Thursday, May 21, 2020
To achieve the research aim both methods of interviewing and surveying will be employed. To complete the first objective doctors will be interviewed in order to assess how they justify using therapeutic privilege and what influence their medical experience has. In terms of the second objective previous patients will be surveyed on their opinions of not giving fully informed consent and what effect they would expect to experience if the therapeutic privilege was used. Investigative interviews I propose to interview eight doctors to obtain their personal opinions on therapeutic privilege. In addition to what arguments they feel they would employ to justify the use of such. This will be dependant on doctorsÃ¢â¬â¢ willingness to participate. Encouraging doctors to get involved will be difficult. There may be a need for a gatekeeper. Before getting doctors involved, specific permission will be required. In Scotland, any NHS research must be approved by the Research Scotland Permissions Coordinating Centre. This body will also hopefully aid me in getting in contact with doctors. Before conducting such interviews ethical clearance will be sought. In these interviews, I aim to include doctors from both genders, with a range of ages and ranges of professional experience. This will maintain fairness and show if there are any differences between justifications depending on their previous medical experience. In the interests of time and cost saving these interviews will be conductedShow MoreRelatedPrimary Research Comes Directly from the Customers682 Words Ã |Ã 3 Pagesare several ways we can get information directly from customers. We can interview customers. We can survey customers. We can observe customers actions and behaviors. All of these methods have their pros and cons. Interviewing Customers We need to identify target customers. Then we need to focus on purpose of interviewing customers. We may want to extend relationship with customers. We may want to increase business with customers. Or we may be trying to address customer grievance. Whatever may beRead MoreThe Importance Of Unstructured Interview1085 Words Ã |Ã 5 Pagesupmost importance is that of interviewing. With greater attention to interpersonal relationships and communication, anthropologists are in an excellent position to engage in a multitude of interview styles, such as unstructured and semi-structured interviews (Schensul and LeCompte 2013). Unstructured interviewing allows for more flexibility in the number and sequence of questions, as well as for greater freedom in the respondentÃ¢â¬â¢s answers. The goal of such interviewing is to elicit open-ended responsesRead MoreEssay on WRITTEN REPORT GARDEN SUPPLIES PART 21412 Words Ã |Ã 6 PagesAssessment 2 Introduction This Project scope Ã¢â¬Å"RegainÃ¢â¬ has been designed to involve all stakeholders of D.A. Garden Supplies so that all aspects of the business can be be analysed through collecting invaluable information and data by the research methods below. Our aim is to identify the cause of the problem that the business is going through right now so that future marketing can be targeted accordingly for positive results. With proper research and strategic planning, D.A. Garden Supplies shouldRead MoreThe Canadian Community Health Survey1152 Words Ã |Ã 5 Pagesinitiative began surveying in 2001, and, in 2015, the CCHS implemented a new collection mandate resulting from a redesign project that included significant content modifications. Cross-sectional Survey v. Longitudinal A cross-sectional survey is conducted at a single point in time and analyzes the prevalence of selected topics. However, a longitudinal survey records observations over a period of time to estimate the incidence of an event. Specifically, the CCHS utilizes the cross-sectional method to interpretRead MoreSources Of Marketing Research Data1191 Words Ã |Ã 5 Pagesinterviewer-bias and avoids the difficulty that people do not always remember their actions - especially trivial ones - very clearly. For example, a hidden camera may be the best way of establishing how customers move through a shop, and a tape recorder the best method of establishing the sales approach used by salesmen. Similarly a physical count is normally used to establish the volume of traffic on key roads and the volume of different brands sold by important retail outlets (increasingly via electronic pointRead MoreBenefits Of A Salon Within Target Stores Essay1542 Words Ã |Ã 7 Pagesto prevent a decrease in sales in their beauty department. Target wants to provide their guests with salon care services to increase sales. Target plans to reach out to their employees and guests to see if they would use the Target salon. Survey Methods Ddescriptive Data Collected A survey is a measurement process used to collect information during a highly structured interview Ã¢â¬â sometimes with a human interviewer and other times without. Questions are carefully chosen or crafted, sequencedRead MoreThe Basic Components Of Launching Learning Organization844 Words Ã |Ã 4 Pagesbuild it? A key prerequisite towards learning demands a strong commitment. However, an absenteeism of inclination to acquire fresh techniques, the organization is certain of reiterating the unchanged traditional methods. These act as a pull-down force against improvement. Three MÃ¢â¬â¢s: Method, management and measurement are the basic components of launching learning organization. Moreover, a proper understanding of the basic components is necessary for moving forward. A fresh perception for problem-solvingRead MoreA Research Process Is Not A Trial And Error One, Rather,967 Words Ã |Ã 4 Pagesaddress my research question. Reflection on how different teacher strategies and a ctivities through interviewing them will give out a clue to what extent are children engaged in situations that facilitate problem solving skills. The use of survey is another strategy that will enable a good reflection of how respondents under my research questions behave in their different fields. Observation is also a method that will greatly facilitate my research work as it will cover all the behavioral activities myRead MoreBuilding Blocks Learning Organizations Should Be Skilled Essay940 Words Ã |Ã 4 Pagesorganizations used this method worldwide since it depends on the scientific method. It starts with making an observation, gathering data/information regarding that observation to form a hypothesis. A hypothesis is a proposed description of the observation made on the available evidence (in the form of data). One of the pioneers of the quality control, W Edward Deming calls it Ã¢â¬Å"Plan, Do, Check, ActÃ¢â¬ cycle while others refer as Ã¢â¬Å"hypothesis-generating, hyp othesis testingÃ¢â¬ techniques. This method outlawÃ¢â¬â¢s focusRead MoreTeaching Science Is Very Important For Our Everyday Lives.798 Words Ã |Ã 4 Pagescurriculum in secondary school: this curriculum is very dry, heavy and we are obliged to explain it all and it takes a very long time to finish it and prevents us to realize different methods of learning to explain the content in a clear and thorough manner. In addition, prevents us from using the different teaching methods and to realize all the experiments necessary for each chapter which is very important in relation to the students to bring them closer to the sciences. Experiments also allow students
Wednesday, May 6, 2020
Kate Grenville is one of AustraliaÃ¢â¬â¢s best known authors, she was born in 1950 in Sidney, Australia. She has won many national and international awards for her writing about AustraliaÃ¢â¬â¢s past and the interactions that may have been taking place between the first settlers and the aborigines. The Secret River was one of these popular novels, which is exploring the past, although it is only historical fiction. The inspiration for writing these historical fictions, came from the fact that she did not knew much about her ancestors which settled on a river named Hawkesbury River in New South Wales. William Thornhill is a convict, who has been transported by the ship Alexander to his new home in His MajestyÃ¢â¬â¢s penal colony with his family in 1806,Ã¢â¬ ¦show more contentÃ¢â¬ ¦His skin swallowed the light and made him not quite real, something only imaginedÃ¢â¬ Ã¢â¬â page 2, section 5. The description of this native man is highly connected and dependent on the narrators experience and thoughts in the situation. The narrator significantly controls the reader; we get a sense of understanding for his situation, we share his concerns and fear because we are able to read his thoughts, and that may be the main reason for why Kate Grenville uses this narration type. William Thornhill is a convict likely from England, who has been sent to His MajestyÃ¢â¬â¢s penal colony, he is married and a father to two children as well. There is not much information regarding his physical appearance in the novel, although there are many psychological indicators. William is suffering mentally because he knows that he will never return home. Ã¢â¬Å"This was a place, like death, from which men did not return homeÃ¢â¬ and Ã¢â¬Å"He would die here under these alien stars, his bones rot in this cold earthÃ¢â¬ These statements or thoughts indicates clearly what he fears, but before the night is through he gets other concerns, such as his and the familyÃ¢â¬â¢s security. The situation with the aborigine shows the kind of person he is, he is not afraid to protect his family even though he is unarmed. The novel is taking place in New South Wales in 1806 at a little penal colony, which is located next to a hill and a bay where the ship Alexander
Yizza Burgueno First Draft Instructor Michael Heumann English 101 March 26, 2013 Bottled Water Most American see bottled water as a necessity, even though bottled water did not exist many years ago. Drinking out of a water bottle has become the standard drinking source for most Americans. We have become dependent on plastic waste. We will write a custom essay sample on Bottled Water or any similar topic only for you Order Now Water is life sustaining, so many of us would think that drinking water out of a bottle is harmless. Regrettably it is not, there have been traces of PET and BPA in the plastic containers we are drinking out of. Both PET and BPA can stimulate sever health consequences. Not only are we putting our life in danger by drinking out of bottled water but our planet as well. Plastic bottles donÃ¢â¬â¢t just vanish into thin air. Most Americans donÃ¢â¬â¢t recycle, so most plastic bottles end up on streets, rivers, lakes, canals, streams, or oceans polluting our planet. Not only is bottled water way more expensive than tap, it also contains the same water quality as tap water. In other words weÃ¢â¬â¢re just paying for the names on the plastic bottles. Rather than paying for quality, our tap water can produce just about the same quality as bottled water. Bottled water is not all it is made out to be. We all need water to survive, especially when up to 60% of the human body is composed of it (USGS, 2009). Water is absolutely necessary to our planet. Approximately 75% of the earthÃ¢â¬â¢s surface is covered by water, but only 1% of that is drinkable (Soechtig, 2009). Hence, clean drinkable water is not as easy to get as it may seem. Representative Dennis Kuchinich from Ohio states that, Ã¢â¬Å"Water is a basic human right, itÃ¢â¬â¢s a necessary for survival of life. When you start commodifying the necessities of life in such a way as to make it more difficult for people to gain access, you have the basis for serious political instability,Ã¢â¬ (Soechtig, 2009). Water is no longer a fundamental right, it has become bankable and sold to people who already have perfectly drinkable water coming out of their tap. People are looking at water as if it were gold and are only looking for a way to profit off of it. Instead of waiting in line to drink from the water fountains, people are waiting in line at the stores to pay for overly priced bottled water. People are no longer drink out of water fountains or out their kitchen sinks because they have the luxury of buying bottled water. Therefore, the demand for water fountains has decreased because of how easily it is to obtain bottled water. The more we buy bottled water, the more we are convinced that bottled water is not a luxury, but rather a necessity (Gleick, 2010, p. 107). Although, drinking out of a plastic bottle can cost twice as much, if not more than the water that comes out of our kitchen sinks and public drinking fountains and may also harm not only our health but our planet as well, millions of people still keep buying and drinking out of bottled water. Peter Gleick author of Bottled and Sold: the Story Behind our Obsession with Bottled Water, wrote, Ã¢â¬Å"certainly, the environmental problems with bottled water, the economic costs to pocketbooks, and the growing support for improving tap water quality and reliability are all contributing to new thinking about the simple act of buying a plastic bottled water,Ã¢â¬ (Gleick, 2010, p. 161). Bottled water was nonexistent many years ago. Elizabeth Royote mentions in her book, that people did not start walking down the streets with their water bottles until 1989 when water could be put in clear, lightweight bottles made of polyethylene terephthalate (PET). Once that was created, bottled water skyrocketed in the 90Ã¢â¬â¢s. Water sales tripled in size, from 4. 5 gallons per year for the average American in 1986, to 12. 7 gallons per person in 1997 (NRDC, 1999). In 2007, Americans bout more than 29 billion bottles of water (Soechtig, 2009). America has engraved into people heads that drinking tap water is not healthy and in fear of the people have turned to bottled water thinking itÃ¢â¬â¢s the healthier option for them. Some people have gone to drinking bottled water literally because they are concerned about their water, and the problem is they are unaware of the fact that buying bottled water is not necessarily safe, that they end up being exposed to other chemical compounds,Ã¢â¬ says Stephanie King (PH. D. , M. P. H. ) a toxicologists and epidemiologist with Toxicology Inc. (Soechtig, 2009). Bottled water can actually lead to health concerns for those with weak immune systems, (NRDC, 1999). Most water bottles are made from polye thylene terephthalate (PET), a polymer derived from oil that adds flexibility, color, and strength to plastic (Royote, 2008, p. 48). Another health risky ingredient in the manufacture of polycarbonate plastic is Bisphenol A (BPA), a non steroidal estrogenic compound (Rubin, Murray, Damassa, King, and Soto, 2001). BPA can be found in many products such as sports bottles, baby bottles, and water coolers (Soechtig, 2009). Every American owns or has own a bottled that contained BPA, and because BPA mimics estrogen most bottles say they are Ã¢â¬Å"BPA freeÃ¢â¬ . Ã¢â¬Å"Bisphoenol A may be one of the most potent, toxic chemicals known to man. The problem is Bisphenol A acts at very low doses as an estrogen,Ã¢â¬ (Soechtig, 2009). Both PET and BPA can be harming to Americans health, one leading to cancer and the other leading to the reproductive system. OneÃ¢â¬â¢s life is not only in danger from drinking out of bottled water but the earthÃ¢â¬â¢s life as well. A large amount of water is wasted to create plastic bottles plus the water used to fill it. The amounts of bottles produce are not nearly close to the amounts recycled. Of the 80 million single served bottles of water consumed daily, 30 million ends up in landfills (Soechtig, 2009). The other ends up all over the streets making their way to the ocean, lakes, rivers, canals. Etc. The average international recycling rate for beverages containers for the word is 50%, but the United States is 20% and this number has been declining (Soechtig, 2009). The cost to produce bottled water is twice as expensive as, if not more, than tap water. Why waste more money on bottled water when people are already paying for it in the comfort of their own home. There is the cost of materials, production, and transportation. Ã¢â¬Å"This energy cost is a thousand times larger than the energy required to produce, process, treat, and deliver tap water,Ã¢â¬ (Gleick, 2010, p. 5). Are we just paying for the brand of the bottle rather than the quality of the water? 40% of bottled water is really just filtered tap water (Soechtig, 2009). Meaning that if people added a filter to their tap they can have bottled water quality coming out of their own kitchen faucet for a lower price. Most bottled water labels show a beautiful picture of waterfalls or mountains with streams running thr ough, portraying that thatÃ¢â¬â¢s where the water comes from but in all reality the bottled water People are drinking from doesnÃ¢â¬â¢t come from afar. Yosemite water one the most popular bottled water in the Imperial Valley comes from Los Angeles California (Gleick, 2010, p. 110). Bottled water can cause illnesses, pollution, and costs lots of money. It may have the advantage of being convenient, but convenient is not worth harming your health, making the earth less livable, or spending more money on something that can comes out of your kitchen faucet, which in most cases youÃ¢â¬â¢re already paying for. Bottled water may look fancy or have a different taste to it but itÃ¢â¬â¢s not worth all the consequences. ThatÃ¢â¬â¢s why bottled water is not all it is made out to be. Works Cited Gleick, Peter H. Bottled and Sold: The Story behind Our Obsession with Bottled Water. Washington, Dc: Island, 2010. Print. Olson, Erik D. Ã¢â¬Å"Bottled Water. Ã¢â¬ NRDC:. NRDC, 1999. Web. 5 Mar. 2013. http://www. nrdc. org/water/drinking/bw/bwinx. asp. Royte, Elizabeth. Bottlemania: Big Business, Local Springs, and the Battle over AmericaÃ¢â¬â¢s Drinking Water. New York: Bloomsbury, 2009. Print. Rubin, B. S. , M. K. Murray, D. A. Damassa, J. C. King, and A. M. Soto. Abstract. Ã¢â¬ National Center for Biotechnology Information. U. S. National Library of Medicine, 20 Dec. 2005. Web. 5 Mar. 2013. http://www. ncbi. nlm. nih. gov/pmc/articles/PMC1240370/. Soechtig, Stephanie. Ã¢â¬Å"Tapped. Ã¢â¬ | Tapped the Movie Ã¢â¬â Official Site |. N. p. , 2009. Web. 19 Mar. 2013. http://www. tappedthemovie. com/. Us Geological Survey. Ã¢â¬Å"The Water in You. Ã¢â¬ Water Properties: (Water Science for Schoo ls). Us Geological Survey, Oct. 2009. Web. 5 Mar. 2013. http://ga. water. usgs. gov/edu/propertyyou. html. How to cite Bottled Water, Papers
Saturday, April 25, 2020
The 60s and Freedom Most of the time, when thinking back to the sixties, people remember hearing about things such as sex, drugs, and racism. However, what they often tend to overlook is the large emphasis "freedoms" had on the era. This does not just refer to the freedoms already possessed by every American of the time. This focuses on the youth's fight to gain freedom or break away from the values and ideas left behind by the older generation. While some authors when writing about the sixties give serious accounts of the youths' fights to obtain these freedoms, others tend to take a different and more dramatic approach to showing the struggles involved in these fights. Yet, all of the authors have the same basic values and messages in mind. They all, more or less, aim to show the many freedoms which their generation was fighting for. These fights were used to help push for freedoms from areas such as society's rules and values, competition, living for others first, and the older generation's beliefs as a whole including the freedom to use drugs. The younger generation just wanted a chance to express their own views rather than having to constantly succumb to the values and rules left behind by the older generation. The two different approaches used by authors to express these views are often representative of the two main systems used by youths to help gain their freedoms. The first approach, taken by the Port Huron Statement and authors such as Gerzon, Reich, Revel and Gitlin, follows the ideals of the New Left. The New Left represents youths striving for political change through cultural means. People are encouraged to work for their ideals. In contrast, the second approach, taken by Rubin and Didion, reflect the ideals and mannerisms of the "Be-in" society. The "Be-ins" represent another group of youths who attempt to gain freedoms through more radical means. This group focuses on more idealistic goals. The members yearn for a utopian society. However, both groups feel that the youth in society should be able to express themselves and live their lives in their own way, not some way left behind by the previous generation. The way left behind by the older generations is greatly influenced by events which occurred during that time. Unfortunately, because of many of these events, Americans lost their sense of hopefulness in the American society. The reasons are various: the dreams of the older left were perverted by stalinism and never recreated; the congressional stalemate makes men narrow their view of the possible, the specialization of human activity leaves little room for sweeping thought; the horrors of the twentieth century, symbolized in the gas-ovens and concentration camps and atom bombs, have blasted hopefulness (Port Huron Statement 166) Unfortunately, however, these feelings possessed by the previous generation seemed to contribute to their views of man as "a thing to be manipulated, and that he is inherently incapable of directing his own affairs" (Port Huron 166). Supporters of the New Left disagree strongly with these views. In fact, the Port Huron Statement makes a point of cutting down these beliefs, claiming that the New Left will not support the idea of human beings as things or objects. Then the document takes it one step further in saying that the incompetence attributed to humans is, in fact, caused by the society in which they live. They have been manipulated into thinking they were incompetent by their surroundings (166). Reich even goes as far as to say that "it is a crime to allow oneself to become an instrumental being" (Reich 56). The older society, by viewing man as incapable of controlling his own life, has also led their generation to concentrate primarily on institutions, public interest, and society as the basic reality. However, the younger generation deals more with the self. One should be able to create their own values, lifestyle, and culture (Reich 56). Rubin seems to claim, in a more vocal manner, that the older generation has not left a place in the world for the younger generation to live. The older society has already done everything which can be done. Instead of helping the youth in society to learn about being themselves, they seem insistent on controlling the youth. They place them in schools to keep them off the streets, they send them away to Vietnam. The older members of society are only trying to keep the youth from spoiling what already exists. They are intent on molding the
Wednesday, March 18, 2020
Nutritional assessment- a vital component Introduction Nutritional assessment- a vital component IntroductionCase scenarioNutritional assessmentMedical history collection approachesPhysical examinationBiochemical dataDiscussionConclusionReferenceRelated Introduction Malnutrition and undernourishment pose a major healthcare problem in the care of hospitalized patients in different care units in developed countries. There are numerous studies in health care literature reporting frequent malnutrition of patients in acute hospitals on admission and deterioration of nutritional status during hospitalization, particularly older people (Inge.K, 1999). Malnutrition can be defined in older people as faulty or inadequate nutritional status; undernourishment characterized by insufficient dietary intake, poor appetite, muscle wasting and weight loss (Carole S. Mackey, 2004). The cause of malnutrition is commonly contributed to medical, social and environmental as well as individual factors, such as poor appetite and disinterest in food, unpalatable or inadequate food, and lack of assistance with eating, poor skills in recognizing malnourished patients or those at risk of malnutrition and the low priority given to patientsÃ¢â¬â¢ nutrition by doctors and nurses. Undetected and untreated, malnutrition is found to be detrimental to the quality of life and can lead to severe consequences such as prolonged hospital stays, high risk of infection, pressure ulcers, reduced wound healing, increased morbidity and mortality as well as increased costs for care, therefore, it is vital that hospital wards for older people have a nutritional care policy to prevent and/or treat malnutrition (Carole S. Mackey, 2004). Case scenario In 2010 August, Mr. Wong complained dizzy and fell in the morning and initially presented to orthopedic ward for collapse of L1 after fall. On admission, Mr. WongÃ¢â¬â¢s ear temperature was 36.8, blood pressure was 100/ 50 mmHg, pulse was 75 /min, oxygen saturation was 93% on 2 L/min oxygen. During the acute state, he was developed hospital acquired pneumonia and put on Augmentin for one week course. In same year of November, Mr. Wong was transferred to rehabilitation ward for recovery and physiotherapy. Mr. Wong was retired. He has a 30-yr smoking history with one pack per day. He tries to quit smoking several times, but does not succeed. He lives in a 4-bedroom house with his wife and two sons and one daughter. He attended a Tai-Chi course with his wife in nearby park every day and had balanced diets prepared by Mrs. Wong. Mr. Wong had past history of ParkinsonÃ¢â¬â¢s disease, hyperlipidaemia and gout followed up by Princess Margaret Hospital medical. On 2008 he had old lacunar infarct on computer tomography scan. In the rehabilitation ward, Mr. Wong had some exercise or limbs training with physiotherapists on the bed, as he could not have enough energy to stand up or walk with or without any support. Therefore, Mr. Wong always lied on the bed and then subsequently suffered from bed sore at his sacral. Firstly, he just suffered from stage one pressure sore, which was redness at the site without any discharge, and protected from duoderm. The health care workers provided daily normal saline dressing, frequent turning and pillows to relieve the pressure at the sacral. However, the pressure sore still became worse. At first, when the health care workers assessed Mr. Wong had high risk of worsening pressure sore; there are six risk factors including mobility, continence, nutritional, skin integrity, physical condition and medication common leading to developing pressure ulcers (Sharp CA, 2006). All possible preventions such as maintenance of well personal hygiene, frequent turning, and use of ripple bed had been provided. Also, wound nurse had assessed Mr. WongÃ¢â¬â¢s situation and recommended the nurses for continuously providing dressing care and frequent skin observation. However, all recommendations and protections were given under strict supervision, but there is one criteria area missing in dealing pressure sore, this is nutrition. Poor nutritional status has been reported by several studies to be contributing factor to pressure ulcer development and malnutrition is positively correlated with pressure ulcer incidence and severity (Sharp. CA, 2006). Inadequate nutrition can increase the r isk of developing pressure ulcers and infection as well as impede the healing process of all wounds. Also, adequate dietary protein is absolutely essential for proper wound healing, and tissue levels of the amino acids may influence wound repair and immune function. As a result, a nutritional support should be given to patients with identified nutritional deficiency and any support be based on nutritional assessment using a recognized tool, general health status, patient preference or expert dietician (Ulrika Soderhamn, 2008). Moreover, nursing staff play an important role in the detection of the patient at risk and the implementation of sufficient preventive strategies. However, a comprehensive nutritional assessment is seldom performed on geriatric patients as routine and very few at-risk patients have a nutritional care plan. And some studies pointed that nurses in geriatric care feel they have a great responsibility for nutritional assessment and care but lack of sufficient knowledge for the tasks as well as of support from physicians (Ulrika Soderhamn, 2008). It is recommended that the health care workers should take the responsibility for informing, ordering, serving food and observing food intake and securing sufficient intake. These require the health care workers have sufficient knowledge and appropriate tools for screening and assessment of the older patients (Sharp. CA, 2006). Nutritional assessment A nutritional assessment is an in-depth evaluation of both objective and subjective data to define a personÃ¢â¬â¢s nutrition status. Specific data are obtained to create a metabolic and nutritional profile of the patient. The goals of the nutritional assessment are identification of patients who have, or at risk of developing malnutrition; to quantify a patientÃ¢â¬â¢s degree of malnutrition and to monitor the adequacy of nutrition therapy. It includes gathering information from the patientÃ¢â¬â¢s careful medical history, dietary history, a physical examination and laboratory tests (Weber, J, 2009). Medical history collection approaches Foremost in nutritional assessment is the patient interview for determining clinical history. Health care workers have recognized the way in which various diseases and conditions affect a personÃ¢â¬â¢s nutritional status. Attention should be focused on the disease state, duration of illness, intake of nutrients and presence of such gastrointestinal systems as nausea, vomiting and diarrhea. Also, the natural aging process can lead to increased nutritional problems among the elderly. Nearly 65% of elderly patients are calorie-protein undernourished or nutritional deficits developed while in the hospital (Vanderwee K, 2010). There some risks that are related with poor nutrition on the elderly such as normal aging changes in the senses of smell and taste, the effects of chronic diseases on food intake, psychological factors, social isolation, side effects from multiple medications or diminished function that subsequently limits their ability to shop or prepare meals. Choosing a dietary approach to nutritional status assessment The most valid or accurate dietary methods are prospective methods. These involve keeping records of foods consumed over the period of time of interest. This can be done by individuals themselves, or by health care workers observing them. Sometimes the foods are weighed before eating and then plate waste is weighed and subtracted. A similar method is to prepare two duplicate meals; one is consumed by the subject and the other is analyzed for nutrient content. Another method is the dietary record, in which the subject records estimated amounts of foods consumed. In any case, these methods are highly reactive because individuals may alter usual behavior to make their diet more socially desirable or to simplify the process of record keeping. Recall methods are the most widely used type of dietary data collection method. They are less reactive, but also less accurate than record methods. Twenty-four hour recalls, in which the previous days intake is queried in detail, for instance, foods , amounts, preparation techniques, condiments, are easiest for health care workers to complete (Sharp. CA, 2006). The data reported are converted from foods to nutrients with the use of food composition tables. Because a single day is not representative of usual intake, multiple twenty-four hour recalls are frequently used. Besides, the twenty-four hour recall of food intake record are used, the health care workers should observe the patientsÃ¢â¬â¢ food preference, history of eating pattern and eating ability such as mood changes or swallow problem that might affect their eating. Physical examination Evaluation of the patientÃ¢â¬â¢s overall appearance and thorough physical examination of the skin, eyes, mouth, hair, and nails provide a clue the presence of malnutrition. Weight is one of the most useful elements of the physical examination for the assessment of nutritional status (Inge.K, 1999). Body weight is expressed as a relative to established norms in the general population. For adults, body weight and height are used to evaluate overall nutritional status and to classify individuals as at healthy or non-healthy weights. The most recent classification is to use body mass index (BMI, in kg/Ã£Å½ ¡). BMI, regardless of age or population, is normal at 18.5-25.0 kg/Ã£Å½ ¡, overweight at 25.0 to 19.9 kg/Ã£Å½ ¡, and obese at over 30.0 kg/Ã£Å½ ¡. In general BMI greater than 30 is assumed to be due to excessive adiposity (World Heart Federation, 2005). Weight loss is often the first clue to an underlying cause of malnutrition. The loss of more than 10% of the patientÃ¢â¬â¢s usual weight necessitates a thorough nutritional assessment. Recent unintentional loss of 10% to 20% of the patientÃ¢â¬â¢s usual weight indicates moderate protein-calorie malnutrition, and loss of more than 20% indicates severe protein-calorie malnutrition (Ulrika Soderhamn, 2008). In addition to weight and height, anthropometric approaches are for most part relatively noninvasive methods that assess the size of body composition of an individual. Anthropometric measures, such as mid-arm muscle circumference and triceps skin-fold thickness, estimate fat and lean tissue mass respectively (Carole S. Mackey, 2004). Anthropometric measures of nutritional status can be compromised by other health conditions. For example, edema characteristic of some forms of malnutrition and other disease states can conceal wasting by increasing body weight. Anthropometric data are used in nutritional assessment to compare measured values with standardized controls and to compare serial measurements over time in the same patient. These are useful in identifying the most severely malnourished patients, especially those with fluid retention as a result of disease (Inge.K, 1999). Biochemical data Laboratory tests based on blood urine can be important indicators of nutritional status, but they are influenced by non-nutritional factors as well. Measurements of serum protein levels are used in conjunction with other assessment parameters to determine the patientsÃ¢â¬â¢ overall nutritional status. Serum proteins used in nutritional assessment include albumin and transferrin and preablumin. Albumin is a complex, high-molecular-weight protein produced by the liver and decreased albumin levels have been shown to correlate with increased morbidity and mortality in hospitalized patients; therefore it is often used as a prognostic indicator. If the patientÃ¢â¬â¢s serum albumin concentration lower then 3.5g/dL and the total lymphocyte count lower than 1500 cells/mm3, it should be take more concern with them (Carole S. Mackey, 2004). Also lab results can be altered by medications, hydration status, and disease states or other metabolic processes, such as stress. As with the other are as of nutrition assessment, biochemical data need to be viewed as a part of the whole. Discussion Before utilization of the nutritional assessment, the health care workers might only concern how the pressure sore can be healed and provided further treatment or protection. The nutritional issue related to wound healing might be ignored. The health care workers should have knowledge and be conscious of nutritional issues and know the importance and relevance of these issues for the particular patient promoted the nutritional nursing assessment. Identifying, assessing and treating older patientsÃ¢â¬â¢ nutritional problems is a challenge for all staff groups involved in the patientsÃ¢â¬â¢ care, therefore, it need to collaboration between other caregivers and professionals and sufficient knowledge about nutrition among the staff groups (C. E. Weekes, 2009). For example, the nurse can organize one person into performing specific tasks like serving food to Mr. Wong to highlight his eating ability and facilitate the assessment process. There is also collaboration between the nurse an d physician, speech therapist or dietician who can help with the estimation of the nutritional requirements and get suggestions of food supplements. The first priority for the nurses is to let Mr. Wong know their nutritional needs and current problems, as he might think that he ate enough every day, but the situation perhaps was adverse. They should have an individual holistic patient view and discuss with Mr. Wong about his situation and then find out how and why the identified nutritional problem influenced the pressure sore. And the four assessment techniques in a nutritional assessment can perform at the same time. The health care workers always perform the twenty-four hours intake and output record with Mr. Wong for calculating the fluid balance and energy intake in the daily nursing routine. Also, it can be recognized Mr. WongÃ¢â¬â¢s nutritional status from physical examination like Body mass index reading and mid-arm circumference to determine the specific needs and problems. And then collaboration with physicians to taking his blood for further laboratory assessment. The laboratory results like protein level and albumin level provide information for the nursing diagnosis. Using the clinical, biochemical and dietary data, influences on the nutritional status can be determined. A nutritional intervention which includes dietary guidance and exercise recommendations is then formulated and discussed with the individual. Further dialogues with and observations of Mr. Wong are used promoting for a continuous assessment process, because it can supply the nurse with information about the effects of the interventions and how the nutritional status of Mr. Wong changed, The nurse then feels a responsibility for him having a continuous and proper nutritional intake (C. E. Weekes e, 2009). If all the possible preventions and nutritional problem can be treated, the rate of getting infection should be minimized and the wound healing should be better. Conclusion Malnutrition becomes a considerable problem among hospitalized patients. The use of nutritional care practices and nutrition assessment of elderly patients is necessary and optimal in hospitals. Nutrition assessment involves a combination of examinations and patient history, and as such, no single laboratory test or finding should be used to indicate poor nutrition. An increased consciousness of the importance of nutritional care and assessment among health care professionals will contribute to further improvement of the quality of nutritional care. Reference Carole S. Mackey. (2004). Nutritional Assessment. Retrieved 19 February, 2011, from diet.com/store/facts/nutritional-assessment Ho. S Lee. S. ( 2011, March 18).Ã Slow food culture on stress-city menu. The Standard, p. A4 Inge.K, Simon. S Wood. J (1999). Nutritional care of the patient: nursesÃ¢â¬â¢ knowledge and attitudes in an acute care setting. Journal of clinical nursing, 8, 217-224 Sharp CA McLawa M.L (2006). Estimating the risk of pressure ulcer development: it is truly evidence based?. International Wound Journal, 3(4), 344-353 Ulrika Soderhamn. Olle Soerhamn. (2008). A successiveful way for performing nutritional nursing assessment in older patients. Journal of clinical nursing, 18, 431-439 Vanderwee K, Clayse E, Bocquaert I, Verhaeghe S, Lardennois M, Gobert M Defloor T. (2010). Malnutritiona and nutritional care practices in hospital wards for older people. Journal of advanced nursing, 67(4), 736-746 Weber, J. Kelley, J. H. (2009). Health assessment in nursing. Philadephia: Lippincott Williams Wilkins Weekes, C. E, Spiro, A, Baldwin, C, Whelan, K, Thomas, J. E, Parkin, D Emery, P. W. (2009). A review of the evidence for the impact of improving nutritional care on nutritional and clinical outcomes and cost. Journal of Human Nutrition and Dietetics, 22, 324-335 World Heart Federation (2005). Body Mass Index [Leaflet]. World Heart Day 2005 Leaflet
Monday, March 2, 2020
Temperature Definition in Science Temperature is an objective measurement of how hot or cold an object is. It can be measured with a thermometer or a calorimeter. It is a means of determining the internal energy contained within a given system. Because humans easily perceive the amount of heat and cold within an area, it is understandable that temperature is a feature of reality that we have a fairly intuitive grasp on. Consider that many of us have our first interaction with a thermometer in the context of medicine, when a doctor (or our parent) uses one to discern our temperature, as part of diagnosing an illness. Indeed, temperature is a critical concept in a wide variety of scientific disciplines, not just medicine. Heat Versus Temperature Temperature is different from heat, although the two concepts are linked. Temperature is a measure of the internal energy of a system, while heat is a measure of how energy is transferred from one system (or body) to another, or, how temperatures in one system are raised or lowered by interaction with another. This is roughly described by the kinetic theory, at least for gases and fluids. The kinetic theory explains that the greater the amount of heat is absorbed into a material, the more rapidly the atoms within that material begin to move, and, the faster atoms move, the more the temperature increases. As atoms begin to slow down their movement, the material becomes cooler. Things get a little more complicated for solids, of course, but thats the basic idea. Temperature Scales Several temperature scales exist. In the United States, the Fahrenheit temperature is most commonly used, though the International System of Units (SI unit) Centigrade (or Celsius) is used in most of the rest of the world. The Kelvin scale is used often in physics and is adjusted so that 0 degrees Kelvin is equal to absolute zero, which is, in theory, the coldest possible temperature and at which point all kinetic motion ceases. Measuring Temperature A traditional thermometer measures temperature by containing a fluid that expands at a known rate as it gets hotter and contracts as it gets cooler. As the temperature changes, the liquid within a contained tube moves along a scale on the device. As with much of modern science, we can look back to the ancients for the origins of the ideas about how to measure temperature back to the ancients. In the first century CE, the Greek philosopher and mathematician Hero (or Heron) of Alexandria (10Ã¢â¬â70 CE) wrote in his work Pneumatics about the relationship between temperature and the expansion of air. After the Gutenberg Press was invented, Heros book was published in Europe in 1575, its wider availability inspiring the creation of the earliest thermometers throughout the following century. Inventing the Thermometer The Italian astronomer GalileoÃ (1564Ã¢â¬â1642) was one of the first scientists recorded to have actually used a device that measured temperature, though it is unclear whether he actually built it himself or acquired the idea from someone else. He used a device called a thermoscope to measure the amount of heat and cold, at least as early as 1603. Throughout the 1600s, various scientists tried to create thermometers that measured temperature by a change of pressure within a contained measurement device. English physician Robert Fludd (1574Ã¢â¬â1637) built a thermoscope in 1638 that had a temperature scale built into the physical structure of the device, resulting in the first thermometer. Without any centralized system of measurement, each of these scientists developed their own measurement scales, and none of them really caught on until Dutch-German-Polish physicist and inventorÃ Daniel Gabriel Fahrenheit (1686Ã¢â¬â1736) built his in the early 1700s. He built a thermometer with alcohol in 1709, but it was really his mercury-based thermometer of 1714 that became the gold standard of temperature measurement. Edited by Anne Marie Helmenstine, Ph.D.
Friday, February 14, 2020
Wal-Marts Sustainability Strategy - Essay Example However, this proves to be more complex, considering that continuous supply of the seafood is the greatest challenge faced by Wal-Mart, according to Peter Redmond, who is its vice President (Wal-Mart, n.d. p1). Since some of the fish are found seasonally, for example the Salmons, which are only available between May and September of every year, maintaining their coViceuous supply is a big challenge. Additionally, the availability of these types of fish is, still low even during their season, and thus FishinÃ¢â¬â¢ Company, based in the US has been contracted to supply Wal-Mart with frozen fish fillets. Commercial fishing of the Salmons is also regulated by the law, where it is allowed only to operators with permits, and during specified seasons. Thus, Wal-Mart has to seek a strategy for obtaining the certification of its boat operators from the Marine Stewardship Council, to enhance a sustainable channel of maintaining regular supply of the Salmons, and thus meet the growing seafood demand. The major challenge that Wal-Mart is facing is the shortage of supply of the seafood. The output of the worldÃ¢â¬â¢s fisheries es had declined by 3% since 1900, yet the demand for the seafood from Wal-Mart is constantly growing at the rate of 25% every year (Wal-Mart, n.d. p1). Therefore, the looming scenario in this case is that; while the demand for the products seem to be continuously growing, its supply seems to be consistently reducing, which raises the concern of how Wal-Mart will be able to meet the needs of its customers, while at the same time taking advantage of the growing seafood business. Several alternatives are available through which this gap can be minimized, considering that Wal-Mart can liaise with the boat operators and the suppliers to ensure increased supply of the seafood.