Research Proposal Essay Example

Research Proposal Essay Example Research Proposal Essay Research Proposal Essay Research Proposal 1. 1Topic Cervical cancer and screening; knowledge and attitude of St. Dominic Hospital Staff in the Eastern egion of Ghana. 1. 2 introduction background Cervical cancer is the most frequently diagnosed cancer among women in Ghana and knowledge about its cause, risk factors, prevention, symptoms and treatment is essential in the fight to reduce cancer morbidity and mortality among women in the country. Cancers are developed, not acquired thus cannot be transmitted to other persons. It is one or some of the individual’s own body cells that transform, divide rapidly and become hostile to other sorounding tissues, organs and sometimes the entire human system. A research conducted by Ghana Health Service indicate that an estimated 3038 women are diagnosed annually of cervical cancer and 2006 women die from the disease every year. Daily Graphic, 2013. Cervical cancer like all other cancers develops from a single cell that defies the laws of cellular division and begins to abnormally replicate and produce cells that differ in structure and function of the parent cells in the tissue. It takes many years for an individual to begin to have symptoms suggestive of disease in the affected part. Unlike breast cancer, another leading cancer among women which women can self examine their breasts for abnormal lumps as an early diagnostic measure, it takes the services of special health professionals and an extended procedure to examine woman’s cervix for abnormal growth or cancer. The Human Papilloma Virus(HPV) infection, early sexual debut, multiple exual partners, multiparity, low social economic status, are the major risk factors to the development of cervical cancer. A lot of studies have identified the Human Papilloma Virus infection as the principal cause of Cervical cancer development, a virus which is sexually transmitted. Women who are sexually active or has had sex before are likely to be exposed the HPV. Knowledge of risk factors, early detection of symptoms and undergoing screening is the way forward for the prevention of advanced cervical cancer among Women who are sexually active. Papanicolaou smear (Pap smear) and visual inspection of the cervix with acetic acid wash (VIA) are the screening options available with the latter being newly introduced, piloted and getting adopted by the Ministry of Health, Ghana because it is simpler and faster and result is readily available after the procedure. Both screening options requires a speculum to be inserted into the vagina for the cervical lining to be visualized and then processed for abnormality. Cervical cancer is curable if detected early. Cryotherapy, a procedure where an iced carbon dioxide is used to kill the cancer cells has been widely used to treat early cervical cancers and has yielded tremendous results. If cervical cancer is not detected early and becomes advanced, its spreads to affect the other organs in the pelvis including the womb, bladder, urethra, rectum, etc. it is very painful, ‘disgraceful’ and offensive as urine and faeces may be discharging continually through the vagina. Such women are often nursed to peaceful death. Statement of problem As already pointed out, cervical cancer ranks the highest in the cancer morbidity and mortality among Ghanaian women. The yearly over 2000 deaths recorded in women as a result of Cervical cancer, a preventable and treatable disease is unacceptable in a developing country that needs to build its human resource for development. Knowledge about cervical cancer and screening programs is necessary and needs to be aggressively pursued to arrest and turn-around the high cervical cancer deaths among Ghanaian women. Health workers are change agents, they belong to Churches, clubs and other organizations. Their knowledge, awareness and attitude towards cervical cancer and screening is crucial and likely to correlate with their uptake of available screening programs and also encourage their friends, families and social organizations to do same to better the health and lives of Ghanaian women. The Ministry of Health, Ghana, is about giving vaccines to about giving HPV vaccines to about 32,000 females aged between the ages of 9 to 11 in the Central and Northern Regions to prevent HPV infection. But what is the fate of the remaining Ghanaian women who are or getting sexual active and worse of all those who can be found under the other risk factors ? Purpose of the study The purpose of this study is to explore the knowledge and attitude of female clinical health staff of St. Dominic Hospital, Akwatia in the Eastern Region of Ghana concerning Cervical cancer and screening programs as a means of reducing cervical cancer mortality. Objectives of the Study 1. To explore the Knowledge and beliefs of respondents on cervical cancer as the major cancer morbidity and mortality among Ghanaian women. 2. To find out the level of knowledge of respondents on the risk factors of cervical cancer development and available cervical screening programs 3. To explore their attitude towards susceptibility to cervical cancer, and willingness to undergo screening. 4. To find out factors that hinder the participation of respondents in screening for cervical cancer 1. Literature Review The knowledge and awareness about cervical cancer and its prevention among interns and nursing staff in a Tertiary care hospital in Karachi-Pakistan was assessed by Ali et al in 2010 revealed that, â€Å"the majority of working health professionals are not adequately equipped with knowledge concerning cervical cancer†. They concluded that, â€Å"Continuing Medical Education program should be started at the hospital level along with conferences to spread knowledge about t his disease†. Ali et al 2010. Results from a study conducted with 171 women in Maroua in Cameroon to assess the knowledge, attitude and assumption of cervical cancer by women indicated that, â€Å"The awareness of cervical cancer by women in Cameroon is still inadequate. Thus, to avoid deaths from cervical cancer, a curable and preventable disease, the need of an aggressive campaign to make Cameroonian women aware of cervical cancer and its prevention is needed† Tebeu et al 2007. In another study conducted in Nigeria by GHARORO and IKEANYI in 2006 where structured questionnaire was used to elicit response from 195 female health workers. They concluded that, â€Å" the majority, 89%, believed that they were not at risk of developing cervical cancer. The self-reported utilization of Pap test among health workers was low. While there was a positive correlation between Pap test awareness and utilization, screening uptake was very poor due to a combination of inappropriate beliefs, misapprehension, and deficient knowledge. There is an urgent need for an aggressive awareness campaign and the provision of a screening program nationally†. A study conducted by Abotchie and Shoker in 2010 on cervical cancer among female University of Ghana students to explore their knowledge and health beliefs revealed that, â€Å"even in these highly educated populations, there is a lack of knowledge about the role of HPV† . they further stated that â€Å"Their lack of knowledge on cervical cancer and the need for periodic screening is indicative of a greater lack of awareness among the larger population of less educated women†. Three barriers were identified to negatively ssociated with screening : lack of belief that cervical screening diagnoses cancer, belief that pap test is painful and belief that the test will take away virginity. In another study, 9 clinicians who were trained in VIA and cryotherapy were observed for 18 months to assess the safety, acceptability and feasibility of a single-visit approach to cervical cancer prevention combining visual inspection of the cervix with acetic acid wash (VIA) and cryother apy of a single-visit approach in Accra, Ghana. A total of 3665 women were screened and 13. 2% tested positive, out of which 70. % received immediate treatment and 21% delayed treatment. It was concluded that, â€Å"a single-visit approach using VIA and cryotherapy proved to be safe, acceptable, and feasible in an urban African setting† for that matter Ghana. Blumenthal et al, 2007. 1. 4 Methodoloty St. Dominic Hospital, Akwatia is a A case study approach will be used to make an in-depth exploration on the knowledge and attitude of the clinical health staff of St. Dominic Hospital, Akwatia in the Eastern Region of Ghana. The case study approach will enable a real-life information collection to be done.

Spanish Loan Words

Spanish Loan Words Spanish Loan Words Spanish Loan Words By Sharon The English language is a thief. What we call English isnt really English at all. Instead, its a collection of borrowings from other languages. Latin is the main one, but theres also a good bit of French and a healthy serving of Spanish. There are thousands of Spanish loan words in English some claim as many as 10,000 and they all entered the language from three main sources. Trade in the Caribbean region brought a number of local Spanish words into the language: barbecue cannibal llama hammock hurricane potato tobacco yucca Many words were brought into English by cowboys working in the Southwest USA, such as: bronco buckaroo (from vaquero, Spanish for cowboy) desperado rodeo vigilante Then there are several words for food and drink that you just cant describe in English: avocado banana burrito chili dorado guacamole maize margarita paella papaya pimento tequila tortilla vanilla yam And then there are others, where we know the Spanish words, but were just not sure exactly how they got here. adobe albino alcove alfalfa algebra alligator (from the Spanish for lizard el lagarto) armadillo barracuda cafeteria canyon chihuahua cigar/cigarette cockroach embargo guerilla guitar iguana incommunicado jaguar macho mosquito renegade savvy siesta tornado This is just a selection of the Spanish loan words we use in English. Have you got any favorite ones to add to the list? Want to improve your English in five minutes a day? Get a subscription and start receiving our writing tips and exercises daily! Keep learning! Browse the General category, check our popular posts, or choose a related post below:Passed vs PastThe Writing ProcessTreatment of Words That Include â€Å"Self†

The Growth of World Exports Research Paper Example | Topics and Well Written Essays - 2500 words - 3

The Growth of World Exports - Research Paper Example Third, the strong regional developments have been accompanied by strong growths in merchant dice trade as Table 1 would show.   The strong economy of emerging countries is accompanied by strong exports and imports. Fourth, export growth the receives continued support from the world economy. As Table 1     below shows, the combined merchandise exports of major economies integrate into the strong export growth of the world of 6.5% in 2005, 8.5% in 2006 followed by a decline of 5.5% in 2007.   In   2007, the effect of the recession is starting to appear as trading slows down in most of the countries, with exception of the emerging economies that displayed its strength beyond the crisis. We have seen China, Asia and India emerged as strong exporters.  Tariff and quotas are both methods of controlling imports but the tariff is preferred over the other because of its advantages. Tariff is a tax placed on imported or exported goods while quota is a government imposed limit on th e importation of goods. Tariff is a source of revenue for the government and frequently imposed to protect domestic producers from foreign competition (Boyes & Melvin, 2000.p. 494).   For instance, a country that does not produce cars may place a tariff on imported cars. The quantity imported will be controlled because of the increase in price and the lessened demand for the cars because of the price.   The tariff has an effect of reducing importation.  The quota is another government tool that puts a limit to the quantity or value of goods and services imported and exported. A quota may be imposed through quantity quota or a value quota.   In a quantity quota, the physical amount of good is restricted. For example, the United States has a U.S. quota for its sugar importation that is set yearly that depends on their domestic needs. For 2010, U.S. quota based on quantity is 1.471 million of sugar (Bjerga, 2010). Another kind of restriction related to quota is valuing quota th at restricts the money value of the product, so instead of physical quota, the U.S. could limit the dollar value of sugar imported (Boyles & Williams, 494)

Social Marketing-Does the kindly reminder on the package of cigarette Research Proposal

Social Marketing-Does the kindly reminder on the package of cigarette can affect the customer buying cigarette - Research Proposal Example 7). There are eight principles of social marketing namely â€Å"customer orientation, insight, segmentation, behavioural goals, exchange, competition, methods mix, and [social marketing] is theory based† (Janssen et al., 2013). Stead et al (2007) found that social marketing can be used to develop an effective framework directed at interventions in behavioral change and can serve as a toolkit that can help organizations change health behaviors. One of the basic principles of social marketing is focus on the audience. Marketing mix cannot be useful until each of its four P’s are designed with the preferences, attitudes, behaviors, and characteristics of the target audience in mind. An example of the significance of perspective of the audience during the intersection of environmental and cultural contexts is provided by Romer et al (2009) who have examined the mass media’s contribution in a campaign for prevention of HIV in sexually active high-risk African American adolescents while addressing misconceptions regarding the use of contraception. The strategy of segmentation, like many marketing interventions, particularly addresses the social desires and norms of cultural subgroup. Behavioral change interventions can be classified according to a plethora of frameworks, though none can be considered as conceptually coherent and comprehensive (Michie, Stralen, and West, 2011). For example, the UK’s Institute of Government’s MINDSPACE is a very influential report meant to serve as a checklist to guide policymakers with the most important behavioral influences (Institute for Government, 2010). MINDSPACE is the acronym that represents the initial letters of these influences i.e. â€Å"messenger, incentives, norms, defaults, salience, priming, affect, commitment, and ego† (Michie, Stralen, and West, 2011). However, all important types of intervention are not

Eddie and Beatrice Essay Example for Free

Eddie and Beatrice Essay Of all the characters in the play, Marco is the one most responsible for the death of Eddie Carbone Do you agree? Consider all the characters in the play who are likely to be involved. Form your own conclusion from evidence, and use six characters minimum. I am going to write an essay about who I think is the most responsible for Eddie Carbones death. I will also say whether I think Marco is the most responsible. I will talk about the different characters, and say what I think makes them responsible/not responsible for his death. Then I will give my conclusion as to whom I think is the most responsible. The characters that I am going to use for my essay are Marco, Eddie, Rodolfo, Alfieri, Catherine and Beatrice and I will write about them in that order. In the beginning Marco was a very nice man. He did not want to put Eddie and Beatrice out, and was always very friendly with them. There was never much conflict between himself and Eddie, they would talk about his family and how he was going to help his children get better. This is illustrated when Beatrice asks Marco if his wife is getting the money ok, and he replies Oh, yes. She bought medicine for my boy. Also when they are talking about money in the beginning, Marco is very eager to send his wife as much money as he can, as soon as possible. He says Because I could send them a little more if I stay here and, I want to send right away maybe twenty dollars. This shows Marco is a very caring man, and wants the best for his wife and children. Then, Eddie started to become jealous of Rodolfo and when they were talking about Marcos family it lead to respecting women, and it was like Eddie was trying to warn Rodolfo away from Catherine. Eddie starts to become very jealous and angry now, and says to Rodolfo, It aint so free here either Rodolfo, like you think Then Rodolfo tells him he does respect her and Eddie starts to talk about just taking away girls. Eddie says I know, but in your town you wouldnt just drag off some girl without permission, I mean (he turns) you know what I mean Marco? Marco replies (cautiously) yes. It was after this that things started to change between them. Eddie tried to teach Rodolfo how to box, but ended up hitting him too hard. Marco then showed Eddie that he could be strong too, by testing his strength: He kneels, grasps and with strain slowly raises the chair higher and higher. Eddies grin vanishes as he absorbs his look. Eddie couldnt lift the chair but Marco could, this was showing Eddie that he (Marco) could be twice as strong as him, and was like saying I can be strong too, Im warning you I also think this was like telling Eddie that, if he wanted to fight Rodolfo, then he would have to fight him as well. I dont think Marco is exactly to blame for Eddies death, because Eddie should have been warned and left it at that. Instead he went to the immigration service. Marco was right to be furious at Eddie who wouldnt be? He was trying to help his family to get better, and wanted them to have a better life, and now all this would go to waste. Then when Eddie brought the knife out and was about to use it on Marco I think it was an act of self-defence when Marco turned the knife around. Eddie went down with the blow of Marco punching him on the neck (because he lunged for him), and then just as Marco is about to stomp on him he brings out the knife. Eddie lunges with the knife. Marco grabs his arm, turning the blade inward and pressing it home Eddie was over-protective towards Catherine right from the start. When she wanted to go ahead with the job her principle had told her to try for he tried to stop her from going a sign that he didnt want her to leave, in case she liked it and wanted to start her own life. Eddie tells Catherine she is walking wavy This shows Eddies concern extends to the way Catherine walks. When Marco and Rodolfo came to stay, things just went from bad to worse. Eddie started being suspicious of Catherine and Rodolfo all the time, and would have a go at Rodolfo. Eddie says I know, but you wouldnt just drag off some girl without permission Eddie is accusing Rodolfo of dragging Catherine off without his permission, and saying he has no respect in for women in doing this. I think Eddie is to blame for his own death, because if he hadnt been so over-protective and jealous none of this would have happened. Another time Louis and Mike ask Eddie if he would like to go bowling with them, but he says no, hes expected at home.

Fighting and School Violence Should Not Be Tolerated :: School Violence Essays

When you are a middle or high school public school teacher, events happen instantaneously, and you have to be equal to the task of confronting the challenge of an unexpected situation face to face. You never know when or where school violence will erupt; a teacher only knows that it inevitably will. Teachers not only must be wary of being inadvertently injured by enraged â€Å"students† fighting in the hallway or the cafeteria, a peer might even wind-up becoming a threat to one’s physical safety. I recall one particular eighth grade Washington trip. As usual, I was chaperoning one hundred twenty eighth graders on the Hammonton Middle School’s annual class DC trip. We had just arrived back at the Mt. Vernon Motel after visiting the Jefferson Memorial. The nine chaperones were fatigued, but the â€Å"students† were still rambunctious. Since the â€Å"children† had been well behaved, the school rewarded them with a pizza party in the motel’s Madison Room. Five of the Hammonton’ chaperones escorted the first half of â€Å"students† from the party back to their rooms, which were located in a remote section of the expansive motel. The other half of the entourage was later escorted to their quarters by three other chaperones and myself. Another male teacher and I made sure all of our â€Å"students† had evacuated the Madison Room, and we brought up the rear of the second batch of sixty kids. Suddenly, a male chaperone from a Catholic high school class that had also been staying at the Tyson’s Corner motel came running over to us, screaming the larynx out of his throat. â€Å"Are you in charge of those nasty kids on the other side of the building?† he hollered. â€Å"Yes we are,† I answered. â€Å"There are five of our chaperones already over there.† â€Å"Well, your kids are banging their fists on the walls and setting a bad example for my kids!† he angrily shouted with a crimson face. â€Å"You’d better get over there quick and settle them down or I’m gonna’ call the cops!† â€Å"Look,† I calmly replied, â€Å"I’ve been assigned to this group of sixty students. Our school has five very capable chaperones already over there to deal with that problem.† Apparently, the livid fellow did not relish my explanation. He took a huge swing at my jaw. I ducked down just in the nick of time. His blow glanced off the top of my head and knocked my baseball cap off.

Loa Loa Essay

Loa Loa â€Å"African Eye worm† [pic] [pic] Loa Loa By Amanda Green Microbiology 210 Loa Loa is a parasite known more commonly as the â€Å"African Eye Worm†. This may be one of the most feared of the parasites. They are classified as filarial worms, meaning they thrive in human tissues. Before the 1920’s , Loa Loa infections occurred more frequently in the United States now it is more commonly found in West Africa and equatorial Sudan. It prefers areas with hot, wet climates, like swamps and rainforests. They are cylindrical and have a cuticle with three main outer layers. This protects the nematodes (larvae) so they can invade the digestive tracts of animals. The outer layers are non cellular. The adult Loa Loa is a thin small worms ranging in length from 20 – 70 mm long and 350 – 430 mm wide. Males are smaller than the females. Loa Loa was first described in 1770 by a French surgeon, Mongin. He was the first surgeon to try to remove a worm from the eye of a woman in Santa Domingo. He was unsuccessful. Another observation came form a French ships surgeon, who observed an eye worm in slaves being taken to the West Indies from Africa in 1778. The first person to identify the microfilaria of Loa Loa in 1890 was Dr. Patrick Mason when he was invited to examine blood smears with Dr. Stephen Mackenzie. This person was thought to have â€Å"sleeping sickness of the Congo. † To reproduce the female produces a pheromone to attract males. After mating the female produces large numbers of active embryos called microfilaria. These microfilaria find their way to the blood stream where they can be transmitted through a bite to the next host. Loa Loa is an obligate endoparasite that feeds on fluids in the tissues of humans. The parasite contains pharyngeal glands and intestinal epithelium that produce digestive enzymes that enable them to feed on the hosts’ body fluids. Extracellular digestion begins within the lumen and is finished intracellularly. The adult parasite has been known to live up to 15 years. A human infected by Loa loa is termed Loiasis. People become infected by the transmission by deerflies. Once the deerfly lands on the host and bites, the larvae then drops into the opening of the skin and burrows into the subcutaneous tissues. The larvae then migrate through the body, commonly to the eye. They congregate in the lungs at night. Damage can be done to the eyes as it crawls through the cornea and conjunctive tissues. It can easily be seen and felt in the eye up to an hour. When they are deeper into the body they can cause encephalitis, if they reach the brain, which can lead to death. Joint pain can occur from swelling if the parasite stays near a joint for a period of time. The larva can remain unnoticed for months or years before becoming an adult, mating, and producing offspring. They continuously travel through deep and connective tissues, often even without the person feeling any sensation other than occasional itching. A person may feel the greatest discomfort when the worm slows or reaches a sensitive spot. It is then that the immune reaction starts, with localized redness and swelling called Calabar. This type of reaction is thought to be caused by a type of allergic reaction to dead worms and their byproducts. Skin eruptions and muscle pain may be evident. Once the worm dies the surrounding tissues may abscess. An accumulation of serous fluid in a sacculated cavity called hydrocele is a less common symptom. Colonic lesions, fibroblastic endocarditis, membranous glomerulonephritis, retinopathy, arthritis, and peripheral neuropathy can occur but are less common in people native to endemic areas. To diagnose Loasis, physicians look for Calabar swelling and the presence of worms in the conjunctiva. Those are the main tests used to diagnose an infestation. Some laboratory tests can help with the diagnosing including, C – reactive protein, elevated eosinophils (called eosinophilia), and IgE quantification. Identification of microfilariae by microscopic examination is the most practical diagnostic test. The collection of the blood specimen is extremely important with the known periodicity of the microfilariae. The smear is stained with Giemsa or hematoxylin and eosin. Concentration techniques can be used for increased sensitivity, including centrifugation of the blood sample hemolyzed in 2% formalin. Checking for microfilaria in the blood on a newly suspected case is not recommended because it can take may years for them appear. Loa Loa is endemic only to parts of West Africa. A study done by S. Wanji at the University of Boea in Cameroon found that in 16 rural villages in southern Cameroon 2. 2% to 19. 23% of people were infected. It also showed that males are almost twice as likely to become infested as females. The level of infection increases from the ages of 15 to 65 years old and then drops. The treatment’s side effects for Loa Loa are more life-threatening than the actual infestation. Two of the most common treatments are diethylcarbamazine and ivermectin. Both of thes e treatments can cause encephalitis, coma, or death in people with high microfilaria loads. These drugs kill the microfilaria but not the adult worms. Other treatments include chemotherapy and surgical removal.

Bar Code Scanning and Patient Safety Essay

The following paper explores eight published articles that address the issue of bar code scanning for medication administration and patient safety. Online research was conducted to locate and review articles which are included in review of literature, and to acquire accurate information addressing the issues discussed. The understanding of Bar Code Scanning for Medication Administration (BCMA) is a valuable tool, providing safe practice needed to reduce medication errors leading to safer patient handling. Patient safety is defined by the Institute of Medicine (IOM) as the prevention of harm caused by errors of commission and omission (Henneman, 2010, p. 8). The use of BCMA changed medication administration, documentation, and communication regarding patient care (Spetz, Burgress, & Phibbs, 2012, p. 158). Key words: bar code scanning of medications, patient safety and workarounds Issues 1. Discuss bar code scanning in medication administration (BCMA). 2. Discuss how the use of BCMA has affected patient safety. 3. Discuss the implications of workarounds in medication administration to the patient. Literature Review Discuss How the Use of BCMA has Affected Patient Safety The following articles were reviewed for the purpose of addressing the issue: how BCMA has affected patient safety. Patient safety has been an issue in all realms of healthcare. The use of BCMA introduced a new avenue to establish the best practice of drug administration for patient safety. â€Å"Medication Administration: The Implementation Process of Bar-Coding for Medication Administration to Enhance Medication Safety† (Foote & Coleman, 2008) discusses the issue of patient safety with the use of BCMA. According to (Foote & Coleman, 2008, p. 207) medication errors strike at the heart of being a nurse: the value of â€Å"do no harm†. The reduction of medication errors has had a direct and indirect effect on the patient and the nurse (Foote & Coleman, 2008, p. 207). The direct effect can be a safety threat to the patient and an indirect effect can compromise the confidence of nursing practice (Foote & Coleman, 2008, p207). The use of BCMA has increased patient safety by system validation of the six rights of medication administration: right drug, right patient, right time, right route, right route, and right reason. The findings concluded patient safety has increased with the use of BCMA. Reduction of paperwork using BCMA for the nurse allows for more time with the patient reducing the risk for error. â€Å"Impact of BCMA on Medication Errors and Patient Safety: A Summary† (Marini & Hasman, 2009) was also reviewed. The Institute of Medicine (IOM) estimates that one hospitalized patient is on average subject to one medication error per day. Medication errors that result in preventable adverse drug events may occur during any stage of the medication use process: ordering (56%) transcribing (6%) dispensing (4%) and administration (34%). The use of BCMA has addressed the issue of medication administration safety as a priority for patient safety (Marini & Hasman, 2009, p. 439). BCMA system use has decreased the errors in the administration phrase by possibly intercepting administration errors before they reach the patient (Marini & Hasman, 2009, p. 439). Enacting the BCMA technology into patient care has acted as a point of care safety system that assists in the protection from potential errors and safeguards the medication administration process where none previously existed (M arini & Hasman, 2009, p. 440). Safeguards that have been put in place since the implication of BCMA into the healthcare field have shown from this article that safe practice has increased. The article, â€Å"Patient Misidentifications Caused by Errors in Standard Bar Code Technology (Snyder, Carter, Jenkins, & Fantz, 2010), discusses some medication errors on misreading wristband bar codes. The use of bar code scanning has decreased transcription errors in many healthcare applications including patient identification (Snyder et al., 2010, p. 1554). The study indicated misidentifications of patients could occur, contributing to unsafe patient practices. Wristbands used for identification can assist with identifying the correct patient in the six rights of medication administration. While this is not a failsafe answer it is valuable in providing a safe practice of medication administration to patients. Discuss Bar Code Scanning in Medication Administration (BCMA) The following articles were reviewed for the purpose of addressing bar code scanning in medication administration. Nursing requires the critical skill of accurate medication administration. The use of electronic medication administration has brought about many changes in the healthcare field. The article,† What Determines Successful Implementation of Inpatient Information Technology Systems† (Spetz et al 2012), was reviewed to address the above question. Computerized patients records and bar-code medication systems continue to gain favor in healthcare. This idea spread across the nation in all VA sites (Spetz et al., 2012, p. 157), providing a safer environment for patient care. The use of bar code scanning utilizes the perfection of computers into medication-administration process. Training to use (BCMA) indicated from the article can be cumbersome and staff can be apprehensive about the change. The time needed for BCMA showed extremely high demands with the implementati on of BCMA system (Spetz et al., 2012, p. 160). The initial implementation of BCMA interrupted the flow of care for physicians and nurses (Spetz et al., 2012, p. 160) Training and time management were issues addressed including support, work flow changes, and communication allowing flexibility for changes and updates (Spetz et al., 2012, p. 161). In review of information, BCMA has assisted healthcare in providing a safer environment for patient care. The use of BCMA has increased awareness of mistakes, increased accountability to the staff by having recorded times of medication administration, and patient identifiers in patient care. The review of article â€Å"An Evaluation Process for an Electronic Bar Code Medication Administration Information System in an Acute Care Unit† (Bargen & Lu, 2009) discussed the development and use of BCMA in medication administration. An IOM report attributed 7,000 deaths annually to medication errors (Bargen & Lu, 2009, p. 356). Bar code medication administration systems were designed as a s afety tool for nurses. The use of this system assists in reduction of errors at the point of medication administration (Bargen & Lu, 2009, p. 356). The reduction of medication errors was introduced by using computerized alerts and warnings. These compelled users to stop and reconsider potentially unsafe steps in the medication administration process (Bargen & Lu, 2009, p. 356). This caused a workflow disturbance for nurses. BCMA processes were examined using direct staff observation, process mapping, and informal group discussion. The process assisted in data collection and reconfiguration of BCMA, thus reducing unnecessary alerts in the BCMA system. The conclusion drawn from review showed that a decrease in the numbers of unnecessary alerts triggered by the BCMA system can help ensure the workflow blocks nurses encounter are clinically significant and justified (Bargen & Lu, 2009, p. 357). Although the workflow blocks are there it is sometimes necessary to assist in safe patient handling. Another article reviewed was, â€Å"Barcode Medication Administration: Lessons Learned from an Intensive Care Unit Implementation† (Wideman, Whittler, & Anderson, 2006). The use of bar code scanning has been used in retail for many years and was adapted for the use of medication administration originally by the Veterans Health Administration in the year 2000 and has spread across the US since that time (Wideman, Whittler, & Anderson, 2006, p. 437). The system was designed to improve accuracy in administration of medication through real time network connectivity. This allowed documentation electronically of administration of medications at the bedside (Wideman et al., 2006, p. 437). On April 04,2004 the U.S. Food and Drug Administration ruled that barcodes were mandatory on labels of thousands of human medication and biological products by the year 2006 (Wideman et al., 2006, p. 438). The VA health care system used barcode scanning already in place and included the barcode of the medications in the safety system. This provided a better opportunity for patient safety using the BCMA system. The use of a handheld barcode scanner at the bedside registered each medication, software verified correct medication was ordered, time of administration is correct, measured in the correct dose, and in real time documents the administration of the medication (Wideman et al., 2006, p. 439). Alleviation of paper medication record for the nurse reduced the chance for medication error and harm to the patient. By the use of this system missed medications, medication actions, and medication ordering could be done as the bedside. The induction of BCMA into patient bedside medication administration also reduced phone calls to the pharmacy from nurses. This helped to increase efficiency for medication administration providing a safer environment for patient care. Discuss the Implications of Workarounds in Medication Administration to the Patient The use of BCMA for medication administration was not received with open arms. The training, computer knowledge, workflow blocks, were some of the complaints by nurses. The following articles reviewed discussed workarounds when using BCMA. The article reviewed â€Å"Patient Safety and Technology† (Henneman, 2010) discussed safety and BCMA. The goal for BCMA systems was to prevent medication administration errors (Henneman, 2010, p. 9). Identifying and verification of the patient’s identity is critical to assure patient safety and reduction of medication errors. Work-arounds have been reported with the use of the BCMA system in place. These work arounds create a serious threat to patient safety (Henneman, 2010, p. 9). Workarounds include affixing patient identification bar codes to computer carts, clip boards and carrying several patients’ pre scanned medications on carts (Henneman, 2010, p. 10). BCMA systems have assisted in creation of some work-arounds with unreadable medication bar codes, non-bar coded medications, malfunctioning scanner s at the bedside, and missing patient armbands used as a patient identifier (Henneman, 2010, p. 10). The review indicates workarounds can be created for any situation. It is the responsibility of the nurse to ensure the correct medication is being administered to the correct patient using the six rights of medication administration. BCMA is only a tool to assist in safe patient handling. Another article reviewed, â€Å"Medication Errors Occurring with the Use of Bar-Code Administration Technology† (Pennsylvania patient safety advisory, 2008) discussed workarounds as a method of accomplishing an activity through other arrangements when not able or willing to use the correct method. A temporary solution is not the answer and, puts the patient at greater risk for medication error. Using work-arounds such as typing the patients’ social security number, indicating the medication will not scan, or affixing the wristband of patients to bedsides rather than the patient’s wrist puts the patient at risk (Pennsylvania patient safety advisory, 2008, p. 125). The summary fro m review indicates it is the nurse’s responsibility to ensure safe medication administration even though it is not always the fastest method. Analysis of Findings Patient safety, bar code scanning and work-arounds all relate safe patient handling. The review of literature indicates safety is the number one priority in healthcare. The development of BCMA was part of the process to ensure a safer procedure for medication administration. Medication errors indicated that BCMA was not always the cause of the problem. Mislabeling of medications, work-arounds, missed scanned wristbands have all contributed to errors in medication administration. Findings indicate that although BCMA is an excellent tool to assist in the six rights of medication administration to the patient. It is not an overall solution to medication errors. The responsibility is a collective effort by physicians, pharmacists, and nurses to ensure the safest practice for the patient. Implication for Practice BCMA is an excellent tool to assist the nurse in bedside medication administration. The inpatient environment is hectic for the nurse, having multiple patients and time limitations. Patient safety is a priority in healthcare and taking the time to ensure the correct medication is being administered to the correct patient is part of nursing practice. The use of BCMA assists this process by ensuring the medication has been correctly ordered by the physician, verified by the pharmacist, and verification of patient identifiers. The system alerts nursing when there is a question of correct dose, medication, time, route, or patient. This assists the nurse in providing a safer method of medication administration. The field of nursing requires critical thinking skills in all realms of patient care. Medication administration is only one area of nursing practice. A safer environment for the patient is part of everyday practice for the inpatient nurse. The use of BCMA assists the nurse in providing this environment in patient care. Although work-arounds are many times easier for the nurse in time management, it is not the safest practice. Identifying and verification of the patient’s identity is critical to assure patient safety and reduction of medication errors. The understanding of Bar Code Scanning for Medication Administration (BCMA) is a valuable tool, providing safe practice needed to reduce medication errors leading to safer patient handling. Patient safety is defined by the Institute of Medicine (IOM) as the prevention of harm caused by errors of commission and omission (Henneman, 2010, p. 8). The use of BCMA changed medication administration, documentation, and communication regarding patient care (Spetz, Burgress, & Phibbs, 2012, p. 158). In the practice of nursing this all relates to everyday practice. Patient safety, avoiding the temptation of work-arounds, and using tools such as BCMA ensure that nursing is uti lizing all the information to assist patients in the healing process. References Bargen, M., & Lu, D. (2009). An evaluattion process for an electronic bar code medication administration inofrmation system in an acute care unit. Urlogic Nursing, 29(5), 355-391. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/19863043 Foote, S. O., & Coleman, J. R. (2008). Medication administration: the implementation process of bar-coding for medication administration to enhance medication safety. Nursing Economics, 26(3). Retrieved from http://web.ebschost.com.lib-proxy.usi/ehost/resultsadvsnced?sid=769055e1-76b1-460c-b5f6-96214bb1c806%40sessionmgr13vid=2%hid=14&bquery=Medication+Administration%3a+theimplementation+process+%22of22+bar-coding+for+medication+administration+%22to%22+enhance+medication+safety&bdata=JmRiPXJ6aCZOeXBIPTEmc210ZT1aG9zdC1saXZ1JnNjb3BIPXNpdGU%3d Henneman, E. A. (2010). Patient safety and technology. Advanced Critical Care, 20(2), 128-132. Retrieved from http://www.ajhp.org/content/66/13/1202/long Marini, S. D., & Hasman, A. (2009). Impact of BCMA on medic ation errors and patient safety: a summary. Connecting Health and Humans. doi:10.3233/978-1-60750-024-7-439 Pennsylvania patient safety advisory. (2008). Medication errors occuring with the use of bar-code administration technology. , 5(4). Retrieved from http://www.ecri.org/Documents/PA_PSRS/2008.12_Advisory.pdf Snyder, M. L., Carter, A., Jenkins, K., & Fantz, C. R. (2010). Patient misidentifications caused by errors in standard bar code technology. Clinical Chemistry, 56(10), 1554-1560. Retrieved from http://search.proquest.com.lib-proxy.usi.edu/healthcomplete/docview/756738318/fulltextPDF/13790524A8A77BE80D2/56?accountid=14752 Spetz, J., Burgress, J. F., & Phibbs, C. S. (2012). What determines successful implementation of inpatient information technology systems. The American Journal of Managing Care, 18(3). Retrieved from www.ajmc.com Wideman, M. V., Whittler, M. E., & Anderson, T. M. (2006). Barcode medication administration: lessons learned from an intensive care unit implemen tation. Advances in Patients Safety, 3. Retrieved from http://wwwfda.gov/cber/rules/barcodelabel.pdf

The Fall Of The House Of Usher Essays (1029 words) - Free Essays

The Fall Of The House Of Usher Essays (1029 words) - Free Essays The Fall Of The House Of Usher Death is defined as, The termination or extinction of something. Edgar Allen Poe uses this description in The Fall of the House of Usher in different ways. Poe's intention when writing The Fall of the House of Usher was not to present a moral, lesson, or truth to the reader; he was simply trying to bring forth a sense of terror to the reader. Poe's mind works this way, and critics believe this statement, especially when related to this story. Poe is grouped with other writers in the Romantic period. Writers of this period focused on life, emotions, and the existence of the human race. Although Poe's work has many characteristics of Romanticism, The Fall of the House of Usher, falls into the Gothic category. It is usually admired for its 'atmosphere' and for its exquisitely artificial manipulation of Gothic claptrap and decor. Bringing forth the symbolism of death is a major part of this writing. All of the characters in The Fall of the House of Usher are linked to death; by physical objects or by other people. There are no symbols of absolute good. The physical aspect of the House of Usher symbolizes death, in the chain of events, during the story. Even Poe's description of the house has deadly characteristics. Poe describes the house as having eye-like windows and being covered by minute fungihanging in a fine tangled web-work from the eaves; a barely perceptible fissure, which, extending from the roof of the building in front, made its way down the wall in a zigzag direction, until it became lost in the sullen waters of the tarn. This fissure is presented to the reader, early in the story, to represent that Roderick's love for his twin sister, Madeline, was dying, because she was suffering from a mysterious malady, or disease, that baffled her doctors. This caused Roderick to be emotionally and physically depressed, and was described as a madman at this point. He was convinced that his whole surroundings, the stones of the house, the fungi, the water in the tarn, the very reflected image of the whole, was woven into a physica l oneness with the family, condensed, as it were, into one atmosphere-the special atmosphere in which alone the Ushers could live. And it was this atmosphere which had molded the destinies of his family. Roderick invites a friend to the House of Usher to visit and support him during this crisis. The narrator is involved in all of Roderick's emotions and problems during the course of the story. He sees Roderick's compassion for his sister during her illness. After Madeline dies he assists Roderick in the placement of her body in a steal coffin in a vault under the house. The reason for such protection of Madeline's body was the fear of her doctors. They were so fascinated by the strangeness of her disease that Roderick feared that they would steal her body for pathologic reasons. Poe uses this whole scenario to show that Roderick really cared for his sister. It was as though they were one being, relying on each other for life; -a brother, his twin sister, and their incredibly ancient house all sharing a single soul and meeting one common dissolution at the same moment. Once Madeline died, Roderick had lost part of himself. Madeline was his connection in the human realm. He knew that his love would eventually kill her, and it did. They loved without any resistance and eventually dragged each other to death. For the Holy Ghost says you must not be as one thing with another being. Each must abide by itself, and correspond only within certain limits. In the end, Roderick's guest finally expresses that Roderick is truly a madman. The purpose for this is that Madeline was alive when they sealed her in the coffin. Usher knew that he had done this many days before, Long-long-long-many minutes, many hours, many days, have I heard it-yet I dared not-oh, pity me, miserable wretch that I am!-I dared not-I dared not speak! We have put her living in the tomb! After Usher finally speaks about what he knew, a figure of Madeline appears to them, but then without those doors there

Get a Look at Some Giant Mammals of the Cenozoic Era

Get a Look at Some Giant Mammals of the Cenozoic Era The word megafauna means giant animals. Though dinosaurs of the Mesozoic Era were nothing if not megafauna, this word is more often applied to the giant mammals (and, to a lesser extent, the giant birds, and lizards) that lived anywhere from 40 million to 2,000 years ago. More to the point, giant prehistoric animals that can claim more modestly sized descendants- such as the giant beaver and the giant ground sloth- are more likely to be placed under the megafauna umbrella than unclassifiable, plus-sized beasts like Chalicotherium or Moropus. Its also important to remember that mammals didnt succeed the dinosaurs- they lived right alongside the tyrannosaurs, sauropods, and hadrosaurs of the Mesozoic Era, albeit in tiny packages (most Mesozoic mammals were about the size of mice, but a few were comparable to giant house cats). It wasnt until about 10 or 15 million years after the dinosaurs went extinct that these mammals started evolving into giant sizes, a process that continued (with intermittent extinctions, false starts, and dead ends) well into the last Ice Age. The Giant Mammals of the Eocene, Oligocene, and Miocene Epochs The Eocene epoch, from 56 to 34 million years ago, witnessed the first plus-sized herbivorous mammals. The success of Coryphodon, a half-ton plant-eater with a tiny, dinosaur-sized brain, can be inferred by its wide distribution across early Eocene North America and Eurasia. But the megafauna of the Eocene epoch really hit its stride with the larger Uintatherium and Arsinoitherium, the first of a series of -therium (Greek for beast) mammals that vaguely resembled crosses between rhinoceroses and hippopotamuses. The Eocene also gestated the first prehistoric horses, whales, and elephants. Wherever you find large, slow-witted plant-eaters, youll also find the carnivores that help keep their population in check. In the Eocene, this role was filled by the large, vaguely canine creatures called mesonychids (Greek for middle claw). The wolf-sized Mesonyx and Hyaenodon are often considered ancestral to dogs (even though it occupied a different branch of mammalian evolution), but the king of the mesonychids was the gigantic Andrewsarchus, at 13 feet long and weighing one ton, the largest terrestrial carnivorous mammal that ever lived. Andrewsarchus was rivaled in size only by Sarkastodon- yes, thats its real name- and the much later Megistotherium. The basic pattern established during the Eocene epoch- large, dumb, herbivorous mammals preyed on by smaller but brainier carnivores- persisted into the Oligocene and Miocene, 33 to 5 million years ago. The cast of characters was a bit stranger, featuring such brontotheres (thunder beasts) as the gigantic, hippo-like Brontotherium and Embolotherium, as well as difficult-to-classify monsters like Indricotherium, which looked (and probably behaved) like a cross between a horse, a gorilla, and a rhinoceros. The largest non-dinosaur land animal that ever lived, Indricotherium (also known as Paraceratherium) weighed between 15 to 33 tons, making adults pretty much immune to predation by contemporary saber-toothed cats. The Megafauna of the Pliocene and Pleistocene Epochs Giant mammals like Indricotherium and Uintatherium havent resonated with the public as much as the more familiar megafauna of the Pliocene and Pleistocene epochs. This is where we encounter fascinating beasts like Castoroides (giant beaver) and Coelodonta (woolly rhino), not to mention mammoths, mastodons, the giant cattle ancestor known as the auroch, the giant deer Megaloceros, the cave bear, and the biggest saber-toothed cat of them all, Smilodon. Why did these animals grow to such comical sizes? Perhaps a better question to ask is why their descendants are so tiny- after all, svelte beavers, sloths, and cats are a relatively recent development. It may have something to do with the prehistoric climate or a strange equilibrium that prevailed between predators and prey. No discussion of prehistoric megafauna would be complete without a digression about South America and Australia, island continents that incubated their own strange array of huge mammals (until about three million years ago, South America was completely cut off from North America). South America was the home of the three-ton Megatherium (giant ground sloth), as well as such bizarre beasts as Glyptodon (a prehistoric armadillo the size of a Volkswagen Bug) and Macrauchenia, which can best be described as a horse crossed with a camel crossed with an elephant. Australia, millions of years ago as today, had the strangest assortment of giant wildlife on the planet, including Diprotodon (giant wombat), Procoptodon (giant short-faced kangaroo) and Thylacoleo (marsupial lion), as well as nonmammalian megafauna like Bullockornis (better known as the demon-duck of doom), the giant turtle Meiolania, and the giant monitor lizard Megalania (the largest land-dwelling reptile since the extinction of the dinosaurs). The Extinction of the Giant Mammals Although elephants, rhinoceroses, and assorted large mammals are still with us today, most of the worlds megafauna died off anywhere from 50,000 to 2,000 years ago, an extended demise known as the Quaternary extinction event. Scientists point to two main culprits: first, the global plunge in temperatures caused by the last Ice Age, in which many large animals starved to death (herbivores from lack of their usual plants, carnivores from lack of herbivores), and second, the rise of the most dangerous mammals of them all- humans. Its still unclear to what extent the woolly mammoths, giant sloths, and other mammals of the late Pleistocene epoch succumbed to hunting by early humans- this is easier to picture in isolated environments like Australia than across the whole extent of Eurasia. Some experts have been accused of overstating the effects of human hunting, while others (perhaps with a view to endangered animals today) have been charged with undercounting the number of mastodons the average Stone Age tribe could bludgeon to death. Pending further evidence, we may never know for sure.

Reflection Essay Example | Topics and Well Written Essays - 500 words - 76

Reflection - Essay Example It is vital to acknowledge that the elements of nature have a significant influence in stimulating an individual or a designer into accomplishing a given design task in a way that suits the demands of the respective environment. A substantial example that illustrates this fact is Thomas’ Seed Cathedrals located at the Expo Shanghai that is built to survive the forces of Mother Nature (Wujec et al. 91). As a recommended pillar in design, clarity of vision certainly helps in the creation of the world’s most spectacular designs that end up solving some of the oldest world’s snags in a postmodern way. Therefore, through â€Å"abductive reasoning† that Roger talks about, fresh and valuable ideas derived from experience laced with keen observation can ultimately solve the expected future complicated problems of the world. Even as some stakeholders in the design industry brag of the availability of a defined process of design, it is apparent that the steps taken by individual designers in coming up with their designs are exceptionally unique. If the story behind the artists of the Shanghai Tower, who emphasized on the efficiency and later delivered a spectacular structure is anything to go by, then there are many aspects beyond processes that come to play. Indeed, making such a remarkable design and implementing it fruitfully does not only demand a defined design process, but a combination of collaborative, fiscal and technical acrobatics (Wujec et al. 133). The fact that individual designers differ significantly in various aspects evidence that their personal talents and unique vision could be the two elements that dictate how far they excel in design. The postulation does not, however, disallow the use of defined processes in undertaking design work. Designers must acknowledge certain standard processes in design. As evidenced by the contemporary developments in the field of design. They should embrace the precedence set by Zaha Hadid