Doing Business in China Research Paper Example | Topics and Well Written Essays - 2000 words

Doing Business in China - Research Paper Example There is more than 1 billion population in China; one sixth of the world’s population lives in China itself (Colson, 2013). More than 56 ethnic groups are recognized in China and 90 percent of the population is Hans Chinese but the group also consists of other ethnic groups like Zhuang, Yi Miao, Uighar Manchu and Dhong (Colson, 2013). Like any other countries culture the cultural values of China has altered slightly due to the impact of globalization (Ward, Entrkin & Pearson, 2002).During the Chinese Cultural Revolution in the People’s Republic of China the orthodox Chinese Confucianism was heavily criticized on several grounds. After the Cultural Revolution there was a slight alteration in the Chinese value system and even culture dominated cities like Singapore, Taiwan and Hong Kong witnessed considerable amount of changes (Yau, 2007). The Chinese culture is largely influenced by the social interactions and interpersonal relationships between the individuals in the so ciety. The Chinese language is spoken by more than 85 percent of the population and is considered as one of the toughest language of the world. The language is also called Putonghua and is also claimed as the country’s national and official language (Kane, 2006). ... China: Individual or Collectivist? It is observed that the Chinese society is a highly collectivist culture where the interest of the team are given more importance than the priority of the individual. It is not necessary that in a family oriented business there would be preferential treatment towards the family members. The workers would prefer working on a holiday or a public holiday to meet the deadlines of the work. The commitment towards the organization is high than the employee interest and goals (Duel, 2012).The relationships of employees within the group are warm and cooperative while the relationship with other groups is hostile and cold. The Chinese employees believe in cooperating with each other for delivery of excellent performance (Pang, Roberts & Sutton, 1998). For example the MG6 was the first automobile designed by Shanghai Automotive Corporation in UK. The success of the car was totally contributed to the effective teamwork between the Chinese employees. If a weste rn organization wishes to collaborate with the Chinese department then they should lay emphasis on communicating the ideas and process to the Chinese employees with patience and clarity for successful performance (Xiaoming, 2011). China: High or Low Power Distance? The power distance lays emphasis on the impact of the influence of the culture within a society or an organization (SagePub, 2006). It is observed that the individuals working in the society and the employees working in the organization are not treated as equal. The Chinese Society maintains a rank system and follows the hierarchy stringently. The Chinese society believes that the inequalities prevalent in the society are

Explain How Christian Charities and Communities Essay Example for Free

Explain How Christian Charities and Communities Essay May put these Ideas into Practice Christian charities and communities put these ideas into action by devoting time to those who are less fortunate than themselves. They may work abroad as a doctor or nurse, or as an aid worker in a refugee camp. They may also provide help from their own homes by not being wasteful and donating old clothes and books and other objects that could be of use. There are certain organisations set up for Christians to help those less fortunate. These include organisations such as Voluntary Service Overseas which offers service to people with the will to help and it helps set them up with some work to do abroad. Other people will make donations to charities or even set aside some of their monthly income to make sure that they give something each month to help thise less fortunate than themselves. Christians are obligated to work towards helping those less fortunate than themselves. Charities such as Oxfam, Save the Children Fund and Comic Relief are all based to eliminate world poverty. However, they are not based on any religious beliefs. Christian charities include the Salvation Army, Christian Aid, Tear Fund and CAFOD. Christian Aid was organised just after the Second World War as many people had lost all their possesions and loved ones, including their home and family. Many people were left with nothing. That is when Christian Reconstruction in Europe was set up, which raised a massive one million pounds! This helped people start to build up their lives again. Once the citizens in Europe started to become more settled, the attention was drawn to other countries where there was still a huge problem with poverty and injustice, such as Africa. The name of the organisation was then changed to Christian Aid and has been known as that ever since. Christian Aid has helped those in natural disasters (such as the war in Lebanon, the famine in Sudan and East Pakistan and others), by sending over money, doctors and medicines, clothes and food. The money sent over is used to build hospitals, education centres and wells for clean water. Most recently Christian Aid has campaigned for fair trade and for an end to Third World dept. Christian Aid works in more than 70 countries, and on more than 700 local projects. There are four main areas to Christian Aid, the first of which is fund-raising. Christian Aid Week started in 1957 and is a major nationwide event. Churches are given a number of towns to manage between them, of which all houses in them have an envelope posted through. In this envelope are the aims of Christian Aid, along with the explaination of the work and asks for a donation. In 1995 à ¯Ã‚ ¿Ã‚ ½8,600,000 was raised. Christian Aid provides emergency aid to deal with natural disasters and refugees- this takes priority over long-term projects due to the extreme nature of the situations. This type of aid involves sending food and medicine as well as providing shelter for those affected. About 10-15% of its funds are spent on emergency aid each year. Long-term projects such as in Bangladesh where a basic drugs factory has been funded have the aim to continue helping the country in the future. This is the main area of Christian Aids work, which encourages people in LEDCs to work themselves out of poverty, so that they will not need aid in the future. The final area of Christian Aids work is education (in the UK mainly), where 5% of the budget is spent. Christian Aid News, a quarterly newspaper gives information on their developments as well as explaining the need for world development and ways in which Christians can help those in LEDCs. Christianity tries to make people in the west aware of the conditions in the Third World. They do this by running advertising campaigns and educatory packs for schools. They believe that increased awareness will mean that Christians and others will be more prepared to give to Third World charities. The Salvation Army began in 1865 when William Booth, and his wife Catherine, realised that the poor were not being treated equally to the richer and they were not even allowed into churches. He believed the church needed to go to the people, rather than the people coming to the church, to be touched by the Christian message. By 1900 the Army had spread around the world to 36 countries.The aim of The Salvation Army is the advancement of the Christian religionof education, the relief of poverty, and other charitable objects beneficial to society or the community of mankind as a whole. The Salvation Army are also aiming to reach out to others, in order to encourage them to do the same. The community outreach team aims at doing just that, making people aware of the hundreds of people who are homeless in London alone! Caritas is a world-wide Roman Catholic organisation which believes that it is not enough to give people in need material help. It believes in providing the solidarity needed to nourish that hope which alone will enable our less fortunate brothers and sisters to take personal charge of their own lives and destiny and thus achieving that liberty which is their inalienable right as children of God. In England and Wales, Caritas is represented by CAFOD (Catholic Agency for Overseas Development). CAFOD is considered one of the United Kingdoms leading development and relief organisations, and funds over a thousand projects in Africa, Asia and the Pacific, Latin America, the Caribbean and Eastern Europe. Not only does CAFOD help those less fortunate but they also work within parishes, schools and community organisations to help teach others about poverty and its causes. They also run many fund raising projects through schools and otherwise, such as sponsored sports events to raise money. CAFOD aims to get rid of poverty in the Developing World, and aims to bring about justice and fair shares for everyone. CAFOD also does a lot of emergency work when it is needed. When there is a natural disaster incident, such as a flood, hurricane, or earthquake they provide food and then help with rebuilding. Some Christians donate one tenth of their earnings as their duty towards helping the poor. Christians faith teaches that the wealth is by no means bad but they must learn the right purposes for earning it and using it, and would argue that they should give money to charity rather than spending it all on luxuries. This is illustarating the Eye of the Needle; it is easier for a camel to go through a needle than for a rich man to enter the Kingdom of God as in the story of The Rich Man If the world were like it should be according to Christian teaching then the world would probably be a better place. The problem is that God gave men and women free will. If all of the worlds wealth was divided up equally between each person then not before very long the rich would be rich once again and the poor would be back where they were.

†REFLECTION Monitoring and Ensuring Quality Care

– REFLECTION Monitoring and Ensuring Quality Care Introduction The purpose of this paper is to reflect on a recent personal experience of patient care, which enabled me to achieve a module 9 competency, Actively seeks to extend own knowledge. I will be critically analyzing one nursing practice incident using Boud, et al (1985) model of reflection, (please see appendix 1) which will enable me to monitor and ensure quality patient care in future practice. The nursing incident happened when I was looking after a patient requiring enteral tube feeding (ETF). It is important to note that all confidential information relating to patients, wards, hospitals and professional colleagues has not been included in this paper to ensure ethical practice and adherence to the NMC code of professional conduct, section 5 which affirms that I must guard against breaches of confidentiality (NMC 2008). Reflection is a useful tool for the continuation of professional development among nurses (Somerville and Keeling 2004). The word reflection originates from the verb reflectere which means to bend or turn backwards (Hancock 1998). It is a tool, which unlike text books and videos, does not have a limited shelf-life, it is cost effective, is portable and can be used world wide. Patient Profile The aspect of nursing care I have chosen to reflect on is the care of a patient who required enteral tube feeding (ETF) due to dysphagia a condition in which the action of swallowing is difficult to perform (Unison Health Care 1998). This nursing intervention was essential for a patient in my care, who I shall call John. Please see appendix 2 for Johns past medical history. The Plan of Treatment for John John was admitted to my area of practice six days ago following his CVA. He is receiving ETF via an NG tube as an immediate intervention and is being assessed to see if he is a suitable candidate for a percutaneous endoscopic gastrostomy (PEG) tube which are used as a more permanent form of enteral tube feeding (Holmes 2004). The nasogastric tube is about 22 inches [55.9cm] in length (Holmes 2004) and was inserted into his left nostril down through the pharynx, through the oesophagus and through the cardiac sphincter muscle and into the stomach (Marieb 2001). Food can be administered through the tube directly into the stomach and the swallowing process does not need to take place. The food is administered by a pump that controls the amount of feed given in mls per hour. This description could sound as though ETF is always safe and effective and has no complications. Elia (2001) affirms that ETF is typically safe and easy to administer. However John did experience a number of difficul ties that could have been rectified sooner than they were. On reflection of Johns care it is clear to see (with the benefit of hindsight) that if Johns care was managed differently and if complications were noticed and acted on promptly, his hospital experience could have been very different. 1.) Returning to the experience Problems John faced. John experienced two main complications as a result of ETF. The first was regurgitation of the feed into his throat and mouth and the second was diarrhoea. The rate of the feed had been increased over a period of days to its optimal rate, following the ETF guidelines provided by the NHS trust that I was working in. The infusion was commenced during the night while he was sleeping to allow John greater freedom during the day as he could be disconnected from the pump. The regurgitation happened during the first night that the pump was running at the optimal flow rate. Davis and Shere (1994) report that regurgitation is a common complication of ETF. As a consequence, John had to swallow what had come up into his mouth. The rationale for John to undergo enteral tube feeding was to prevent further weight loss and aspiration which can be caused by dysphagia (DeLegge 1995, Gibbon 2002 and Davies 1999). Aspiration has various meanings, however in this context it refers to the movement of for eign material i.e. fluids or food, into the trachea and further down into the lungs (Unison Health Care 1998). This can occur when the swallowing mechanism is ineffective or impaired. Infection of the lobe of the lung, in which the foreign material has lodged, occurs. This is called aspiration pneumonia (Unison Health Care 1998). Patients suffering from dysphagia are at risk of developing aspiration pneumonia (DeLegge 1995 and Gibbon 2002). ETF was commenced to overcome this risk but now the very intervention that was intended to eliminate the risk has caused an even greater risk of aspiration pneumonia. According to Marieb (2001) there are two stages of deglutition (swallowing). The buccal phase, which is a voluntary action, occurs in the mouth and is the first phase of deglutition. The tongue progressively elevates anteriorly to posteriorly, propelling the bolus through the oral cavity. When the bolus has moved to the base of the tongue, the soft palate is raised, preventing food from being regurgitated via the nasal passage (Davies 1999). The second is the involuntary pharyngeal-oesophageal phase which Davies (1999) describes as a complex sequence of muscular movements. After a CVA the ability to initiate the secondary phase of deglutition can be disrupted resulting in ineffective or complete failure of this phase of deglutition. This short explanation of pathophysiology demonstrates how important it is to know nursing rationales for nursing interventions. Patients suffering from dysphagia can sometimes overcome the problem by eating a pureed diet and drinking thickened fluids, but this depends on the severity of the dysphagia (Stringer 1999). John needs ETF because his dysphagia is too advanced to be overcome by a change in diet. Arrowsmith (1993) recommends that patients who are receiving ETF via a NG tube that are lying in bed, should have their head and shoulders elevated 30-40 degrees during feeding and up to one hour afterwards to minimise gastric pooling and reflux of the feed. This example demonstrates how a simple action can make a substantial impact on the quality of care that they experience. It has the twofold purpose of Impact of the quality of care that they experience. It has twofold purpose of promoting the effectiveness of the intervention and minimises harm to the patient by reducing the risk of aspiration pneumonia. Assessing for signs of aspiration in a patient suffering from dysphagia should always be taken seriously by nursing staff. Stringer (1999) reports that if dysphagia is serious enough it can prevent the victim from swallowing their own saliva. The average person swallows approximately 590 times each day 146 when eating, 394 when awake and not eating and 50 times during sleep (Davies 1999). With the average person swallowing literally hundreds of times each day, patients are at risk of aspirating (on their own saliva) regardless of ETF. Barer (1989) found that over one third of conscious acute stroke patients admitted to hospital had unsafe swallowing. Davies (1999) citing Ellul and Barer (1994) affirms that dysphagia in the first three days after stroke is associated with a five to tenfold increased risk of chest infection during the first week. This is due to varying degrees of aspiration. Aspiration is a potentially fatal complication of ETF. John also experienced three episodes of diarrhoea since starting ETF. John was only provided with a commode which was only dealing with the symptoms rather than treating the cause. No contact was made with the senior house officer or dietician. Furthermore there did not appear to be much concern among the nursing team and there was no discussion or sharing of knowledge between colleagues accept what came from myself. I told my mentor what I had been reading during my reflection time and pointed out some reasons that have been identified as causing diarrhoea for patients receiving ETF. The attitude of my mentor was apathetic, and commented, Hes bound to pick up a bug, give it time, it will pass. This shocked me as Somerville and Keeling (2004) reports that the nursing profession depends on a culture of mutual support, and this was not what I received from my mentor. I wanted to discuss the temperature of the feed, his current medication and the cleanliness in which the feed was prepared and administered. If the feed is too cold when it is administered it can cause diarrhoea (Arrowsmith 2003). Howell (2002) reports that diarrhoea can be the result of ETF but it can also be due to the side effects of medications. Antibiotics can cause the common side affect of diarrhoea (BMA 2001) but John was not receiving any. Diarrhoea in ETF can also be caused through the introduction of bacteria through poor hygiene standards in the preparation and administration of the feed; however the preparation and administration does not need to be performed aspptically. This is only indicated if the patient is immunocompromised (Arrowsmith 1993). My professional knowledge reminded me that I could not dismiss the diarrhoea as a coincidence. If there were nursing interventions that could be used and I didnt use them, I would be failing to provide quality care for my patient. Nurses are responsible not only for their actions but also for their omissions (NMC 2008). I wanted to refer to each others professional knowledge through discussion, and to the ETF guidelines to see if there was a simple cause to the problem that could be rectified before consultation with the doctor or dietician became necessary. I was able to rule out most factors that can cause diarrhoea. This led me to believe that the infusion rate could be too fast. These are the factors that I wanted to discuss with my mentor so I could contact the dietician to seek help from the multidisciplinary team. Gibbon (2002) asserts that stroke care requires the services of a multi-professional te am, working towards an agreed therapeutic plan hence my reason to collaborate with the dietician. 2.) Attending to feelings What did I feel was Positive? During reflection time I was very interested and pleased to find this research to suggest that there could be something that I could do to put an end to the discomfort, distress and potentially disastrous complications of a patient in my care. Many times as a student I have felt that I personally, am not making a great difference to my patients health and wellbeing as I am not working independently, but under my mentor who in general decides on a course of action for our patients. This time I have found the answer from my own research. All that remains is for me to bring this research to my mentors attention and then put the intervention into practice. The patient will benefit, and I will have a great sense of achievement as I will have, in a small way, improved the quality of someones life, accomplishing one of the reasons why I decided to take a career in nursing. Attending to feelings What did I feel was Negative? In response to the apathy that I encountered, I felt disappointed and powerless and undervalued. My original mentor was off on temporary short term sickness due to a small operation and therefore I was allocated another Junior Ward Sister to take her place for the short period of time in her absence. I felt disappointed because my contribution to the care of my patient was not welcomed and that this mentor was not as patient or interested in my learning and on-going development. I also thought it was unfair because I had evidence to base my suggestions on. It was not a vague idea I had conceived but it was grounded in research. I felt powerless because as a junior and inexperienced member of the team I felt I had little influence over the overwhelming hierarchy. Morris (2004) states that student nurses possess little power because they are viewed as inexperienced. I wanted to make my mentor realise that the patient could be suffering (from diarrhoea and regurgitation) because of our negligence and not from inevitable causes. Why was Cognitive Learning Being Achieved? In this situation I was learning a number of things, mainly relating to communication, team work, assertiveness, accountability and responsibility. I learned that my priority is with the care of my patient and not with my popularity among colleagues, just as the NMC (2008) signifies when it states when facing professional dilemmas, your first consideration in all activities must be in the interests and safety of patients. When I met with my original mentor on her return back to work we discussed this incident of practice and she praised my efforts in extending my knowledge to improve patients care. I therefore achieved the competency, actively seeks to extend own knowledge. Do Any Barriers to Learning Exist? The barriers that existed to my learning were the apathy of the nurses and the limits of my own assertiveness. It was very hard on this ward to feel proud of the care that was being given. The ward was poorly staffed, the ward manager was unanimously unpopular, the ward relied heavily on agency staff that was not familiar with the ward and my temporary mentor wanted to leave nursing because of all of the above (and more). As a new and enthusiastic team member I found my self fighting against the low morale and low motivation of the current staff. Job satisfaction can impact on the care that nurses provide. Brown (1995) believes that when nurses enjoy good job satisfaction they provide a higher standard of care to their patients. Rohrlach (1998) and Govier (1999) cited by Kitson (2003) discovered that nurses who were happy with the care they were giving were more likely to stay within the clinical area which would in turn provide some stability and security within the workplace. Accor ding to this research, the inability to give quality care (due to the problems mentioned) was resulting in low morale. The dilemma I faced was as follows. I had already approached my mentor once regarding Johns problems and detected that there was little interest in what I had to offer and in the nurses willingness to correct any problems. If I addressed the issue again, I risked worsening the relationship between my mentor and myself. Morris (2004) identifies that student nurses often feel nervous about speaking out because they feel the need to conform or do not wish to be viewed in a negative way. Student nurses risk upsetting the status quo by speaking out. If I left the issue my patient may be suffering discomfort unnecessarily, but as a student I will never be held accountable in a way that registered nurses midwives or health visitors are (NMC 2008). Would this justify me leaving the issues and conforming to the apathy and bad practice of my mentor? Morris (2004) disagrees. She says that although students are not legally accountable for their actions and omissions, they are morally responsible for ensuring that patients are receiving good standards of care. The student nurse must be responsible. Semple and Cable (2003) affirm that responsibility is concerned with answering for what you do. Registered nurses, midwifes and health visitors are accountable which, Semple and Cable (2003) defines as being answerable for the consequences of what you do. 3.) Re-evaluating the Experience Drawing Conclusions Drawing conclusions is the most vital part of the process of reflection. It will shape future practice and quality of care. Conclusions that are drawn from reflection must agree with the Nursing and Midwifery Council code of professional conduct. It is with the NMC that all matters of conduct, practice and attitude are dictated to nurses. The NMC (2008) motto, protecting the public through professional standards can only be achieved if all those on the NMC register are willing to submit to the conditions and regulations that it upholds. Indeed Somerville and Keeling (2004) affirm that in order for nurses to meet the demands of the NMC, they must focus on their knowledge skills and behaviour which can be achieved through reflection. On reflection of the described incident, it was difficult to know what to do. My mentor was not up to date with the knowledge of this area of practice. I cannot, and do not expect her to know everything, however Glover (1999) points out the nurses should be reliant on others for information. The NMC (2008) states that nurses should work cooperatively within teams and respect the skills, expertise and contributions of colleagues, treating them fairly and without discrimination. Therefore I expected my temporary mentor to take more interest in what I had to offer. Indeed Morris (2004) argues that qualified nurses are obliged to listen to other staff regardless of their qualification status. Announcing that practice should be in accordance with the NMC is too simplistic an answer to such a diverse problem. It is correct to say this but how will this be achieved? The ward is in need of good clinical leadership, first of all from the sister in charge. Nadeem (2002) states that the call for good leadership in the NHS has reintroduced the matron figure and also the new role of nurse consultants. Specialist nurses do have a role in ensuring safe practice and quality care but this should be in addition to effective local leadership i.e. leadership from the ward sister. Leadership is perceived as being good if there is good team working and if managers have good relationships with staff (Lipley 2003) which is one area that needs consideration in this scenario. Meeting the staffs needs improves satisfaction, productivity and efficiency (Nadeem 2002) which in this instance principally means the provision of resources, i.e. human resources. Nurses who are happy with the care they give are more likely to stay within their clinical area (Rohrlach 1998 and Govier 1999 cited by Kitson 2003). This would provide some stability and security in the workplace. Clinical governance has also come to play a prominent role in ensuring quality care. The government has defined clinical governance as a framework through which NHS organisations are accountable for continuously improving the quality of their services and safeguarding standards of care, by creating an environment in which excellence in clinical care will flourish (Department of Health 1998). It had been noted that unacceptable variations in clinical practice where becoming common in the NHS (Department of Health 2010). While some patients were receiving excellent health care, e.g. in stroke care, other patients in the country were receiving sub-optimal stroke care due to differences in facilities, funding, education and staff. Each clinical area can improve the quality of care by (1) using modern matrons and nu rse consultants as clinical leaders, (2) by having adequate staff to care effectively and to lift morale among existing staff and (3) by implementing clinical governance which will result in the flourishing of good practices across wards, departments and NHS trusts through the sharing of expertise, research and ideas. The wards problems could also be addressed through annual reviews or by encouraging staff to keep an up-to-date portfolio (Somerville and Keeling 2004). This will allow nurses to identify strengths and opportunities for development. Critically analysing using reflection on this incident has been valuable in maintaining the quality of care as set out in the NMC code of professional conduct. Gallacher (2004) says that she questions different peoples practices in order to provide her patients with first class quality care. Clinical practice will not improve if it remains unquestioned. Hindsight gives the practitioner the opportunity to discriminate between good and bad practices. Safe, legal and quality care can only be given if it is in keeping with the NMC code of professional conduct. Reference list Arrowsmith, H. (1993) Nursing Management of Patients Receiving a Nasogastric Feed. In: British Journal of Nursing. 2 (21) 1053-1058 Barer, D. (1989) The Natural History and Functional Consequences of Dysphagia after Hemispheric Stroke. In: Neurol Neurosurg Psychiatry. 52, 236-241 BMA (2008) New Guide to Medicines and Drugs. London: British Medical Association. Brown, R. (1995) Education for Specialist and Advanced Practice. In: British Journal of Nursing. 4 (5) 266-268 Department of Health (1998) First Class Service: Quality in the New NHS. London: The Stationery Office. Davies, S. (1999) Dysphagia in Acute Strokes. In: Nursing Standard. 13 (30) 49-55 Davis, J. Shere, K. (1994) Applied Nutrition and Diet Therapy for Nurses. 2nd Ed. Philadelphia: PA,WB Saunders. DeLegge, M. (1995) Percutaneous Endoscopic Gastrojejunostomy: A Dual Centre Safety and Efficacy Trial. In: Journal of Parenteral and Enteral Nutrition. 19 (3) 239-243 Gallacher, G. (2004) Gaining a Better Understanding of Reflection to Improve Practice. In: Nursing Times. 100 (23) 39 Gibbon, B. (2002) Rehabilitation Following Stroke. In: Nursing Standard. 16 (29) 47-52 Glover, D. (1999) Accountability. In: Nursing Times Clinical Monograph. 27, 1-11 Elia, M. (2001) Trends in Artificial Nutrition Support in the UK during 1996-2000. Maidenhead: BAPEN. Hancock, P. (1998) Reflective Practice using a Learning Journal. In: Nursing Standard. 13 (17) 36-39 Holmes, S. (2004) Enteral Feeding and Percutaneous Endoscopic Gastrostomy. In: Nursing Standard. 18 (20) 41-43 Howell, M. (2002) Do Nurses know enough about Percutaneous Endoscopic Gastrostomy? In: Nursing times. 98 (17) 40-42 Hutton C (2005) After a stroke: 300 tips for making life easier, London.UK Kitson, J. (2003) Education for High Dependency Nursing. In: Paediatric Nursing. 15 (1) 7-10 Lipley, N. (2003) Research Shows Benefits of Nurse Leadership Training. In: Nursing Management. 10 (2) 4-5 Marieb, E.N. (2001) Human Anatomy and Physiology. 5th Ed. United States of America: Benjamin Cummings. Morris, R. (2004) Speak out or Shut up? Accountability and the Student Nurse. In: Paediatric Nursing. 16 (6) 20-22 Nadeem, M. (2002) Evolution of Leadership in Nursing. In: Nursing Management. 9 (7) 20-5 Nursing and Midwifery Code of Professional Conduct. London: Nursing Council (2008) and Midwifery Council. Nursing and Midwifery An NMC Guide for Student of Nursing and Council (2008) Midwifery. London: Nursing and Midwifery Council. Semple, M. Cable, S. (2008) The new Code of Professional Conduct. In: Nursing Standard. 17 (23) 40-48 Somerville, D. Keeling, J. (2004) A Practical Approach to Promote Reflective Practice within Nursing. In: Nursing Times. 100 (12) 42-45 Stephanie K, Daniels, Maggie Lee Huckabee (2008) Dysphagia following stroke (clinical dysphagia) London. Stringer, S. (1999) Managing Dysphagia in Palliative Care. In: Professional Nurse. 14 (7) 489-492 Appendix 1 Three stages to the process of reflection. Boud, Keough and Walker (1985). a) Returning to experience Observations what happened? What was my reaction? Clarify personal perceptions b) Attending to feelings What did I feel at the time? What did I feel was positive? Why is cognitive learning being achieved? What did I feel was negative? Do any barriers to learning exist? Raise awareness and clarify feelings c) Re-evaluating the experience Draw conclusions and insights together with existing knowledge Identify gaps in knowledge Integrate existing and new knowledge

Media and the Writing Process :: Television Media TV

Media and the Writing Process When looking at a work of media, ones tries to find something that would enhance the writing process. Television, as well as cinema often lends to this process. One example of this is with the John Carpenters’ Vampires, which incorporates the use of suspense and anticipation to lure the viewer into concerning themselves more in to the story. Another example, is the television documentary Hitler’s Henchmen which uses a systematic, chronological method to tell the story of Adolf Hitler’s main Architect, Albert Speer. Of course literary works also can help in enhancing the quality of one’s work. A River Runs through it, Norman Macleans’ personal memoirs, lends to the reader the idea of the metaphor to pursue plot. Another literary work The Perfect Storm, by Sebastian Junger tells the story of a doomed vessel lost at sea and does so through the use of creative language. Cinema is often overlooked as an outlet for literary enhancement. On the contrary, however, many films often tend to use or incorporate ideas which can be transferred with success to a literary piece. The film, Vampires uses many literary devices to progress its story and plot. The devices which were used most extensively, those of suspense and anticipation, can easily be incorporated to enhance a literary piece aesthetically. Television, again, like Cinema is a media which is overlooked when searching for methods to enhance ones work. A television documentary, recently aired, Hitlers Henchmen used a technique which is perhaps vital to a successful literary work. Displaying a information in a systematic, or chronological fashion, as done in the documentary, often clears the path for the reader, or the viewer in this case to make their own assumptions, or judgement of what they have seen. The most important of all media to be used to enhance ones’ own work of course is another piece of literature. The metaphor, as in Norman MacLeans’ work, A River Runs Through It is an excellent device used to give more meaning to single ideas, and can easily enhance a work.

Human genome online assignment Essay

1) If genetic manipulation does become a reality, I think allowing non-disease characteristics to be altered would have serious ethical and social implications. Screening for diseases and treating or eradicating them totally would be a huge benefit to mankind, but to use genetic technology to produce â€Å"designer babies† will most likely lead to a social divide similar to that portrayed in the movie â€Å"Gattaca† (De Vito and Niccol, 1997). Such technology would most likely be expensive and only those who can afford it will benefit and gain undue advantage over those not fortunate enough to have the financial means to avail of the technology, leading to a social system where you have the genetically-enhanced superior class and the â€Å"inferior† citizens conceived the natural way. 2) I don’t think life insurance companies should have access to a person’s genetic information. As it is, I believe insurance policies already hold a lot of stipulations that policy holders more often than not, end up receiving the short end of the bargain. If insurance companies find out that a person has a predisposition to a disease, they could easily refuse to provide that person with insurance and that I think, would be unfair since they would be depriving that person of his need to secure financial aid in case he does get sick. In the interest of fairly sharing risks though, insurance companies may be allowed limited access to genetic information. Limited, because I believe the welfare of policy holders should still be of topmost priority and any form of discrimination against individuals should not be allowed. 3) Yes, I believe that the information from the Human Genome Project (HGP) will bring tremendous benefits to a lot of people in the next 20 years. Technology develops at a very fast pace and it is not impossible that Collins’ predictions may very well come true. Already, the underlying genetic problems responsible for certain diseases have already been identified and with the genetic map from the HGP, the causes of a lot of other afflictions will be identified and from there, therapies can and will be developed. Even though custom-made therapies will most likely be more difficult to develop and perfect, the identification of disease genes will still greatly benefit the general population (Nova Online, 2001). 4) I think we are not that prepared for the implications that will result from the applications of these information. Right now, our society is already struggling with various other ethical issues in other biotechnological fields like stem cell research and it would be too naive to ignore the present and potential issues that may arise due to the far-reaching consequences of the HGP. 5) I don’t think employers should have access to an individual’s genetic information since there is the danger that a person may be discriminated on the basis of his genetic profile. As of present, I think discrimination may be viewed as singling out an individual for what he is (e. g. his race, gender, etc. ), but to discriminate someone based on his genetic profile would also mean discriminating him for what he could be. A person can be at risk for a certain disease but that’s just it – it’s a probability, not a guarantee. Besides, it would also mean discounting a person’s capabilities in spite of whatever genetic condition he may have. There have been countless stories of people overcoming their disabilities so there is no reason that one should be discriminated or favored based on his genetic makeup. 6) I don’t think it is that surprising, especially if I consider that like me, these lower organisms are alive, so it’s really just logical that we do share something in common. Considering though how much more complex we seem to be compared to these organisms, then yes, it is surprising that we don’t seem to be that genetically different from them. 7) I believe that testing of unborn children should be confined to deleterious genes, i. e. those that have serious and possibly life-threatening consequences such as that with diseases. I believe it’s a matter of putting things in perspective. Traits and disabilities like homosexuality or color blindness may be undesirable but they really seem trivial compared to serious afflictions that may mean life or death for the child. 8) If it’s a curable or preventable disease, then I would probably be in favor of being tested so that I can take the necessary steps to prevent or prepare myself in case I do get sick. However, I can’t say that decision would be as simple in the case of non-treatable diseases, because as with the woman who tested positive for a BRCA mutation (Nova Online, 2001), knowing that I am at risk for a disease that has no cure will probably mean that I will be living my life everyday with a sword hanging over my head and it would be very hard to live life that way. 9) Yes, I would want my mate and I to be tested if we were carriers for a disease prior to having children. I wouldn’t want to take the risk of bearing a child only to have him/her suffer from the disease that we carry when we could’ve spared him/her from that difficult life. I believe that I owe it to my future child to have myself and my partner tested. 10) I don’t think genes or genomic material should be patented because as Lander has observed, apprehensions over whether a particular gene or part of the genome has already been patented has become a limiting factor in that drug companies usually wouldn’t want to take the risk of working on treatments that might already be protected by a patent (Nova Online, 2001). I believe that there are several ways that scientists can approach a disease and develop a treatment for it, so why patent genes or genomic material? Why not just let everybody have access to such information so that not only one drug company can work at a specific disease but rather several, so that there’s a better chance that one of them will be able to develop a treatment which they would then have all the right to patent? Let’s take for example the case of cystic fibrosis. The gene responsible for this disease was discovered way back in 1989 and yet no cure has been discovered up to now (Nova Online, 2001). It only goes to show that identifying the gene responsible for the disease does not automatically mean that the cure would also be discovered consequently, so why allow the burden of further limitations brought on by patents? References: De Vito, D. (Producer), & Niccol, A. (Director). (1997). Gattaca [Motion Picture]. USA: Sony Pictures. NOVA Online. (2001). Cracking the code of life. Retrieved May 30, 2007, from http://www. pbs. org/wgbh/nova/genome/program. html.

Crucibal GUIDE~~~~ Essays - Salem Witch Trials, The Crucible

Crucibal GUIDE~~~~ Essays - Salem Witch Trials, The Crucible Crucibal GUIDE~~~~ Cast of Characters: For each of the following characters, write a brief description of them including personality traits, what their relationship is to other characters, important events they are involved in and anything else you feel is significant about them. Reverend Parris ? He is the reverend and minister of Salem. He has many enemies in the neighborhood. He knows witchcraft well. As far as personality goes, he is self-conscious of his reputation in the community. He can act distrustful towards situations or events. Betty Parris ? She is the daughter of Reverend Samuel Parris. Betty is a 10 year old little girl who dances in the woods with Tituba. Tituba- She is a slave from Barbados. She is very eccentric (her personality). She is caught dancing in the woods and accused of being a witch. Abigail Williams- Abigail is the niece of Reverend John. She used to be an employer for Mr. Proctor but Elizabeth, his wife fired her. Elizabeth found out Abigail was having an affair with John. Her personality is very intriguing because not only is she manipulative and smart, but she is a really good liar! Susanna Walcott Susanna is one of the girls under Abigail uses. She basically puts her under her spell. Susanna joins in with Abigail to accuse different villagers as witches. Mrs. Ann Putnam-She is married to Thomas Putnam, a wealthy man. Putnam gave birth to 8 kids but only one survived. The other children are speculated by Ann to have been killed supernaturally. Thomas Putnam- Thomas is very wealthy. As we know, he desires more. He uses the witch trials to get more money when he accuses people of witchcraft just to buy their land. Mary Warren- She is a servant for the Proctor?s. Mary is part of Abigail?s enchantment group. She is a shy and will go with the crowd very readily. John Proctor ? John had an affair with Abigail. His wife, Elizabeth was furious when she found out. Thou Shalt not commit adultery is the only commandment he forgets which is ironic. Rebecca Nurse- She was very godly. Her husband was Francis. Reverend Hale has doubt of the witch trials when Rebecca is accused . This is unexpected for most. Giles Corey- he is a big supporter of his wife. He tries to prove her innocent. Later he is put into jail with John Proctor. Soon, he is stoned to death. Reverend John Hale- he was a witch hunter. He was very judgmental and insistent. John was in the mid 40?s. He spends a lot of time in court. Elizabeth Proctor- She is the wife of John Proctor. She caught him cheating on her with Abigail. She keeps this affair hush-hush because she certainly does not want it getting around town. Francis Nurse- he is married to Rebecca Nurse. He fights for her innocence in court because he needs her. They own 300 acres of land together. Ezekiel Cheever- he is an official in the court who has to arrest anyone accused; This is his primary job. Marshal Herrick- he is the marshal in Massachusetts. Judge Hathorne- Hathorne is the judge during the Salem Witch Trials. Hathorne makes heavy decisions in court. Deputy Governor Danforth- he believes that he is led by God. His personality comes across as a little prideful. If one is innocent they have no worries; but if one is guiltybe afraid. He was the persecutor in the cases. Hopkins- he is the jailor Literary Examples: Describe an example in the text in which the following literary terms are demonstrated. Allegory I would say that the Crucible in itself is an allegory since it revolves around the idea of the communist witch hunt and it actually tells us the story of an actual witch hunt. Tone The tone is cynical, serious, and formal. Arthur Miller achieves this tone when he uses the mental struggles in the book. Irony John had an affair with Abigail. His wife, Elizabeth was furious when she found out. Thou Shalt not commit adultery is the only commandment he forgets which is ironic. Another thing ironic is that the girls who are actually guilty of witchcraft are accusing everyone else.. Conflict Betty, Ruth, Abigail, and other girls dance with Tituba, the Barbados servant. They go into the