Constructivism Essay Example | Topics and Well Written Essays - 750 words - 1

Constructivism - Essay Example They all talk of identities and interests in world politics. They believe that for some levels of predictability and orders to be in place in the international politics and domestic society, and then identities must be present. The state must have some intersubjective identities that are sufficiently stable so as to bring some patterns of behavior that are more predictable. They believe that the absence of identity in the world can trigger chaos, pervasive and irremediable uncertainty and the world can be more dangerous compared to anarchy. The importance of the identity is that it implies the state’s preference and consequent actions. They believe that the state’s understanding of others can improve according to the identities it attributes to them. Also when the state produces its own identity through the daily social practice. Ted Hopf contrary to the other authors who believe that the change in the world politics is so easy. He appreciates the power of structures an d believes that actors through ordinary practice are able to produce their own constraints. This in turn strengthens the world politics. He also admit that there can be some rooms for dynamism, though minimal. Therefore by viewing the relationship between the social grounds and agency, he admits that social change is both possible and difficult. These differences are existing due to the differences in their view of the social relationship between the agency and social change. The two factors play a major fundamental role.

Glaser Health Products Coursework Example | Topics and Well Written Essays - 500 words

Glaser Health Products - Coursework Example In most situations, these costs are part of recurrent expenditure treated as a liability in the company’s profitability index.In as much as production costs are characterized with a multiplier effect on the overall performance of the company, their increase in efficiency is always added to the value of production and increases the profitability of the firm.In order to trace various costs to activity groupings, arbitrary allocations of overheads to products, services, and consumers will be vital. At the first stage, there will be the derivation of the activity cost pool. These will consist of costs such as; material handling, procurement, and set-up. While the second stage will be made up of; costs per material movement, costs per purchase order, and costs per set-up.In primary stage cost drivers in relation to products, one needs to employ the use of activity drivers by assigning the activity costs to outputs on the basis of the consumption and demand for the outputs. All the outputs will be identified on the performance of an activity segment which consumes resources(Barrett, 2005). It is necessary to use preliminary and primary stage cost drivers because they aid in assigning resource costs to activities.This is done in three main ways which include; direct, indirect, and general/administrative costs. Direct costs consist of such costs that are traceable directly to one output such factory painting and repairs in the factory and other coats of production.

Information Communication Technology Ethics Essay Example for Free

Information Communication Technology Ethics Essay Reflection (1) Philosophy Ethics; â€Å"allows us to breakout of prejudices and harmful habits that we held since we were too young or too naà ¯ve to know better†. Also allows us to see and appreciate other views of the world and study it to see â€Å"the consequences of our views†, because what we think know might not be right â€Å"inconsistent†. What is Ethics? â€Å"Ethics deals with what we should and should not do, what acts are â€Å"good† and â€Å"wrong† â€Å". Ethics in my point of view is a very crucial yet sensitive controversial topic (Fluffy?). As humans there are defiantly dos and don’ts since the day of our birth, but since this is molded and inferred by ones culture, community, circumstances. These rules tend to change from one place to another (region, family culture, religion), also from times to others (eras). It is important to have ethics in our lives to co-exist as humans and have predictable consequences. The difficult part is the sensitive part, where the people are not open enough for change, sometimes not open minded enough for simply discussing their ethics, believes or their code of life, and just want to impose believes, culture, any form of ethics on others who don’t want to follow (you can’t please everyone when it comes to ethics). I personally follow somewhat a mixture of Deontological, virtue Ethics. Reflection (2) There is a difference between your molarity and your professional morality, where your morality doesn’t it always corresponds to the morality that your profession dictates. On the other hand the reason that a person would chooses a certain profession is because of its attractive value system that matches his/her morality and values, but it’s not always the case as discussed in class some people have the ability to switch entirely between their personal and professional lives, and some might be put in a position that opposes their morality and they are fully responsible for their actions and fully aware of the consequences that might follow. Ethics in information communication technology discipline is quite new, mainly because the major advancement in this system is fairly new as well, where it’s constantly changing and developing. The discipline now also occupied a huge rule in our daily lives, where we are almost always in contact with technology from the moment we wake up till the moment we sleep. Digital media significantly now alters our ethical responsibility on one another, because now we live in the digital world â€Å"we can’t assume that our ways work for everyone†, since the world not too long ago wasn’t that close, actions and data didn’t travel that fast, people and cultural ethics were preserved and rarely affected. In the meantime now data is flying everywhere the once local is now global in minutes maybe seconds and it’s just too soon unstudied cultural shocks and misunderstanding occur more often, but with this misunderstanding with the right people is corrected for good and others misconceived for good. By these experiences some therefore ethically knowing the cultural difference would tend to rethink before doing something offensive or controversial to avoid troubles. Reflections (3) Privacy†¦Ã¢â‚¬ we are our data† I do believe that. I also believe that if we are our data we can’t be denied the freedom of using, sharing or hiding it, because it’s a part of you. In this era of computer technology our data can be our thoughts regardless it might be moral or not it still belong to us, where in any other age than ours, it would have been kept the way you choose it to be, but now you can’t help but to feel stalked or judged. The floating â€Å"malleable† â€Å"greased† data privacy is a two edged sword, it can protect from evil and can cause evil and misfortune. And since evil and misfortune always exists and always will, the way it was before is known, which the freedom of our privacy choices is and that is because it will at least control one known evil which is this data misuse. Reflections (4) Intellectual freedom is a basic human right for all humans of all cultures and believes. This freedom has to be respected and protected universally. Furthermore I believe even if this is a basic human right, it must not be abused, and that’s where ethics and morality acts in, because even though you are entitled to your own opinion the person must bear in mind that words are very powerful and can do harm. The controversy between censorship and intellectual freedom, where one of the requirements of intellectual freedom to be fulfilled is that â€Å"the society makes an equal commitment to the right of unrestricted access to information and ideas regardless of the communication medium used, the content of the work/and the viewpoints of both the author and receiver of information.†

Discharge Plan for Older Person

Discharge Plan for Older Person In this assignment the author will discuss a discharge plan with rationale for an older person with a long term condition. Included will be potential and actual problems presenting from the patient profile on discharge from an acute care setting. Reference to the Nursing and Midwifery Councils (NMC) professional code of conduct (2008) shall be made throughout the assignment along with a discussion of legislation in the latter part that is relevant to the plan of care arranged. Moreover any copies of documentation used in the appendix will remain anonymous maintaining confidentiality. The theoretical model used to formulate this plan of care is Roper et al (1990) activities of daily living which concentrates on twelve elements essential for daily living skills and the level of dependence required for them. The elements of the theoretical model chosen will be those applicable to the patients discharge care for example, mobility and breathing. The patient profile referred to is that of an elder gentleman in his late seventies admitted to hospital following weakness on waking to the left side of his body which had mainly affected his mobility. There also appeared to be some facial drooping with dysarthria. For the purpose of this assignment when referring to the patient he will be named as Mr Smith as to personalise the plan of care. Mr Smith has a past medical history of chronic obstructive pulmonary disease (COPD) and asthma for which he receives drug therapy of salbutamol and becotide inhalers. He is also the main carer for his wife whom suffers severe Alzheimers disease. Discharge plan Liaise with the discharge co-ordinator as to the impending discharge of Mr Smith. This will ensure the continuity of his care on discharge. The discharge co-ordinator provides valuable assistance and is able to amplify the experience of a patients venture from hospital to the community Day et al (2009). They are highly skilled nurses in this specialist area and mediate between the multidiscipliness involved in the care needs of Mr Smith. Mobility. Problem 1 Possible changes to Mr Smiths movement, function and orientation. Method/outcome Complete a falls risk assessment using an identified tool and follow advisory notes on completion. With consent liaise with occupational therapy and physiotherapy departments for a discharge assessment and continued rehabilitation within the community. Make certain a home visit with therapy teams has been undertaken before discharge. Rationale A falls risk assessment tool (FRAT) is a way to establish risk and manage falls prevention. Its use is advocated in the National institute for clinical excellence (NICE) guidelines in falls prevention document (2004). Following the use of FRAT (appendix 2) it is decided that Mr Smith is at moderate risk of falling and advices of therapy team input. Mr Smith requires an assessment by the occupational therapy team in his home environment prior to his discharge. This ensures his safety and well being for day to day living and maintains his independence. The visit presents an opportunity for the occupational therapist to evaluate the need for adjustment in the home. For example it is recorded that Mr Smith has some difficulty in rising out of the bath he would therefore need modification in his bathroom to enable him to do this, promoting independence and maintaining his dignity. Mobility doesnt just include the physical aspect of movement it involves fine motor activity, personal assertion, feeling and communicative function also. Having a stroke can cause dysfunction, having a dramatic causatum on the persons life Barnet et al (2009). Making adjustments in the home can be an upsetting experience. An assessment by the physiotherapist will maximise rehabilitation in physical movement and allow instruction on the use of equipment that may be required in doing so, this ascertains safety and accuracy during use. Physiotherapists have superior kinetic knowledge and can introduce advice in falls prevention minimising the occurrence. NMC (2008) requires you as a nurse to refer to another practitioner when it is in the best interests of a persons care. Both therapists will be able to initiate communication with day hospitals for continued rehabilitation therapy sessions within the community. Maintain a safe environment and communication. Problem 2 Mr Smith is to administer daily medication and understand the information provision. Method/outcome Ensure the prescription with 7 days supply is provided and sent to pharmacy in time for discharge. Guarantee Mr Smith and his relatives receive relevant information regarding medication. Explain in an accessible manner. Arrange an out patients appointment. Present written and verbal information regarding the appointment. Inform the GP of Mr Smith discharge. Rationale Mr Smith has been prescribed aspirin 75mg following an ischaemic cerebral vascular accident (CVA). The aspirin is given prophylactically and inhibits platelet aggregation which could otherwise result in a thrombus formation British national formulary (BNF) (2009). Eighty percent of strokes result from ischemia, caused by a thrombus blocking the cerebral circulation therefore, preventative medication such as aspirin reduces the risk of a reoccurrence Greenstein and Gould (2009a). It is important to provide Mr Smith with written and verbal information with regard to instruction on how and when to take his medication, along with the dosage and possible side-effects he may encounter. Educating Mr Smith on the need for medication and possible consequence of non compliance present him with an informed choice and reduces the risk of a drug induced re-admission. Reports suggest that fifty percent of older people may not take medicines prescribed for them as they have not received valued information about the benefits and risks involved Department of health (DOH) (2001). The NMC (2008) says that you must share information about peoples health and regimes in a way they can understand. This facilitates informed choices and compliance. Nurses have a responsibility to continue assessment of their patients suitability for self-administration; the NMCs standards for medicines management (2008) standard 9 require you to acknowledge changes to a patients condition and safety with regard to self-administration. Assessing Mr Smiths understanding and capability of remembering to take his medication is of great importance as if he is likely to encounter difficulty, provision for pre-dispensed medicine or help from a carer can be arranged Wade (2007). Indirect questioning will provide some indication as to how much Mr Smith understands and will not make him feel inadequate, maintaining his dignity and respect. An outpatients appointment with a neurologist will maintain consistent specialist monitoring of Mr Smiths condition even though once discharged the GP is responsible for care in the community and continued prescribing. It is therefore vital that the GP has documentation on this hospital admission and any follow up appointments to be attended. Problem 3 Change to Mr Smiths social and home environmental needs. Method/outcome Inform Mr Smith as to the importance of social services participation and gain his consent. Liaise with social services for an assessment of needs completing the relevant documentation (sections 2 5) in acceptable time ready for Mr Smiths discharge. Rationale Consent must be given by Mr Smith prior to the involvement of social services, even though it is documented that they have had previous input with Mrs Smiths care. It is the individuals right to confidentiality and as a nurse you must respect this NMC (2008). Mr Smith has indicated that he has concerns with regard to coping and caring for his wife whom has severe Alzheimers disease when he is discharged. Social services must assess the need for a care support package and provide financial advice for the services required as Mr Smith is a home owner. With Mr Smiths consent social services may even consider the possibility of Mrs Smith remaining in the nursing home until Mr Smith is more able bodied. The need fulfilment of the dependent can generate emotional stress in the carer and burden their physical well-being with the high level of physical exertion needed to provide endowed care Mackenzie and Lee (2006). When Mr Smith returns home it is the expectation that he will be allowing himself time to recover and not put his self under duress which could result in a relapse in his health. Anecdotally, caring for his wife at this stage would not be beneficial to his rehabilitation. Problem 4 Transportation home on discharge from hospital. Method/outcome Liaise with relatives regarding transport home and if necessary arrange hospital transportation. Verify Mr Smith has keys to his property, that someone will be there to receive him or that the key safe number is available. Rationale It is of upmost importance that Mr Smith and his relatives are fully aware of the date of discharge and the preparations for his arrival. Where possible, Mr Smith and his relatives should contribute to the discharge plan. The expectation of you as a nurse is that you uphold peoples rights to be involved in decisions about their care NMC (2008). Working and playing. Problem 5 Possible isolation and lack of social contact. Method/outcome With consent refer Mr Smith to the community stroke liaison services and complete the relevant referral documentation. Provide the services contact details. Rationale The community stroke liaison nurse is there to provide support with initial changes to Mr Smiths life. She is a specialist in stroke rehabilitation and can present him with coping strategies. These will help Mr Smith focus on problem solving approaches and heighten his sense of control Carpenito-Moyet (2008a). The nurse specialist may also be able to provide Mr Smith with mini health checks and details of support groups, clubs and give advice regarding enrolling on an expert patient programme if it is available within the local authority. The expert patient programme is a self management course for people with long term conditions. It was launched in 2002 as a pilot programme but is now national. The course is delivered over a six week period by a trained tutor who is either a volunteer or a previous programme attendee and is vastly beneficial. The service reduces isolation, promotes confidence and empowers those living with deficits or complex needs DOH (2001). Eating and drinking. Problem 6 Nutritional support and secondary prevention Method/outcome With consent refer Mr Smith to a community dietician completing the documentation. Highlight the importance of lifestyle and dietary changes with regard to his condition. Outline the need to attend to any future difficulty in swallowing or further dysarthria. Rationale Following his stroke Mr Smith may have a reduced appetite. Carpentino-Moyet (2008b) suggests this may be due to fatigue, being less mobile or even because of some pain from limb limitation. Carpentino-Moyet (2008c) also discuss that during Illness or convalesce a good nutritional consumption can reduce the risk of further complications and aid faster recovery. Referring to the community dietician ensures that a diet plan optimal in calories and nutrition is received. Making certain that Mr Smith has some understanding about his condition will endeavour compliance with diet and life style changes. The reoccurrence of a CVA is much higher during the first year of rehabilitation, therefore regular checks and life style conversions need to be initiated DOH (2001). Mr Smiths awareness and detection of further difficulties with speech and swallowing is a desired outcome as this could most definitely interfere with his nutritional intake in the future and would incorporate further change to his diet and lifestyle they would also warrant a referral to a speech and language therapist for a swallow assessment. Breathing Problem 7 Mr Smith has COPD and asthma and requires respiratory maintenance and secondary prevention advice. Method/outcome Ensure Mr Smith is aware of how to use his inhalers with the correct technique. Inform him of the importance to have regular visits to the GP or respiratory nurse in order to maintain adequate respiration. Provide cessation of smoking advice. Rationale Belamy and Booker (2000) suggest that the recommended maintenance appointment for patients with mild to moderate COPD should be annually within the primary care setting, they also indicate the monitoring session should involve a full assessment of the patients smoking status, symptom control, and medication efficiency with inhaler technique. Furthermore it allows the health care professional to perform spirometry. It appears that Mr Smiths therapeutic intervention of becotide and salbutamol inhalers have symptomatic control of his COPD at present however, he is now also prescribed aspirin which could contraindicate his condition. Occasionally aspirin causes bronchospasm Greenstein and Gould (2009b) therefore close monitoring is essential. In practice we can promote smoking cessation and provide advice to Mr Smith with regard to the health risks involved following his stroke and COPD. It is his individual choice as to whether he will participate. Many people given smoking cessation advice will continue smoking disregarding concern for their health. The NMC (2008) stipulates that as a nurse you must not discriminate against those in your care, treating people as individuals regardless of whether their choice exacerbates their illnesses. Key issues in older adults and long term conditions care provision: Extensive change has been underway with regard to the care standards and expectations of health and social care services for older people. The force for change has happened due to demographic analysis, which indicates that people are living much longer with an increase in those above the age of eighty. According to the DOH (2001) this figure is expected to have doubled between 1995 and 2025. Such longevity influences the amount of people living with long term conditions. Research and reports from extensive consultation with older people, their carers, healthcare professionals and from media coverage, discuss services declining to meet the needs of older people with age discrimination and depletion of dignity and respect being a major domination as clinical areas lacked evidence based practice DOH (2001). The introduction of clinical governance has helped develop effectiveness of evidence based practice assuring the quality of care is of a high standard. Zwanenberg and Edwards (2004) describe clinical governance as a system to advance the quality of care in which healthcare managers are responsible for policy compliance. They explain that primary care trusts are accountable for providing evidence of their effectiveness and quality of clinical practice and further acknowledge the level of need for accountability since public interest in cases of malpractice. Care plans are aspects of clinical governance policies Lugon and Secker-Walker (1999) as is the essence of care document developed by the DOH in 2001. The essence of care document is a guidance tool specific in enabling healthcare professionals to deliver a structured and patient focused practice within eight areas of care. Some of the areas include food and nutrition, self-care and privacy and dignity. The document also enables professionals to distinguish areas of poor practice allowing for remediation DOH (2001). The national institute of clinical excellence formulated guidelines for practice in assessment and prevention of falls, declaring that falls are a major cause of disability or mortality in the elder population and impact on their quality of health and life NICE (2004). NICE (2004) also report that falling can have a devastating repercussion to an individual causing psychological distress, lack of confidence and poor self esteem, dependency and even pressure injury. The guidelines provide strategies for assessment (FRAT appendix 2) of those at risk of falling, including individuals following a stroke and suggest setting provision for interventions such as physical therapy, home adjustment and the revisal of visual deficit NICE (2004). The development of the national service framework (NSF) for older people by the DOH (2001) delivers policies as to the standard of healthcare that older people should receive. The NSF endeavoured to set strategies over a 10 year programme looking for improvements within specific areas of health promoting independence and providing treatment with respect and dignity. The document lists the quality of care that is required on the best available evidence and provides one standard for all, achieving consistency within healthcare DOH (2001). The focus of the NSF for older people was to abolish age discrimination and provide a patient centred approach to care DOH (2001). The document defines stroke and falls prevention, promotion of health and introduces standards of care for hospital and intermediate settings and for mental health illness in older people. The DOH in connection with the NSF for older people also developed the NSF for long term conditions in 2005. The document expresses the need for the promotion of quality of life with autonomy based around the individuals specific need for their condition. Implementation of this policy includes provision of support for housing, benefits, education and pension schemes helping those suffering with long term conditions to live as independently as possible with access to services as required DOH (2005). A stroke (CVA) is classified as a long term condition and the DOH (2007) stroke strategy document identifies the need for health promotion and management of risk. The plan of action firstly focuses on awareness and prevention, treatment and services available for those whose lives have been affected by stroke. Secondly, it identifies that all needs, health and social of the individual, should be contemplated in a plan of care not just medical ones DOH (2007). The stroke strategy guidelines allow for individuals following a minor event to be given an MRI scan within 24 hours, as evidence suggest eighty percent will follow on to have a severe stroke DOH (2007). Clinical areas can therefore reduce deaths in practice if they adhere to this policy. Promotion of healthy weight, physical exercise and smoking cessation along with regular blood pressure checks and advice on alcohol consumption further reduce risks DOH (2007). The stroke strategy also expresses the need for a multidisciplinary approach, all health and social care workers collaborating together cultivating a stroke care community that will provide the best possible service for those affected returning home DOH (2007). Continued assessment by the multidisciplines following a hospital admission is essential to ensure an individuals suitability for discharge. The DOH (2004) suggests that consideration be made for the individuals physiological, functional and psycho-social wellbeing during the assessments. Being fit for discharge means that receiving care in an acute setting is no longer needed and continued care can be provided between the GP, community services and outpatients appointments DOH (2004). One professional included in the multidiscipline approach within the community is a pharmacist with initiatives developed to increase their involvement in care, such as repeat dispensing, medication reviews and independent prescribing especially for those with long term illness DOH (2005). The pharmacists involvement within the multidisciplinary team is very beneficial to patient care as it decreases medication errors, discovering discrepancies and many contra-indications before the medication reaches the patient. All legislation and government policies have influence on the way healthcare professionals practice. They provide guidelines as to accommodate continuity of healthcare in general. They set standards for quality of care that service users can expect when accessing healthcare provision and project how they will receive this provision. Legislation is an important aspect of healthcare and individuals have the right to life without discrimination, being treated equally with dignity and respect regardless of their condition, disability or age. The writer concludes that Mr Smith is awaiting discharge from hospital following a stroke. Evident from the patient profile he has achieved a satisfactory level of independence and he appears to be making good progress. The discharge plan documented for Mr Smith incorporates many of the NHS and social care policy initiatives to deliver continuity of care from hospital to home using elements from the Roper et al (1990) theoretical nursing model. The discharge plan supports the inclusion of multidisciplines, health promotion, prevention strategies and patient participation. It also up holds the NMC code of professional conduct (2008) whilst focusing on independence and maintenance of ones dignity, providing community support and rehabilitation. References: Barret, D. Wilson, B. Woollands, A. (2009) Care planning a guide for nurses, Essex: Pearson Education Limited. Belamy, D. Booker, R. (2000) Chronic obstructive pulmonary disease in primary care, all you need to know to manage COPD in your practice 3rd ed. London: Class Publishing. BNF 57 (2009) British national formulary. London: BMJ Group/RPS publishing. Carpenito-Moyet, L.J. (2008) Nursing care plans documentation, nursing diagnoses and collaborative problems 5th ed. Hong Kong: Lippincott Williams Wilkins. Day, M.R. McCarthy,G. Coffey, A. (2009) Discharge planning: the role of the discharge co-ordinator, Nursing Older People, 21, (1), pp. 26-31. Department of Health (2001) Medicines and older people: implementing medicine-related aspects of the NSF for older people, The Department of Health. [online]. Available from: http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_4008020 [accessed 18/03/2010]. Department of Health (2001) The essence of care: patient-focused benchmarking for healthcare practitioners, The Department of Health. [online]. Available from: http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/dh_4127915.pdf [accessed 12/02/10]. Department of Health (2001) The national service framework for older people, The Department of Health. [online]. Available from: http://www.dh.gov.uk/dr_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/dh_4071283.pdf [accessed 14/02/2010]. Department of Health (2002) The expert patient program, a new approach to chronic disease management for the 21st century, The Department of Health. [online]. Available from: http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/dh_4018578.pdf [accessed 30/03/2010]. Department of Health (2004) Achieving timely simple discharge from hospital, a toolkit for the multi-disciplinary team, The Department of Health. [online]. Available from: http://www.dh.gov.uk/dr_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/dh_4088367.pdf [Accessed 26/03/2010]. Department of Health (2005) The national service framework for long-term conditions, London: The Stationary Office. Department of Health (2007) National stroke strategy, Department of Health. [online]. Available from: http://www.dh.gov.uk/dr_consum_dh/groups/dh_digitalassets/documents/digitalasset/dh_081059.pdf [accessed 25/03/2010]. Greenstein, B. Gould, D. (2009) Trounces clinical pharmacology for nurses 18th ed. London: Churchill Livingstone Elsevier. Lugon, M. Secker-Walker, J. (1999) Clinical governance, making it happen. London: Royal Society of Medicine Press. Mackenzie, A. Lee, D.T.F. (2006) Carers and lay caring, In: Nursing older people: Redfern, S.J. Ross, F.M. (eds.) Nursing older people. 4th ed. London: Elsevier. National Institute of Clinical Excellence (2004) Clinical practice guidelines for assessment and prevention of falls in older people. CG21. London: Royal College of Nursing. Nursing and Midwifery Council (2008) Professional code of conduct, London. Nursing and Midwifery Council (2008) Standards for medicine management, London. Roper, N. Logan, W. Tierney, A.J. (1990) The elements of nursing, based on activities of daily living. New York: Churchill Livingstone. Wade, S. (2007) Refusing discharge or transfer of care, in: Nurse facilitated hospital discharge: Lees, L. (ed.) Nurse facilitated hospital discharge. Keswick: MK Publishing. Zwannenberg, T.V. Edwards, C. (2004) Clinical governance in primary care, in: Clinical governance in primary care: Zwannenberg, T.V. Harrison, J. (eds.) Clinical governance in primary care. 2nd ed. Oxon: Radcliffe Medical Press Ltd.

The Trials and Tribulations Faced In One’s Youth :: Personal Narratives Peer Pressure Essays

The Trials and Tribulations Faced In One’s Youth My life has been filled throughout with influences both good and bad. My high school, although plain and simple from the outside, was anything but on the inside. My high school was known for its academic excellence and its more flush attendance area. But, few not and even some who were associated with my school knew of the problem within. A problem that would even be ignored even when it came right to the forefront of the local news. I never knew that drugs could become such a large part of my life, even without doing them. I never expected to ever find myself in trouble in a drug related incident. But, throughout my time in high school I just did what every other person did and ignored it. But I escaped the problem, others weren’t as lucky. My whole life I could not wait to get to high school. I guess it was always conveyed to me to be the best years of my life. So you can imagine how ecstatic I was to finally began attending Sabino High School in Tucson, Arizona. Home to around fifteen hundred or so students. A school set in a nice community, that was always supportive. It always had much parent backing, and the test scores from the school were some of the best in the state, competing with those scores of private schools. There was a problem though, one that would be ignored throughout my class’ tenure there. As a senior I found myself trapped in a school filled with narcotic sales and use. I even found some of my closest friends involved, and none of them were left with a care in the world. My best friend Zane kept his problem from me. It was not until later that he would admit to participating in any sort of drug activity. He would later tell me that throughout our junior year he used cocaine regularly. I knew nothing of this, and as his best friend worried about him when I did find out. I remember being so mad when he told me about his use of cocaine for that year because people would always tell me that they heard that he was doing it, and I always stuck for him and said that it was a lie.

The Mating Dance in Jane Austen’s Pride and Prejudice Essay -- Pride a

The Mating Dance in Jane Austen’s Pride and Prejudice As befitting the title of Jane Austen’s novel, pride and prejudice – as well as social decorum – restrain the protagonists’ feelings toward each other, resulting in a love that is forged by caution and tempered by time. Allen suggests that â€Å"simply because desire is not expressed, it does not cease to exist; repressed, it does not disappear. Instead it is symbolically displaced, returning with repetitive insistence in a concealed form† (426). In other words, although Elizabeth and Darcy’s feelings are hidden, these â€Å"concealed forms† of expression continue to fuel the lovers in their courtship. Literature and dance coexist with social decorum in strengthening Elizabeth and Darcy’s relationship, while facial expressions have neither social nor cultural boundaries. Abiding by the laws of decorum, literature, dance, and facial expressions help Elizabeth and Darcy break through their personal repressions and discover their l ove for each other. Literature appears in Pride and Prejudice in the form of books and letters. For most of Parts One and Two of the novel, Elizabeth Bennet’s social standing and the indecorum of her family repel Darcy. He remarks that because the Benett sisters have family in Cheapside, it â€Å"must very materially lessen their chance of marrying men of any consideration in the world† (Austen, 33). However, Darcy’s distain is greatly reduced when he discovers that Elizabeth prefers reading to cards. It is a matter of nurture triumphing over nature, for Elizabeth is cultured and educated despite her upbringing. Darcy may be subconsciously or even purposely referring to Elizabeth when he adds the virtues of extensive reading to the list of qualities he admires ... ... love for Elizabeth: he â€Å"was in the middle before [he] knew that [he] had begun† (Austen, 317). While still adhering to social norms and decorum, Elizabeth and Darcy are able to shed their pride and prejudice through the natural influences of literature, dance, and facial expression. As these modes of expressions are not immediately apparent in terms of love, they help Elizabeth and Darcy build a relationship that withstands the test of time and of scrutiny. Works Cited Allen, Dennis W. â€Å"No Love for Lydia: The Fate of Desire in Pride and Prejudice.† Texas Studies in Literature and Languages. 1985 Winter: 27: 425-443. Austen, Jane. Pride and Prejudice. New York, U.S.A.: Signet Classic, 1996. Stovel, Bruce. â€Å" ‘A Contrariety of Emotion’: Jane Austen’s Ambivalen Lovers in Pride And Prejudice.† International Fiction Review (IFR). 1987 Winter: 14 (1): 27-33.

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Learning Module 3 Connor MacLeod 100254620 The first video, The Solar Nebular Theory, describes the planetary formation through a collapsing cloud of dust and gas that spins in the same direction at a fast pace. Through angular momentum, as it collapses even more, it speeds up and flattens into a disk. As it flattens, the materials start to come together and planets start to form as well as a young star is created in the middle. What I liked about the video is how they used good analogies such as the pizza and the figure skater to get the idea of angular momentum across.What I didn’t like about the video is how they didn’t go more in depth about the other bodies that are created around the star. To make it better I would’ve used our solar system as an example in order to relate to it better The 2nd video is the Planetisimal video. It goes on to describe how particles grow by condensation, the process of adding matter to an atom or molecule. Once they get to a big enough size, the particles start to stick to others through a process called accretion. Planetisimals continue to grow by colliding and sticking to others until it gets large enough to turn into a protoplanet.The stage where iron falls to the core and heat is generated while lighter materials stay on the outside to create the earths crust. What I did not like about the video is how they do not specify how long it takes for it to turn into a protoplanet from a planetisimal. The woman talks about millions of years to get to the diameter of the particle to centimeters until they start to collide, but lacks the information of how long the collisions take to get bigger. They could improve the video by adding these details into it.What I liked about the video is how it goes in depth about protoplanets and the gravitational collapse as the textbook had me somewhat confused. The 3rd video is the extra solar planets. It is about how to detect planets outside of our solar system that gravita te around other stars. They don’t try and find planets directly, they observe the stars in which they believe planets gravitate around and watch how the star reacts. The way they can measure this is through the Doppler affect. As the planet gravitates around it, it pulls the star in different directions.So when a star comes towards you, its light gets compressed, and when it is moving away, the light waves get stretched. What I liked about the video is the way they illustrated how the Doppler affect worked with visuals as oppose to the dog theory in the textbook. That being said, what I didn’t like about the video was how they focused solely on detecting planets through the Doppler affect, I would improve upon this video by not leaving out the other approach of detecting the difference in light when a planet moves in front of it.The 4th video is about meteorites. It discuses how meteoroid’s cause meteors, that is until it reaches the ground and are renamed to me teorites. It then describes how each meteorite is classified by its composition. Each different composition inside a meteorite allows geologists to identify their space origins. What I liked about the video is how they discussed the different kinds of meteorites and the significance of different compositions of the meteorites. What I didn’t like is how they did not touch upon meteor showers and different meteor showers.To improve this video I would’ve included some facts of the Perseid meteor shower. The 5th video is about asteroids. It discusses how Italian astronomer Piazzi discovered the first asteroid. Now there are over 100,000 asteroids that lay in the asteroid belt near mars and Jupiter. They also describe the reason the asteroids are in the belt could be due to a planet that never formed. The pull of Jupiter’s gravity kept the particles accelerating so fast, they could never accrete.What I liked about the video is how it spent the most time discussing wh y the asteroid belt exists as that caught my attention the most in the textbook, where its only mentioned briefly. What I didn’t like about the video is it didn’t discuss the shapes and size of the asteroids themselves. To improve this video I would’ve added some interesting facts from the textbook such as some are asteroids are 200km in diameter. The 6th video is about comets. It talked about how civilization was influenced from comets and the association of comets to earth through eligious or mythological oriented societies and how they were viewed as a bad omen. What I did not like about this video is how it did not describe at all what a comet is, or what it is made up of. They could make this video better by discussing the basics of a comet, not just the historic significance it played on our societies. That being said, what I did like about this video is the telling of how it played a role in our societies that if something bad happened, and a comet was in the sky, it started to be associated with each other.