Relativistic Theory of Ethics Essay Example for Free

Relativistic Theory of Ethics EssayOne relativistic theory of morals is featureism. Situationism (also known as situation ethics) was devised by Joseph Fletcher, who was strongly against absolutist theories for instance legalism and also disliked how religions were taught implying there were some chemical formulas that could never be broken, as he thought these rules ar too demanding and restrictive. He then created this theory of situation ethics which is seen as the mid way because it lies between antinomianism and legalism. Antinomianism is very anti faithfulness whilst legalism emphasises the important of law. However, situationism lies between the two as Fletcher was very enthused by making a decision on individual situations. Situation ethics maintains that its the consequences of pull throughs which restrict whether an action is right or wrong, so it is very much a consequentialist position. Situationists enter distributively decision making situation with ethical maxims of their community and culture, each they treat with respect. Fletcher proposed that not only the situation guides an individual on what they should do but also the principle of agape ( get along).In Fletchers book he suggests that Christians should make the right choices without blindly following rules but rather by thinking for themselves. Decisions should be made on the sole basis of one rule agape. Such love involves doing the best thing possible for the other party involved. So maxims could be ignored if they dont serve agape, for example if a priest is presented by a young lady who is having underage promiscuous sex, the right thing to do would be to insist the young lady uses contraception.This is because the about loving thing to do for the other person is to ensure she is safe. For the situationist the rule of agape is always right. Fletcher created 4 working principles which outlined how situation ethics works. The scratch line one is pragmatism, which states tha t what you propose must work in practice. Second is relativism, so Fletcher eliminates words like always, never, and absolute. He states there are no objective rules but all decisions must be relative to agape. Thirdly is positivism, which states a value judgement needs to be made, giving the commencement exercise place to love.Finally personalism, people are put in first place morality is personal and not centred on laws, this emphasises the idea that morality is relative to situations. Fletcher put forward 6 propositions which also aid the theory. The first proposition is only one thing is intrinsically good namely love zip else at all Thus, only love is good in itself action arent intrinsically good or evil. Instead they are good or evil dep checkent on whether they promote the most loving result.Fletcher rejects any statements like Adultery is wrong as the circumstances are always different, and sometimes it may be right for adultery to take place. The second proposition is the ruling norm of Christian decision is love, nothing else Fletcher claims Jesus replaced the Torah with love, also the ecstasy Commandments are not absolute even Jesus broke them when love demanded it. contend replaces law. The third proposition is that justice will follow from love, because justice is love distributed. If love is put into practice it can only result in justice.Fourth is that love has no favourites and does not give whom we like preferential treatment. Love wills the neighbours whether we like him or not The fifth fundamental principle, love must be the final end, not a means to an end. For Fletcher, the end must be the most loving result. Finally the sixth proposition is that the most loving thing to do will depend on the situation and since situations differ, you cant say an action will be right in every situation. Fletcher, the good result is that which serves agape love best. Any action that leads to that end is right.

Asynchronous and Synchronous Essay Example for Free

asynchronous and Synchronous EssayA twist is a singular digit compensateed by a binary number. A credit is represented in computing terms but a code called ASCII There are 7 bits to an ASCII number With resemblance bit added there are 8 bits, parity is added to aid in error detection. 8 bits is equal to a byte. 1 1 0 This plot represents an 8 bit binary number (1byte). The step represents a 1 and the flat part represents nothing. This number would then look like this, 100000001. In ASCII this represents the constitution A. Packet Structure Instead of sending singular theatrical roles it is possible to send many in one go, this is called a packet.For example we use the ASCII code to represent a sentence and this may take up to 50 characters. When sent in the form of a packet we must split the packet up, this is do by using control characters. The control characters are SYN = Synchronise STX = Start of text ETX = End of text Above is an example of a packet coordinate used with Asynchronous sending. Bit and Baud Rate When the term bit rate is used, it means the amount of bits per min that are sent. A adept character is to be sent for example, the character is ASCII code is made of 7 digits and a parity bit and this is called the useful data.The standard speed for transmission sending is 8bits a second. This number or ASCII code that is sent ordain not only comprise of the 7 bit and parity, it contains a contract bit and an end bit to represent where the character starts and stops. The bit rate is then combined to include these two extra bits and this is called the baud rate, this would then be 10 bits a second (8+2). Start bit Stop bit Parity bit Asynchronous and Synchronous Asynchronous communications do not depend on the synchronising of a transmitter or a clock. It can be said that they are never independent.When sending individual characters there is no need for synchronization at all. Asynchronous has a very simple interface and the data ra te is normally at 64kbps. It can be used for connecting Printer, Terminal, Modem and home connections to the internet. Asynchronous protocol was one of the first around and was popular with the early invention of the tele typewriters. It requires the use of start and stop bits as previously said and this provides byte measure and smash-up. No clocks are needed and a parity bit is also sent to help with error detection.Asynchronous transmission will send single bits of data at a time. There is a standard for this form and it is called RSC323C. Asynchronous represents negative voltage as 1 and positive voltage as 0. Information is sent in a packet with the start and stop bit plus parity for error detection. This method of transmission is suitable for downcast speed. This is because for every character that is sent a further 2 bits (start and stop) must be added. For example, 1000 characters are to be sent, there are 8 bits per character plus a start and stop for each thats a total of 10000 bits. This is very in efficient.Its packet structure is known as a packet frame. Asynchronous Transmission Start bit Stop bit Parity bit The synchronous transmission form occurs when bits are sent in the packet form. This form of data sending is normally sent through bigger Networks. To calculate the efficiency you must divide the bit rate by the baud rate and then multiply by 100. Synchronous communication is far more efficient than its counterpart. To start, there is no need for a start and a stop bit. This time however the data is grouped, and then sent with characters and the start and the end of the packet.This can be seen above with the syn x 3 which stands for synchronization idol, stx for start of etx and etx for end of text. Synchronous can achieve much higher speeds than asynchronous and is preferably used within large network structures. It would be whence worth bearing in mind that if large amounts of data were to be sent then the synchronous form would be far better. Less overhead means greater efficiency and asynchronous just cannot match this. However asynchronous does have its benefits and would be deemed worthy of smaller data packets.Its the lack of timing information sent with the data which restricts it so greatly. Synchronous Transmission Packet of data Effect Of Bandwidth Limitation And Noise Bandwidth is the sum amount of data macrocosm sent to a recipient in a given time through a form of communicational media. This sum is normally represented on bit per second. Bandwidth also has an alternative meaning and can represent the differing frequency ranges. All media types have their own forms of bandwidth limitation this means we cannot transmit the same things on the differing types of media at the same speeds.If sending something with 10bits it will be sent at 10bits a second. This should apply for the bandwidth also (10 bits a second) however it can be modify by something that is known as cross talk. This is interference on the line, also known as noise. Noise can occur in many forms and this will always affect speed. The only method of transmitting data without any electrical noise affecting it is by using a fibre center cable. Fibre optic cables uses the use of light and mirrors, this is why it can not be affected. However it is also very expensive.

Ladybird book Essay Example for Free

Ladybird book EssayQuestion How does the poet use language to communicate her discussions response to reading and how does she direct her own feelings to you?AnswerIn the poem, the poet shows us closely her little genius password who can do everything except for reading. Throughout the description about her sons behavior in reading, she conveys to us her frustrated feelings when her son doesnt have any interest in reading.Firstly, the contrast in 2 aspects which inhabit inside her son is clearly shown by the first stanza. In 4 first lines of the first stanza, the poet asserts that her smart son can do more things that many other kids cant do make sculptures, fabulous machines, solemn advice The images of a smart and sensible boy is painted beautifully under poets pen only stupefy who are supremely proud of her son can makes this masterpiece. Here, the use of exaggeration is used to describe the wonderful abilities of poets son, which is a leverage to pull the frustration in poets feelings up when she said but he is slow to read. The word but suggests the changing in tone of the poem from excitement, pride to disappointment.Although her love spend on him is very immense, the difference between adults and childrens thinking prevents her from being optimistic consistently about her sonWhen I take him on my kneewith his Ladybird bookhe gazes into the air,sighing and shaking his headlike an old manwho knows the mountainsare impassable.The poet tries to pull in her son but his action makes her down it is a such a drag on her thinking. Listing three verbs which suggests the negative effect, she conveys to us how languid her son is in reading book. Using the simile, poet portrays image of her son like an old, thoughtful man knowing that the mountains are impassable. Facing with book her son is deactivated.Through the first stanza, mothers feeling goes down from the top to the bottom of a mountain when she told us about her son. The contrast between what h er son can do and reading puts her in tumult.Secondly, as evidence, the second stanza is an infallible description about her sons response to words.He toys with words,letting them go coldas gristly meatAt first, he son has a little try on making words become familiar with what he is externalise in but all he can do bring him to a boring world of words.Normally, people cant so something that it is not strong enough to attract them and in them same case, her son tries in hopeless he cant do reading under his mothers pressure. One more time, the simile is used. It conveys how hard with the poets get close to reading like swallowing a tough, chewy meat. His response to reading is totally like the feelings of bird imprisoned in the cage vain, empty and tedious.Finally, the fish are released the son is liberated from reading. His feeling is full of beatitude.a fish revertingto its element,or a white-eyed colt shying from the bit who seesthat if he takes itin his mouthhell never runqui te free again.He enjoys his freedom like the fish returns to its element. The poet exhaled utilise this idiom to describe her anxiety when her son became active again after hardcore reading.Here, the mother (poet) seems to find out the inscrutable behavior of her son that makes him feed up with reading. The image of a untried male horse suggests the using of metaphor. The poets son is forced to read and the freedom is out like the young male horse when he is bound by the bit hell never run quite free again.At this point, the poet emphasizes that her son seem to be regenerated after the reading section, which pull her down when she tries her best to help her son.The poem is written the heart of a mother who spends all her love to him, tries to help him forever while her son cant show his positive behavior to reading. It reflects the a difference between the adult perspective and children point of view.

Effectiveness Of Non Medical Nurse Prescribing Primary Care

Effectiveness Of Non Medical Nurse Prescribing Primary C atomic number 18Nurse-led clinics stir been increasing for some time and Marsden (1992) identified the wins of using specialist nurses to congratulate services already offered by doctors. Read (1999) defined nurse-led disturbance as being the interface between nursing and medicine. Miles (2003) cited ten idiosyncratic authors as manifestation that explore shows that nurses be capable of carrying out procedures usu totallyy in the domain of doctors, often resulting in crackinger uncomplaining gaiety.Patient satisfaction is an serious tincture indicator. Yellen (2002) felt that the touchstone of patient satisfaction with nursing care was particularly important as it provided a good measure of overall satisfaction with services. interbreeding (1997) agreed with this principle but c at one timentrated more than on the competitive edge and financial survival being reflected in patient satisfaction. Cohen (1994) advo cated the use of satisfaction questionnaires, but both Avis (1997) and Westbrook (1993) doubted their efficacy, questioning the validity of questionnaires and the way in which they are measured. Westbrook (1993) felt that questionnaires may be limiting and poorly evaluated, giving rise to a poor reputation for satisfaction questionnaires. Duffin (2002) commented that questionnaires with tick boxes appear to gull limited use and may include leading questions where on that point is no s care for the patient to enlarge upon their answers.Both Robson (1993) and Wiles (1996) warned that the results of look intos dope sometimes paint a falsely positive picture and may be difficult to translate into a career of action. However, Backhouse (2000) says that the power of a successful nurse-led user satisfaction survey lies in the immediacy and relevance of the results. This may have enormous potential to transform praxis, particularly if the staff are able to remain positive about any possible negative feedback. Backhouse (2000) commented that nurses may tend to take praise for granted, as a regular stream of cards and thanks is often the only feedback they receive. This may produce the belief that the service is satisfactory, but it has been found that although there is a great deal of satisfaction, there is also some dissatisfaction, particularly with respect to information (McColl (1996), Backhouse (2000), Byrne (2000), Duffin (2002)).As a Business Manager in General Practice in an affluent rural environment, the author has found that there are increasing frustrations and boundarys with time and resources where a competent healthcare professional could manage a patients care more than adequately during one appointment. Additionally, continuity of care and health care management in a more patient centred, balanced way could benefit the patient. Discussion or so the management of their medicines and general health preparation could aid to the patient taking r esponsibility for their own health care management.The Welsh fictionalization Government (WAG) (WAG 2001, WAG 2005) has prioritised patient access to primary care services for the last few years which has impacted on patient expectation around the contend for an urgent appointment. This has caused pressure on appointment systems, and subsequently mixed bags have been made to deal with the demand. One way in which the practice would identical to cope with these demands is by enabling the Senior Practice Nurse to give more holistic care, making the consultation seamless for the patient, thus reducing the need for superfluous appointments, having already consulted with an trance healthcare professional (WAG 2001, WAG 2005).This practice nurse is currently undertaking the Independent Nurse Prescribing (non-medical). When qualified, this will tie in with the nurse-led diabetes clinic and broken inly Illness clinics for which she is qualified. The natural progression would be for her to prescribe appropriate medicine or dressings in relation to the competencies she has accumulated following prove based practice in these disciplines.A nurse may spend a considerable amount of time dealing with the assessment and management of a patient, then time lag outside a GPs door for a prescription to be signed. This situation is far from ideal, and with the enhancement of the prescribing qualification, this could be done in a more appropriate way. This lit surveil looks at aspects of nurse prescribing in primary care, and how this trick lead to patient satisfaction, autonomy and job satisfaction for nurse prescribers.Literature seem Strategy (Method 10% c350 oral communication) 582LoBiondo-Wood (2002) describes a literature explore as an efficient retrieval of scholarly literature related to the composition of interest, while Cormack (2000) describes a literature search as a review of previously written literature on a related topic in order to provide the in vestigate worker and the reviewer with knowledge of the field being seeked. explore literature can originate from many sources. The volume of literature would be unmanageable if careful picking was non carried out (Cormack 2000, LoBiondo 2002). Polit (2004) recommends using electronic databases to locate relevant enquiry information and points out the limitations of manual and internet sources as being time consume and inconvenient, internet searching possibly not providing required results and bibliographic information. Polit (2004) likens locating all relevant information on the chosen subject to being like detective work.Primary inquiry only was sought. CINAHL Plus (Cumulative Index of Nursing and Allied Health Literature) with Full Text and MEDLINE were used to search for key words non-medical AND nurse prescib AND primary care with published dates between January 2004 to present, resulting in 209 hits. These were restricted to research, years 2004-2010 and English-only c onditions in order to reduce the number of members to 29.Playle (2000) suggests that the title of a research article is extremely important and should cover center on as well as identifying the research approach used (McCaughan, 1999 Stevens et al, 1993).In the authors case, an informative solicit facilitates the election of research article.The abstract or introduction, as Bailey (1991) suggests it should prepare the stage for the problem to be investigated, as well as being brief.As suggested by Playle (2000) a well written abstract identifies the main points of the study, although the main weakness can be the word restriction as suggested by Burns and orchard (2001). It should typify an hi-fi picture (Reid, 1993) of the study with concise modeology, sample subject, notifyed findings and conclusion. This would enable any reader to base a decision to read the article (Reid, 1993).The rationale for choosing the critique guidelines from Benton Cormack (2000) is based on th e convenience and manageability of a well structured cultivate that enables to author to appraise with ease.A literature review is an important element of a research question. Rees (2003 p. 17) indicates that a thorough review of the literature is essential to provide the theoretical and conceptual context for the study. Parahoo (1997) carrys this stating a literature search provides the identification and locating up to date material, relevant to the topic under review. It inculpates the scanning along with critical reading of the literature chosen to assess improvement to the question under discussion.The authors knowledge and prior reading of literature directed at change management in primary care dictated the final exam choice of research articles to Richards, L.A Richards, A Gilead, L Stessman, J blab la bla and Raz, I (1999) title of an article International Journal of Dermatology 38, 623-627 (appendix 1).Those chosen for review were cardinal qualitiative and one quantit ative research articles relating to the question under evaluation.AUTHORSAll eleven authors have either the appropriate professional qualifications or academic qualifications, for example MD or PhDs. A except research on the authors names and using databases CINAHL and Medline xx to present showed that between them they have published xxx articles in dissimilar medical journals with different topics. Most have no carriage on the subject of maggots and wounds blab la bla, while most of them have some bearing.The review (50% c1750 words) 2168THE REVIEW(PAULAs)LITERATURE REVIEWA good literature review draws on a wide range of sources (McCaughan, 1999) and will identify the need for research. Nevertheless, A poor literature does not invalidate the findings but a good one does enhance the status of the research (Stevens et al, 1993135).HYPOTHESISA possible action is not include and an explanation could be that the aim of this study is to provide new information by utilising a descrip tive research method. Burns and plantation (2001) suggested that if there is very little or no research being conducted on a particular question, then researchers state accusatives or questions and there is an objective.OPERATIONAL DEFINITIONSQuantitative research should have all terms explained or defined. Stevens et al (1993) refer to common error by researchers in the assumption that readers are knowledgeable about the jargon and terminologies employed.METHODOLOGYThe research approach is not acknowledged inside the article. Howedver, it can be assumed that the approach is quantitative, in that it involves use of goods and services of the independent variable.. On the other hand, to provide the strongest evidence with a greater degree of ..Also included are certain soft components such as .. that would indicated possible combination of the two approaches, qualitative and quantitative. Using this combination in approach to research may not appear to be very scientific, as yet Docherty (2000) suggests that this method may produce a more meaningful and richer data. Even so, there is strength and weakness to both approaches and neither have been verbalize at heart this study. On the other hand but backed up with . And the author agreed with this type of approach as it enables a reader to scrutinise the data, without having to be familiar with research methodology, data statistics or the terminology.SUBJECTSThe subjects are identified as 43xx in five depts. Of xx hospital . Nevertheless, many potential or adapted candidates for this type of research may be unwilling to participate (burns Grove, 2001 and Reid Boore, 1987) due to the xxxx.SAMPLE SELECTIONThe approach to the sample selection is not clearly stated and a good research study should explain the sample selection method as suggested by Baxter (2001b). However On the other hand, all the subjects are typically,.DATA COLLECTIONData collection procedures are.. not acknowledged..The validity and reli ability are undefined within this study and McCaughan (1999) suggests that if the researcher has not mentioned testing for reliability and validity then it is unlikely that it has been done.ETHICAL CONSIDERATIONSXxxxx ethical committee .. In the authors vox populi, ethical consideration should have been an important part of this article..NonethelessAppendix 3 shows/..As suggested by Matthews Venables (1998) every published research report should include a description on how the informed swallow is given. On the other hand, lack of acknowledgement of anonymity, confidentiality as well as the description of informed consent does not necessarily mean they have not been considered (Firby, 1995 McCaughan, 1999), merely that the researchers assumed that the results and method were more interesting to the reader.RESULTSThe results are presented as xxxxx and backed up by xxx, which showed that xxx. However, quantitative data is limited wtug xxxx. In provoke of this, there is sufficient detail that would enable a reader without any research experience to look at the results and understand what they signify and to judge with authorization the findings.DATA ANALYSISThe data compend is appropriate to the type of data collected that is percentages and for the type of read that xxx was aiming for. In some ways the method employed is simple and easy to replicate. However, thereClarke (1999c) suggests that the data analysis relies heacily on the researchers skill and judgement to see that it is accurately exeuted, also not report are values such as test values df and p. In addition, poor quality analysis will render the data anecdotal and unfocused, yet the analysis is focused, credible and to improve upon this, the author would suggest the inclusion of statistical tables.DISCUSSIONThe discussion is not really balanced, as it only mentions and draws upon xxxxHowever, what is discussed is very concise and knowledgeable. thither is also no acknowledgement of the limitati ons or weakness of this particular stify and there is only one reference to disadvantages, THAT IS ..(Teresas)LITERATURE REVIEWThe aim of the literature review was to find out what the nurses role is in primary care, in relation to providing xxxxx. To assist in the critiquing process, quantitative and qualitative papers were reviewed using the Benton and Cormack (2000) model. Although the author finds this framework comprehensive and simplistic, it is noted Rees (2003) states qualitative and quantitative research are extremely different, and same method of critiquing cannot be used. This opinion is not upheld by Benton and Cormack (2000) as they hike the use of one framework for both.Within the articles reviewed the evident themes that emerged are xxx and xxxx.In order to guide the reader to continue reading a paper, the abstract should set the scene for the rest of the report. Playle (2000) states an abstract that is soundly written will list the main points of a study. It is not ed three out of the four articles reviewed have concise detailed abstracts. Although, that by xxx (2006) lacked depth, cause and did note cite up to date government papers to support the topic of xxxx. Burns and Grove (2001) highlight that a potential weakness noted wihin Gibbs et al (2004b) paper was the difficulty the reader encountered at determining whether the paper was quantitative or qualitative. Parahoo (1997) concedes this should have been obtained within the abstract, as this should briefly summarise the method, sampling and main findings within a study. Within the abstracts of the articles reviewed, the researchers have clearly portrayed and accurate image of all study methodologies, reported findings, sample subjects and conclusions.EDUCATIONGibbs et al (2004a) initial quantitative research paper tested one hundred and forty-one general practitioners and cardinal practice nurse opinions relating to xxxx. Results favourably showed that ninety-seven percent of practice n urses raised xxxx but the article concluded xxxx within primary care and mainly relied upon xxxx. jumper lead on from this study, Gibbs et al (2004b) carried out a quantitative study involving eight general practices and one thousand five hundred and forty-nine kxdffdsdf. The article reports on xxxx. This quantitative paper involved structured interviews where questions were asked in a planned format. A structured interview involves set questions with no deviation from these (Parahoo 1997).A limitation of the study was the elevated drop-out rate but positively forty percent achieved a five percent or more weight loss at twelve months. It highlights whether the researcher has performed the study in a logical, systematic method, having paid attention to pointers that may influence the accuracy of the results (Rees 2003). Although Burns and Grove (2001) argue that a rigorous study should have exact measurement tools, a representative sample and a tightly controlled design. Audit was c onducted in all practices prior to the study, where measurement tools such as weighing scales, height measure and large blood pressure cuffs were assessed. The provided consistency of the tools used at each centre along with evidence of their validity. Validity refers to whether an instrument measures what it stated to be measuring whilst reliability relies upon individuals using the tools and reporting accurate measurments obtained (Carter and Porter 2000).It was noted those practices participating in this study were self-selected, already having an interest in obesity management, thus possibly weakening representations. It was encouraging that a cross-section of those involved included large practices, rural, urban, single handed and those fro low deprivation areas. This appeared to provide a representative population with no evidence of bias selection. The xxxx project was ethically approved by xxxx.In contrast Moore et al (2003) in a cluster randomised control studyxxxxxxxx Clu ster randomised trual means the sampling frame are geographically spread or the individual elements of the population are not know (Rees 2003). The advantage of this process is achievement of an accessible sample from an almost impossible total population (Rees 2003). Donnan (2000) states experimental research is the gold standard way of representing in a rigorous style that a treatment or intervention is effective. It concludes it si an essential tool for qualitative evaluation of a studys worth. Greenhalgh (2006) draws attention to the fact that publication of an article does not mean the evidence is big-boned.In conclusion as found in xxxx. Rees (2003) states bias is anything that distorts or affects a study, potentially altering or influencing the accuracy of the findings. Results noted that xxxx. They conclude more in=depth training of health professionals is needed xxxx. This would involve further implementation of training progrmmes and additional research. Ethical approval was granted by the xxxx ethics committee.The research paper by XX (2007) mixes quantitative and qualitative approaches and is known as triangulation,. Docherty (2000) suggests use of triangulation provides richer, more meaningful data. Holloway and Wheeler (2002) support this method stating it to be a way of obtaining adversity in qualitative research. Rees (2003 p. 235) lists this as being the use of more than one method of data collection within the same study in an attempt to produce more accurate information and understanding.This was a cross-sectional study with questionnaires being completed by forty General Practitioners and forty-seven practice nurses. A limitation to this study was no indication was made of the total number of initial questionnaires sent out in similarity to the response rate. A cross-sectional study is a survey that gazes at a situation at one point in time (Rees 2003). The qualitative results by xx (2005) were not shown within the report and rigour was disputed on reading the research paper as a full conclusion of the findings could not be made. It is realised word restriction could be the main reason for the results being omitted, but unfortunately it leaves the reading having to guess what they might have concluded. Ethical approval was supported by xxxx.In comparison with Gibbs et al (2004b) article the outcomes indicated mirror one another, with both papers coming to the conclusion that opportunties for xxxxxx in primary care are often missed or inadequate time given to education and support. Although the report by xx(2-3) shows xxxx, it was indicated this was in accordance with increasing responsibilities in implementation of chronic disease management. It is highlighted in the report that caution regarding results needs to take place. Also this article, although mainly quantitative, has a small sample size. Parahoo (1997) states quantitative research usually involves large numbers in fortune samples. The importance of large numbers aims to lessen the chance of bias and correctly achieve statistical procedures (Rees 2003).A pilot study was not carried out prior to this research. Piloting of a questionnaire increases research validity and reliability as it highlights any anticipated problems accessing data, and ensures the method used to gather data works (Parahoo 1997). Research should be instigated because the researcher wants to extend knowledge base and understanding through rigorous collection of information, answering a question objectively and with accuracy (Rees 2003).SUPPORTSoanso (2009) article is a qualitative study and deals with support and perceptions of the patient who is obese. This is a primary study that reports research findings first hand (Greenhalgh 2006). Rees (2003) states to have involvement in qualitative research and understand a topic, individuals first have to see it through the eyes of those who experience it. This method aims to summarise perceptions, experiences, behaviou r or interpretations. This process included a qualitative study with semi-structured interviews drawing on grounded theory methodology. Grounded theory aims to produce a concept or explanation that is grounded in the results and arises inductively by researchers understanding and analysis (Rees 2003). Polit et al (2001) strongly supports interviews stating they by far outweigh questionnaires. The response rate is higher, reaching a wider population than questionnaires, are less likely to misinform those reading the questions and provide wealthier data. Rees (2003) agrees with the above adding, those involved can experience the belief of being in control and positively feeling more valued. It is noted there are disadvantages such as high cost, participants providing socially acceptable answers, affect of interviewer status and difficultly in expressing feelings (Rees 2003). Five general practices from differing socioeconomic backgrounds in Sheffield were involved with interviews con ducted at their homes. This provided a varied population adding rigour to the study, and it could be generally assumed an individual would feel more comfortable being interviewed within their own surroundings. Although, it can be argued that interviewers have less power to control the interview within this environment as there is no assurance that the interviewee will maintain a safe place with no interruption, disturbance or being overheard (Pontin Webb 1995, Webb Pontin 1996).Kdfsdfsfhskdfhsd. Ethical approval was sought prior to this study from xxx Ethics Committee.Application to clinical practice (30% c 1050 words) 1086APPLICATION TO PRACTICEAt present within the authors practice setting issues of xxxx are raised xxxx. Since April 2006 the General Medical Service bless (National Health Service 2006) awarded points for the xxxx.This critical review of the literature has aimed to answer the question xxxxxxxxxxxxxxxxxxxxxxxxx? It is well documented that xxxx. Research that has b een carried out in an ethical manner and is of robust design can benefit all involved and improve practice (Royal College of Nursing 2004). The document Best Research for Best Health (Department of Health 2006a) states research provides the support and evidence to tackle increasing challenges that disease and ill health have placed on society. This document supports a pilot study within primary care in England to improve evidence based practice of care by facilitating the conduct of clinical trial and other well designed studies. It would hardly be an exaggeration to say, pending successful results in 2014, the use of this structure within primary care in Wales could potentially benefit practise of much needed research findings into practice.Findings of this review showed the counterweight project by Gibbs et al (2004a, 2004b) provided the best evidence of implementation within practice, showing xxxx. The Cochrane Library for Sytematic Reviews (2004) supports the equalizer Project (2004b) stating The Counterweight Programme is an evidence-based weight managmentxxxx Brown Psarou (2007) in their literature review also supported this project stating it was rigorously conducted and soundly funded. Presentation of these research findings were undertaking xxxx.Banning (2005) suggests the management of obesity should focus on xxxx. The National Institue for Clinical Excellence (2001) states that primary care nurses are ideally placed to manage and assess obese individuals. This comprehensive package addresses issues and management of .. The material is simplistic with the alforithm providing an easy guide for the primary care nurse to follow, The pathway opportunistically at go appointments or reviews.To implement this in the clinical setting, xxxx.Successful implementation of this pathway into the practice setting would require change management issues to be addressed. Implementation of change following research can be a difficult process. Resistance, resentmen t and jealousy can all impede implementation of the change process (Cormack 2000). To cut through resistance to change the key factor is leadership, along with effective communication and a sound understanding of what motivates people (LaMonica 1994). Those involved in the change process must be unploughed informed and involved at each stage of change. Individuals like equilibrium and are keen to be involved once they know the process will not cause problems or a change of workload (Broome 1998).(Paulas)CONCLUSIONA conclusion was included within the abstract, xxxxAs suggested by McCaughan (1999) and Playle (2000), there is a restriction placed on researchers and authors by publications to condense from a much larger and more detailed research report. It can be assumed that this is the case with this research article.However, as suggested by Baxter (2001c) that in qualitative research to aid the flow and understandings, discussion and conclusion are kept together under one heading. In the authors opinion, the conclusion should have RECOMMENDATIONSStevens et al (1993) suggests the realistic researcher would draw conclusion from the data presented and then make further recommendations on what other research is required. However, there is no heading of recommendation or any indication that one was included. Alternatively, suggestions for further research studies and in the authors opinion threr should have been a recommendation for future randomised control trial.There is a possibility as suggested by Playle (2000) that the actual research report is more detailed with recommendations, but this may have been lost when condensed for publication.Teresas conclusionIn conclusion, this literature review has shown xxxx. To achieve this, implementation of findings along with ongoing research is demand to sustain the evolving needs of xxxx. It should be noted that a limited number of research articles were used for this review, providing partial evidence. Thus, it is su ggested more concrete evidence is needed requiring a further search and review of the literature on xxxx. It would hardly be an exaggeration to say that this review has highlighted the need for further research on the topic of xxxx relating to support and education. It can be said this would potentially emphasise additional studies, which in turn could be applied to practice improving nurse education and support to the obese patient.APPLICATION TO CLINICAL PRACTICEAUTHORS CONCLUSIONSThe article on . Appeared to be a concise, informative and innovative piece of research on first perusal. However, what appeared at first glance to be just.. turned out to be more complicated upon cobblers lastr iinvestigation and mmmmmm. The reader begins to questionIt has a focus and direction, which is to assess the efficacy of maggot therapy and a very concise and informative methodology, which would enable anyone to reproduce a similar type of research. The data collection procedures are not clearly identified, although the simple representation allows it to be easily followed and replicated.This is further confounded by the entwined discussion and conclusion and as suggested by Baxter (2001c) this often occurs with qualitative research. Nevertheless, the reader must balance the evidence presented and sometimes more than one type of evidence (Roberts, 1999) is needed to determine if the interventions is practicable or efficient, as well as ethical and morally sound (Freak, 1995). Another point is the ethical considerations . Ethical significance .An assumption is the researcher focus on the results or alternative the method, as being more interesting or important (Firby, 1995) to the reader.As suggested by various authors including Polit Hungler (1991) all research has limitation and can be imperfect and if this research article has been condensed from a much larger research report, then this critique has been conducted on a published condensed research article and not the ac tual research report. Therefore, what imperfections or liitations that are identified within this critique, is the ability of the researchers to actually condense their work and the readers have to assume that the researchers have honestly presented their fndings (Firby, 1995).For all the points highlighted like ethical, functional definitions, qualitative/quantitative approach, this is a very good informative research article that allows anyone to replicate the study.AUTHORS RECOMMENDATIONThe author would like to recommend that Furthermore, it . However, as reported by XX, the main disadvantage is,,,, nevertheless,A readonable recommendation in the authors opinion would be, In addition, if there isINTEGRATING RESEARCH INTO PRACTICESdfhsdkfhshdfhdfh to advocate and support the patient.ReferencesAvis, M. Bond, M. Arthur, A. (1997). Questioning patient satisfaction an empirical investigation in two outpatient clinics. Social Science Medicine. 44,185-92Backhouse, S. Brown, Y. (2000). Using a patient satisfaction survey to close the theory-practice gap. Nursing Standard. 14,3832-35Byrne, G. Richardson, J. Patel, A. (2000). Patient satisfaction with emergency nurse practitioners in AE. Journal of Clinical Nursing. 9,183-93Cohen, L. Delaney, P. Boston, P. (1994). Listening to the customer implementing a patient satisfaction measurement system. Gastroenterology Nursing. 17,3110-115Cormack, D. (editor) (2000). The Research Process in Nursing. (4th ed). Blackwell Science Ltd. Oxford.Duffin, C. (2002). If youre happy and you know it. Nursing Standard. 16,3212-13Ford, R. Bach, S. Fottler, M. (1997). Methods of measuring patient satisfaction in health care organizations. Health Care counselling Review. 22,274-79LoBiondo-Wood, G. Haber, J. (2002). Nursing Research, Methods, Critical Appraisal and Utilization. Mosby. Missouri.Marsden, E. (1992). Outpatient nurses must adapt to survive. British Journal of Nursing. 1(7) 356-357McColl, E. Thomas, L. Bond, S. (1996). A study to determine patient satisfaction with nursing care. Nursing Standard. 10,5234-38Miles, K. Penny, N. Power, R. Mercey, D. (2003). comparing doctor and nurse-led care in a sexual health clinic patient satisfaction questionnaire. Journal of Advanced Nursing.42 (1), 64-72Polit, D. Beck, C. Hungler, B. (2004). Essentials of Nursing Research, Methods, Appraisal a

Effects of Back Massage on Chemotherapy-related Fatigue

Effects of Back Massage on Chemotherapy-related put onShahida AbbasiThis paper is aimed to critique on a quantitative enquiry article. Effects of ass massage on chemotherapy-related fatigue and anxiety Supportive care and therapeutic touch in crabby person nursing Written by Karagozoglu and Kahve (2013) as part of my assignment.The ProblemThe problem is significant to nursing as noted by Karagozoglu and Kahve (2013) that nurses are directly concern to provide care and deal with patients receiving chemotherapy and their experienced ramp effects. It is also mentioned that problem is significance to nursing, as nursing interventions intend to improve quality of life by reducing the stress level of the patient with cancer.Moreover, the habit of conducting quasi experimental and cross sectioned subject field investigate was to determine the strong point of back massage, a nursing intervention, on fatigue process which develops due to chemo therapy. Furthermore, on the anxiety lev el which develops, and has been explained explicitly. In my point of view this field of battle can accomplish its purpose as Burns and Grove (2011) mentioned that effects of autarkic variables on dependent variable can be determined through quasi experimental studies. In appendage, quasi experimental a quantitative approach theme build is best fit to determine the trenchantness of back message. In the article research variables back massage independent variable and fatigue as dependent variable has been explained with literary productions support, whereas I feel the dependent variable anxiety adopt more elaboration. The investigators promptly introduced the problem statement at the end of the introduction. In my point of view the answer to the problem provide insight into current issues in nursing practice because there was no report found which determine the effects of back massage in decreasing fatigue and anxiety of chemotherapy patients. In addition, the investigators h as stated the assumptions actually intelligibly that back massage providing during chemotherapy reduces fatigue and anxiety Moreover, limitations are not listed explicitly but reader can infer easy as evident by this statement, small precedent size was apply therefore, the findings of the necessitate could not be generalized. The limitations of quasi study design are as mentioned in Polit and Beck (2012) noted that in interventional study participants show reluctance to be selected through randomization. Thus these assumptions and limitations are realistic.Review of the LiteratureThe literature reviewed by the researchers is comprehensive, critical, and logical. Moreover, the literature was published during the period 1988- 2013 and most of them were not recent but relevant to the problem. The relationship to the research purpose is evident by the literature review. In addition to that the researchers included 21 recent research studies and of these three studies published in 2013 were also used. The investigators paraphrased the reviewed adequately did not use any quotation. The researchers made a cocktail dress logically for conducting a new study found on the reviewProtection of Human RightsThis study was designed to minimize risk and maximize benefits to participants. Moreover, the researchers indicated very explicitly that participants gave voluntary, verbal and written informed consent and no evidence of coercion was found. However, it is not evident in study that participants were invited to consent during periods of high stress. there is no evidence in the study that individuals can be identified and linked to study. The researchers very clear mentioned that approval to conduct the study has been taken from an independent ethics committee of Cumhuriyet University Faculty of Medicine.Theoretical / Conceptual FrameworkThe researchers did not describe any theory or framework to guide their study. Coughlan, Cronin and Ryan (2007) noted that sup posed frameworks tend to be break away developed in experimental and quasi-experimental studies. Burn and Grove (2011) noted that a well-developed quantitative study is based on clearly stated framework and quality of frame work needs to be evaluated for practicality. However, in this study the absence of theory or frame work did not detract the researchers from the significance of the research.HypothesisThe investigators formally stated hypotheses. It is curb to present the hypothesis in quantitative study as the investigators were interested to test the effectiveness of back massage. Burns and Grove (2011, p.167) stated that this type of researches are required to have hypothesis in order to predict outcome. Moreover, hypotheses are naturally derived from the research problem and transform the problem into predictable leave alones. In this study hypotheses contain two dependent and independent variables. Furthermore, the investigators stated hypotheses clearly and objectively and the prediction is evident. It is very obvious that these predictions are supported by the literature.SamplingThe target population carefully described by the researchers i-e patients who at least underwent for chemotherapy. The target population was appropriate according to the study problem and desirability. However, resource limitations are not mentioned in the study. The investigators described experiment selection procedures by giving strict eligibility criteria. However, it would be better if they had clearly mentioned the type of take in procedure used. Moreover, the sampling method fits with the research design and level of inquiry of study. However, the authors did not describe potential sample biases. harmonize to Polit and Beck (2012) under representation of the sample pertaining to research question should be acknowledge by the researchers. The sample is sufficiently large as Polit and Beck (2012, p.285) propose that small sample size will be adequate if researcher is certain about the strong relationship of the independent and dependent variables and it is described under the subheading of methods p.212.This study can be generalized on the target population and patients receive chemotherapy. The investigators have described the eligibility criteria to enroll participants on ( p.212) to ensure a representative sample. However, sampling error can be minimized by increasing the sample size. look DesignThe investigators used quasi experimental and cross sectional design to determine the effects of the interventions. The design used for the level of inquiry of research question and purpose of research was appropriate as Burn and Grove (2011, P.151) mentioned that this study design is to determine the effects of back massage on independent variables. The researcher did not discussed potential effects of confounding variables and possible measures to control such effects (validity). Polit and Beck (2012) proposes selection of homogeneous sample to control confounder, however, statistical analysis can also be used for the same purpose. The researchers gave enough information based on which study can be replicated.Data CollectionThe instruments Personal Information Form, The State apprehension part of Spielberger State- Trait Anxiety Inventry (STAI) Brief Fatigue broth (BFI) were used for data collection. Personal Information consists of nine questions for that detail is given under the subheading of Personal Information on p. 212. Moreover, State- Trait Anxiety Inventory (STAI) instruments developed by Spielberger et.al in 1964 has been used by Oner and Le Compte. Cronbachs alpha coefficient was given that shows validity and reliability. In addition, Brief Fatigue Inventory (BFI) developed by Mendoza et.al. (1999) which consists of 10 questions was used to assess fatigue, and the same scale was used by Cinar, Sezerli,Sarsmaz and Ments. The value of Cronbach alpha reliability coefficient of the scale verifies its validity an d reliability. However, precept for the selection of instruments was not given. Instruments used in this study were congruent with research questions. Are results of these tests sufficient to indicate their use?The instruments are suitable for use with the study sample.Quantitative AnalysisDetermining the effectiveness of back massage is the third level of inquiry of study question, and for that quasi experimental and cross sectional study design is best fit.The investigators calculated mean and standard deviation for age. Chi-square test has been used for qualitative ordinal variables. A non-parametric Friedman test that is substitute of ANOVA has been used to analyze mean BFI score for intra group variability. Moreover, a Wilcoxon non-parametric test alternative to paired t-test was used to examine mean STAI scores of patients before, subsequently and right after chemotherapy. Furthermore, Mann-Whitney U test was used for mean STAI and BFI score of patients before and right afte r chemotherapy. Despite the fact that data were normally distributed, non- parametric test have been used. The link between the analysis and findings are logical, clear, and are evident by statistical rejection of null hypothesis by P-value. The researchers did not go beyond the data during interpretation of the findings, and they presented statistical result both in the narration and in tabulated form. The investigators used inferential statistic that is enough evidence to establish the correctness of the statistical result as Coughlan Cronin, P., Ryan (2007) noted that statistical significance assist the investigators to rule out threat to validity. The investigator presented findings in a table which is clear, simple, and accurate.Conclusions and RecommendationsData analysis clearly explained in reference to research questions and hypotheses.Since the study sample was small, the researchers made appropriate decision based on significant findings and did not claim for generalizat ions beyond the study sample or population. However, the results are applicable on our patients who are planning for chemotherapy. If we will implement this intervention to our context, then it will lead to increase comfort, accrue fatigue, and anxiety. Furthermore, there are no risks of implementing study findings mentioned explicitly or inferred. The authors also recommended that back massage during chemotherapy is effective intervention to be practiced to control the side effects especially fatigue and anxiety and this recommendation is well supported by the others studies. However, the investigatorsdid not give recommendations for future research studies.To determine the efficacy of back massage, a nursing intervention is a unique study which is significance for nursing practice. In this study the investigators used quasi experimental and cross sectional study design. Moreover, the study purpose of the study is explicitly stated. The investigators tested hypothesis with instrum ent which are reliable and valid and they described the instrument very comprehensively. Moreover, sample selection was carried out on strict eligibility criteria. Study findings have been explained in narration and in table. Finally, investigators gave conclusion based on findings that back massage is effective nursing intervention to decrease the fatigue and anxiety of the patients who receive chemotherapy. The investigators also mentioned that study cannot be generalized other than target population.ReferencesBurns, N., Grove, S. K. (2012). Understanding Nursing Research Building an Evidence-Based Practice. Elsevier Health Sciences.Polit, D. F., Beck, C. T. (2012). Nursing Research Generating and Assessing Evidence for Nursing Practice. Lippincott Williams Wilkins.Coughlan, M., Cronin, P., Ryan, F. (2007). Step-by-step guide to critiquing research. Part 1 quantitative research.British Journal of Nursing,16(11), 658-663.

Cerebral Pasy vs Muscular Dystrophy :: essays papers

Cerebral Pasy vs Muscular DystrophyMuscular dystrophy is a r atomic number 18 get sinew builder distemper in which the muscle fibers argon unusually susceptible to damage. The muscles, primarily the voluntary muscles, become progressively weaker. In the late stages of stringy dystrophy, muscle fibers often are replaced by fat and connective tissue. There are several types of mesomorphic dystrophy. The various types of the disease affect more than 50,000 Ameri shadowers. Many are associated with specific transmitted abnormalities.The well-nigh common muscular dystrophies appear to be due to a genetic deficiency of the muscle protein dystrophin. These types of the disease are called dystrophinopathies. They acceptDuchennes muscular dystrophy. This is the most severe form of dystrophinopathy. Duchennes muscular dystrophy affects young boys. Signs and symptoms of the disease usually appear between the ages of 2 and 5. Children with the disease fall and take on difficulty get up off the floor. By late childhood, most are unable to walk. Most die by their late teens or archaean 20s, often from pneumonia, respiratory muscle helplessness or cardiac complications.Beckers muscular dystrophy. This is a milder form of dystrophinopathy. It generally affects older boys and young men, and progresses more slowly, usually everywhere several decades.Duchennes and Beckers muscular dystrophy are passed from mother to news through one of the mothers genes. The disease crowd out skip a generation until another son inherits the defective gene. In some cases of Duchennes and Beckers muscular dystrophies, the disease arises from a new mutation in a gene rather than from an inherited defective gene. separate types of muscular dystrophies can be handed on from generation to generation and affect males and females equally. Still others require a defective gene from both parents.Signs arMuscle weakness Apparent lack of coordination Inability to elevate your arms over your head Progressive crippling, resulting in loss of mobilityDiagnosisBlood Tests-Damaged muscles departure enzymes such as creatine kinase (CK) into the blood. High blood levels of CK suggest a muscle disease such as muscular dystrophyElectromyography- Electrical body process is measured as you relax and as you gently tighten the muscle. Changes in the pattern of electrical activity can confirm a muscle disease. The distribution of the disease can be determined by testing different muscles. Muscle Biopsy-A small piece of muscle is taken for laboratory analysis. The analysis distinguishes muscular dystrophies from other muscle diseasesGenetic Testing-This can be done simply by a small blood sample for laboratory testing to go over weather in that location is a abnormal geneCerebral Pasy vs Muscular Dystrophy essays papersCerebral Pasy vs Muscular DystrophyMuscular dystrophy is a rare inherited muscle disease in which the muscle fibers are unusually susceptible to damage. The mus cles, primarily the voluntary muscles, become progressively weaker. In the late stages of muscular dystrophy, muscle fibers often are replaced by fat and connective tissue. There are several types of muscular dystrophy. The various types of the disease affect more than 50,000 Americans. Many are associated with specific genetic abnormalities.The most common muscular dystrophies appear to be due to a genetic deficiency of the muscle protein dystrophin. These types of the disease are called dystrophinopathies. They includeDuchennes muscular dystrophy. This is the most severe form of dystrophinopathy. Duchennes muscular dystrophy affects young boys. Signs and symptoms of the disease usually appear between the ages of 2 and 5. Children with the disease fall and have difficulty getting up off the floor. By late childhood, most are unable to walk. Most die by their late teens or early 20s, often from pneumonia, respiratory muscle weakness or cardiac complications.Beckers muscular dystroph y. This is a milder form of dystrophinopathy. It generally affects older boys and young men, and progresses more slowly, usually over several decades.Duchennes and Beckers muscular dystrophy are passed from mother to son through one of the mothers genes. The disease can skip a generation until another son inherits the defective gene. In some cases of Duchennes and Beckers muscular dystrophies, the disease arises from a new mutation in a gene rather than from an inherited defective gene. Other types of muscular dystrophies can be handed on from generation to generation and affect males and females equally. Still others require a defective gene from both parents.Signs AreMuscle weakness Apparent lack of coordination Inability to elevate your arms over your head Progressive crippling, resulting in loss of mobilityDiagnosisBlood Tests-Damaged muscles release enzymes such as creatine kinase (CK) into the blood. High blood levels of CK suggest a muscle disease such as muscular dystrophyEl ectromyography- Electrical activity is measured as you relax and as you gently tighten the muscle. Changes in the pattern of electrical activity can confirm a muscle disease. The distribution of the disease can be determined by testing different muscles. Muscle Biopsy-A small piece of muscle is taken for laboratory analysis. The analysis distinguishes muscular dystrophies from other muscle diseasesGenetic Testing-This can be done simply by a small blood sample for laboratory testing to see weather there is a abnormal gene

Essay example --

ThailandIntroduction A.Thailand is located in Southeast Asia in the Indochina peninsula. The country makes up around 198,117 square miles and is bordered by Burma, Laos, Cambodia, and Malaysia. Some well-known rivers that flow through Thailand are the Chao Phraya River and the Mekong River. The estimated population is approximately 67,448,120 with 75% being Thai, 14% being Chinese, and 11% categorized under other. Thailand is governed under a constitutional monarchy headed by King Rama IX. It joined the United Nations in 1946 after World War II. Thailands population has risen 6.2 % since 2010 and is undergoing mild population growth.Demographic Data(a.)Thailands birth prescribe has been steadily decreasing through the years. In 2000 the birth regularize stood at 16.86 (births per 1000 population). Today however the birth rate sits at 12.66. (b.)The death rate in Thailand is at 7.47 (deaths per 1000 population). This means since the death rate is lower than the birth rate there are on average twice as more births than deaths in Thailand.(c.) The fertility rate has also been declini...