The Argument For Stricter Gun Control Laws Essay Example for Free

The Argument For Stricter Gun Control Laws Essay I am writing a persuasive argument in favor of stricter gun control laws. I am very passionate about this topic because the use of firearms in the wrong hands is a deadly prophecy. It can be in the form of children getting a hold of a gun and hurting themselves or others, an adult with violent propensities mishandling a weapon, or someone who wants the use of a firearm in aiding suicide. When one looks at the increased incident of injury to children, homicide, and suicide, it is clear there is a need for stricter gun control laws. This paper argues that firearms continue to play a dominant role in violence both criminal and accidental regardless of laws such as the five-day waiting period and the Brady Law. I will show how easier access to guns, rather than preventing crime, creates more of it through the use of examples and statistics Those whom are opposed to gun control laws do not like to admit there is a link between access to guns and violence. The NRA says guns dont kill people, people kill people. They will claim that the right to bear arms for se lf-defense and civil rights would be diminished. However, this view is only one sided and it fails to address the link between the ownership of guns and the violence that occurs because of it. Almost everyday we can open up a newspaper or turn on a national news broadcast on the television and discover a new case of someone being killed by the use of a gun. Perhaps it was a child whom had access to his/her parents gun they keep in the house for self defensive purposes, an adult whom was an innocent bystander during a workplace massacre or robbery, a shooting at a school by a disturbed kid, or a domestic dispute turned deadly. Unfortunately, it is rare that a day goes by that we do not hear about one of the above events. Whatever the case may be, it is apparent that too many people have access to firearms and that access must be restricted. The Brady Campaign is one that enforces gun control laws, elects pro gun control public officials, and informs the public about gun violence. It was enacted in 1994 and because of it, all 50 states must do background checks on anyone wishing to purchase a firearm. While this has helped quell some gun violence that may have occurred otherwise, there are still too many who are falling through the cracks. These background checks are targeting the wrong people and criminals are still able to obtain guns from illegal sources. Take a look at the Virginia Tech massacre last spring. This reopened the legislative debate over gun control that was never resolved from the Columbine high school shootings eight years earlier. Many wonder how Cho-Seung Hui was able to get his hands on powerful automatic weaponry that killed thirty two of his classmates. This proves that the background checks performed are insufficient and need to be more thorough. More than fifty survivors and family members of this tragedy signed a letter to Congress with one simple message- finish work on legislation that could prevent future tragedies. The notion of more complete background checks leads me to another issue that is the abolition of handguns. More handguns are used in criminal acts than any other type of firearm. The FBI reports that more than 60 percent of murders are caused by guns and handguns account for 70 percent of these. Lets look at some scenarios that stem from the lack of access to handguns: Sure, anyone with a penchant for killing could pull out a knife or a baseball bat but the victim has much better chance of survival. The likelihood of injury and not death are much greater as the victim may be able to get away. The next scenario are home burglaries. Most of these occur with the occupants are out of the house so the need for a gun inside the home is unnecessary. If there is a gun inside of the home, the perpetrator will confisca te it along with other valuables, thus placing it in the hands of criminal for future misuse. Approximately 40 percent of handguns used in crimes are stolen out of homes of law abiding citizens whom had guns for their own protection. If handgun manufacturers were stringently restricted and only allowed to sell to police, our environment would be much safer. Fewer criminals would have access to them if the sale of handguns to ordinary citizens were outlawed. They could not obtain them by way of stealing and their illegal underground network would be hampered. If this were to occur, those dangerous people would not have the opportunity to slip through the cracks and get a hold of a weapon. The end result would be fewer violent crimes and fewer injuries and/or deaths related to these crimes. Many states in the United States have right to carry laws that allow citizens to carry concealed handguns if they are qualified. Qualification includes a clean criminal history, age restrictions, and completing a firearms safety course. In 1986 only nine states had that law and as of 1998, 31 states have right-to-carry laws. Half of the citizens of the U.S. live in those states. This will engender only more violence as journalis t Philip Cook states if you introduce a gun into a violent encounter, it increases the chances that someone will die. In the end, the notion of violence in self-defense will only create more violence. It is for that reason that not only should handguns themselves be eradicated from the hands of the general public, but they should never be allowed to carry out in public. It is a fact that the Constitution guarantees us the right to bear arms. The Second Amendment in the Bill of Rights states: A well-regulated militia being necessary to the security of a free State, the right of the people to keep and bear arms shall not be infringed. Our founding fathers who authored the Constitution were certainly aware of the British efforts to disarm the colonists and believed a militia was necessary to defend democracy. However, in the present day, owners of handguns are not members of a militia attempting to fight a tyrannical power or oppression. Any type of gun that can be concealed should be abolished from the hands of ordinary citizens and only placed in the hands of the men and women of our police force whom are trained professionals. This will de-emphasize the use of another slogan If guns are outlawed, only outlaws will have guns. It simply will not be the case as long as only those who are legitimate protectors of society are the only people who have access to them. WORKS CITED Agresti, James D. Gun Control. Just Facts Foundation. 10 June 1999. 20 October 2007. www.justfacts.com. Desuka, Nan. Why Handguns Must Be Outlawed.. Current Issues and Enduring Questions. Boston: Bedford, 1993. Cassidy, J. Warren. The Case For Firearms. Current Issues and Enduring Questions. Boston: Bedford, 1993. Brady Campaign to Prevent Gun Violence. Families of Virginia Tech Victims and Survivors Call on U.S. Senate to Strengthen Brady Background Checks. 21 October 2007. www.handguncontrol.org

Employee Recruitment and Retention on the Plumbing and Heating Industry Essay Example for Free

Employee Recruitment and Retention on the Plumbing and Heating Industry Essay The way in which companies recruit and retain their employees is considered as a competitive weapon. Not until recently that firms are becoming serious on the act of recruitment as the Bureau of Labor statistics estimates that jobs will grow faster at a rate that is not proportional with the labor force, hence forcing the aforementioned to appeal to various groups such as omen and minorities. As such not only recruitment is very vital but also retaining employees (Denton, 1992, p. 14). According to Frank Doyle, the senior vice president of corporate relations at General Electric: For U.   S. corporations, tomorrow’s competitive battle will be won or lost on the strength of their ability to build and retain a skilled work force (Richman 1990, 76 as cited from Denton, 1992, p. 14). General Electric believes that labor shortage does not significantly matter if companies know which people to hire and to retain. For instance, companies such as Merck Co. often times target certain universities or campuses that give a more detailed specialization on certain knowledge and skills that are very vital to their business. The Plumbing and Heating Industry  The plumbing and heating industry has been experiencing shortages as well on their workforce due to the difficulty of finding skilled plumbers and retaining them. It needs several numbers of years training on order to become a qualified plumber and heater and such also requires a deep dedication for a lifelong learning process. Certain skills are also necessary to be a good plumber such as need a head for heights, the ability to work in cramped conditions and the stamina to complete physically hard work day after day (The Institute of Plumbing and Heating Engineering, 2007). In addition with this, plumbers also need the intelligence to solve complex equations. More importantly, they must have the expertise and flexibility to install various systems and the capability to comprehend the logic of various systems. They should also have the ability and initiative to solve a problem and a passion to know and apply various technologies on their work. Plumbers and heaters must also have a creative mind and a sound judgment, and finally they should be professional and honest (The Institute of Plumbing and Heating Engineering, 2007). Employee Recruitment Interviews In order to find the right people, the process of interviewing and getting to know them not only through their answers but also through their eye contacts, body languages and the likes (Dibble, 1999). For instance, some companies like Merck often conduct a 30-minute interview in order to assess the qualifications of prospective employees. Hewlett-Packard did it further by implementing a technique called behavioral interviewing that is developed by organizational psychologist Paul Green that would assess the future behavior of a prospective employee based on his or her past behaviors. In using this technique, interviewers can design employee questions that would allow them to elicit behaviors that are closely related to the job that they are looking for (Denton, 1999, p. 16). The process of behavioral interview often times identifies 21 skills that are very vital for certain jobs such as coping, decisiveness, assertiveness, tolerance of ambiguity, written communication skills, creativity, commitment, team building, versatility, and leadership (Denton, 1999, p. 17). For the aforementioned skills there are still eight job behaviors that are needed to be known such as how prospective employees deal with â€Å"varied duties, deal with diverse groups, respond to others needs, be socially flexible, roll with the punches, understand individual differences, make others comfortable, exhibit wide range of social behaviors ( More 1988, as cited from Denton, 1992, p. 17). Decentralized Hiring Traditional recruitment approaches that focuses on interviewing prospective employees by a single person is no longer deemed as vital nowadays. For instance, the Springfield Remanufacturing Corporation (SRC) one of Americas most successful small companies still has their hiring process as a group activity. SRC adopts a non-traditional method of recruitment by having all of their applicants have five or six interviews with various individuals that he or she might be working with (Denton, 1992, p. 18). Recruitment through Reputation The reputation of the company is also one of the leading factors in which highly knowledgeable and skilled employees will desire to work for the aforementioned. For instance SRC received more than 2,500 applications for a small company that only employs 300 people. It could also be noted that the company only pays $6 or $7 per hour, yet applicants are still flocking to them. One significant reason for this is its reputation for being one of the best places to work. One of the ways of doing such is the capacity of a company to manage the diversity of their workforce (Denton, 1992, p. 19). The shortages in terms of prospective employees is a growing concern among companies that is why there is a need to focus more on recruiting minorities and women. However, in order for a company to have a wide application pool, such must first establish to have a good reputation of being able to effectively manage organizational diversity (Denton, 1992, p. 20). Aggressive Recruitment for Entry-Level Workers One of the best ways to tap to a good employee resource is through recruiting entry-level workers through implementing various programs such as â€Å"Adopt-a-School† or â€Å"Join-A-School†. These programs allow companies and organizations to establish partnerships between business and schools which may involve elementary school, vocational school or even a university (Denton, 1992, p. 5). The main value of such programs is the establishment of closer relationships between schools and in a macro perspective, creating better understanding businesses and industry. More importantly, partnerships such as like these, would allow companies to easily recruit personnels that can improve the companys image that could help the prospective applicants to view your companys business as a career, hence a better chance of creating a wide labor pool (Denton, 1992, p. 26). Employee Retention If finding good people is hard, so as looking for ways to make them stay. One of the companies that have displayed such an admirable trait is Federal Express, wherein they have emphasized the importance of retention, recruitment and employee relations (Dibble, 1999). If a particular company is very careful in terms of recruiting, there is also a relatively better match of keeping them. One best way of doing such is the company centralizing all of its recruitment centers (Denton, p. 47). After which, they provide immense value on putting their people first on their list. Good employee relations for Federal Express involve deeds that impress employees and improve relations (Denton, p. 48). According to Fred Smith, CEO of Federal Express, I think a lot of companies talk about how their employees are their most important asset, but where you can really tell whether it is very important or not is how much their senior management spends on the issues ( Trunick 1989, 19 as cited from Denton, 1992, p. 48). Through implementing the philosophy of people, service, Profits the company makes their people feel that they are indeed needed in the organization. They let them answer several basic questions such as What is expected of me, and what do you want me to do? (p. 48). These questions are answered by having all of their employees attend extensive orientation programs wherein the Federal Express values are discussed Incentives Career advancement is not the only incentive that will make people stay within the organization. For instance the use of awards program that is designed to reinforce a particular desired behavior such as superior quality of work and customer centricity played a lot in terms of motivating employees to stay (p. 49). One very good example of this is Federal Express Bravo Zulu Voucher Program: wherein employees who displayed admirable work performance such as going beyond what is expected of them are able to receive cash or non cash rewards. Also, their Suggestion Awards Program allow employees to participate in the management process by sharing their ideas that will enable the company to improve its operations. Any idea implemented that will lower costs, increase productivity, revenues or promote safer working conditions will receive recognition and $100 to $25,000 worth of cash (p. 49). Communications Open Communication among employees is also vital to solve a problem. The internal employee response program allows employees to find answers to situations that they perceived as something that is disagreeable, controversial or is contrary to existing policies. If employees express negative concerns about their work or with the management, the latter is expected to respond within 14 days. These concerns are assured to be forwarded to the CEO (p. 50). Appeals Board The Appeals Board is a venue wherein decisions among complaints could be given and also disciplines could be implemented. However, it is very important that when keeping such a type of venue for resolution of organizational conflicts, the organization must have the capability to streamline its process to make the time alloted for every case reasonable enough (Denton, 1999, p. 52). Survey, Feedback, Action (SFA) An annual survey of employee attitudes is also important for the company to measure its employee opinions and to make changes that could hopefully change not so favorable employee attitudes to the company (Dibble, 1999). This assures that the management will see clearly what its team feels about the organization. In addition such allows a fair gauge of attitude and anonymity among employees (Denton, 1999, p. 52). Education and Trainings Continued learning is a venue wherein employees themselves would feel that they are indeed valued by the company. As such it us also very relevant as well that the organization will invest on trainings or even scholarships to employees who wanted to continue their education (Logue, Yates and Greider, 2001, p. 46-47). Conclusion The Plumbing and Heating Industry has been experiencing a significant decline in terms of its workforce. Hence in order to solve this problem the industry must be able to adopt effective recruitment and employee retention practices that were formulated in theory and practice of various management scholars and organizations. For the purpose of this research, in order to have an effective recruitment process, the research has emphasized the importance of: Interviews, Decentralized Hiring, Recruitment through Reputation, and Aggressive Recruitment for Entry-Level Workers. On the other hand, in order to retain employees, companies must be able to focus on: Incentives, Communications, Appeals Board, Survey, Feedback, Action (SFA), and Education and Training.

Case Study of clinical decision making in practice

Case Study of clinical decision making in practice This assignment was written by a Community Matron working in a Primary Care setting for a local GP surgery. Using a case study approach, it aims to illustrate a clear, logical account of clinical decision making in the practice environment, whereby the patient was fully assessed, differential diagnosis reached, and effectively treated, furthermore, through a collaborative model of consultation (Rudisill et al 2006) and working, professionals pooled knowledge and resources and carers were educated to reduce further incidences of the problem illustrating the benefits of proactive care from the Community Matron ( Boaden, Dusheiko and Gravelle 2005). The patient was chosen for this study as this was the third incidence of the presenting condition in as many months, making it obvious to the practitioner that whilst the problem had been treated on previous occasions, further investigation of the condition and a constructive, concerted approach was needed to prevent future recurrences and to maintain patient comfort. In accordance with the Nursing and Midwifery Councils Code of Conduct (NMC 2009), consent was granted by the patient prior to undertaking the study and names changed to protect identity and maintain confidentiality, for this reason the patient will be referred to as Jack Lowe and his wife as Linda. Multiple complex pathologies and socioeconomic conditions influenced the development of the patients skin condition, due to the constraints of word allowance it was not possible to elaborate on all the contributing factors; for the purpose of this assignment, the practitioner aimed to give a brief overview of pathologies and to concentrate on consultation and clinical decision making from a primary and secondary prevention perspective Jack had been registered with the Community Matron for eighteen months; he had a history of coronary heart disease having experienced a cerebrovascular accident resulting in right sided hemi paresis with reduced mobility ten years ago, and a diagnosis of type 2 diabetes two years ago. Following a history of poor diabetic control, Jack was referred to the Community Matron by his Gp in June 2008 to provide ongoing education and support for Jack and Linda in order to more effectively manage Jacks condition and minimise complications of diabetes (DoH 2001). Information, education and psychological support is the cornerstone of diabetic care (DoH 2001); the Diabetic Specialist Nurse proved an invaluable resource to the Community Matron who was subsequently able to provide dietary advice to Jack and Linda both verbally and written using a patient handbook (NICE 2002a). This approach proved successful and diabetic control improved, consequently Community Matron visits were reduced to a mont hly support and monitoring regime. However, carers recently noticed a skin problem during morning visit (see Appendix 2) and referred Jack to the Community Matron for reassessment. Systematic and sensitive assessment has been a key government policy in primary health and community care (RCN 2004); accurate medical history taking is vital as this is arguably the most important aspect of consultation (Crumbie and Walsh 2006) with 80% of diagnoses formulated on the interview alone (Epstein, Perkin, Cookson and Bono 2003). Skin problems constitute 15% of GP consultations; essential management requires a history of the complaint as well as background information, including general health and concurrent treatment (Parker 2009). Following a full explanation, reassessment (appendix 1), took into consideration the personal areas involved and the possibility that the condition was sexually transmitted; sensitive questioning of sexual history was undertaken and noted. Information was gained using a variety of methods, including open questioning of Jack, wife Linda, medical notes, hospital discharge letters and Care Agency daily records. Whilst interviewing Jack it became apparent that he was feeling depressed, further questioning confirmed that Jack had been feeling depressed for some time (Patient Health Questionaire-PHQ 9 completed and filed in Jacks notes with a copy to GP), Linda had been ill with a cold earlier in the year and had snapped at Jack, he said that he felt that he was a burden and refused to be persuaded otherwise becoming very tearful during the consultation. After further discussion, Linda agreed that she had been finding it difficult to cope and agreed to accept more help during the day; referrals were made to social services and to crossroads to provide day sitting service to allow Linda time to herself. Antidepressants were discussed for short-term relief of symptoms but both Jack and Linda felt that with extra support they would both improve. Assessment tools to aid memory and ensure relevant information is identified include mnemonics whereby an easily remembered acronym associates with list items (mnemonic). Mnemonics have been used since the second century BC (Nager and Heinrichs 2009), whilst SOCRATES is generally used by medical professionals as a pain assessment tool to gain insight into patients condition (http://en.wikipedia.org/wiki/Socrates-(pain assessment), the practitioner could find no validation of this tool, although Clayton et al (2000) use this acronym in their study, they too fail to highlight the origins of the acronym and provide no validation or references. A plethora of mnemonics can be found to assist in consultation and assessment http://www.medicalmnemonics.com/), acronyms considered, included SWIPE (starts, worse, improves, pain, episode), LOSTWAR (location, onset, severity, worsening, alleviating and radiating), nevertheless, the practitioner found SOCRATES easy to remember and relevant to Jacks condition, pertinently, she found this particular tool an invaluable resource when gaining a concise history of the presenting problem(See appendix 2). Recent blood test results reviewed (appendix 3), vital signs of blood pressure, pulse, and temperature recorded, and shown to be within normal limits, no pyrexia was noted which precluded infection, weight, BMI, waist measurements and random capillary blood glucose levels were taken and compared to previous results. Whilst there appeared little change in general observations, Jack had gained 5kg in weight with a proportional 7cm increase in girth measurements, Hba1c levels had increased from 6.3% in June 2009 to 7.8% in January 2009; also his eGFR had decreased from 49ml/min in June 2009 to 44ml/min in January 2010. Medication (appendix 1) was reviewed to assess if this may have contributed to the condition and whilst Aspirin, Bisoprolol and Xismox all have itching and rash listed as a side effect, this is indicative of an allergic reaction which occurs suddenly (BNF 2009), over the counter medication and herbal remedies were also explored and Jack confirmed that he only used prescription medication, and therefore it was perceived medication could not have initiated the problem. Jack has no documented allergies to medication which could possibly have caused a rash, and has not been receiving antibiotic therapy which may have predisposed him to fungal infections (Hilson 2002). Jacks wife confirmed that no new topical agents or laundry powders have been used recently which may have triggered a skin reaction (Parker 2009). Following history taking and full explanation, consent for examination was obtained. Whilst Jack was well known to the practitioner and a confident, professional relationship established, sensitivity was shown to the fact that he would be partially undressed during the procedure, examination was then conducted in the privacy of the bedroom with the curtains and windows closed, pertinently, a clean sheet was used to cover areas not under scrutiny to ensure only the relevant areas of Jacks body remained uncovered at one time during the procedure to maintain dignity, Linda was present throughout the examination at Jacks request. Physical examination was then undertaken using the skills of inspection and palpation, the senses of touch, listening and smell, physical findings from the examination were then integrated into the diagnostic process. According to Epstein, Perkin, Cookson and Bono (2003) there is a tendency to focus on the localised area of skin but as an organ in its own right skin should be fully examined to gain maximum information. A full examination in good light is essential to identify details necessary to formulate a differential diagnosis, these include, site, distribution, pattern, colour, heat, flat or raised surface and any ulceration (Chadha 2009 Bickley and Szilagyi). A careful inspection ruled out rash or dry skin problems elsewhere on the body, however, the skin between the groins extending onto the scrotum was intensely reddened, cracked in skin folds, covered in a moist rash with a creamy curd discharge, well defined borders and scaling on the edges, small satellite lesions outside the scaly borders and a yeast like odour was present. On palpation, the skin felt damp, heat radiated from the skin and the area was sore when touched. Nevertheless palpation of the inguinal area revealed no pain, or l ymph node enlargement, Jack was apyrexial and said that he felt well apart from the skin problem indicating no outward signs systemic infection. Clinical decision making is often fraught with uncertainties, however, expert diagnosticians maintain a degree of suspicion throughout the assessment process, consider a range of potential explanations, then generate and narrow their differential diagnosis, based on own experience, familiarity with the evidence related to various diagnoses, and understanding of their individual patient. Ultimately, diagnosis is confirmed or ruled out by combining findings from physical examination and history and comparing them to findings from diagnostic studies which closely match presentation of the problem (Goolsby and Grubbs 2006). A plethora of skin conditions exist which were initially considered including eczema (or dermatitis), the commonest inflammatory condition accounting for 30-40% of dermatology consultations (Forslind and Lindberg 2003), flexural psoriasis had some features and associated factors i.e. affecting skin folds but as no lesions elsewhere on the body and no history of psoriasis this was only fleetingly considered, whilst distribution, symptoms and appearance of incontinence dermatitis was almost identical to Jacks condition, he had in situ a fully functioning urethral catheter and no faecal or urine leakage problems which could have initiated the condition. Following reassessment, consideration of medical, social history, physical findings and clinical manifestations of the disease, only five conditions were included in the diagnostic process (appendix 4). Differential diagnosis of Intertrigo was initially included but discounted as the area had signs of skin infection not associated with Intertrigo which is an inflammatory condition and not an infection (Parker 2009), Erythrasma, and Bacterial Intertrigo were considered as the localisation, namely skin folds fit the inclusion criteria and then discarded as images of Erythrasma and Bacterial Intertrigo were too dissimilar to Jacks rash, coupled with the fact that the yeasty smell and white areas on the skin appeared more consistent with fungal rather than bacterial infection. Tinea Cruris is commonly caused by the fungus Trichophyton rubrum and looked remarkably similar; however, this diagnosis was discounted as there was fungal rash to scrotum which was inconsistent with Tinea Cruris and no Tinea Pedis (maceration of interdigital web folds) consistent with the condition (Brannon 2009). Whilst a KOH test, performed by examining skin scrapings under a microscope, would have given an absolute diagnosis, the practitioner felt confident that as the description of Candidal Intertrigo (Brannon 2004) most closely matched the physical manifestations and characteristic distribution of Jacks skin condition, coupled with the fact that Intertrigo Candida had been previously diagnosed and treated if not eradicated, this appeared the most likely diagnosis. In order to effectively treat the skin problems one must first consider the underlying pathology of the condition. The skin is the largest organ of the body and forms a barrier between the internal organ and the external environment as people age, less efficient micro-circulation results in reduced blood flow, skin becomes drier, less elastic and more permeable, making it more susceptible to damage (Ousey 2005). Elderly people, therefore like Jack who are obese and less mobile, have increased prolonged occlusion in areas such as groins, resulting in more moisture and warmth in skin. Intertrigo occurs when two occluded, moist surfaces of skin rub together with the resulting friction setting up the inflammatory process (Parker 2009). Following activation by cells present in tissues, macrophages, dendritic cells, histiocytes, Kuppfer cells and mastocytes inflammatory mediators are released and vasodilation increases blood flow, causing itching, redness and heat, the blood vessels become more permeable resulting in oedema and the release of bradykinin increases sensitivity to pain (http://en.wikipedia.org/wiki/Inflammation). This cycle continues due to the constant chafing stimulus provided by the two skin surfaces leading to chronic inflammation and a moist warm environment where Candida can thrive (Gullo 2009). Key aims of the health professional in treating Candidal infections are identifying and encouraging the management of underlying predisposing risks as this will improve symptoms and minimise recurrence(Parker 2009). Candidal (yeast infections) are commonly caused by Candida Abicans, which is normally present on body surfaces, colonisation with the fungus (Mims et al 2001) has an increased incidence in obese, the immunosuppressed, and diabetic patients with increased prevalence in the elderly and in those with poor personal hygiene (Weller et al 2008, Parker 2009), antibiotic therapy is also known to predispose the patient to fungal infections (Hilson 2002). Interestingly, whilst it is generally accepted that diabetics are more prone to Candida Albicans infection, the practitioner could find only scant explanation for this, Hall and Hall (2009) and Laube and Farrell (2002) suggest that high blood glucose levels encourage proliferation of bacteria and attacks from microbials and fungal infections, Mims et al (2001) agree and also propose that skin sepsis is poorly controlled in diabetics probably due to defective chemotaxis and phagocytosis in polymorphs which show impaired energy metabolism, they add that in vitro, the energy of polymorphs is rapidly restored by the addition of insulin. Following diagnosis and identification of multifactoral elements and risk factors, treatment was commenced, primarily to eradicate the Candida infection and secondly through a structured programme of health promotion, and collaborative working, risk factors were reduced to minimise recurrence. Treatment options considered included therapeutic and non therapeutic options. Therapeutic treatment is aimed at secondary prevention whereby therapy is commenced to treat the condition and prevent further complication. Whilst Candida Albicans is a common infection in the elderly (Hall and Hall 2009), invasive candiadasis (candidaemia) occurs when the pathogen become systemic and is associated with significant mortality and morbidity (Gullo2009, Candiadasis http://en.wikipedia.org/wiki/Candidiasis ). Guidelines show (BNF 2009) that therapeutic interventions of Candidal Intertrigo are confined to topical treatment with an Imidazole cream with an added steroid component where inflammation is present. The decision not to treat the skin inflammation with combined antifungal and steroid cream was based on the fact that steroid therapy is contraindicated in occluded groin areas where dermal uptake of the steroid may be systemically increased, signs of infection reduced, and itching made worse (Watkins 2004, Brannon 2004). As previous infection responded to a course of antifungal treatment but recurred, advice was sought from the local pharmacist who suggested that recurrence could be partly due to stopping the treatment once condition appeared resolved, he advised that treatment with antifungal creams should be used twice daily for a minimum of two weeks after symptoms cleared. As evidence suggest(BNF 2009) that no one Imidazole more effectively treats fungal infections than the others, the choice of which to prescribe was based on nothing more than the cost of the product, past experience and availability at the small local pharmacy, therefore Clotrimazole Cream 1% 20mg was prescribed by the practitioner (NPF 2009-2011). Whilst keeping the affected area clean and dry relieves symptoms of inflammation and improves healing (Parker 2009), the practitioner could find no non-therapeutic remedies to treat the fungal infection. Here, non therapeutic treatment relates to primary prevention of the disease process, namely prevention of the disease process occurring (Katz et al 2000). This included lifestyle management to control weight, improve mobility, reduce occlusion of skin in groins, improve blood glucose control, effective skin care, and prompt identification of intertrigo (Gullo 2009, Parker 2009, Hall and hall 2009) to limit the condition and reduce the risk of infection. Carers were responsible for all Jacks hygiene needs and played a key part in primary and secondary prevention, in order to ensure effective treatment with continuity of care, written and verbal instructions were needed, consequently a care plan was devised by the practitioner in conjunction with Linda and Jack to incorporate therapeutic and non therapeutic interventions. Whilst accurate research-based information was available on the internet (http://www.library.nhs.uk/skin/SearchResults.aspx?tabID=290catID=83420), neither Jack nor Linda had access to a computer, therefore downloaded information was printed out and given to Jack to reinforce information contained in care plan. Following consultation with the Care Agency manager, a copy was then placed in Jacks file and one at the Care Agency Office. The empowerment model of health advocated by Katz (2000) suggests that the aim of the health professional is to teach people the skills to take care of their own health. Consequently, Linda and Jack were encouraged to take an active role both in treating his skin condition and in improving general health and well being. Being assertive is advocated in this model, and as Linda reported that the carers were often in a hurry to complete hygiene within allocated time limits, she was encouraged to be more assertive and to ensure that Jack had sufficient time allowed by social services for his needs, the practitioner agreed to request a reassessment if Linda considered that carer time allotted to Jack insufficient for his needs. Scrupulous cleaning is essential, however, with ph of 5.5 skin is slightly acidic (Skewes 1996, Hampson 2006) and whilst soap cleans effectively it is alkaline (ph 10-12) and if not rinsed off thoroughly, can elevate the skins natural ph, reduce antibacterial property, and encourage fungal growth; lipids naturally present on skin surface are removed making skin drier and affecting barrier function (Warner and Boissey 1999) further increasing the risk of infection. Linda was advised not to buy perfumed soaps or bubble baths as these can cause allergic reactions and skin dryness (Lievre 1996), an emollient cream was prescribed, carers were advised through the care plan to rinse and dry skin thoroughly to reduce opportunistic fungal growth (Parker 2009). Jack agreed to inform the carers if he was not dry between the groins. A management plan was included in the care plan, as early treatment can often delay or reduce the impact of the condition, carers were therefore encouraged, to closely observe groins for the first signs of the condition, and to report to Linda so that effective treatment could be implemented. Jack was subsequently referred to the physiotherapist and commenced a weekly programme of physiotherapy, he was encouraged not to use the wheelchair in the home and very slowly his mobility increased, the diabetic nurse visited to advise on diet and Linda was encouraged to participate and try to eat more healthily. About three days into treatment with the antifungal cream, Jacks skin showed marked improvement, the cream was discontinued after three weeks. Unfortunately, four weeks later, Linda reported that the condition had recurred, examination of the area showed Jacks groins only mildly affected by intertrigo with skin folds slightly reddened, no infection was noted therefore a prescription was issued by the practitioner for Actisorb Silver which she advised carers to place between groins, this served to both separate the skin folds as suggested by Practice Nurse (2009) and reduce bacterial skin count (BNF. org 2009. Whilst the practitioner could find no research based evidence to support this decision, reflection upon practice based evidence illustrated that in the past, placing this dressing on reddened groins reduced redness and prevented further exacerbation. Fungal infections can be unsightly, chronically itchy and are increasingly being recognised as a threat in critically ill adults and can be life threatening in some adults (Gullo 2009), and whilst Jack had a further recurrence of intertrigo, prompt identification of the condition and treatment reduced severity and prevented the complication of a fungal infection, however with the multifactoral elements of the condition it may recur at a later date. Hopefully, an empowered team approach will minimise risk factors and ensure that these episodes are at least reduced if not prevented.

Comparing the Artwork of Dr. Seuss and Rube Goldberg Essay -- Compare

Comparing the Artwork of Dr. Seuss to the Artwork of Rube Goldberg Dr. Seuss has an interesting background that is often overlooked. Many fans do not know that the beloved children’s book author actually began his career drawing cartoons for magazines and advertisements (â€Å"The Advertising Artwork of Dr. Seuss†). In many of his advertisements and children’s books he has amazing elaborate machines that complete different tasks. This aspect of his artwork has many similarities to another famous cartoonist, Rube Goldberg. In this essay I will be comparing the artwork of Dr. Seuss to the artwork of Rube Goldberg. For those who are not familiar with Rube Goldberg here is a very brief background on the famous cartoonist. Rube Goldberg had many talents; he was a Pulitzer Prize winning cartoonist, a sculptor and an author (â€Å"Rube Goldberg Biography†). Born in San Francisco in 1883 his father had big plans for Rube to become an engineer. Rube became an engineer only to work as one for a short time. He had other plans; plans to become an artist. Eventually Rube got a job in New York drawing cartoons for the Evening Mail. Rube became a founding member of the National Cartoonist Society. He was a successful political cartoonist and a Pulitzer Prize winner. Rube Goldberg is best known for his â€Å"Inventions† cartoons. Goldberg’s inventions show wacky, complex ways to complete somewhat meaningless tasks much like Seuss’s â€Å"inventions† in many of his books. A good comparison of the way that Goldberg may have influenced Dr. Seuss can be seen in Seuss’s famous book, The Cat in the Hat. On page fifty-six we see the Cat’s great machine that he uses to pick up his messes. The Cat shows a very complex way of picking up his â€Å"playthings†. The wonder... ...ad it is extremely easy to see Goldberg’s influence on Seuss. Seuss created a very complex machine for the simple task of applying make-up. Other examples of Seuss’s inventions exist in some of his children’s books. These books include: The Cat in the Hat, The Butter Battle Book, and The Sneeches. There are probably many more; it seems that with every turn of a page one can find some sort of wacky Seuss invention. To see the pictures of Rube Goldberg's work go to http://www.rubegoldberg.com To see the pictures of Dr. Seuss's Advertising art work go to http://orpheus.uscd.edu/speccoll/dsads/index.shtml Works Cited: â€Å"Rube Goldberg Biography† The official Rube Goldberg Website. 8 April 2003. http://www.rubegoldberg.com/html/bio.htm. 20 April 2003. â€Å"The Advertising Artwork of Dr. Seuss†. http://orpheus.uscd.edu/speccoll/dsads/index.shtml 20 April 2003.

Prejudice in Heart of Darkness - Racism in the Heart :: HOD Joseph Conrad Heart of Darkness

Racism in Heart of Darkness I find no elements of racism in Joseph Conrad's Heart of Darkness. I will admit that I began reading this with a little hesitation based on the fact that I do not like to read about human cruelty. However, after reading the story, I did not feel any negative feelings toward the story or author. I feel one must realize that the occurrences of this story were really happening. I do not feel that by the virtue of performing a task that one is hired to do makes one a racist. Many times social problems are so overwhelming that one individual does not know where to begin in correcting the problem. Marlow was described as unemployed with a childhood dream to go to the uncharted Africa. I feel Marlow went to the Congo with no real knowledge of what was truly happening in the Congo. In addition to this thought, people really do not have the capabilities to know the severity of a problem until one experiences it first hand.   I believe that injustices towards another human race are intolerable. However, social change takes time from many people experiencing the issue. In my opinion, there were several incidents within the story that indicated to me that Conrad's character, Marlow, was not a racist. For example, when Marlow is first at the station, he spies a big shade tree in the distance and decides to investigate. Marlow goes under the tree and finds many African people moaning and waiting to die. Marlow is stunned at what he encounters.   This encounter stays with him throughout his time in the Congo.   Marlow was never cruel to his black crewmembers.  Ã‚   After his helmsman died in the attack ordered by Kurtz, Marlow was quite shaken. He later describes that he will never forget the look on his face. I also feel he did a service to the deceased man by throwing him overboard as opposed to letting him possibly be eaten by the rumored cannibals that were part of the crew. In another incident, Marlow saw the pilgrims poising themselves to shoot the natives that had lined up along the river after retrieving Kurtz.   As opposed to allowing them to shoot them unmercifully, Marlow blows the steamers horn knowing it would scare the natives back into the forest and saving them from the guns.

THE EPIPHANY OF DIVORCE Essay -- essays research papers

â€Å"Logic: The art of thinking and reasoning in strict accordance with the limitations and incapacities of the human misunderstanding.† Ambrose Bierce, American Writer, Journalist, Editor 1842-1914 The Epiphany of Divorce   Ã‚  Ã‚  Ã‚  Ã‚  Through much evaluation and reflection I can identify one instance in my life when my perception of the situation was far from the true reality. The ending of my first marriage and the subsequent change in my thought process has allowed me to step out of a perpetual cycle of enculturation imposed upon me by society. †¢ What did you think was going on?   Ã‚  Ã‚  Ã‚  Ã‚  I felt there were no problems with this relationship. The perception was that we were happy, everything was going perfectly or so I thought. We were building a new home, building a future together, and building a better life. I was content and satisfied with life and the relationship I was in. The marriage was idyllic, with little to no confrontation or major crises and ultimately fulfilling. Because we never had any knock down drag out fights or spoke badly of one another there was the perception that everything must be ok. We were financially secure, young and healthy and in love, well at least I was. †¢ What was really going on?   Ã‚  Ã‚  Ã‚  Ã‚  The reality of the situation was my marriage was on the rocks. There was a rift developing within the marriage and I was blind to the reality. Blinded because I was working too much in my pro...

Learning management system Essay

Department of Applied Finance and Actuarial Studies Faculty of Business and Economics Unit Guide S1 External Session 1, External 2013 Table of Content Table of Content General Information 2 3 Convenor and teaching staff Credit Points Prerequisites Corequisites Co-badged status Unit Description 3 3 3 3 3 3 Learning Outcomes Assessment Tasks 4 5 Assignments Case Study Quizzes 5 5 6 Unit Schedule Delivery and Resources 7 8 Classes Prizes Required and Recommended Texts and/or Materials Technology Used and Required Unit Web Page Teaching and Learning Strategy Policies and Procedures 8 8. 8 8 8 8 9 Academic Honesty Grades Grading Appeals and Final Examination Script Viewing Special Consideration Policy Student Support UniWISE provides: 9 9 9 9 10 10 Student Enquiry Service Equity Support IT Help 10 10 10 Graduate Capabilities 11 Capable of Professional and Personal Judgement and Initiative Learning Outcome Assessment Task 11 11 11 Problem Solving and Research Capability Learning Outcome Assessment Task 11 11 11 Socially and Environmentally Active and Responsible Learning Outcome 11 11 Discipline Specific Knowledge and Skills 11 Learning Outcome Assessment Task 12 12. Critical, Analytical and Integrative Thinking Assessment Task 12 12 Research and Practice 13 Page 2 of 13 General Information Convenor and teaching staff Unit Convenor: Peter Mordaunt Email: peter. mordaunt@mq. edu. au Consultation Hours: As this course is an online course students can consult with staff through iLearn or through the e-mail addresses above. Students experiencing significant difficulties with any topic in the unit must seek assistance immediately. Other Staff: Sue Wright Email: sue. wright@mq. edu. au Credit Points 2 Prerequisites 45cp Corequisites N/A Co-badged status This unit is not co-badged. Unit Description For details of this unit contact the Faculty of Business and Economics. Page 3 of 13 Learning Outcomes 1. Develop personal financial goals as appropriate to anticipated life stages 2. Construct and maintain a working budget using appropriate financial tools 3. Select appropriate investment instruments to support budget results and achieve financial goals 4. Recognize the features and implications of common financial contracts 5. Compare and contrast different â€Å"employment† structures Page 4 of 13 Assessment Tasks Task Weight Due Date. Linked Learning Outcomes Linked Graduate Capabilities Brief Description Assignments 10% See timetable in iLearn 1, 2, 3 1, 2, 3, 8 Tasks set for students Case Study 50% See timetable in iLearn 2 1, 2, 8 A case study covering material in Modules 1,2 & 3 Quizzes 40% See course timetable in iLearn 3, 4 3 A series of online multiple choice quizzes Assignments Due Date: See timetable in iLearn Weight: 10% Warning This is an online course and therefore it is the student’s responsibility to have available and access to the technology to access the material and to complete the tasks. No exceptions or extensions will be granted because of issues with the student’s technology,the student’s internet provider or the student’s internet connectivity. S ubmission Submission is on-line. Module 1 assignment due by mid-night 11th March 2013. Module 2 assignment due by mid-night 25th March 2013. Extension No extension will be granted. Students who have not submitted their assignment prior to the due date will be awarded a mark of 0 for the assignment, except for cases in which an application for special consideration is made and approved. Penalties See extension. What is required to complete the unit satisfactorily. In order to pass this subject, students m ust pass the case study, which enables them to dem onstrate their accum ulated and integrated understanding of the unit m aterial. If perform ance in the case study does not dem onstrate this level of achievem ent, a passing grade overall can be achieved by higher perform ance in the quizzes and the assignm ents. Case Study Due Date: See timetable in iLearn Weight: 50% Warning This is an online course and therefore it is the student’s responsibility to have available and access to the technology to access the material and to complete the tasks. No exceptions or extensions will be granted because of issues with the student’s technology, the student’s internet provider or the student’s internet connectivity. Submission Subm ission is on-line. C ase Study answer due by m id-night 20th May 2013. Page 5 of 13 Extension No extension will be granted. Students who have not submitted the case study prior to the deadline will be awarded a mark of 0, except for cases in which an application for special consideration is m ade and approved. Penalties See extension What is required to com plete the unit satisfactorily. In order to pass this subject, students m ust pass the case study, which enables them to dem onstrate their accum ulated and integrated understanding of the unit m aterial. If perform ance in the case study does not dem onstrate this level of achievem ent, a passing grade overall can be achieved by higher perform ance in the quizzes and the assignm ents. Quizzes Due Date: See course timetable in iLearn Weight: 40% Warning This is an online course and therefore it is the student’s responsibility to have available and access to the technology to access the material and to complete the tasks. No exceptions or extensions will be granted because of issues with the student’s technology, the student’s internet provider or the student’s internet connectivity. Submission Subm ission is on line. Module 1:Q uiz 1 on the 8th April 2013 Q uiz 2 on the 29th April 2013 Q uiz 3 on the 6th May 2013 Q uiz 4 on the 20th May 2013 Module 4:Q uiz on the 3rd June 2013 Module 5:Q uiz on the 7th June 2013 Extension No extensions will be granted. Students who have not attempted a quiz prior to the deadline will be awarded a mark of 0, except for cases in which an application for specila consideration is m adenand approved. Penalties See extension. What is required to complete the unit satisfactorily? In order to pass this subject, students m ust pass the case study, which enables them to dem onstrate their accum ulated and integrated understanding of the unit m aterial. If perform ance in the case study does not dem onstrate this level of achievem ent, a passing grade overall can be achieved by higher perform ance in the quizzes and the assignm ents. Page 6 of 13 Unit Schedule Modules 1. Goals (anticipated student workload 4 hours) Online presentation of content Online discussion Reading/website reference. Set your own goals Individually written discussion 2. Budgets (anticipated student workload 5 hours) Online presentation of content Your Money – ASIC resource and associated activities Online discussion Complete, explain & submit your own budget 3. Investments (anticipated student workload 50 hours) Basic Principles Interest calculations Tax Overview of Financial Scams Overview of investment options Overview of debt management Overview of Superannuation Asset protection issues Case Study Complete online tests 4. Common Contracts (anticipated student workload 20 hours) Introduction. Overview of common contracts Online Test 5. â€Å"Employment† Structures (anticipated student workload 12 hours) Introduction Overview of common employment structures Online Test Again, please note: it is the student’s responsibility to have available or access to the technology to access the material and to complete the assigned tasks. No exceptions or extensions will be granted because of issues with the students’ technology. Page 7 of 13 Delivery and Resources Classes 5 x online modules delivered via iLearn Prizes There are no prizes for this unit. Required and Recommended Texts and/or Materials. Students will be referred to online resources via iLearn as required for each module. Technology Used and Required Technology used iLearn Microsoft Office Internet Voice boards Technology requirements Access to a computer Access to Microsoft Office Access to the Internet Unit Web Page Course material is available on the learning management system (iLearn). The web page for this unit can be found at www. iLearn. mq. edu. au Teaching and Learning Strategy Students are expected to listen to online lectures and read the material supplied via the Learning Management System. Students are expected to apply the knowledge in answering the various quizzes and assignments. Page 8 of 13 Policies and Procedures Macquarie University policies and procedures are accessible from P olicy Central. Students should be aware of the following policies in particular with regard to Learning and Teaching: Academic Honesty Policy http://www. mq. edu. au/policy/docs/academic_honesty/policy. html Assessment Policy http://www. mq. edu. au/policy/docs/assessment/policy. html Grade Appeal Policy http://www. mq. edu. au/policy/docs/gradeappeal/policy. html Special Consideration Policy http://www. mq. edu. au/policy/docs/special_consideration/policy. html In addition, a number of other policies can be found in the L earning and Teaching Category of Policy Central. Academic Honesty The nature of scholarly endeavour, dependent as it is on the work of others, binds all members of the University community to abide by the principles of academic honesty. Its fundamental principle is that all staff and students act with integrity in the creation, development, application and use of ideas and information. This means that: all academic work claimed as original is the work of the author making the claim all academic collaborations are acknowledged academic work is not falsified in any way when the ideas of others are used, these ideas are acknowledged appropriately. Further information on the academic honesty can be found in the Macquarie University Academic Honesty Policy at http://www. mq. edu. au/policy/docs/academic_honesty/policy. html Grades Macquarie University uses the following grades in coursework units of study: HD – High Distinction D – Distinction. CR – Credit P – Pass F – Fail Grade descriptors and other information concerning grading are contained in the Macquarie University Grading Policy which is available at: http://www. mq. edu. au/policy/docs/grading/policy. html Grading Appeals and Final Examination Script Viewing If, at the conclusion of the unit, you have performed below expectations, and are considering lodging an appeal of grade and/or viewing your final exam script please refer to the following website which provides information about these processes and the cut off dates in the first instance. Please read the instructions provided concerning what constitutes a valid grounds for appeal before appealing your grade. http://www. businessandeconomics. mq. edu. au/new_and_current_students/undergraduate_current_students/how_do_i/grade_appeals/ Special Consideration Policy The University is committed to equity and fairness in all aspects of its learning and teaching. In stating this commitment, the University recognises that there may be circumstances where a student is prevented by unavoidable disruption from performing in accordance with their ability. A special consideration policy exists to support students who experience serious and unavoidable disruption such that they do not reach their usual demonstrated performance level. The policy is available at: http://www. mq. edu. au/policy/docs/special_consideration/policy. html Page 9 of 13 Student Support Macquarie University provides a range of Academic Student Support Services. Details of these services can be accessed at: http://students. mq. edu. au/support/ UniWISE provides: Online learning resources and academic skills workshops http://www. mq. edu. au/learning_skills/ Personal assistance with your learning & study related questions. The Learning Help Desk is located in the Library foyer (level 2). Online and on-campus orientation events run by Mentors@Macquarie. Student Enquiry Service Details of these services can be accessed at http://www. student. mq. edu. au/ses/. Equity Support Students with a disability are encouraged to contact the Disability Support Unit who can provide appropriate help with any issues that arise during their studies. IT Help If you wish to receive IT help, we would be glad to assist you at http://informatics. mq. edu. au/help/. W hen using the university’s IT, you must adhere to the Acceptable Use Policy . The policy applies to all who connect to the MQ network including students and it outlines what can be done. Page 10 of 13 Graduate Capabilities Capable of Professional and Personal Judgement and Initiative We want our graduates to have emotional intelligence and sound interpersonal skills and to demonstrate discernment and common sense in their professional and personal judgement. They will exercise initiative as needed. They will be capable of risk assessment, and be able to handle ambiguity and complexity, enabling them to be adaptable in diverse and changing environments. This graduate capability is supported by: Learning Outcome 1. Develop personal financial goals as appropriate to anticipated life stages 2. Construct and maintain a working budget using appropriate financial tools 3. Recognize the features and implications of common financial contracts Assessment Task 1. Tasks set for students 2. A case study covering material in Modules 1,2 & 3 Problem Solving and Research Capability. Our graduates should be capable of researching; of analysing, and interpreting and assessing data and information in various forms; of drawing connections across fields of knowledge; and they should be able to relate their knowledge to complex situations at work or in the world, in order to diagnose and solve problems. We want them to have the confidence to take the initiative in doing so, within an awareness of their own limitations. This graduate capability is supported by: Learning Outcome 1. Develop personal financial goals as appropriate to anticipated life stages 2. Construct and maintain a working budget using appropriate financial tools 3. Select appropriate investment instruments to support budget results and achieve financial goals Assessment Task 1. Tasks set for students 2. A series of online multiple choice quizzes Socially and Environmentally Active and Responsible We want our graduates to be aware of and have respect for self and others; to be able to work with others as a leader and a team player; to have a sense of connectedness with others and country; and to have a sense of mutual obligation. Our graduates should be informed and active participants in moving society towards sustainability. This graduate capability is supported by: Learning Outcome 1. Select appropriate investment instruments to support budget results and achieve financial goals 2. Recognize the features and implications of common financial contracts Discipline Specific Knowledge and Skills Page 11 of 13 Our graduates will take with them the intellectual development, depth and breadth of knowledge, scholarly understanding, and specific subject content in their chosen fields to make them competent and confident in their subject or profession. They will be able to demonstrate, where relevant, professional technical competence and meet professional standards. They will be able to articulate the structure of knowledge of their discipline, be able to adapt discipline-specific knowledge to novel situations, and be able to contribute from their discipline to inter-disciplinary solutions to problems. This graduate capability is supported by: Learning Outcome 1. Develop personal financial goals as appropriate to anticipated life stages 2. Construct and maintain a working budget using appropriate financial tools 3. Select appropriate investment instruments to support budget results and achieve financial goals 4. Recognize the features and implications of common financial contracts Assessment Task 1. Tasks set for students 2. A case study covering material in Modules 1,2 & 3 Critical, Analytical and Integrative Thinking We want our graduates to be capable of reasoning, questioning and analysing, and to integrate and synthesise learning and knowledge from a range of sources and environments; to be able to critique constraints, assumptions and limitations; to be able to think independently and systemically in relation to scholarly activity, in the workplace, and in the world. We want them to have a level of scientific and information technology literacy. This graduate capability is supported by: Assessment Task 1. Tasks set for students 2. A case study covering material in Modules 1,2 & 3 Page 12 of 13 Research and Practice This unit uses research from external sources. This unit gives you practice in applying research findings in your assignments.