Lung Cancer Detection Methods

There are several ways in which lung cancer may be detected and some of these are the following: First of all is to have the patient undergo what is technically referred to as â€Å"screening† (The Health Alliance, 2006, n.p.). Here, a series of laboratory tests and other examinations are carried out (The Health Alliance, 2006, n.p.). Second is known as blood test (The Health Alliance, 2006, n.p.). Here, the blood is placed under scrutiny to see if the â€Å"lung cancer† has multiplied and have already reached the patient’s liver or bones (The Health Alliance, 2006, n.p.). Third is the â€Å"bone marrow biopsy† wherein a needle is utilized to take out a small portion of the bone located at the â€Å"back of the hip bone† and is placed under the â€Å"microscope† to see if any cancer cells may be detected (The Health Alliance, 2006, n.p.). Fourth is technically referred to as â€Å"mediastinoscopy† (Harvard University, 2008, n.p.). Here, the neck is incised to allow a lighted pipe to go through and to eventually get a sample of tissue inside it (Harvard University, 2008, n.p.) Again, this will confirm if cancer cells are there or not by looking at it under the microscope (Harvard University, 2008, n.p). Fifth is known as â€Å"bronchoscopy† (The Health Alliance, 2006, n.p.). Like the aforementioned fourth detection method, a lighted pipe is involved here as well (The Health Alliance, 2006, n.p.). However, with this method, the tube will be inserted on the nose and will look for tumors or obstructions in the lungs (The Health Alliance, 2006, n.p.). It may also take tissue samples or fluids so that it may be checked under the microscope for cancer cells’ presence (The Health Alliance, 2006, n.p.). Last but not least is technically referred to as â€Å"needle biopsy† (Radiological Society of North America Inc., 2008, n.p.). Here, the lungs are monitored through a machine known as â€Å"CT Scan† while a needle is utilized to take out a mass sample in the lungs (Radiological Society of North America Inc., 2008, n.p.).Like in the other methods, the aforementioned sample will have to be checked under the microscope (Radiological Society of North America Inc., 2008, n.p.). References Harvard University. (2008). Mediastinoscopy. Retrieved February 14, 2008 from http://www.health.harvard.edu/diagnostic-tests/mediastinoscopy.htm Radiological Society of North America, Inc. (2008). Needle Biopsy of Lung (Chest) Nodules. Retrieved February 14, 2008 from http://www.radiologyinfo.org/en/info.cfm?pg=nlungbiop&bhcp=1 The Health Alliance. (2006). Lung Cancer Detection. Retrieved February 14, 2008 from http://www.health-alliance.com/Cancer/lung/detection.html   

Negative Effects of Social Media Essay

Social media has had made many impacts on society. Any website that allows social interaction is considered a social media site (Schurgin O’Keeffe, Clarke-Pearson). Due to the new technology taking over, social media has been easier than ever to get a hold of by the applications that have been made for portable devices. Through these devices and applications, being socially connected has made it easier to communicate with each other. Unfortunately, it all hasn’t been positive communications. There are many negative effects of social media, the biggest being addiction and self esteem. The definition of an addiction according to the Merriam-Webster Dictionary is: an unusually great interest in something or a need to do or have something (addiction). While social media addiction is not clinically diagnosed at this point, the behavior displayed and language of the students use suggests that society is not that far from becoming physically dependant on mobile devices (Westfa ll). With the new technologies right at the fingertips of society and easy access to check the newsfeed of the word, addiction to social media is on the rise. There are many factors that classify someone as an addict in different parts of the world. According to psychology professor and author Larry Rosen, â€Å"Social media addicts spend most of their waking moments checking for updates, chatting in instant messaging rooms, posting updates and checking their friend’s latest postings. Even when they delete their accounts, they usually are driven to make new accounts within twenty-four hours† (Gabriel). Some cases of addiction to social media are not as severe as others. In some extreme cases there are symptoms that can be observed. These symptoms include: spending at least four hours per day using social media, canceling more and more activities with family, friends or coworkers, bringing cell phones or other internet capable devices into the bathroom, and feeling anxi ous when you cannot get onto the internet. Once the individual has gotten involved in networking sites, things can escalate quickly. One reason these sites are so addictive is that there is a nonstop stream of messages, photos, updates and information coming from those in the network. If you have ten friends, it should not be a problem keeping up with them. If an individual’s network is one hundred friends or more, the individual might end up online for hours  every day, trying to check all of the updates. Trading messages back and forth with other members, the individual might find himself or herself even more caught up in the exchange, just as it would be in a normal conversation. see more:speech on social networking Social networking sites are meant to be casual, relaxed ways to connect with others. If you start losing sleep or are unable to concentrate because you’re always thinking about going online to check your friends’ statuses, then that is a sign of trouble. Social media has become an addiction to people because it is a form, or a way, to escape reality. It is also a way that someone can create their own cyber reality (Cosper). According to an associate professor in a program of science, technology, and society, Natasha Schull states, â€Å"Online games and social networking sites use psychological principles to keep you hooked† . Recent study shows that online dependency is not so different from a physical addiction. â€Å"MRI scans of patients checking their social media feed and those using cocaine look exactly the same,† says Schull. Most addictions begin as a harmless satisfaction of needs and desires; checking a few media sites stimulates those pleasure centers in the brain (Jensen). Another reason these sites are so addictive is that they provide outlets for when you are feeling down. People post fewer negative than positive updates on networking sites. They might mention trips they have taken or new cars, but they will rarely mention when they get poor grades or if they gained twenty pounds. If the individual’s own â€Å"real† life is not going so great, they can always go online and pretend it to be better. This in most cases, is how depression from social media usage is started. It is easy for someone to lose himself or herself in what experts say, â€Å"happyland† and forget about the hurdles in everyday life (Bocco). With new studies there has been known to be at least ten different types of social media addiction. A few of these types of addiction are: â€Å"The Alert-Lover†, â€Å"The Social Guru†, â€Å" The Verb Creator†, â€Å"The Blog Referencer†, â€Å"The Multi-Mayorâ € , and â€Å"The Freak Out-er† (Laird). Just like any other addiction, social media addiction is a disease. Social media addiction can become a destructive compulsive habit which as with any addiction can lead to broken relationships, job loss, and even financial issues. Individuals addicted to social media often feel anxiety or even may feel physically ill if not able to connect to the internet or their favorite social media sites. Evidence suggests that that the typical addict is  usually a teenager, usually male, and has no social life outside of their computer and or mobile devices. Though this is not truefor all. This disease has been known to affect millions of people all over the world. The most important being the â€Å"constant checker† and the â€Å"vowel hater† (Laird). In today’s world, checking social media on a regular basis can be easier than ever before. For some, this great access is not all that great. Those people are known as the â€Å" constant checkers†. They feel the need to check their handheld devices on a regular basis to feel up-to-date on the newest news that they may have missed, in what they may feel, has been a very long time. A study done by the University of California suggests that on average, study subjects check their mobile devices thirty-five times out of habit. It was also shown that nearly eighty- eight percent of teenagers and young adults check their news feed before even getting out of their bed in the morning. Through this study those subjects then realized that they were losing the relationship s that they have had with the people closest to them because they were being annoying. Some, but not all, of those studied admitted to having a physical attachment to their mobile devices and having withdrawls when taken away. Lisa Merlo, a psychologist at the University of Florida, says, â€Å"If you hear ‘put the phone away’ more than once a day, you probably have a problem† (Cohen). Another type of social media addiction is being a â€Å"vowel hater†. These people are known to take out every vowel possible in order to save time and space in either a text message or posting onto any form of social media site. This addiction has been known to alter all parts of the individual’s specific speech. It alters their speech in regular conversation and those electronically. From it leaking into the regular everyday conversation it can cause confusion to those around. Some may not know all the up to date slang terms that are used in instant messaging and so cial media. The same is for electronic messaging. This could be email or instant messaging on a media site. The most common type of people that this kind of addiction has been found is the younger generation. This is the age group of those from the age thirty to seventeen. It has been found that the younger the individual the more vowels are taken out of each word in each sentence. Some of the most noticeable symptoms of being a †vowel hater† is when posting on a social media site, such as Twitter, they are known for dropping vowels just to reach the one hundred forty character  limit (Hivesocial). Like any other disease there are a variety of treatment options. These treatment option vary from AA type meetings to meetings that can be held via webcam, other instant messaging alternatives or sometimes even a therapist. Unlike drug or alcohol addiction there will be no physical side effects from lowering your usage and stopping completely. The individual will be battling behaviors that have built up over time so it will be difficult to cut back on social media time. However, it is extremely doable. One of the first steps in addiction treatment is the individual must admit to himself or herself that there is a problem. Once the problem is recognized it is best that the subject take note on which kind of social media or technology that are addicted to. This may be hard for the individual for they in most cases, do not realize that they are checking their mobile devices and social media sites. Therapy can give the individual a tremendous boost in controlling internet use. Cognitive-behavioral therapy provides step-by-step ways to stop compulsive internet behaviors and change the individual’s perceptions regarding internet, mobile phone, and computer use. Therapy can also help you learn healthier ways of coping with uncomfortable emotions, such as stress, anxiety, or depression. Joining a support group is also another great way to help the addict make them feel like they are not alone. Ironically, some of these support groups are online which may not be too supportive to those who have a heavy addiction. Which in some cases should be monitored carefully (Sherwood). Research from the University of Buffalo indicates that women who base their self worth on their appearance are likely to post more pictures of themselves online for validation and to have larger social media networks (Henderson). Positive comments on social media can and do boost self esteem. Some people get a boost of healthy self esteem and get ego driven self love based on how many â€Å"Likes† they get on a social media site. Everyone wants to feel worthy of love and belonging. In some ways, the â€Å"Likes† we get on social media sites satisfies this need in almost a distorted way. Perhaps we are looking for love, or †Likes† in all the wrong places. According to lead author Elliot Panek, â€Å"Among young college students, we found that those who scored higher in certain types of self worth posted more often on Twitter. But among middle- aged adults from the general population, those that had more self love posted more frequent status updates on Facebook† (Bergland).  Fac ebook serves self loved adults as a mirror. As for a middle- aged adult, these findings of the difference between Facebook and Twitter may be influenced by a generation technology gap. Panek says of Facebook, â€Å"It is about creating your own image, how you are seen, and also checking on how others respond to this image.† Many middle-aged adults have already formed their social selves. They use social media to gain approval from those who are already in their social circle. For some self loved college students, the social media is a tool for them in helping them reach there wanted social standings (Bergland). Along with being addicted and having a low self esteem there is yet another negative effect of social media, cyberbullying. Access to electronic devices like smartphones that capture photos, videos and have the ability to upload to video sites or be sent through a mass messages within seconds mean the bullying never ends. Reports of teens recording fights, sexual assaults and more have been in the news with several being caught after sharing it on their Facebook pages. There are even sites dedicated to publishing and promoting teen fight videos which does not warrant a link. Teens already dealing with the pressures of fitting in now have to fear being targeted by bullies, who can easily smear their reputation with a few clicks of the mouse. The most dangerous part is this content lives on well after the damage is done, a daily reminder to the victim. Most commonly cyberbullying is found on chat sites and social media that has had a huge boom within ten years or less such as Facebook. MySpace, LinkedIn and Twitter. It is easier for the bullier to pick on their victim because they are not talking to them di rectly. In fact, in almost all cases it is not face to face but rather, typed, hateful words. Saying hurtful words is not the only form of cyberbullying. Cyberbullying can also be done through impersonation. Impersonation means that the person does not even have to know the individual that is bullying them. These types of online harassments should not be taken lightly. Many teens and even professionals have been known to quit what they love or even in severe cases, have committed suicide. On average, those that are bullied tend to all have the same or nearly the same symptoms. Those symptoms include: skipping school, experience in-person bullying, be unwilling to attend school, receive poor grades, have lower self-esteem, have more health problems, and the used of alcohol and drugs. Cyberbullying is different from any other kind of  bullying because it can reach the individual at any time of the day, any time of the week (Social Media Makes Cyberbullying More Dangerous). Granted, not all cyberbullying is no all done on Facebook, but since the social networking site is so popular among tweens and teenagers everywhere, it is a regular source of problems. Nearly half of all teenagers in the United States have experienced some online bullying, according to statistics from the National Crime Prevention Council. Twenty percent of middle school students said they have seriously thought about suicide due to online bullying, according to a recent survey conducted by the Cyberbullying Research Center (Levine). It doesn’t take a scientist to figure out that victims of cyberbullying have lower self-esteem than those who have not experienced it. On the other hand, research has also surprisingly shown that the actual cyberbullying offenders have lower self-esteem than their peers. It would seem that when it comes to bullying, everyone loses. Since low self-esteem has been linked in many studies to poor grades in school, health issues, excessive absences, and crimin al behavior, it would be in everyone’s best interest to take steps to shut bullying down early on. Addiction and self esteem are some of the many negative effects of social media. In review, addiction not only hurts the individual but also how the individual acts and may participate in events. Not only does it hurt them but it also hurts the relationships that they are in. This includes family, friends and co-workers. Addiction also can play a role in how they treat people on a day to day basis. From being addicted to social media the individual can start to lose their sense of how to communicate with others face to face. Luckily, with this understudied addiction there are treatment options that are beginning to take place for those that would like to take a stand on their addiction. Self esteem is also a negative factor in social media today. Those individuals that have a higher and possibly lower self esteem tend to post more online than those that do not. This is dependant on how much self worth an individual may have for him or her self. Some people keep posting online just he lp themselves boost their self esteem because they may have a hardship outside of the â€Å"cyberworld.† In that case, for some the only way to boost their self esteem is to cyber bully others. Impersonation is one of the more common types of cyberbullying because the individual does not have to know the victim on a personal level or even at all. Addiction and self  esteem are only a few of the numerous negative effects of social media. Works Cited â€Å"addiction†. Merriam-Webster.com. Merriam-Webster, 2014. Web. 14 January 2014. Bergland, Christopher. â€Å"Social Media’s Dual-Edged Sword: Narcissism vs. Self-Esteem†. Psychology Today. 12 June 2013. Web. 2 February 2014. Bocco, Diana. â€Å"What makes Social Media Networking Sites So Addictive?†. N.D. 12 February 2014. Cohen, Elizabeth. â€Å"Do You Obsessively Check your Smartphone?†. CNN Health. 28 July 2011. Web. 18 January 2014. Cosper, Alex. â€Å"Why People are Addicted to Facebook & MySpace†. eHow. Web. 12 February 2014. Gabriel, Peter. â€Å"Social Media Addiction: Symptoms and Treatment.† Voices.Yahoo.com. Sherwood, Rena. 6 March 2013. Web. 14 January 2014. Henderson, Maureena. â€Å"Is Social Media Destroying Your Self-Esteem?†. Forbes. 11 July 2012. Web. 4 February 2014. Hivesocial, Tom. â€Å"Disconnect to Reconnect†. Tom Locke. 26 June 2013. Web. 28 January 2013. Jensen, Sarah. â€Å"How Do People Be come Addicted to Online Games and Social Networking Sites?†. 22 October 2013. Web. 12 February 2014. Laird, Sam. â€Å"The 10 Types of Social Media Addicts [INFOGRAPHIC]†. Mashable. 11 October 2012. Web. 14 January 2014. Levine, Beth. â€Å"Facebook’s Effects on Self-Esteem†. 26 March 2013. Web. 12 February 2014. Potarazu, Sreedhar Dr. â€Å"Addicted to Facebook? Studies show users are lonelier†. Fox News. 24 January 2013. Web. 28 January 2014. Schurgin O’Keeffe, Gwen, MD, Clarke-Pearson, Kathleen, MD. The Impact of Social Media on Children, Adolescents, and Families. Vol.127 No 4. American Academy of Pediatrics. 23 March 2011. Web. 14 January 2014. â€Å"Social Media Makes Cyberbullying More Dangerous†. Social Media Club. 17 May 2013. Web. 11 February 2014. Westfall, Leah. â€Å"Student’s Becoming Addicted to Social Media†. Fastweb. 13 April 2011. Web. 28 January 2014. â€Å"What is Cyberbullying†. Web. 12 Februar y 2014.

Module discussion

Organization Priorities Identify the current health policy priorities for your state nurses association. Identify the benefits that could come to you, your community, health care consumers in the district, and other members of the nursing profession if proposed priorities were supported. Develop a plan of action to educate your state senators and representatives about these priorities. The Florida Nurses Association (FAN) Is Involved In a couple legislative related projects that I found on their website.Firstly, I found the Fan's position on the expansion of Medicaid. In the document provided on their website there Is lot of background Information on Medical and how this would affect the population (FAN, 2012). While this legislative topic has already been addressed, I still thought It would be useful to discuss. I found another bill, H. R. 5113, which alms to end the Increased federal funding for Medicaid expansion with respect to Inmates hospital care under the Patient Protection a nd Affordable Care Act (FAN, 2014).As the FAN already supported the expansion, I find this would contradict their previously stated position on Medicaid expansion. Personally, I do think this bill should be supported. As a nurse, I cannot see the fairness of removing coverage of individuals who are inmates. To educate my state senators and representatives on my position, I would plan to write them a letter. I would write my letter Just as we did for one of our assignments. After that assignment I feel as though I can accomplish a lot more than I could before hen it comes to writing professional letters.

Infrastructure Protection Essay Example | Topics and Well Written Essays - 750 words

Infrastructure Protection - Essay Example The Homeland Security is responsible for the coordination of the nation’s overall protection efforts expressed by NIPP and the SSP. The homeland security watches and directs the development, integration and the NIPP with the national preparedness initiatives. The NIPP and the SSP therefore relies on homeland security department for success in implementation of their plans towards achieving infrastructural security in the nation. This is therefore how the three departments relate with one another and each of them is quite essential for the development of tight infrastructural security in any nation (National Infrastructure Protection Plan, 2015). Every Sector-Specific Plan is developed by a Sector-Specific Agency with a purpose of providing information on the application of concepts borrowed from the NIPP to the special characteristics and conditions of their sector. These Sector-Specific Plans are undergoing updates to make them work effectively with the most recent NIPP. An example of an effective SSP is the Information Technology sector-specific plan. The Information Technology Sector-Specific Plan (ITSSP) provides details of the efforts made by the IT department in managing the national level risks experienced in the nation. It provides the information on its progress and how promising these efforts are in managing the risk. This includes the details on the completion of the IT sector Baseline Risk Assessment. The IT SSP is also expected to make a presentation on how the IT department is making use of the results from the baseline analysis to inform the sector’s infrastructure and key resources (CIKR) protective p rograms, development, research, and measurement activities. For the sake of maximum protection of its critical infrastructure, the IT SSP provides updates each year on the details required. In the past years, the sector has also accomplished a few missions here and

The Failure of Prince George's School System Research Paper

The Failure of Prince George's School System - Research Paper Example Lack or minimal competition leads to poor delivery of services. G. Lack of Accountability: One of the mission targets of the school system is the development of customized training programs to meet the needs of the highly competitive job market. However, Prince George's school system is rarely held accountable for the undereducated students they channel in the job market. Lack of accountability stems to what is taught and what should be learnt in the school system. III. Systemic Challenges: The wide range of programs and distinct learners that the school system serves makes the education system to be complex. However, Prince George’s education system is becoming a victim of its own challenges. IV. Other Factors: Other factors leading to failure include: the conflicting interests facing the interests and requirements of federal education legislation and the unique goals of the institutions to satisfy the local educational demands and decreased availability of resources required to satisfy people’s needs among others. V. Recommendations: To avoid failure, the college should: i. Extensive Training ii. Hiring qualified Staff iii. Better Administration iv. Improved Learning facilities v. Adequate funding vi. Improvement of enrollment system vii. Collaboration with county government and the community VI. Conclusion: The current trend in state of the education system is not future bound and thus effective measures are required to revive it. Both parents and teachers should collaborate in ensuring that their children put necessary efforts to improve on performance. What Are The Factors That Are Contribute To The Failure Of Prince George's School System? Name Module Professor Aug 4, 2012 What Are The Factors That Are Contribute To The Failure Of Prince George's...The school system is usually less expensive compared to state colleges and most of the courses they offer normally focus on practical instead of liberal arts. Owing to its open admission policy, t he school system makes the enrollment process easy. This makes most people to be eligible for admission in the school system as compared to other colleges in Maryland. Prince George’s school system also offers both need and merit-based funding to cater for the fees requirements of its students. This has enabled financially challenged society members to access education. Despite gains, Prince George’s school remains Maryland’s lowest-rated system. Recently, the system has experienced both internal and external challenges that are an impediment towards achievement of its educational obligations. According to a performance report by Prince George’s Business-Education Alliance, â€Å"...the test scores of the school system are low as compared to other systems around the nation.†(7) The report indicates that only 44 percent of the students attained proficiency in reading and 35 percent demonstrated proficiency in mathematics; poor performance was noted in African Americans and Hispanics. (Prince George’s Business-Education Alliance report 7) This portrays poor performance.

Marketing research of Arriva Plc Essay Example | Topics and Well Written Essays - 3500 words

Marketing research of Arriva Plc - Essay Example Arriva Plc is one of leading transport service provider in the entire Europe. Primarily, this multi-national corporation is a UK-based based company and it was founded by T.S. Cowie during 1938 in Sunderland. Initially, the founder, T.S. Cowie started the venture for selling second hand motor cycle and later in 1960, he also started retailing motor car. Finally, the company entered in the transportation business by acquiring Grey-Green Bus Company. By the end of 1996, it became one of the largest bus transport service providers in London. â€Å"Arriva was born in 1997: when it acquired â€Å"Unibus Holdings in Denmark† which is its first international expansion with Europe market. Arriva was acquired by Deutsche Bahn, a leading logistics and passenger service providers in August 2010. Currently, Arriva is present in 12 major countries of Europe and it has acquired major market share in these countries that has made it one of third largest transport service provider in European market. Considering its history, the company has grown with non-organic strategy i.e. by acquiring a number of firms. Currently, including its associated companies, it has nearly 47500 employees and it is operating in 12 countries with more than 16,150 vehicles generating more than 3billion revenue per year. (Arriva plc-b, n.d.). 3. Task A 3.1. Internal Analysis Before framing a set of plausible and effect marketing strategies it is necessary to assess the internal condition of the company.

Complaint letter (Analysis of a unsatisfactory experience with a Essay

Complaint letter (Analysis of a unsatisfactory experience with a company) - Essay Example As a result of this situation created by your establishment, I was forced to seek for a cheaper accommodation in the nearby town, a situation that led in the delay of the opening of the International Orphan Conference I was supposed to attend. In fact, to state that I was subjected to a psychological and emotional torture accompanied with an outstanding public embarrassment would be an understatement. As it has been the custom, over the years I have had countless satisfying stays in your hotel located in San Francisco, a convenient place for the nature of programs that we hold within and outside the states. Prior booking has also been the most convenient business method between the hotel management and me until the recent event. As you can imagine, the experience went way below my expectations with much consideration of the huge amount of money that I spent in your facilities during the numerous visits. In addition, I have played a huge role in encouraging my friends to use your facilities for conveniences as it was the case before this disappointing incidence. In the light of this, I am not certain if I will ever feel comfortable seeking services from your establishment. As such, I humbly request for a thorough investigation to be conducted involving the accommodation arrangement to establish why I encountered such an embarrassing situation even after I had booked a room and paid for one of the most important events I was to attend. Furthermore, I would recommend that legal and ethical actions should be taken against the culprits to swiftly curb and/or reverse this worrying trend and resolve the grossly appalling issue. To be honest, your response to my concerns will highly determine on the further action I will take. If you have any further clarification or questions, you can contact me via md@kleenchildfoundation.uk .Thank you in advance for your prompt

Painter Francisco de Goya Essay Example | Topics and Well Written Essays - 1000 words

Painter Francisco de Goya - Essay Example Francisco de Goya then moved to paint cartoon design for the royal tapestry factory in Madrid from 1775 to 1792, which was considered as the most important phase in de Goya’s artistic development. This exposure as a tapestry designer provided the experience for de Goya to paint genre paintings or paintings derived from everyday life. It made him a keen observer of everyday behaviour of people which served as the technical foundation for him to paint his later renowned works such as First of May which was a social commentary about peasant’s uprising against French occupation in Spain (www.franciscodegoya.net, 2014). He was also an avid follower of the works of Velazquez that influenced his looser and more spontaneous painting technique. Later, Francisco de Goya explored his method by learning neoclassicism which was gaining popularity over the rococo style during his time. He then became a established portrait painter to the Spanish monarchy where he was elected to the Royal Academy of San Fernando in 1780, named as painter of the king 1786 and a court painter in 1789 (www.franciscodegoya.net, 2014). As a court painter, Goya was fashionable painter and high society portraitist. During the height of his success, De Goya was not only a fashionable court painter but also an advocate of justice and a staunch supporter for ending the war. He is considered as a social recorder of his countrymen’s struggle and travails whose style was associated with â€Å"anciens regimes† or the â€Å"first of the moderns† (Web Gallery of Art, nd). Francisco de Goya’s The Third of May 1808 is his most known artwork. It featured a peasant being shot by a soldier in the middle of a night. It was intentionally painted with the face of the executioner kept to be anonymous to highlight the drama of innocent civilian that was about to be executed. In this particular work, the artistry was

Ben n Jerry's Essay Example | Topics and Well Written Essays - 750 words

Ben n Jerry's - Essay Example The decision by Cohen and Greenfield not to always adhere to traditional investor-relations practices such as strategic planning raises concerns on just how committed the company is at giving the best returns to investors. The company’s lack of a strategic plan is demonstrated in the interview with Cohen when he portrayed his ignorance of the company’s future plans with regards to earnings and spending (Schill et al. 4). The basing of Ben and Jerry’s corporate operating decisions on the company’s community welfare interests sends a strong message concerning the importance of the company’s social obligations over the other obligations (5). Moreover, the willingness of the company’s management to make decisions that favor social gains at the expense of profitability also confirms the company’s preference for satisfying its social responsibilities over maximizing returns for shareholders (6). 2. Even though the case of Ben and Jerry’s Homemade demonstrates the difficulty in embracing corporate social responsibility (CSR) while working to maximize share holder value, it is possible to balance the two if the company finds a way of benefiting from its CSR obligations. Given that corporate investors expect profitable returns within a certain period of time for every dollar they invest in a business, organizational leaders need to evaluate every program that they invest in so as to determine the potential value of the investment not only to the shareholders but to the organization as a whole. In order to satisfy social obligations while maximizing shareholder returns, an organization should focus on investing in social programs that have the potential of increasing the overall performance of the company improving its market share and profitability, and therefore increasing investors’ return on investments. For instance, an organization could take advantage of

Business Communications Essay Example for Free

Business Communications Essay * Interim deadlines may be set by individual tutors * You must choose at least one of the two presentations referred to below in Tasks 2 and 6. It is expected that the presentations will take place the week beginning 21st January. A summary of the Assessment and Grading Criteria In order to pass this unit, the evidence that the learner presents for assessment needs to demonstrate that they can meet all the learning outcomes for the unit. The assessment criteria for a pass grade describe the level of achievement required to pass this unit. Summary of the Edexcel Assessment and Grading Criteria| To achieve a pass grade the evidence must show that the learner is able to:| To achieve a merit the evidence must show that, in addition to the pass criteria, the learner is able to:| To achieve a distinction grade the evidence must show that, in addition to the pass and merit criteria, the learner is able to:| P1 Explain different types of business information their sources and purpose.| M1 Analyse the content of P1| D1 Evaluate the appropriateness of business information used to make strategic decisions.| P2 Present complex internal business information using three different methods| M2 Expand on P5 and offer an analysis of the legal and ethical issues| D2 Evaluate the effectiveness of business information and its communication as key contributors to the success of an organisation, using examples to illustrate your points. Unit 4: Business Communications learning outcomes:- 1. Understand different types of business information 2. Be able to present business information effectively 3. Understand the issues and constraints in relation to the use of business information in organisations 4. Know how to communicate business information using appropriate methods. Assignment Task 1 Scenario You have applied for a job in marketing communications working for Next plc (or another organisation of your choice). Prepare a paper entitled, â€Å"An explanation, analysis and evaluation of different types of information sources and purpose.† (P1, M1, D1). Please note that if you are aiming for a pass, you only need to write an explanation. If you are aiming for the merit you need to offer a detailed analysis and for a distinction you will need to demonstrate that you have evaluated your analysis e.g. look at the advantages and disadvantages of using various types of information sources. Task 2 Scenario You have been successful in your interview and you have been offered the job of assistant marketing communications advisor. Working with another member of the team, your first job is to prepare and deliver a 10 minute presentation on the subject of marketing research. This is to take place the week beginning the 21st January. Continuing to work with your partner, prepare a memorandum report for your supervisor, Jayne Koweleski, explaining the importance of competitor analysis, and design a press release for the general public, informing them of the benefits of on-line shopping with Next. (P2) Task 3 In a memorandum report to your supervisor write up an evaluation examining advantages and disadvantages of various types of business communications, in helping an organisation to improve its performance and be successful. Use a variety of examples to support your evaluation (D2). Task 4 Working with someone else in your marketing communications team, produce two different examples of corporate communications. One must be an advertisement for the press and the other a story board for a TV advertisement. This could be for NEXT plc or an organisation of your choice (P3). Task 5 Prepare an evaluation of two different types of external business communication. One could be a TV advert and another could be a press release. Examine the communication methods and assess their strengths and weaknesses. In the conclusion of your evaluation suggest ways in which the different forms of communication could be improved (P4). Task 6 Working with another member of the team, prepare and deliver a 10 minute presentation, the week beginning 21st January, entitled, â€Å"Understanding the legal, ethical and operational aspects of using business information†. In your presentation include reference to the Data Protection Act 1998, Freedom of Information Act 2000, The Computer Misuse Act 1990, backing up stored information, security of information, health and safety and organisational policies. (P5, P6). Task 7 Write an essay entitled, â€Å"An analysis of legal and ethical issues facing modern business.† (M2) Task 8 Prepare a training session for your colleagues on how to effectively communicate business information. Include in the session: understanding the audience (e.g. gender, expected attentiveness), the use of body language, verbal communication, listening, formal and informal communications (e.g. Meetings) written communication (memorandum), visual (e.g. the use of flow charts, graphs and pictures) electronic communications (e.g. e-mail) (P7).

Merger and Acquisitions Theories in Management

Merger and Acquisitions Theories in Management Management theory and practice Mergers and acquisitions are a main means by which single and individuals are able to grow and then enter the new markets. After this happens, the competitive structure of the whole industries may alter radically in a span of a short time. Mergers are the unifications of two or even more firms into forming a new one whereas acquisitions are the companys purchases of the majority of the shares from another. Mergers and acquisitions can also represent a major mechanism through which the firms that are national are able to become multinational firms. The cost and benefit analysis of the mergers and acquisitions affect the decision by the managers and the shareholders of whether to take up a specific merger and acquisition. The decision by the employees also can lead to the acceptance or refusal of the merger and acquisition (Paul Simon 2). In this paper, I am going to research on why the employee-related issues prevent the succeeding of a merger or acquisition. The modern business environment is characterized by change that is continuous in nature. Every organization is considered as a system where work, process, system, people are all aligned in order to ensure that the unit of the individual, individual and overall systems are well fit to deliver the strategies of the organization. The objective of the integrative process is to integrate people, processes, technologies and strategy without interrupting service, quality or product and not only to combine financial standing of any two companies. Employees issues in relation to the integration phase always relate to the human capital related integration issues such as integration of the culture of the organization, leadership, organization structure and design, processes and systems and retention of the key talent. The other important issues are effective planning for the purpose of integration, employee communications, and the selection of good leaders to manage the business combination and the creation of practices and policies for knowledge sharing and learning and also the transfer. The failure to address the issues that concern merger and acquisition impacts the new and current organization very negatively at the stage of post-merger in two levels. One of these two levels is the individual level and the reactions of the individual employees are insecurity, powerlessness, alienation, a drop in productivity, loss of energy and the rise in absenteeism which increases turnover and profits. Other stress factors include the performance evaluation criteria, the loss of control over the life of the professional and also the alterations in the reporting relationships which would also impact the merger or the acquisition adversely or negatively. There are also many other psychological impacts which result from the merger activity. These are lifestyle instability, loss of confidence, depression, anxiety among others and these symptoms may lead to large-scale industrial strikes at times (Nilanjan and Bhattacharya 143). From this we can find that due to these impacts, the employees can resist the mergers and or acquisition in their companies. The other level is the corporate level and at this level the impacts are long-term in the cultural integration, organization structure and design, processes and systems. The failure to tackle these issues in the phase of planning of the merger process can lead to outcomes such as benefits integration, high financial costs, incompatible HR plans and policies, inadequate communication to the employees, insufficient provisions and reserves for risks that had not been discovered and/or improperly evaluated, inefficient financial accounting for the integration costs, the loss of loyalty of the employees leading to the high turnover rates, the dilemma of the workforce reduction, reduced productivity and finally leads to lowered employee morale (Nilanjan and Bhattacharya 144). These issues are the ones that drive the employees to be against and protect the mergers and acquisitions. The strategic combinations of the mergers and acquisitions have a dramatically greater chance of success in terms of providing the added value to all employees, and shareholders. The success could also be experienced in justifying of the acquisition premium when they are led, designed and implemented with these four elements. The first element is the integrative perspective in which the mergers need to be seen as combinations that try to balance the interplay of the organizational architecture and organizational strategy with the guiding principles of the management of the change. The second element is the designed integration which is the scope, intensity and degree of the integration and should be driven by elementary business case for the merger or acquisition which defines integration process. The third is the differential leadership because leadership is very vital and different leaders have different roles. The leadership roles should be considered and assigned at the initial stages because this could bring confusion at the late stages. Lastly, the expanded due diligence factor is considered where the organizational issues are discussed. In this case, the organizational diligence is made a crucial part of the merger and the acquisition chain of events as is the due financial and legal diligence. An example of the job losses caused by mergers and acquisitions and also the reduction of salaries of the members of banks is the European banking sector. Since the start of 1990s, the European banking sector has witnessed massive job losses and the decrease of the salaries of the employees who were left. The impact of these job losses has been greater in the Northern Europe rather than in the southern Europe. The employment in the sector of insurance has also been affected as a result of mergers and acquisition. The nature and quality of the employment has greatly changed from the year 2000 in Europe (Paul and Simon 2002: 45). The reductions of employment have affected the branch administrative and networks functions. The older workers with the conventional banking skills who do not qualify and therefore not transferable easily to the new developed and centralized functions, for example those that work in the call centers, are affected adversely. These are the people who may rise ag ainst any mergers and/or acquisitions and also the banks may consider these people and reach a decision not to accept any mergers and acquisitions. Mergers and acquisitions have been known to accelerate corporate practices because the enterprises tend to review the whole cost structure entailing the mergers and acquisitions with the aim of identifying the very maximum savings that are possible. The job losses have increased greatly from 17.5% to 24% due to many mergers and acquisitions. A merger and/or acquisition also referred to as a takeover invalidates in many ways the employment contract. The employee works for someone else without having taken the required steps to change his or her employers. This brings into clear view in an emphatic manner the one-sidedness of the employment relationship and also the idea that the employees do not have any control over the decision of who their employers are. The mergers and/or acquisitions are described as the legitimate means for breaking the implicit contracts in the view of restructuring (Paul and Simon 2002: 183). The mergers are seen as avenues to disrupt job security that the employees have held for long periods and therefore are bound to disrupt the process of mergers and/or acquisitions. These mergers and acquisitions appear to the employees as deliberate strategies to violate the internal norms and also as a hard, brute exercise of powers and therefore they can prevent the succeeding of the mergers and acquisitions. The integrating of the different company procedures and systems requires the harmonization of the different aspects of terms and conditions that apply to the employment signings. These include job titles, pay scales, job descriptions, entitlements and benefits, supervisory and reporting lines are all subjected to revision in order to ensure that there is common practice in the new mergers and acquisitions. These changes may make the employees to reject any mergers and acquisitions. The mergers and the acquisitions upset the links between explicit and implicit contracts in accompany that was in the past based on trust between workers and managers, they are presently founded on assumptions and beliefs regarding mutual responsibility between employees and employers. The integration, merger and acquisition also requires the harmonization of the different aspects of conditions and terms of the employment to ensure that common practice in the combined organization which may alter the existing practices of the human resource and management of either or even both of the organizations. Workers or employees have also considered the lack of incentives due to mergers and acquisitions. There is no transparency in the reward systems and the mergers also lead to contradiction between performance assessments that focus on personal contribution and the objectives that require team-based work. The employees therefore call for better balanced team-based and individual rewards. This is supported by trade unions where they argue that the alterations to the psychological contract which include erosion in the job security are not well reflected in the enterprise reward systems after the mergers and acquisitions. This decreased job security, increased workloads, stress and anxiety are other significant consequences of the heightened merger and acquisitions activity. These factors coupled with lowered morale and also a deterioration of the organization performance has led the employees to be against the implementation of mergers, takeovers and acquisition. This human side of the acquisitions and mergers is all about the overall impact that mergers and/or acquisitions have on the employees in a certain company. These impacts on the psychological difficulties that the employees experience, the culture clashes which may emerge in companies during the post-merger integration period. Finally the ways in which these outcomes manifest themselves that include communication breakdowns, there is also the we-they mentality that occurs between the inclusive organizations in the merger and acquisitions, minimized commitment, reductions in productivity, organizational struggles for power and also office politicking and at last the loss of the key and main organizational members. All these factors combined include the employee issues that affect the realization of mergers and acquisitions (Anthony and James 3). Through research through face to face interviews, a writer concluded that the employees were an important asset to the companies and that they should be considered when the management decides on mergers and acquisitions. Through an interview with an employee of a company that had undergone acquisition, Hayes was told that the employees would not make any move because they were told that their methods were outdated and that they would have to readjust to the new companys way of conducting their activities. He indicated that when he tried to complain to the corporate about the situation, he was warned that if he squawked too loud, his position would be in jeopardy. This resulted to the destruction of the company morale and with time, the main people started leaving and it did not take much time before he also resigned (Hayes 1981: 131). If the company had taken into consideration all complains of their employers, they would have retained their experienced workers and this would increas e the productivity levels. Acquisition and mergers can adequately transform the organizational processes, systems, structures and also cultures of one or both of the companies involved that the employees will often feel confused, frustrated, frightened, stressed or even frustrated and therefore whenever the employees of a particular company here of any merger and/or acquisition they are ready to prevent the realization of the same. On the personal level, these feelings often lead to psychosomatic difficulties, sense of loss, marital discord and at the extreme level, they can lead to suicide. On the level of organization, these feelings are manifested in lowered productivity and commitment, increased disloyalty and dissatisfaction, increased turnover among the key managers, power and leadership struggles especially among the managers who remain in the organization and finally an increase in the dysfunctional work-related behaviors at all the levels of the hierarchy. These impacts on the employee and by the empl oyee are issues that negatively affect the mergers and acquisitions. It is reported that in the 3000 and above mergers that occurred in the year 1985, so many employees estimated to be more than ten thousand lost their jobs and others were forced to accept early retirement (Kanter and Segger-man 1986: 17). It was also estimated that by the year 1990, there will be 2500 savings and loans and 5400 banks that would be involved in mergers and these would affect more than 900, 000 people in the United States. In the year 2009, it was noted that there were decreasing mergers and acquisition activities and that also the credits were tightening. One of the reasons of a successful merger and transaction activity is the compensation which is never done and if it is done it is only given to the executives. The compensation can be a powerful tool to motivate the management and its team to influence positive outcomes in the activity involving mergers and acquisition. This has not been the case in the recent past and the employees are laid off without being paid well leading to the negative feelings that they experience shortly afterwards. This can explain the reduction of the merger and acquisition activity because the employees through their managers are able to prevent the realization or completion of a merger and/or acquisition owing to the fact that they are not compensated. In the recent past there was the acquisition of Merrill Lynch by the Bank of America, there was a problem in the executive pay and compensation and this led to a very expensive roadblock to the desired transaction. A report by the PricewaterhouseCooper indicates that the merger and acquisition activity has decreased 86 percent from the year 2008, the previous year. In addition to these statistics, when the High Court approves the schemes of arrangement of a merger, it takes into account the workers interests. The scheme of arrangement must provide for adequate protection for the employees service benefits and conditions. If the scheme shows otherwise, the High court does not agree to the terms and conditions of the merger and therefore we find that the issues of the employee are considered. The organizational behavior is always reflected by acquisition behavior, the relative size and the cultural compatibility. Global mergers and acquisitions are the main corporate strategies which the multinational corporations use to diversify, expand or even consolidate their businesses. In the year 2006, there was a recorded worldwide annual value of the acquisition transactions exceeded US $ 4 trillion (Larsen 2007: 23). This trend was also recorded in the year 2007 where the worldwide transaction value of the acquisitions in only the first 3 months ranged at US $ 1.13trillion which was the highest busiest recorded quarter ever in history (Saigol and Politi 2007: 145). However, almost 83%of these transactions were unsuccessful (KPMG, 1999; Sirower 1997). A considerable amounts of research developed that the failures were caused by the absence of a national cultural fit which is the cultural distance of the workers and employees (Rottig and Reus 2006: 340). This may lead to cultural problems and clashes among the involved workforces. This in return lowers the employee cooperation and commitment, cause voluntary turnover of the acquired top managers and could also complicate the process of post-acquisition integration (Very and Schweiger 2001:22). The cultural distance might have some positive results but it is among the high points that lead to the failure of the mergers and acquisitions and it is an employee-related issue. The organizational culture which is defined as the interdependent and interrelated system of practices, beliefs, norms and assumptions that the members of the organization bear collectively should be put into consideration before a merger and/or acquisition because when they are altered extensively after the merger, the employees will tend to work against them and this will not promote success of the merger and/or acquisition. The assumptions, norms and practices could be unconscious which are learnt through the socialization of the organization and often reflect the shared perceptions of the daily practices and also determine the things that are carried out within an organization (Gertsen, et al. 1998: 123). An example is the acquisition of the Tokyo Bank by the Mitsubishi Bank in the year 2003. These two organizations had very dissimilar organization cultures. The employees of the Mitsubishi Bank shared a common cultural norm of being to work on time, wearing only white shirts while at work and also thanking their department supervisors and managers in person for any monthly pay checks. But in contrast, the employees of Tokyo Bank were not used to strict dress code and being reprimanded for getting to work late and they also had no duty to carry out a thanksgiving ceremony as they collected their monthly salaries. After the acquisition activity, a huge number of the employees of the Tokyo Bank were alienated by the strict culture of the Mitsubishi Bank and they left the combined company voluntarily. This was in the United States. This is an example of how the employee-related issues could lead to unsuccessful mergers and acquisitions. Poor communication between the employees of the same company after a merger or an acquisition could lead to problems of integration in both the domestic and the international mergers and/or acquisitions. This may cause unsuccessful mergers and acquisitions and it is an employee-related issue. On the other hand, the international acquisitions are characterized by ethnocentrism; nationalistic attitudes; xenophobia and language barriers (Vaara 2003: 864) and these could lead to the failure of the mergers and acquisitions. Work cited Nilanjan Sengupta and Bhattacharya Mousumi. Managing change in organizations.PHI Learning Pvt. Ltd. Anthony Buono and James Bowditch. The human side of mergers and acquisitions: managing collisions between people, cultures and organizations. Chicago: Beard Books, 2003 Kanter, R and Seggerman, T. managing mergers, acquisitions, and divestiures. Management review, Oct 1986, pp 16-17. Hayes, R. what happens to my people after I sell? The human side of acquisition. In S. J. Lee and R. D. Colman (eds.), handbook of mergers, acquisitions and buyouts. Englewood Cliffs: Prentice Hall, 1981. Paul Temple and Simon Peck. Mergers and Acquisitions: critical perspectives on business and management. : Taylor Francis, 2002. Thomas Straub. Reasons for frequent failure in mergers and acquisitions. Germany: DUV, 2007. Rottig, D. Reus, T.H. Organizational and national cultures consequences for acquisition performance: A meta-analysis, Paper presented at Southern Management Association, Clearwater Beach, 2006. Saigol, L. Politi, J. MA volume tops $1,000bn, Financial Times, March 30: 13, 2007. KPMG. Mergers and Acquisitions: Global Research Report 1999. London: KPMG, 1999. Gertsen, M., Soderberg, A.M. Torp, J.E. Cultural Dimensions of International Mergers and Acquisitions, Walter de Gruyter: Berlin, 1998 Gertsen, M.C., Soderberg, A.M. Torp, J.E. Different concepts of culture, in Gertsen, M. C., Soderberg, A.M. Torp, J. E., editors (eds.) Cultural Dimensions of International Acquisitions, Walter de Gruyter: Berlin, 1998. Vaara, E. Post-acquisition integration as sense making: Glimpses of ambiguity, confusion, hypocrisy, and politicization, Journal of Management Studies, 40(4): 859-94, 2003 Very, P. Schweiger, D.M. The acquisition process as a learning process: Evidence from a study of critical problems and solutions in domestic and cross-border deals, Journal of World Business, 36(1): 11-31, 2001. Sirower, M.L. The Synergy Trap: How Companies Lose the Acquisition Game, Free Press: New York, 1997.

Web Based Technology and Continuing Medical Education

Web Based Technology and Continuing Medical Education This dissertation explores the use of Web based technology to enhance and maintain procedural skills in the context of continuing medical education. The research was initiated by the perceived need for novel and alternative methods of providing procedural skills training to health practitioners. This observation, supported by learning needs analysis, led to the design and implementation of a Web based educational resource aimed at doctors and other healthcare practitioners. The assessment part of the research focused on an empirical evaluation of the effectiveness of this Web based educational resource. This dissertation draws on a number of strands of Health Informatics: Principals of Heath Informatics Research Methods Clinical Information Systems Creating Online Educational Resources Whilst on a small scale, the results are relevant to medical educators involved in developing and evaluating web based educational resources. BACKGROUND Medical practitioners receive comprehensive procedural skills training and it is expected that this is maintained and regularly updated to limit skills decay and ensure clinical competency. Skills decay is defined as the loss of a trained or an acquired skill after a period of nonuse. Skills decay rapidly as the period of nonuse lengthens; and the extent of the decay is influenced by the characteristics of the skill and how and when these skills were learnt. Arthur et al., (1998) Skills are classified either as closed loop or open loop tasks. Arthur et al., (1998). Closed loop tasks are fixed sequence tasks with a defined beginning and end, for example, the preoperative anaesthetic machine check. Open loop tasks are tracking and problem solving tasks, for example, managing patients hypoxia. Arthur et al., (1998) in their review on the rate of skills decay and its influencing factors concluded that closed loop tasks decay more slowly than opened loop tasks. Arthur et al., (1998) also mentions that mental tasks decay more quickly than physical tasks and after 28 to 90 days of nonuse of the trained skills, task performance declines by 23% and by 40% after a year of nonuse. Clinical practice alone may be insufficient to prevent skills decay as indicated in a simulated airway management training study Kovacs et al., (2000). Skills decay quickly without practice; and procedural skills are only optimally retained when trainees regularly practiced the procedure on their own, in their own time and received periodic feedback. Training on simulation modalities, mannequins, fresh cadavers and live patients have the potential to successfully teach the procedural skill with significantly less skills decay over time as compared to didactic teaching alone. TI L et al., (2006). The traditional one to one apprenticeship model of medical procedural skills training and the in-hospital continuous medical education and maintenance of a skills base are often inefficient, expensive, and labour intensive. Patients, who are often used as practice tests subjects during skills training, safety is reliant on the medical practitioner skills retention and task competency. Maintaining procedural skills competency may prove to be increasingly more challenging as expense, time constraints, available manpower, lack of resources and patients reluctance to be used as experimental models make this endeavor increasingly impossible to set up. The resultant worldwide move towards competency based training programs and self directed problem oriented based learning has made necessary the search for alternative valid and reliable educational methods for skills training and its maintenance. Fortunately, the last decade has seen an explosion in the use of technology to enhance medical education. Web-based educational programs, computer aided virtual reality situations, and high fidelity simulation has played an increasingly important role in medical education owning to its efficiency, ability to provide flexible learning experiences, multimedia capabilities, and economies of scale and power to distribute instructional content internationally. Vozenilik et al., (2004) In the last 5 to 10 years extensive empirical research has been conducted on the use of computer aided and web-based instruction in medical education where there has been overwhelming support for these mediums of instruction. Unfortunately the literature is strikingly sparse on the use of Web based instruction for procedural skills training and in the few studies where empirical research has been carried out; study designs were not robust enough to withstand interrogation or had inconclusive results. LITERATURE REVIEW A review of the literature was conducted to ascertain what work had been done in the field of Web based learning, medical education and procedural skills training. A CINAHL and Medline search was carried out exploring all citations up to June 2010. The search using Medical Subjects Headings (MeSH) Computer Aided Instruction, Internet, CME returned 322 publications. Adding the MeSH term Review returned 21 reviews of which four were relevant. Replacing CME with Procedural Skills Training produced only one noteworthy empirical research paper and 2 publications worthy of discussion. Relevant systematic reviews of the literature are summarized in the table below: 3 Title Author / Date Findings Review Conclusions Assessment of the Review Internet-Based Learning in Health Professionals: A Meta-analysis Cook et al., 2008 201 eligible studies with qualitative or comparative studies of Internet based learning accounting for 56 publications Internet formats were equivalent to non-Internet formats in terms of learner satisfaction and changes in knowledge, skills and behavior. Internet based learning is educationally beneficial. Comprehensive work with a robust study design. Skills outcomes included communication with patients, critical appraisal, medication dosing, cardiopulmonary resuscitation, and lumbar puncture. Unfortunately the study had many limitations as many publications were poorly designed with low methodological quality, without validity and reliability evidence for assessment scores and with widely varying interventions What the meta analysis did suggest was that no further studies comparing Internet based interventions with traditional methods or no intervention were merited as these types of studies would almost invariably be in favour of Internet Based interventions. The author of the review suggested that the questions that warranted further research would be when and should Internet based learning be used and how could it be effectively implemented giving impetus to the exploration of Internet based skills training and maintenance. Title Author / Date Findings Review Conclusions Assessment of the Review The Effectiveness of Computer-Aided (CAL) Self-Instructional Programs in Dental Education: Rosenberg et al. 2003 1024 articles systematically reviewed. 12 publications included in the final review. Five studies significantly favored CAL. CAL is as effective as other methods of teaching and can be used as an adjunct to traditional education or as a means of self-instruction. This study is a comprehensive review of controlled randomized studies with clear and relevant inclusion criteria assessed with good inter and intra rated reliability. The reviewer limited the study to dental students. Forms of Computer Aided Instruction was not clearly defined or specified in the inclusion criteria. It is unclear whether web based studies were included. The skills referred to in the studies were dental diagnostic not procedural skills. The apparent dearth of studies assessing procedural skills justified the investigation undertaken by this dissertation. Title Author / Date Findings Review Conclusions Assessment of the Review Internet-based medical education: a realist review of what works, for whom and in what circumstances. Wong et al. 2010 249 papers met their inclusion criteria. Learners were more likely to accept a course if it offered a perceived advantage over available internet alternatives, if it was easy to use technically, had elements of interactivity and gave formative feedback. This study is a realist review and the methodology used answered the question of the study which aimed to provide a theory driven criteria to guide development and evaluation of Internet based tools. The findings and guidelines suggested in this review would later be incorporated in the design of the resource to be investigated in this dissertation. Title Author / Date Findings Review Conclusions Assessment of the Review eLearning: a review of Internet-based continuing medical education (CME). Wuton et al. 2004 16 studies met their eligibility criteria Internet based CME programs were as effective as traditional formats of CME A comprehensive and appropriate search of databases. Randomized controlled trials of Internet based education in practicing health care professionals. These results showed that Internet based interventions do have a place in CME and that these effects on skills behavior warrants further investigation. Title Author / Date Review Conclusions Assessment of the publication Procedures can be learned on the Web: a randomized study of ultrasound-guided vascular access training. Chenkin et al. 2008 Web based tutorial may be an useful alternative to didactic teaching for learning of procedural skills A randomized control trial with non inferiority data analysis. The non inferiority margin was specified at a 10% margin however the actual amount of improvement was not specified. Blinding bias was not assured and the trial relied on the reputation of the investigator. No mention of inter rated reliability was made. Despite its inherent weaknesses, the trial suggested that web based intervention is as good as the alternatives; however, the study incorporated the use of simulation and live models to teach the actual procedural skill. David Cook is a prolific writer of many reviews and publications investigating Internet based formats in medical education. His noteworthy publications Web based learning: pros, cons and controversies Cook, (2007) and Where are we with Web based education Cook,( 2006) extolled the benefits overcoming barriers of distance and time with novel instructional methods, and extenuated the disadvantages which included social isolation, upfront costs and technical difficulties of Web based education. He concluded that Web based instruction can be a potentially powerful tool and strongly recommended that the focus of future studies should concentrate on the timing and application of Web based learning tools. Summary of literature survey The review of the literature has outlined the use of Web based procedural skills training as an area that requires further research. Empirical research and systematic reviews that has been carried out thus far has been limited. The literature research conducted for this dissertation (though in its self may have been limited) was unable to find publications exploring the whole use of the Internet as a means of procedural skills training and skills maintenance. Justification and Learning needs analysis To assess the effectiveness of an Internet based learning resource in the context of procedural skills training, a skill had to be chosen that was relevant, involved both a physical and mental task, and had the potential of decaying. A procedural skill is defined as the mental (knowledge) and motor activities (behaviour) required to execute a manual task and usually involves patient contact. Kovacs (1997). Furthermore, a learning needs analysis was undertaken to assess the value of this topic choice. Justification Intubation with a Laryngeal Airway Device (LAD) was chosen as the representative procedural skill. When a patient collapses from a cardiac or respiratory cause, timely control of the patients breathing and airway with prompt delivery of cardiopulmonary resuscitation (CPR) and defibrillation have resulted in life saving survival and neurological recovery. The LAD is a breathing maintenance device that can, with minimal training, be inserted effortlessly into the mouth of the patient allowing for breathing and oxygenation. It is increasingly being used in the repertoire of techniques available to frontline practitioners (practitioners first on call to resuscitation events) in emergencies where the technique has proven to be easy to use and life saving in the management of an airway crisis. Kette, (2005). In a survey of family medicine practitioners, all practitioners surveyed agreed that insertion of an LAD during a resuscitation procedure was a core procedural skill that most practiti oners were required to perform in any setting; 86% admitting that they had been called upon at some point to perform the procedure. Wetmore et al., (2005). Insertion of a LAD with knowledge of the patients anatomy, indication and contraindication for use and technique of use both under a controlled setting and in an emergency is representative of a procedural skill a frontline practitioners is expected to perform. Learning needs analysis A key step in developing an effective educational website is performing a learning needs analysis to determine what the learning needs the resource hopes to address are and why these needs were not met by existing learning or teaching arrangements. Cook Dupras, ( 2004). A questionnaire not previously validated, making use of closed type questions, were used to assess three broad areas; knowledge and training, skills application and Internet accessibility. Eleven frontline practitioners were asked to provide an indication of how often they were called to attend resuscitation or airway management situations in the last two years. They were surveyed regarding training received in LAD usage and insertion, their desire to obtain more information or skills updating, and whether there was a perceived need for Internet-based continuing medical education courses on LAD usage and intubation. Their attendances at CME workshops in the last year were surveyed and the barriers to CME workshop attendance were assessed. The respondents were surveyed regarding access to the Internet and previous exposure to e-learning modules. This was done to assess whether the uptake of the resource would be biased towards participants with Internet access, frequent Internet uses or previous e-learning experiences. The results of the learning needs analysis showed that most respondents (90%) received exposure to the device. It is a requirement of their post as frontline practitioners, to be Acute Life Support (ALS) trained where usage of the device in resuscitation is taught. Half the respondents indicated that they were not comfortable with their level of knowledge; and 63% felt unconfident about inserting the device as they were on average, only exposed to two resuscitation scenarios per year. All had Internet access at work and at home; and half had previous experience of online learning. Only one percent of the respondents were able to attend a CME session in the last year, citing lack of time and convenience as the main reasons. 80% of respondents were interested in taking courses through the Internet, as continuous education credits are a requirement of a license to practice in medicine. Interest in the topic was high and given the above self-appraisal, it was felt that the course was nee ded and should appeal to this population. METHODS The method section is dealt with in two parts. The first will focus on the development and design of a Web based educational resource and the second on the evaluation of the resource. 1. Development and design The idea was to develop an educational resource that could be used to train, reinforce knowledge and maintain a procedural skill by employing and integrating principles of effective adult learning with the unique features of the web. The development was driven by educational needs and outcomes of learning needs analysis completed by participants in a previous part of this study. 1.1 Development Theories The course design reflected Adult Learning Principles and the aim of the course was to improve knowledge (cognition), integration of attitude changes (confidence) and in so doing result in a change in behaviour (competency). Gale (1986). With accessibility of the Web based educational resource, it was hoped that the resource would be accessed frequently until the task becomes automatic or accessed as a refresher when required or at regular intervals. The resource incorporated principals that were shown to be effective. It was centered on the learners needs, was focused on a specific task and recognised past experiences of the learner (Gale 1986). The theories used in the development of the resource included; Experiential Learning Theory, which concluded that experiential learning should have personal relevance, should be self-initiated and lead to pervasive effects on the learner. Rodgers (1969) Constructivist Theory where learning is an active process with learners constructing new ideas and concepts based upon past and current knowledge. Bruner (1966) Information Processing Theory where knowledge is presentation in sequences or chunking to accommodate short attention spans (Miller 1956). The educational resource strived to be pedagogically sound uniquely applying these principles online. Information was presented in small chunks in a sequential fashion, was self-contained, had interactive components and contained assessments with instant feedback. Online communication did not occur in real time as which happens with video conferencing and online chat rooms, instead the resource used communication that was asynchronous where participants logged on, viewed and downloaded course material, read postings and submitted interactive tasks. The advantage of using an asynchronous format was that learners and/or the instructor did not need to be online at the same time allowing the participant to work at his or her own pace. The asynchronous nature of this web based learning environment allowed for barriers of time, location and expense to be overcome. Sanoff (2005) 1.2 Moodle Description University College Londons (UCL) Moodle was the platform used to develop the educational resource. There are many applications offering free alternatives to the commercial software WebCTTM and BlackboardTM, however the UCL Moodle was chosen as a matter of convenience because it was accessible, independent of specific operating systems, fit for purpose and easy to use without much technical computer knowledge thereby potentially removing barriers to any future course design and development.. Moodle (Modular Object Oriented Dynamic Learning Environment) is software freely available to use and was developed by Dougiamas. Moodle. org (1999). The Moodle software was designed on pedagogical principles that encourage learner interaction in a virtual learning environment. Moodle is a course management system used to support Web-based courses and has a number of innovative tools that could be used to create courses that promoted collaborative learning. Moodle is able to run without modification on Unix, Linux, FreeBSD, Windows, Mac OS and Netware. (Moodle. Org). After an initial learning curve, the program was easy to use with simple but comprehensive online instructions. Moodle It did not require pre-existing computer programming knowledge, and in fact the author of this dissertation considered herself a novice computer user. Moodle is written in hypertext pre-processor (PHP) which is HTML embedded scripting language used to create dynamic Web pages.  PHP allows for connecting to remote servers, checking email, URL encoding and setting cookies. It offers good connectivity to many databases including MySQL, and PostgreSQL,  which Moodle uses as a single database. MySQL is a  relational database management system  that runs as a server providing multi-user access to a number of databases. (www.php.net). Moodle had the support for easily displaying multimedia aspects of the educational resource and the interface could be used in over 70 native language translations. The Web based educational resource was easily built up using multimedia activity modules and design elements, which included with easy navigation; Authentication and enrollment, Syndication with a chat forum made available to others as newsfeeds, Current evidence based didactic teaching, Interactive quizzes allowing import/export in a number of methods Hyperlinked resources to provide for branched learning, The use of a Wikipedia, A glossary of commonly used terms, Instructional video presentations. All the attributes of the Moodle made for an international transportable tool ideal for knowledge presentation, learner interaction, comments and reflection, dynamic and interactive assessments, flexibility, extendibility, and most importantly, support for autonomous learning and continued educational development around the world. The only noteworthy disadvantage of using the UCL Moodle was an imposed instructional design. 1.3 Resource Description The educational resource was named; VIRTUAL [emailprotected]: Onà ¢Ã¢â€š ¬Ã¢â‚¬Å"line Laryngeal Airway Device training. à ¢Ã¢â€š ¬Ã¢â‚¬Å" Virtual suggesting both the virtual reality of an Internet based generated environment and the adjective, meaning practically or almost Collins English Dictionary ( 2008). The Web based educational resource was developed for distance learning and contained all the elements of a totally Internet delivered educational resource. The content of the course was drawn from the authors personal experience using the Laryngeal device; peer reviewed journal articles, manufactures product information and videos downloaded from the Internet. Permission for the use of copywriter-restricted material was sought and obtained where appropriate. 1.3.1 Screen Design The screen design refers to how the information was arranged and presented on the display screen. The guidelines used followed those (amongst others) suggested by DoD HCI Style Guide (1992). The screen was kept simple, orderly, clutter free and consistent with a limited, non-dominating colour palate of four colours à ¢Ã¢â€š ¬Ã¢â‚¬Å" blue, black, white and blue à ¢Ã¢â€š ¬Ã¢â‚¬Å" green, a combination that has been shown to cause little fatigue and distraction. Kelley (1988). The content of each lesson was presented on a plain white background with black text in a non-jarring informal style font that made the lessons easy to read. Clark (1997). One template was used and the navigation bar, top bar and individual lesson heading bars kept the same with only the content of each lesson changing. All the content was displayed statically on one screen with individual lessons accessed by scrolling vertically down to the individual lesson. Unnecessary menus and long selection lists were avoid ed. This allowed for an overall view of the content, minimized pointer and eye movements and caused less distraction with easy navigation. (Gruneberg 1978). A discussion forum, interactive quizzes and an end of resource examination were included to allow engagement and self-assessment. The quizzes and examination included a range of question types à ¢Ã¢â€š ¬Ã¢â‚¬Å" multiple choice questions, true/ false, photo matching and random short answer matching type questions. These varieties of questions were shown to improve the learning experiences of adult learners. (Mackway-Jones, 1998). Information was provided in chunks and the writing style kept informal, with plain, simple language and in conversational tone with some elements of humour. There were fewer than 60 à ¢Ã¢â€š ¬Ã¢â‚¬Å" character positions on a standard 80 à ¢Ã¢â€š ¬Ã¢â‚¬Å" character line, spacing between characters were 25 à ¢Ã¢â€š ¬Ã¢â‚¬Å" 50% of character height and spacing between lines were equal to the character h eight, this to increase reading efficiency. 1.3.2 Course Content The course material was presented as text, graphics, power point presentations, hyperlinks and video demonstrations of the procedural skill presented in animation and on an actual patient. Knowledge was provided in five short lessons that followed the natural sequence of usage and intubation with a Laryngeal device. Aims of the resource and objectives of each lesson were stated at the beginning of the course. Here too a glossary of commonly used terms and a baseline knowledge assessment quiz were included. Each lesson was kept succinct with hyperlinks to websites and folders for those seeking extra information. This was to limit download times. Each lesson was concluded with an interactive quiz used to reinforce and test the knowledge learnt. Instant responses were provided to the quizzes after submission with suggestions to either revisit the lesson or to continue depending on the results obtained in the quizzes. The resource was concluded with an end of course examination and the c ourse was predicted to take 1 to 2 hours to complete. The resource content was accessed with a secured password with all content downloadable by way of an Internet connection. All the participants were supplied with a secure company email address and all the ISTCs had Internet access. Permission was requested for the use of company time and resources e.g. airway device training mannequin and time during the working day for those who chose to access the resource at work. Participants were supplied with instructions on how to use Microsoft Word and how to log on to and navigate the Moodle site. The course material was available online for two weeks with access monitored. 1.4 Pilot Study The aim of the pilot study was to assess the ease of navigation, gauge the time it took to complete the course, the integrity of the hyperlinks and the validity and reliability of the content and examination questions. Font preferences, layout and download speeds were also assessed. A prototype of the resource was tested on a selected sample of five participants of similar profile to the participants used in the study. The participants of the pilot study were excluded from participating in the actual study. An external panel of three Consultant Anaesthetists and two trainee Registrar Anaesthetists where used to provided expert advice. The Consultant Anaesthetists were selected based on their special interest in emergency medicine or difficult intubation scenario teaching. A few typographic errors were corrected, aims and objectives were clarified, difficult navigational issues were corrected and some content deemed repetitive and lengthy by the pilot participants were excluded before rolling out the resource. These changes however, were minor and further usability studies were deemed unnecessary. 1.5 Content Validation The content presented was current, evidence based and peer reviewed for content validity by the panel of experts (made up of three Consultant Anaesthetists and two trainee Registrar Anaesthetists), who deemed the content to be relevant and appropriate. The panel of experts and the pilot participants also judged good face validity. 2. Evaluation of the Resource The study evaluates effectiveness and acceptance of a Web based educational resource used to train and maintain a learnt procedural skill in the context of continuous medical Education (CME). The evaluation of the resource was undertaken in two parts. First the effectiveness of the resource was evaluated and the endpoints measured were changes in knowledge, confidence and technical ability. This evaluation made use of a summative framework redefined by Saettler (1990); which takes place after interaction with the resource. A before and after interventional ipsative assessment was undertaken where participants performance was compared to their own over a period of time. The second part of the evaluation was undertaken to assess the acceptability of the Web based educational resource as a medium for procedural skills training and this was done by way of an evaluation questionnaire completed by the participants after course completion. 2.1 Participants and Setting The participants and settings were specifically targeted, as they would ultimately be interested stakeholders and end users of this type of resource. The research was conducted at five Care UK TM Independent Centers (ISTCs) on practitioners employed at these facilities. The ISTCs are part of the governments initiative to reduce long NHS waiting times for elective surgery by adding increased capacity and alternative treatment venues for patients. There are approximately 25 ISTCs in the United Kingdom with Care UK TM represents 20% of this market. The ISTCs were chosen as a setting because: They are not part of the UK NHS medical training scheme and therefore have no formal programs of medical training or teaching that similar grades of staff in the NHS would receive. Contractual obligations of the ISTC contract decreed that the ISTCs could not employ medical practitioners from the NHS; therefore, most of the medical staff employed at the ISTCs have trained abroad and are waiting either to enter a formal career path within the NHS or wanting UK work experience. This situation has resulted in a mixture of nationalities, non-uniform medical training and medical staff with differing levels of post qualification experience and more importantly, a high staff turnover. (ref) These resulting factors were conducive to a system of competency-based appraisals and continuous medical education, which could be addressed with Web, based educational resources. Participants in the study were all frontline practitioners employed at Care UK TM ISTCs, which employs 48 practitioners of this grade. This represents 50% of all frontline practitioners employed in ISTCs throughout the UK. This intended sample size of 48 adequately represented the wider population in this type of analysis. frontline practitioners are the first practitioners on call to the resuscitation of a collapsed patient where they would be called upon to secure the patients airway and ensure oxygenation until the Anaesthetists or the resuscitation team arrives. It is expected that frontline practitioners are trained and certified with acute cardiac and life support skills and confident in dealing with clinical emergencies. In reality, analysis has shown that frontline practitioners in these ISTCs, though some trained and certified, rarely use these skills due to the infrequent nature of resuscitation clinical emergencies, making these scenarios potentially high-risk events when they do occur. Frontline practitioners are made up of Resident Medical Officers (RMOs), Anaesthetic Assistants (ODAs) and Recovery Room Practitioners (RNs). RMOs are doctors who have completed their medical training and have at least two years post graduate work experience as qualified doctors. They are employed to provide 24 hours on site medical management of patients at the ISTCs and like general practitioners (RACGP 2006) and doctors outside NHS academic hospitals, are usually first on call for emergencies and the sole source of medical advice on the premises on which they work. Anaesthetic assistants and recovery room practitioners are nursing practitioners

Succeed :: essays research papers

When I chose to attend any university I knew I wanted to live in a good Christian environment where the word of God was believed and practiced through the classroom. My entire family had gone to major public universities, but I knew that I needed a good sound environment without all the distractions one would see at a public institution. Now that I’m here, I know it is going to take hard work on my part to accomplish my degree in whatever field I choose. In order to survive here at a higher learning institution, I will need sacrifice some social, physical, and emotional things will be hinging on whether I succeed or not.   Ã‚  Ã‚  Ã‚  Ã‚  First off, there will be many social sacrifices that will arise at times. People will come to my door, doing there best to distract me while I’m doing homework. I will need to think over the situation, and either leave the room or ask them to leave. However, this will not be easy. To maintain an â€Å"edge† I will have to find times when not many people are around and get my work done at those times, instead of waiting till the last minute to do my work.   Ã‚  Ã‚  Ã‚  Ã‚  I will also have to make some physical sacrifices. There will be times when I am up till at least 1 or 2 in the morning, and have to get up for an Eight am class. I will just have to adjust to the fast paced schedule here at college. One thing I could do to solve a late night study session is to do the homework right when I get out of class.   Ã‚  Ã‚  Ã‚  Ã‚  The last sacrifice I plan to overcome will be emotional stress. Stress is one thing that many people today have troubles with, including myself. At school, stress can and will build up. At a Christian institution, they will expect me to keep on spiritual issues such as daily devotion and prayer. Finding times to do this will only enhance my personal relationship with Christ.

Radio Frequency Identification :: Technology, Electromagnetic Radio Waves

RADIO FREQUENCY IDENTIFICATION Introduction RFID is a technology which enables detecting and identifying objects using electromagnetic radio waves. This is processed through exchange of information between a reader and a tag being attached to the object that includes the data associated with the object. This can be used to detect and classify vehicles, animals, patients, shipment goods and airline baggage. [1] RFID technology involves two main components, they are transponders which are also known as tags or labels, contain the relevant information about the object and other the interrogators, also known as readers or transceivers, that extract the data from the tags. These tags can be passive or active tags. Passive tags use the energy from the EM radiation of the reader for its processing, where as active tags receive power from an internal battery for its processing and communication with the reader. An integrated electronic circuit is embedded in tags for storage and processing operations and an antenna that transmits and receives the RF signal. [2] Figure : components of RFID Source : http://www.docstoc.com/docs/17328767/Draft-SP800-98 The tags used in RFID are enabled with read-write operations, with a large storage capacity. Data can be modified any number of times. Tag and reader act as two way radio communication in which each antenna carries the modulation and demodulation of RF signals, with operation frequency ranges from low frequency to UHF. As radio waves are used, RFID does not require line of sight for communication and the operating distance between the reader and tag varies according to the frequency range from few centimetres to few meters. [3] [1] http://en.wikipedia.org/wiki/Radio-frequency_identification [2] [3] http://www.docstoc.com/docs/17328767/Draft-SP800-98 History The start of RFID took place in 1915, by the British with a system called IFF, which means Identification Friend or Foe. In 1940, during Second World War, the first installation of IFF transponder was in a German aircraft named FUG. [4] Leon Theremin, in 1945 invented a device which retransmits an incident radio wave and audio information. This passive device which was activated from an external source became the forerunner for RFID technology. [5] The concept of RFID came into existence in 1973 when Mario Cardullo invented a passive transponder which emits information when activated by an interrogating signal and consisted a 16bit memory unit for storage purposes. [6] In 1973, at the Los Alamos National Laboratory, Steven Depp, Alfred Koelle, and Robert Freyman developed the RFID tag system that uses 12bit tags, operating at 915 MHz. [7] After many years of research RFID tags came out with active tags that eliminated the use of external power source.

Nursing Theorist Grid

Nursing Theorist Grid Use grid below to complete the Week 4-Nursing Theorists assignment. Please see the â€Å"Nursing Theorists’ Grading Criteria† document, located on the Materials page of the student Web site. Name: Thomas Miller Theorist Selected: Ida Orlando Description of Theory: â€Å"Orlando’s theory is a reflective practice that is based on discovering and resolving problematic situations† (Alligood, 2010, p. 339). This theory is focused on defining the nurse-patient relationship. According to Orlando, the main function of nursing is to determine the needs of the patient and ensure that these needs are met, whether by the nurse or by others.The patient will have verbal and nonverbal behaviors that clue the nurse into the nature of his or her problems. The nurse must explore these behaviors with the patient to determine the needs that must be met to resolve the problematic situation that the patient presents with. The nurse must also be aware of hi s or her reactions to the cues the patient presents and must validate these reactions with the patient. It is always possible for the nurse to misinterpret the behaviors of a patient, and form incorrect ideas about what the patient needs.Validating the behaviors with the patient ensures that the nurse can fulfill the function of nursing, which is to find and meet the patient’s immediate need for help in the immediate situation which results in improvement (Alligood, 2010). The success of the help provided can be evaluated by observing for improvement in the patient’s verbal and nonverbal behavior. These behaviors must also be validated with the patient. This makes this theory dynamic and collaborative. Theory’s Historical background: Orlando developed her theory in the 1950s after receiving grants for studies integrating mental health concepts into nursing education.This was the first inductively developed nursing theory. Orlando recorded nurse patient interacti ons over three years and categorized her records as â€Å"good† or â€Å"bad† nursing (Alligood, 2010). Orlando conducted a second study where she â€Å"assessed the relevance of earlier formulations, educated and evaluated nurses in the use of her formulations, and tested the validity of the theory formulations† (Alligood, 2010, p. 338). This helped her validate her original observations and to extend â€Å"her theory to include the entire nursing practice system† (Alligood, 2010, p. 338).Major theory assumptions related to: Define according to theorist:| How does this concept relate to nursing practice? | How does this concept relate to nursing education? | PersonTo Orlando, a person is a unique individual with his or her own behaviors and perceptions that are related to the context in which those behaviors and perceptions occur. Each person has his or her own needs that must be met and these needs change depending on the context and perceptions of that person. Each person is also the only one able verify if his or her behavior means what it appears to mean.In the context of the nurse-patient relationship, a person is an individual who needs help in order to have his or her needs met. The unique patient behavior provides cues to indicate the needs that must be met. | â€Å"Improvement, according to Orlando (1990), is the goal of the nursing process† (Faust, 2002, p. 15). Because the individual is unique, each patient must be approached for validation of his or her behaviors separately. The nurse cannot make assumptions of one person’s behaviors based on what they learned from another patient with the same behaviors.It also means that â€Å"patient behavior requires assessment at the time it occurs† (Faust, 2002, p. 15). It is possible that the same behavior occurring at different times means different things. The nurse must always validate the meaning of behaviors with the patient before attempting to meet the needs of the patient to ensure the correct needs are being met. | This is an important concept for nursing education. Nurses are educated on how to plan for the care of a patient. The goal of nursing is patient improvement by meeting the needs of the patient.It is impossible to meet the needs of the patient if the nurse does not know the needs of the patient. Nurses must be educated to validate patient behaviors with the patient. Nurses must also be educated to be aware of their own feelings about patient behaviors and how to avoid making assumption about the needs of the patient. Nurses must learn to recognize the uniqueness of every individual and how behaviors can mean different things in different contexts. | HealthOrlando did not clearly define health. It is possible to infer what Orlando considered health to be from her writings.According to Faust (2002, p. 15), â€Å"health is the result of a patient’s needs being met. † This means that for a person to be healt hy, they must be in a state where all their needs are met or are capable of being met. If their needs are not met, they are in a problematic situation and have an immediate need for help from the nurse. Improvement of this problematic situation results in the patient being restored to a state of health. This is the goal of the nurse-patient relationship. | Improving the patient’s problematic situation and restoring the patient to a state of health is the goal of nursing.This can only be done by finding and meeting the patient’s immediate needs. â€Å"It is the nurse’s responsibility to meet the patient’s need for help either by supplying it directly or by calling on the services of others† (Schmieding, 1987, p. 432). The important thing about this for the nursing process is to take this in a systematic approach. The nurse must first determine what needs the patient has before planning how to meet those needs. The nurse plans the appropriate activit ies to help the patient and return him or her to a state of health. This concept of health means that nurses must be educated to focus on the needs of the patient and validating these needs with the patient. Nurse education for restoring a state of health should not be focused on tasks to perform, but on forming relationships to discover what the patient needs to maintain his or her health or to return to a healthy state. Although the tasks are important, nursing education must focus on how nurses choose the correct tasks to help the patient. Nurses must also be educated on how to recognize whether he patient has an immediate need for help or not. Nursing â€Å"Nursing is an interaction with people who have an immediate need for help – the subsequent relief of distress. Stress relief provides improvement, leading to a sense of well-being† (Faust, 2002, p. 16). The goal of nursing is to discover and meet the patient’s immediate needs for help. Nursing is â€Å"à ¢â‚¬ ¦concerned with providing direct assistance to individuals in whatever setting they are found, for the purpose of avoiding, relieving, diminishing, or curing the individual’s sense of helplessness† (Alligood, 2010, p. 339).Nursing is a process in which the nurse determines if the patient has an immediate need, what that need truly is, and plans actions to meet that need. | The nurse must develop a therapeutic relationship with the patient by validating the patient’s behaviors and not making assumptions about the behaviors. â€Å"In Orlando’s theory, nurse–patient interaction involvesreciprocity; making the relationship dynamic and collaborative† (Sheldon & Ellington, 2008, p. 390). This means the nurse must evaluate constantly and validate patient behaviors.It is imperative for the nurse to determine what the patient actually needs in order to plan interventions to meet the needs. The nurse must also be aware that each behavior is unique within the context in which it occurs. This means that each behavior must be assessed and validated when it happens to avoid making assumptions about the patient’s needs. | Learning to perform this process correctly should start early in the education process. It takes practice to do this correctly. â€Å"Finding out and meeting the patient's immediate needs for help becomes an acquiredway of thinking† (Schmieding, 1987, p. 32). This process needs to become automatic for the nurse. He or she must be able to recognize their own internal feelings and overcome them to avoid making assumptions. Nursing education needs to take this into account and help student nurses practice this concept early and often. Nursing education must also teach proper communication techniques so that nurses will be comfortable and able to validate patient behaviors with the patient. | EnvironmentThe environment is the context in which the patient’s problem exists and his or her behavior manifests.Orlando does not clearly define environment, but relates it to the immediate situation. â€Å"A disruption in the environment creates a problematic situation. At that moment the person experiences an organic response† (Schmieding, 1987, p. 434). Orlando calls this an immediate reaction. This immediate reaction to the environment causes the problematic situation that the patient needs help with. The patient may have needs based on his or her environment that is not being met that result in the problematic situation. This results in the patient seeking help. â€Å"Environment is part of any nurse-patient interaction, because it is involved in all nursing situations. To help a patient, it may be necessary to take action related to the environment† (Faust, 2002, p. 16). The nurse may have to educate the patient to avoid things in his or her environment. This has implications for Orlando’s theory because this will involve fully assessing the patient’ s needs and validating his or her behaviors relating to their environment. The nurse must determine if the environment is interfering with meeting the patient’s needs. If this is the case, the nurse must act to deal with the environmental problem.This may involve educating the patient or enlisting the aid of others to help the patient overcome his or her environmental barriers. | This is another case in which nurses need early and frequent practice. Nurses do not often consider the patient’s environment when planning care. Many patients do not consider their environment as a cause of their problems, either. It is the responsibility of the nurse to determine if this is a problem. Nurses must learn how to validate patient behaviors appropriately and assess the needs of the patient. Nurses must learn how to interact with patients to draw this information out.This takes practice and should be done early in an educational setting. Practicing this skill is important so that it will become a habit for the nurse. | References Alligood, M. R. (2010). Nursing theory: Utilization ; application  (4th ed. ). Retrieved from The University of Phoenix eBook Collection database Faust, C. (2002). Orlando's deliberative nursing process theory: A practice application in an extended care facility. Journal of Gerontological Nursing,  28(7), 14-18. Retrieved from http://search. proquest. com/docview/204155222? accountid=35812; http://linksource. ebsco. om/linking. aspx? genre=article&issn=00989134&volume=28&issue=7&date=2002-07-01&spage=14&title=Journal+of+Gerontological+Nursing&atitle=Orlando%27s+deliberative+nursing+process+t Schmieding, N. (1987). Problematic situations in nursing: analysis of Orlando's theory based on Dewey's theory of inquiry. Journal Of Advanced Nursing,  12(4), 431-440. doi:10. 1111/1365-2648. ep13107529 Sheldon, L. , & Ellington, L. (2008). Application of a model of social information processing to nursing theory: how nurses respond to pa tients. Journal Of Advanced Nursing,  64(4),