Sunday, November 24, 2019

Analysis of essays

Analysis of essays Maya Angelou has been one of the most ground-braking poets in American history. Being a poet, educator, historian, best-selling author, actress, playwright, civil-rights activist, producer and director, Dr. Angelou continues to travel the world making appearances, spreading her legendary wisdom. She captures her audiences lyrically with vigor, fire and perception, and is recognized as one of the great voices of contemporary literature as well as an extraordinary Renaissance woman. Ms. Angelou travels the world spreading her legendary wisdom, captivating her audiences lyrically with strength, fire, and understanding. Through her books of poetry and her autobiographies, she has the unique ability to shatter the concealed prisms of race and class. Highly regarded by presidents and cherished by scholars, Maya Angelou's life is a collection of great achievements as well as personal tragedy. Maya Angelou was born on April 4, 1928 in Saint Louis, Missouri. She was born with the name Marguerite Johnson. The daughter of Bailey and Vivian Baxter Johnson, Ms. Angelou acquired the name Maya from her beloved brother Bailey Jr., who preferred "Maya" to "my sister". When Maya was about three years old their parents divorced and the children were sent to live with their grandmother in Stamps, Arkansas. Maya claims that her grandmother, whom she called "Momma, had a deep-brooding love that hung over everything she touched." Growing up in Stamps, Maya learned what it was like to be a black girl in a world where boundaries were set for her by whites. As a child she always dreamed of waking to find her nappy black hair changed to long blonde hair because she felt life was better for white girls than for blacks. Despite the odds, her grandmother instilled pride in young Marguerite, with religion as an important element in their home. After five years of being apart from their mother, Marguerite and her brother, Bailey, were sent back to ...

Thursday, November 21, 2019

Nahil computers company internship Essay Example | Topics and Well Written Essays - 3500 words

Nahil computers company internship - Essay Example Currently, the company focuses on the sale and support of its diverse range of products in the Saudi Arabia kingdom. It has established a network of branches throughout the Saudi Arabia kingdom. An outstanding factor about the Nahil Computer Company is the fact that the company has been a leader in the market indulging in the distribution, reselling, as well as system integration of both computers and other computer related products. The Nahil Computer Company’s focus is to promote customer satisfaction of a remarkably high level. The company ensures the quality of products and service reliability, as well as the establishment of reputable brands. Recently, the company has indulged in downsizing its operations by adjusting its structure. The structural adjustments and the downsizing of the structure have served to propel the company to higher success. When the company started, it had less than ten employees and a single office located in Riyadh. However, the company has exhibited growth over the years and has numerous branches across Saudi Arabia. The company’s vision is to become the most preferred and trusted supplier that provides personalized, modular and turnkey IT solutions. In addition, the company seeks to ensure that it provides the best available services to all the customers (SÃ £vulescu 76). The company’s mission is to ensure that it achieves a 100% customer satisfaction through the launching of high-quality products and providing customers with remarkable support. Therefore, the company has technicians with outstanding skills who ensure that clients make the right decisions and provide them with cost-effective solutions. Since the company focuses on creating a positive customer relationships, it seeks to improve its quality in order to provide customers with their products. One of the outstanding core values of the company is the organization that seeks to ensure that customer choices and opinions have the priority (Mohammed 1). The

Wednesday, November 20, 2019

Tsunami Essay Example | Topics and Well Written Essays - 1750 words

Tsunami - Essay Example (Boork, 2005). a. Studies into the causes of tsunamis have revealed that there are actually many different factors that can lead to tsunami generation – including the already mentioned earthquake – but not every earthquake causes a tsunami and not every tsunami is caused by earthquake. b. Earthquakes can cause tsunamis. It is generally believed that earthquakes that move in a vertical direction are more likely to cause tsunami, but Dr. Tony Song from the NASA Jet Propulsion Laboratory has shown how â€Å"horizontal motions of continental slopes confer five times the energy of a vertical displacement.† (Mayer, 2006), indicating that movement of the continental margins should be the focus of tsunami detection. c. Landslides are another possible cause of tsunamis, whether they occur above or below the water level. Landslides that occur above water and slide into the water can cause tsunamis while underwater landslides can cause a high degree of water displacement. These landslides can be caused by excessive flooding or, more commonly as global warming continues, due to the melting of layers of permafrost. Sometimes underwater landslides work in combination with earthquakes to cause tsunami. â€Å"For example, submarine slope failures can be triggered by much smaller earthquakes which could not cause a tsunami by themselves.† (Lauterjung cited in Mayer, 2006). d. A third way in which tsunamis can be generated is with the eruption of volcanoes, again with equal devastating effect regardless of whether the volcano exists above or below the water level. â€Å"Tsunamis started by this process are uncommon, but present a real threat to residents of the lower Cook Inlet region, the Alaska Peninsula, and the Aleutian Islands.† (Haeussler, 2006). f. Characteristics of tsunamis caused by earthquakes and volcanoes are that they travel long distances from the earthquakes epicenter and strike coastlines thousands of miles from their

Monday, November 18, 2019

The Role of Faith in Night by Elie Wiezel Essay Example | Topics and Well Written Essays - 750 words

The Role of Faith in Night by Elie Wiezel - Essay Example How his faith shifted from one phase to another requires a deep understanding on reader’s path regarding Eliezer’s role in Night. This paper intends to discuss the role of faith in the holocaust story. The story begins with an introduction of a boy who was enthusiastic and devoted to study Talmund and learn Cabbala. He had committed his life to learn the teachings of Cabbala. He would cry in his local temple where he prayed over the obliteration of the Temple in Israel. He had raw but strong faith in God at this point. He would insist his father to arrange a mentor for him to teach him Cabbala and Talmund. When he saw that his father was ever disinterested, he decided to convince a temple assistant, Moshe the Beadle, to help him understand the complicated texts of the Cabbala. His passion toward his learning shows how strong a faith he had in his religion and how much he wanted to learn about God. He wanted to extend his knowledge about his religion. However, since he h ad blind faith without logic, there were huge chances that his faith would change as he grew up. We can get the hint because when Moshe asked him why he prayed, he replied why he breathed, which shows the extent of blind faith he possessed. Soon Elie made some heart-wrenching observations which shook his faith in God. He witnessed a burning death ditch in which thousands of babies were laid and used as target practice by the Nazis. It was such a brutal thing to see that Elie was brought to think the first time in his life why God ever allowed human beings to commit such an evil act. He was so shaken and depressed that he started considering committing suicide before he was told to turn away from the death pit. Elie was unable to forget the shocking scene and this was the first time he started losing faith in God and religion. He was not able to figure out why a just God would ever permit anyone to be so brutal to other innocent human beings. The next event which further weakened Eli ’s faith was the public hanging of the â€Å"pipel†. When he saw how the little boy was given the deliberate and excruciating death, he also experienced at the same time the death of his faith and beliefs. He considered pipel’s death as divine death as he said that it was not the pipel who was hanged but it was God hanging on the gallows. Up to this point, Elie’s beliefs had abandoned. He had given up his loyalties toward God. His faith had been shattered to pieces and he had no plans to collect those shattered pieces and join them up again. As a token of expression, he stopped praying to God. He did not pray on the holy days of Rosh Hashanah and Yom Kippur. He announced during the New Year celebrations that he had accused God who was answerable to him. However, this shift in his faith did not satisfy Elie internally. He knew that he was restless and empty from inside, when he should have been feeling satisfied upon accusing the guilty one. Elie was witho ut help and was blank. The rebellion against God strengthened when Elie stopped practicing any religious ritual and did not even fast on the Day of Atonement. He was encouraged by his father who had always been disinterested in Elie’s faith. Elie made sure he â€Å"swallowed† his meals on the Day of Atonement expressing his rebellion against God and faith. However, faith had still not died entirely. Elie experienced some portion of it coming back to him which forced him to pray twice. Or

Friday, November 15, 2019

Pain In Cardiothoracic Surgery Numerical Rating For Pain Nursing Essay

Pain In Cardiothoracic Surgery Numerical Rating For Pain Nursing Essay Pain is frequently experienced post-operatively, after cardiothoracic surgery, and is thus a core component of nursing practice (Kalso, Perttunen, and Kaasinen, 2002). This assignment introduces the concept of pain and highlights the importance of the accurate assessment of pain in terms of the Nursing and Midwifery (NMC, 2008) Code of Practice and recommended guidelines. This is followed by an evaluation of pain assessment outcome measures, with particular focus on the Numerical Rating Scale (NRS) for pain. The NRS, when used as a self-report outcome measure, is the gold standard for pain assessment. It is a psychometrically and operationally robust pain assessment measure, as supported by the evidence presented within this assignment. Not only is the NRS associated with a number of beneficial patient outcomes, but it has also been found to facilitate communication between patients, healthcare professionals, and multidisciplinary teams (de Rond et al., 2001). Pain in Cardiothoracic Surgery: The Numerical Rating Scale for Pain Assessment This assignment introduces the concept of pain and highlights the importance of the accurate assessment of pain within the cardiothoracic surgery setting. This is followed by an evaluation of pain assessment outcome measures, with particular focus on the gold standard self-report outcome measure, the Numerical Rating Scale for pain. Background In the UK, over 10,000 cases of thoracic surgery are carried out each year, with pain being frequently reported post-surgery (Perttunen, Tasmuth, and Kalso, 1999; Maguire et al., 2006). One study found that persistent pain lasting more than 6-months was reported by 44% of patients after a thoracotomy (Kalso, Perttunen, and Kaasinen, 2002). The prevalence of chronic pain after thoracic surgery has been reported as a significant problem that is consistently rated by patients as being one of the most difficult problems following surgery; it can impact a patients life for several years, severely depleting their quality of life (Maguire et al., 2006). Despite the prevalence and burden of pain, the literature highlights many cases of poor clinical practice in the assessment and management of post-operative pain (Dihle et al., 2006; Schoenwald and Clark 2006). This is regardless of past quality improvement initiatives and changes to practice, which comprised the establishment of clinical nurse specialists, multidisciplinary pain teams, and standardised pain assessment tools (The Royal College of Surgeons of England and College of Anaesthetists, 1990). Inadequate assessment and management of post-operative pain poses a number of implications for the patient and the NHS. For example, pain can result in increased levels of anxiety, sleep disturbance, restlessness, irritability, and aggression, as well as limitations in mobility (Macintyre and Ready, 2001; Carr et al., 2005). More importantly, post-operative pain is an unnecessary ordeal that causes heightened distress (Macintyre and Ready, 2001; Carr et al., 2005). It can also have physiological effects on patients, which may lead to complications and delayed discharge from hospital, including increases in heart rate and blood pressure, delayed gastric emptying, nausea, vomiting, and paralytic ileus (paralysis of the intestine). Difficulties coughing, resulting from increased pain on exertion, can result in chest infections and additional problems, such as deep vein thrombosis and pulmonary embolus (Sjostrom et al 2000; Macintyre and Ready, 2001). At worst, unrelieved pain can be lif e-threatening, especially in older people with comorbidities (Hamil, 1994). Pain is the fifth vital sign in the physiological assessment of patients, making it a core component of nursing practice (Chronic Pain Policy Coalition, 2008). The Joint Commission on Accreditation of Healthcare Organisations has made it mandatory for hospitals to assess pain in patients (Krebs, Carey, and Weinberger, 2007). Nurses are morally and ethically responsible for the accurate assessment of post-operative pain (Dimond, 2002), since this is vital for identifying the nature and severity of pain as well as for administering pain relief interventions and ascertaining the effectiveness of such interventions (Mackintosh, 2007). As an example, pain scores can be used alongside the WHO (1990) three-step analgesic ladder in the administration of pain relief. The assessment of pain is complex and decisions are required as to the most accurate method of assessment within different clinical environments and with different patients. One such complex decision is whether to measure pain observationally or via self-reports and this decision is most likely to be led by conceptions of pain. If defined as a subjective experience, or as described by McCaffery and Beebe (1968, p. 95) as, whatever the experiencing person says it is, existing whenever the experiencing person says it does, then choice of assessment is most likely to be self-report. Self-report is the gold standard for measuring pain since subjective experiences can only be measured from the perspective of the patient (Wood, 2004). The importance of self-report pain assessment is highlighted in a study by Whipple et al. (1995) whereby, out of 17 trauma patients admitted to an intensive care unit, 95% of doctors and 81% of nurses felt that the patients had adequate pain relief; in contrast, 74% of patients rated their pain as moderate or severe. Many other studies confirm this inconsistency between the subjective pain reported by patients and the objective pain reported by healthcare professionals (Sjostrom et al., 2000; Marquie et al., 2003; Sloman et al., 2005). There are a vast array of patient-reported outcome measures for assessing pain, including uni-dimensional scales that measure one element of pain (such as intensity) and multidimensional scales that measure more characteristics of pain and its impact (Macintyre et al., 2010). Whilst multidimensional tools might be better for chronic long-term conditions, uni-dimensional scales have been reported to be effective for acute pain, which can be experienced in the cardiothoracic surgery setting (Wood, 2008). Multi-dimensional measures of pain are rarely used post-surgery as they are more complex and time-consuming (Coll et al., 2004). Therefore, this assignment evaluates selected literature on uni-dimensional outcome measures within this context, with particular focus on the measure recommended by the Australian and New Zealand College of Anaesthetists and Faculty of Pain Medicine in their guidance on Acute Pain Management: Scientific Evidence (Macintyre et al., 2010): The Numerical Rating Scale for Pain. Methodology Literature pertaining to the Numerical Rating Scale (NRS) for pain was searched in order to identify articles on the NRS and comparative pain assessment tools. The following keywords were used within the search strategy: pain AND numerical rating scale OR NRS AND surgery. The search was limited to articles comprising adult participants. The search was also limited to records no earlier than 2005 in an effort to obtain the most recent evidence examining the NRS. Nevertheless, where these records have cited earlier research assessed as being applicable to this assignment, these records have also been obtained and used as evidence. Results A total of 88 records were retrieved from the pre-defined search criteria, 28 of which were not relevant to this assignment. A total of 60 records were evaluated for evidence to be included within this assignment. In synthesising the evidence within these records and the utilised pain assessment tools, a framework created by Fitzpatrick et al. (1998) was adopted. This framework, designed to facilitate the selection of the most appropriate patient-reported outcome measures, promotes a consideration of the following psychometric properties and operational characteristics: appropriateness of the instrument to the purpose and setting; reliability; validity; responsiveness; precision; interpretability; acceptability; and feasibility. Examples of three of the most frequently utilised uni-dimensional pain assessment measures, as discussed within the following appraisal of the literature, can be found in appendix 1. Literature Appraisal The reviewed evidence suggests that the four most commonly utilised uni-dimensional pain assessment tools are the verbal rating scales (VRS), numerical rating scale (NRS), visual analogue scale (VAS), and pictorial rating scale (PRS). Such tools were developed due to the lack of feasibility associated with using multidimensional outcome measures within the clinical environment (Wood, 2004). Uni-dimensional tools such as the VRS, NRS, VAS and PRS enable health professionals to quantify pain intensity from a subjective perspective without being too time-consuming and without creating a burden for patients. Verbal rating scales are descriptive in nature, allowing patients to rate their pain intensity on a scale of no pain, mild pain, moderate pain, or severe pain (Wood 2004; Williamson and Hoggart, 2005). They have been reported as being one of the easiest tools to understand and use, whilst also offering the option of being completed verbally or in written format. The VRS has been adopted and integrated into acute settings, with numbers to rate pain being used in observation charts (e.g. 1=mild pain; 2=moderate pain, etc.). Such integration into standard practice increases the feasibility of the scale, whilst using numbers to document pain provides ease of interpretability. Of caution, however, is that although verbal rating scales are easy to use, the adjectives do not necessarily represent equal intervals of pain. Indeed, patients may wish to express their pain in via a word not appearing within the list of adjectives they have been presented with (Schofield, 1995). Due to the use of words to describe pain, the VRS is dependent on both the respondents interpretation and understanding of the terms, as well as the health professionals interpretation. It has, therefore, been suggested that this scale lacks the sensitivity and accuracy of other pain rating scales (Baillie 1993). Jensen et al. (1994) suggested that the lack of sensitivity of the VRS could lead to an over or underestimation of changes in pain being experienced and, as such, could make it difficult to manage pain appropriately and effectively. In contrast to the VRS, the visual analogue scale (VAS) uses a 100mm horizontal or vertical line with extremes of pain placed at either end of the line so that the patient marks their pain intensity along the continuum. The distance to the line can then be measured and documented. A VAS rating of greater than 70mm is usually the threshold indicative of severe pain (Aubrun et al., 2008). However, the VAS poses a number of limitations within the clinical setting. It requires a greater degree of cognitive functioning, physical dexterity, and concentration than other measures of pain, and thus it is not suitable for some patients, including older patients and those with visual difficulties (Krulewitch et al., 2000). Indeed, Chapman and Syrjala (1990) estimated that 7-11% of adults would have difficulty using the VAS, whilst Wood (2004) went on to find that about 20% of patients are either unable to complete the VAS or find it confusing. Also, because it is administered verbally, it might be difficult to use after general anaesthesia or administration of some analgesics. In addition, the VAS has been found to be highly sensitive to changes in levels of pain, which can make it difficult to use (Bird and Dickson, 2001). Overall, the VAS has been found to be the least suitable uni-dimensional pain assessment measure, especially if administered after cardiac surgery (Pesonen et al., 2008). Numerical rating scales (NRS) offer an alternative to descriptive measures of pain by assessing pain intensity numerically, on a scale of 0 (no pain) to 10 (worst pain imaginable). A value of four or more is most often used as a threshold to guide clinical intervention (Mularski, 2006). On the other hand, the most recent guidance from the World Union of Wound Healing Societies (WUWHS, 2007) makes no reference to pain score thresholds, merely offering that change in pain level may indicate a need to reassess the patient. The NRS has been found to be highly acceptable to patients when compared to other pain scales (WUWHS, 2007) and, like the VRS, it has the advantage of being validated for verbal or written administration, which makes it feasible for use with patients who have differing levels of ability to complete such assessments (Paice and Cohen, 1997). It has been shown that older patients, post-operative patients, and patients with poor motor coordination are able to use the NRS (Rodriguez, 2001; Aubrun et al., 2003). It is not recommended, however, for patients with post-operative confusion (Ferrell et al., 1995). The NRS is more sensitive than the VRS, although some patients might find it difficult to describe their pain numerically (Carpenter and Brockopp, 1995). The NRS for pain is recommended by the The Australian and New Zealand College of Anaesthetists and Faculty of Pain Medicine developed guidance on Acute Pain Management: Scientific Evidence (Macintyre et al., 2010), which is endorsed by the Faculty of Pain Medicine, Royal College of Anaesthetists in the UK as well the International Association for the Study of Pain. The guidance aims to combine a review of the best available evidence for acute pain management with current clinical practice and was designed to provide information based on best evidence. The support cited within the document shows a good correlation between the VAS and NRS, indicating good levels if convergent validity with a measure purporting to assess the same construct. However, this correlation is not as strong in cardiothoracic patients compared to non-cardiothoracic patients (Ahlers et al., 2008). The document also highlights that the NRS is usually preferable, most certainly among patients (Herr et al., 2004). This is likely due to its feasibility in terms of burden to patients and staff since it only takes 30 seconds to complete (Downie et al., 1978). Importantly, the NRS has been found to be responsive to interventions such as patient-controlled analgesia (Li, Liu and Herr 2009), making it an effective instrument for monitoring pain management. The scale is also highly Downie et al. (1978) also found the NRS to have superior accuracy when compared to the VAS and simple descriptive measures of pain such as the VRS. It could be argued that the NRS provides a compromise between the VRS, which offers only a few descriptors for patients to choose from, and the VAS, which has been reported to offer too much choice and to be confusing. In terms of comparability against observer-based measures of pain, the NRS has been found to be more sensitive to detecting pain than the Behavioural Pain Scale (BPS) in both cardiothoracic and non-cardiothoracic patients (Ahlers et al., 2008). The authors rationalise that when using the NRS, health professionals tend to gather more background information on the patient, taking into consideration pain over time. In contrast, the BPS measures pain at one point in time, is objective, and lacks a contextual basis for interpretation. Therefore, the authors recommend that the BPS is only used alongside the NRS (Ahlers et al., 2008). This again supports self-reported pain as being the gold-standard for pain assessment and management. Importantly, studies have demonstrated that improvements in pain assessment and documentation frequently lead to more effective pain management (Erdek and Pronovost, 2004). In terms of the NRS, the evidence suggests that using this scale frequently results in favourable clinical outcomes such as decreased incidence of pain and agitation, as well as a decrease in the duration of mechanical ventilation (Chanques et al., 2006). It also enhances the nurse-patient relationship by providing acknowledgment of pain (Briggs, 2003). These positive outcomes are likely related to the fact that healthcare professionals are less liable to underestimate a patients level of pain when using the NRS than when compared to not using it. One study showed that of patients experiencing pain, where a discrepancy was reported between patient and nurse ratings, the NRS had not been used in 45% of such cases (Lorenz et al., 2009). This problem is especially apparent when patients rate their pain as being unacc eptable; nurses tend to underestimate the level of pain if not collecting pain ratings from patients using the NRS (Ahlers et al., 2008). In this sense, the NRS and, indeed, other pain measures are invaluable for facilitating patient communication of pain and expression of pain (Wood, 2004). The NRS also offers a number of practical advantages in that it is easy to teach to all staff and patients, as well as being easy to score and document. The documentation of all measures of pain is fundamental for the delivery of effective care, and it also facilitates communication between multidisciplinary team members (American Pain Society, 1995). The NRS is a valid and reliable measure of pain, but does still need to be used with caution and professional judgment as some studies have found a lack of consistency between ratings of pain. For example, one study found that whilst a patient might express a reduction in pain after an intervention, their score on the NRS remains the same (Mackintosh, 2005). Furthermore, a rating of, for example, seven by one patient might have a different meaning to another patient (Sloman et al., 2000). However, provided that such limitations are taken into consideration and efforts made to supplement the information gathered from the NRS, the instrument can be a highly effective tool for the assessment and management of pain (Mackintosh, 2005). Such supplementary enquiry might include observation and history taking, as recommended by McCaffery and Pasero (1999). Implications for Practice Despite the many benefits to uni-dimensional outcome measures of pain, such tools need to be used with caution as they only focus on limited aspects of the pain experience, arguable oversimplifying the complexity of the experience (Wood, 2004). They also pose the risk of being misinterpreted, a risk that cannot be rectified via descriptive tools since interpretation difficulties are also present when using the VRS. For example, what constitutes moderate pain might vary across patients and health professionals, as well as be dependent on factors such as personality, culture, and experience (Closs et al., 2004). The validity and reliability of all pain assessment tools, including the NRS, can be enhanced by familiarising the patient with the assessment tool and explaining the reasons for its use. Indeed, Giordano, Abramson and Boswell (2010) have emphasised the importance of listening to the patients subjective descriptions of pain and being consistent in the documentation of any pain assessment. At the same time, it is imperative to acknowledge that a pain assessment tool is only one aspect of the overall assessment of the patients pain (Duke, 2006). In the cardiothoracic setting, pain assessment should include static (rest) and dynamic (sitting, coughing, etc.) pain assessment and management (Macintyre et al., 2010). Although the assessment process should not be rushed, it does need to commence soon after surgery since studies have shown that high levels of pain immediately after surgery are associated with increased risk of developing chronic pain (Katz et al., 1996). In the clinical environment, it is not always feasible to carry out extensive assessments of pain, but the benefit of utilising a tool such as the NRS is that it provides an initial brief assessment of pain intensity. This, in turn, provides vital information on whether pain relief is required or whether a previously administered intervention has been effective. It is understood, however, that awareness of other pain measures is essential for the purpose of providing equal care to patients who might not be able to complete the NRS. For example, patients with cognitive impairments might find the Abbey Pain Scale easier to complete (Abbey et al., 2004), whilst patients with learning disabilities might prefer Zwakhalen et al.s (2004) scale of non-verbal indicators. Conclusions Effective pain management needs to commence with effective pain assessment, as well as the identification of factors requiring urgent intervention (Fear, 2010). The Numerical Rating Scale for pain provides a psychometrically robust method of assessing pain intensity and monitoring pain reduction interventions. As well as being psychometrically robust, the scale is acceptable to patients and feasible within busy clinical environments such as the cardiothoracic surgery setting. The best available evidence suggests the Numerical Rating Scale for pain is a suitable tool for the assessment and management of post-surgery pain and using this tool thus adheres to the Nursing and Midwifery (NMC, 2008) Code of Practice for providing a high standard of evidence-based practice at all times. Not only does this scale provide improved patient outcomes, but it also promotes communication between the patient, nurse, and multidisciplinary team (de Rond et al., 2001). More research is needed on the acc uracy and effectiveness of the NRS, as well as exploration as to any potential improvements to the instrument (Krebs, Carey, and Weinberger, 2007); however, until then, the evidence suggests that the NRS is an acceptable and efficacious screening tool for measuring pain in patients. Appendix 1: Pain Rating Scales Visual Analogue Scale (VAS) Numerical Rating Scale (NRS) Faces Rating Scale (FRS)

Wednesday, November 13, 2019

A Cleaner Future: A Comprehensive Pollution Prevention and Reduction Pr

A Cleaner Future: A Comprehensive Pollution Prevention and Reduction Program Introduction Pollution is a major problem globally and it becomes greater as the human population continues to rise exponentially. One of the major problems with increased population is higher waste production, which creates increased air, soil, and water pollution. To resolve this problem waste reduction must be of primary importance in preventing and reducing pollution. Waste management can be an expensive undertaking if not managed correctly so sustainable practices must be addressed. While pollution prevention and reduction programs can be expensive if not managed correctly, waste reduction is essential for the reduction and prevention of pollution. Recycling, Water preservation, Municipal solid waste management, and population stability are the essentials to a cleaner tomorrow. Municipal solid waste (MSW) is a significant problem globally. The biggest obstacle in waste reduction is public involvement. Society specifically in-developed countries produce significant waste through overconsumption. To address this problem it will take significant public participation. Careful considerations and planning must go into confronting the issue of MSW with the public. According to O'Connell (2011) â€Å"Waste and consumption practices are multi-dimensional and the methods for engaging the public in reducing MSW must incorporate feelings, practical considerations, and education.† It is evident that for significant municipal solid waste reduction to occur education and public feelings must be addressed. Without public participation MSW reduction cannot occur. The pollution prevention and reduction program will take aim at educating the public of the significance ... ...& Industry. (Document ID: 1552023631). Jiboye, A. (2011). Sustainable Urbanization: Issues and Challenges for Effective Urban Governance in Nigeria. Journal of Sustainable Development, 4(6), 211-224. Retrieved January 23, 2012, from ABI/INFORM Global. (Document ID: 2535474281). O'Connell, E.. (2011). Increasing Public Participation in Municipal Solid Waste Reduction. The Geographical Bulletin, 52(2), 105-118. Retrieved January 8, 2012, from Research Library. (Document ID: 2517583571). Miller, G. T., Jr., & Spoolman, S. E. (2012). Living in the environment: Concepts, connections, and solutions (17th ed.). Belmont, CA: Cengage Learning Wang, H.. (2010). A Sustainable Decision-Making Model for Materials Recovery Facilities Problems in Waste Management. Competition Forum, 8(2), 248-253. Retrieved January 9, 2012, from ABI/INFORM Global. (Document ID: 2174555611).

Sunday, November 10, 2019

Credit Card Hacking

Credit card also referred as plastic money. It is a card provides by bank to user in respect of his bank account or even with out bank account in that bank but against his income amount which he have through his job or business or even his cultivated land. There are two types of card, Credit card and debit card. Credit card is interest base and has certain amount of money which that particular bank pays against you and you will have to pay it back to the bank with interest. Debit card is different from credit card, you can also use it for payments but this payment goes directly from your own account. The concept of cards are basically introduced the idea of CASH WITHOUT MONEY, just for safe your cash from lost and theft. Cash is secure by credit card, but is your card secure .In the world of crime, a new crime has taken birth and it is Credit Card hacking. What you know about credit card hacking? It is simply awesome or a night mare but it can happen. Many people are unaware that when they give their credit card, it can be hacked. There are many ways by which the card can be hacked. Some are here for general purpose. The most common way of credit card’s hacking is quite easy and almost safe. When someone gives his card to any retailers for payment, the retailer copies the code and sells it to the hackers. The retailer copied the code of credit card and then with the help of MSR, transfers it to computer and makes a new but fake card. The credit card holder can’t imagine even what had happened with him. The other method of credit card’s â€Å"hacking† is â€Å"white card†. These white cards are easily available in many countries’ markets and samagals to Pakistan by many people. Unfortunately these cards cannot check in scan machines at Pakistani’s airports. (Quoted from Cyber crime wing FIA Pakistan). These white cards used for as ID cards in big companies as their workers showed it in their scanners and get in the company. But hackers are doing misuse of these cards and they convert the hacked data into this white card’ chip and coated it into fake credit card. To avoid such crimes, the banks are going more conscious to save and secure their DATA that no hacker can reach to them. Now a day’s many banks are introducing Credit card’ insurance plan. It is quite safe and pinafore of card holders. The banks take extra charges for insurance but in the case of insurance, bank is liable to pay you your extra money which is not spend by you, either in case of theft or fraud.

Friday, November 8, 2019

Pearl Harbor1 essays

Pearl Harbor1 essays Japan had aided in the defeat of Germany by Allied powers, and the Americans seemed to them by preaching self- determination and an open door policy (Goldstein 35). Woodrow Wilson believed that Japands entry into World War I, and its intervention during Russias civil war (Rusbridger 55). Japanese learned that power was its on justification (Rusbridger 56). The Japanese also became aware that power rather than national law (Rusbridger 55). Japan accepted such a World and became an apartment pupil of the West (Marcello 29). Japanese leaders presumed that imperialism was the equivalent of being modern and civilized (Marcello 29). Internation relations were characterized by power politics, aggressive nationalism and Western colinialism (Clarke 101). The label Japan the overt attacker while portraying the United States as an innocent victim (Goldstein 23). Japanese bombed civilian population in China, these attacks were not on the massive scale of the bombing by Germany, Great Bri tain and United States (Goldstein 23). American military authorities in the 1920s and 1930s carried out the fighting based on simulated Japansese attacked on Pearl Harbor that looked like the real one (Wray 1). Japanese attacked on Pearl Harbor leaded greater charity for the causes of Pacific War (Wray 1). ...

Wednesday, November 6, 2019

Definition of Leadership and Its Traits

Definition of Leadership and Its Traits Although there is no universal definition of leadership, or the traits that comprise it, all definitions can be summarized as the â€Å"process of social influence in which one person can enlist the aid and support of others in the accomplishment of a common task† (Blake and Mouton, 1985). Advertising We will write a custom essay sample on Definition of Leadership and Its Traits specifically for you for only $16.05 $11/page Learn More Basically, leadership concerns organizing a group of persons to realize a common objective and this involves inspiring them to adopt a teamwork strategy. There are four main concepts involved in leadership, i.e. the leader, the followers, communication, and situation. The leader must be honest in all his/her roles. It is vital to point out that it is the subjects who decide the success of a leader. Consequently, the leader must employ two-way communication and consider the situation before choosing a communication strat egy. There are two models of leadership in use today: the Four Framework Approach and the Managerial Grid. The Four Framework model proposes that leaders show leadership traits in one of the following structures: Structural, Human Resource, Political, or Symbolic. However, the Managerial Grid employs two axes: â€Å"concern for people† and â€Å"Concern for task or results† (Blake and Mouton, 1985). The dimensions are plotted in the vertical axis and horizontal axis respectively and have a range of 0-9. Since a leader interacts with all persons, below, at par or above his/her rank, it is vital that he/she wins their support and be able to inspire them. This can be effected by understanding human nature, which is defined as the common traits of persons such as values, beliefs, and customs. Another important aspect in leadership is vision, purpose, and goals. Goals must be realistic and attainable, should improve the organization in all aspects, should involve all peopl e, and should run on a predefined program. In addition, the following characteristics are important in goal setting: goal difficulty, specificity, feedback, and participation.Advertising Looking for essay on business economics? Let's see if we can help you! Get your first paper with 15% OFF Learn More Although there are no common leadership traits, the following traits are vital towards the success of a leader: honesty, competency, forward-looking (vision), inspiration, intelligence, fair-mindedness, broad-minded, courageous, straightforward and imaginative. These are just a fraction of the traits that a leader should possess. There are various styles of leadership, each of which should be used according to the situation. They are authoritarian, participative, and delegative forms of leadership. A good leader employs all the styles with one of them being dominant, however, a bad leader tend to stick to one form of leadership. A leader may be required to cre ate a matrix team, lead one, or form a part of one. A matrix team may be a work group, task groups, brainstorming teams, or similar specialized groups in an organization. Communication, collaboration, and collective efforts is important in these working groups. One of the greatest challenges in leadership is to get all members of an organization to embrace diversity. Diversity is all about empowering persons and it increases the efficiency of an organization by making the most of the employees’ strengths. To develop diversity, a leader can use either of the following methods: training, education, and development. Time management is important too in all leadership processes. In today’s changing and highly competitive business environment, one of the proven methods of surviving is to adopt change. This strategy will ensure that consumer demands of quality products and services are met. Reshaping the organization may involve picking a highly flexible and committed workfo rce. Training can also increase output, but should be followed by an After Action Review (AAR) which evaluates the success of the tasks and goals set by the leader. Reference Blake, R. R. Mouton, J. S. (1985). The Managerial Grid III: The Key to Leadership Excellence. Houston: Gulf Publishing Co.Advertising We will write a custom essay sample on Definition of Leadership and Its Traits specifically for you for only $16.05 $11/page Learn More

Monday, November 4, 2019

Leadership Essay Example | Topics and Well Written Essays - 500 words - 5

Leadership - Essay Example Trust from others – a leader has to develop the trust from his/her constituency. In a soccer game if the couch has given specific instructions of how a game strategy should be followed, all team members must trust that this strategy is going to be followed out in the field; Think creatively and objectively – a leader needs to create situations that will enhance the outcome results and be objective in the process. This creative thinking and objectivity may be discussed with the coach and the team members during practice for field performance; Partnership – a leader needs to make adjustments in his/her role and use the avant-garde posture: horizontal and vertical communication and make everyone feel that they are the owners of their fate and as such they are responsible for their actions. If a soccer player is not in place to receive the ball, an alternative player may be the receiver of the ball until the player is in place to perform the strategy that was delineated; Justice to think fairly – a leader should be able to balance criteria so that a fair view of different situations is present. A player may not feel well, therefore, his/her performance may not be up to par during a given

Friday, November 1, 2019

Position review Essay Example | Topics and Well Written Essays - 250 words

Position review - Essay Example lly by (a) providing reasons and evidence that the audience will see as persuasive, (b) anticipating and responding to objections or questions the audience is likely to raise, and (c) making appropriate appeals? The paper could be more persuasive in the 4th paragraph where the writer was trying to convince the reader that the cost of having an on call interpreter for every language in the hospital is a necessary evil. This could have been done by presenting actual statistics relating to the effective treatment of patients in hospitals that do have easily accessible interpreters. The writer has created a clear voice that speaks for the non-English speakers who need hospital care. The voice used is clearly appropriate for use throughout the whole paper. However, his ethos is hampered by the lack of citations in the paper that would have added credibility to his arguments. 7. What did you learn from the conclusion that you didnt already know after reading the introduction and the body? What information does the writer want you to take away from the argument? Does the writer attempt to change your attitude, action or opinion? I learned that the changing ethnic landscape of America has also changed the way we treat patients in the hospitals. We need to make sure that the hospital policies follow suit in order to be able to provide ample healthcare to all concerned. The writer wants the reader to come away from the argument realizing that universal healthcare should also speak international languages in order to be highly effective in treating their patients. The writer however, does not attempt to make the reader change his attitude, action, or opinion. Instead, he presents all of the factual data that he can muster and then allows the reader to come to his own