and technology readiness while the recurring cost-drivers are complexity, project scope, and quantity of production.
The production quantity refers to the number of flight units developed, combined, and tested on similar contract to the development initiatives. hile the development and production initiatives…… [Read More]
Since gang-related crimes fall within the jurisdiction of state, this research will give an insight on the need to find solutions that increasingly include all levels of government. Congress needs to pass legislation that will change immigration enforcement laws and make more aliens deportable. In addition, the federal government should take a more active participation in helping local and state jurisdictions develop anti-gang responses. The local, state and federal governments must take a stand, and combine forces to combat the immigration problem that continue to plague this country into the next generation.
Importance of the Study
The die has been cast, there is no turning the clock back now and the Mara Salvatrucha and 18th Street Gang have established themselves in the United States and far beyond. The origins of the current situation with MS-13 and the 18th Street Gang date back to the late 1980s and early 1990s…… [Read More]
Nursing Leadership Issues
eflect on how you would create a safe environment in a healthcare setting by applying the 4 characteristics of a culture of safety. They are:
• Psychological safety. People know their concerns will be openly received and treated with respect.
One of the tenets of the total quality movement as expressed by W. Edward Deming is "Drive out fear" (Edward, 2012). The recommendation comes from a fundamental understanding of human nature: people do not like to call problem to the attention of their supervisors. No one wants to be the bearer of bad news, and in medical and healthcare settings this may be particularly true. Unsafe conditions can mean that patients are exposed to hazards or that employees are more likely to incur injury. In addition, nursing staff may occasionally find themselves in a position where a peer or another staff member are not following procedure. Not…… [Read More]
esponse to instruction and intervention TI2 is reported as a general approach in education to closing the gap in achievement. TI2 methods are constructed upon the esponse to Intervention (TI) model that was an option for schools under the 'Building the Legacy, Idea 2004 reauthorization of the individuals with Disabilities Education Act IDEA. (California Department of Education, 2011) TI and the expanded TI2 are reported as being based upon "17 years of practice that has refined continuous progress monitoring as a strategy for keeping students on a path toward success." (California Department of Education, 2011) TI is reported as a strategy that moves all students through the steps set out in the learning standards and is further more stated to be an approach that views both academic and behavioral achievement of students.
Tier 1 included the 'Universal Interventions' which include "preventive, proactive, universal intervention in all…… [Read More]
Down These Mean Streets believe that every child is born a poet, and every poet is a child. Poetry to me was always a very sacred form of expression. (qtd. In Fisher 2003)
Introduction / Background History
Born Juan Pedro Tomas, of Puerto Rican and Cuban parents in New York City's Spanish Harlem in 1928, Piri Thomas began his struggle for survival, identity, and recognition at an early age. The vicious street environment of poverty, racism, and street crime took its toll and he served seven years of nightmarish incarceration at hard labor. But, with the knowledge that he had not been born a criminal, he rose above his violent background of drugs and gang warfare, and he vowed to use his street and prison know-how to reach hard-core youth and turn them away from a life of crime.
Thirty years ago Piri Thomas made literary history with this lacerating,…… [Read More]
treatment using the drug, tamoxifen, and higher mortality rates in females aged over forty years. The peer-reviewed papers employed for this study reveal a dynamic scrutiny of the aforementioned link. Quantitative as well as qualitative research works have been utilized, with a comparison and contrast made of the most apt methodology employed by the researchers. The end goal is ascertaining whether or not it is a risky decision to not adhere to tamoxifen treatment and how much information patients possess with regard to the drug and its effects.
The esearch Question and its Importance
After the diagnosis of her health condition, Ms. Jones is prescribed tamoxifen as medication. For an entire year, Ms. Jones fails to consume this prescribed drug. Upon revisiting the hospital after a year of not complying with this recommended treatment plan, she is told that her cancer has reappeared and is much more lethal than before.…… [Read More]
Autism is a problem with significant negative impacts on affected children and their parents/families who require wide-ranging support services for their children. For family members, the condition generates distress when raising the affected child due to the psychological and social problems it creates. Therefore, the consideration of parental mental health is an important aspect for social workers and mental healthcare providers when attending to these special needs' kids and creating interventions for children diagnosed with autism. In this regard, the research problem to be examined in this study is the link between hopefulness, quality of life (QOF) and internalized stigma for parents with autistic children.
Plan for Identifying Research Question and Sub-questions
The plan for identifying the research question and relevant sub-questions in this study involves utilizing the PICO format. First, the researcher identified the population or problem of interest i.e. parents with children suffering from autism. This was followed…… [Read More]
For basement and Slab- on -- Grade houses, the reduction is done through any of the four methods of soil suction: drain tile suction, sump-hole suction, drain tile suction or block wall suction. For claw-space houses, the radon levels are reduced effectively by using high-density plastic sheet to cover the floor. Radon is vented to the outdoor by drawing it under the sheet using fans and vent pipe. Other method of radon reduction is sealing of the cracks found in the foundation that limit the radon flow into the house ("How to reduce radon levels in your home").
Association between lung cancer and exposure in the residential houses has been shown by many studies conducted by scientists In the United States and other parts of the world though not all studies has shown this association. The reason for this inconsistencies in the different studies is because of disparate radon…… [Read More]
The development of lung cancer is the primary health risk regarding radon, though even this risk was only discovered in the mid-1980s and it is possible that there are other health issues that could be caused or exacerbated by the presence of unsafe radon levels in many buildings (MDNE 2010). Government as well as private intervention through awareness programs, self-testing, and subsidies for installing air-exchangers, filters, and other devices proven effective at removing radon from the air and trapping the particles can and should be explored as possibilities for mitigating the negative effects of radon gas, or even eliminating them altogether (MDNE 2010; EPA 2010; SGO 2007). The government also must serve as the primary source of information on this topic, as it is simply not a major media issue for other reasons, and is a constant and ongoing problem rather than something that might receive a spike in attention…… [Read More]
Bell (2011) reported on work at the University of Illinois School of Dentistry which led researchers to conclude that raisins, consumed either alone or added to sugared bran flakes, lowered the pH in the mouth, thus making that environment less hospitable for bacteria-causing caries. aisins thus may be an alternative hygienists can recommend to patients and parents as a food that satisfies the craving for sweetness but is a healthier choice for teeth.
There are no "wykked worms." Tooth decay is not something that just happens. Caries are both preventable and treatable. Dental hygienists have an important mission to not only provide oral care but to educate patients about nutrition and decisions under personal control that support good oral health.
Arola, L, Bonet, M.L., Delzenne, N., Duggal, M.S., Gomez-Candela, C., Huyghebaert, a., Laville, M., Lingstrom, P., Livingstone, B., Palou, a., Pico, C., Sanders, T., Schaafsma, G., van Baak, M.,…… [Read More]
This created problems in the care of patients that should have been admitted to other units, as well as for all patients receiving care in the emergency department on an inpatient or an outpatient basis.
In addition, research was undertaken that examined alternatives to simply increasing the efficiency with which ED patients are either treated and released or admitted on an inpatient basis, and it was found that increasing staffing level and other practices were still insufficient. The research all quite clearly suggested that the practice of inpatient boarding in emergency departments was detrimental to patients as well as to medical, nursing, and support staff, and was also not cost effective for hospitals. It was recognized that a huge benefit could be derived from a comprehensive and conclusive survey of the issue, which would lead to clearer recommendations for nursing and medical staff as well as hospital administrators than have…… [Read More]
In his attempt to paint the goddess, the Renaissance painter inspired from the mythological legend of Venus's birth. The Roman Goddess of love apparently emerged out of the sea as a result of a foam formed around Uranus's genitals that had just been cut by his son, Cronus. Cronus apparently did so in order to get revenge, since his father treated him very cruelly (Deimling 52).
otticelli focused on emphasizing the painting's contours with a black stripe, making them contrast the rest of the picture. This concomitantly makes the painting clearer and gives it a detached character. The flowers falling from the sky were also taken from the legend, since flowers and spring are associated to Venus's birth (Deimling 52).
Whereas the painting's title refers to the actual birth of the goddess, the painting itself seems to represent something else. Instead of showing Venus as she comes into this world,…… [Read More]
His firms' methodology concentrates on tracking shoppers throughout stores and videotaping their behavior, then analyzing it in the context of displays, traffic routing strategies and the use of signage in the stores. As a result of this methodology, the company Envirosell captures 50,000 hours of video each year. His firms' analysis shows that the front of stores is often used as a decompression zone, and that Americans tend to turn right when they walk into a store. As is the case with auto dealerships' service centers, the most crucial time to meet a customer is when they first enter the dealership or store. Mr. Underhill's analysis supports this fact with his firm stating that the first minute a customer enters the store is the most important in getting them to purchase. he challenges that Mr. Underhill highlights for retailers are to control the flow of traffic through their stores and…… [Read More]
In North America the system progression will start from Time division multiple access (TDMA), change to Enhanced Data Rates for GSM Evolution (EDGE) and then to UMTS.
Evolution from 2G to 3G
2G networks were built for the most part for voice data and slow communication. Due to rapid changes in user anticipation, they do not meet today's wireless requirements. Cellular mobile telecommunications networks are being improved to use 3G technologies from 1999 to 2010. Japan was the first country to introduce 3G nationally, and in Japan the transition to 3G was largely completed in 2006. Korea then adopted 3G Networks soon after and the transition was made as early as 2004.
From 2G to 2.5G (GPRS)
2.5G and even 2.75G are technologies such as i-mode data services, camera phones, high-speed circuit-switched data (HSCSD) and General Packet Radio Service (GPRS) that present some functionality domains like 3G networks, but not…… [Read More]
The Renaissance gave them the opportunity to explore and create without restraint. As a result of this, learning took on an entirely different meaning in that it included the human experience as a significant aspect of knowledge, increasing the desire to know more.
A result of a desire to learn resulted in an invigorated self-confidence that only reinforced the belief that mankind had the power within him to understand all things, including nature. This new outlook on life and mankind resulted in an expansion of knowledge, especially in literature and science. Renaissance artists broadened their skills by using oil paints and incorporating realism to their work. Leonardo di Vinci is perhaps one of the most prominent artists of this time. His work illustrates the new trains of thought that mankind was taking. Another artist that cannot be ignored when mentioning the Renaissance is Michelangelo; a man whose art speaks volumes…… [Read More]
In Hamlet's case, the dark Ages conquer the light and the last scene displays before Fortinbras'(the Prince of Norway, whose father was killed by Hamlet's father) eyes. Fortinbras seems to be the symbol for the rebirth of Denmark, in the light of a young king that lacks the putrid inheritance of an alienated royal family, like Hamlet's. The Renaissance man, Prince Hamlet, seems aware of the inutility of trying to restore the reign of his royal family in Denmark, since its members are proved to be corrupt and not suitable any more to lead a country in the spirit a new born world. His acts could also be in the spirit of sacrifice, suitable for a Renaissance man, in the name of restoring the dignity of his subjects and the glory of his country. People like Galileo and Savonarola were ready to give up their most precious possession, life, for…… [Read More]
" Initially, the painters were given the assignment to create sample frescoes which were to be evaluated. On the basis of the evaluation, they were to be employed or not. However, their talent was rapidly acknowledged and they were commissioned to continue the work without any other testing. The individual scenes constitute a whole because they comprise typological references to one another. They present Moses as prefiguring Christ. We must mention, however, that, only after Michelangelo's later work (1508-1512) did the Chapel become famous.
After the Medici's expulsion from Florence, otticelli felt the influence of a Dominican monk called Girolamo Savonarola. In Savonarola's point-of-view, everything that wasn't useful in the life of humans didn't deserve any attention. Therefore, he destroyed many works of art, in his "bonfire of vanities." ecause of this man, Sandro was deeply affected and his interior feelings were also reflected in his work.
As a review,…… [Read More]