Cultural, compare and contrast Assignment Example | Topics and Well Written Essays - 250 words

Cultural, compare and contrast - Assignment Example If a cost benefit analysis is carried out, then the overpricing of the chocolate products will create great profit for the business. Furthermore, the pleasant environmental conditions will attract more tourists that could come to Melbourne for adventure and would not mind to try out the chocolate products at whatever prices. The cultural differences could be handled through various ways. For instance, both cities could decide to hold exchange programs that could aid in the elimination of cultural differences in the long-term. Lastly, both cities could encourage the standardization of goods and services that could encourage the elimination of cultural differences despite discouraging competition (Tierney, 23). In conclusion, both cities have their own cultural differences and similarities. The similarities could work efficiently in encouraging the chocolate business; however, it is important to handle the cultural differences between the two cities for

Structural Analysis Assignment Example | Topics and Well Written Essays - 1500 words

Structural Analysis - Assignment Example In engineering construction, material’s strength and the cost are the main parameters to be considered when selecting a particular material. Another important aspect in structural engineering the design. Structures should be designed in such a way that no failure occurs in future. For instance, for the I- Section given, there are two possible stresses. Compressive stress and tensional stress. In designing, the least possible stress should be used for safety. From the stress distribution diagram, it can be seen that stress is zero at the beam axis. This therefore, makes an I-Section the best beam for structural engineering. When the beam bends, the top most fiber is in compression while the bottom most fiber is in tension. The stresses are greatest at the top and the bottom fibers. I-section provides the stiffest beam with the least amount of material. This is because it only requires more materials at the bottom and top flanges. The diagram below shows a cross section through an I-section. This shape is used when the load is parallel with the flange. As you can see, the shape is not so good with lateral forces unless you turn it sideways. When the load will come from two directions, a square tube is used.  The section is normally designed so as to minimize materials on. This type of section is better than other sections due to the fact the maximum beam stiffness is achieved with minimum

Two Treatises of Government Essay Example for Free

Two Treatises of Government Essay John Locke was born in 1632 and died in 1704. Locke is among the most in fluential polictical philosophers of the modern period. John Locke argued that the people have rights like the right to life,liberty and property. Locke was one of the founding fathers who were in favor of the right to revolt. The second amendment is opposed by the founders today. The american revolution its self is one of the most persuasive testimony illistrating the right to bear arms. The right of Revolution is the right or duty of the people of a nation to over throw a goverment that acts against their common interests. The concept of the right of revolution was also taken up by John Locke in two treaties of goverment as part of his social contact theory. The first treatise was aimed squarely at the work of another 17th-century political theorist, Sir Robert Filmer, whose Patriarcha (1680, though probably written in the 1630s) defended the theory of divine right of kings. Locke claims that Filmer’s doctrine defies â€Å"common sense. In Lockes Second Treatise on Civil Government Locke implies that all equal human beings will choose to obtain goods that will inevitably lead to conflict. Human beings must be governed by this natural law of morality before entering into a society. Locke proposed a radical conception of political philosophy deduced from the principle of self-ownership and the corollary right to own property, which in turn is based on his famous claim that a man earns ownership over a resource when he mixes his labour with it. Government, he argued, should be limited to securing the life and property of its citizens. John Locke, who writes from the view of a realist, argues that the government is established by a social contract, although they have limited powers, they can be modified by the authority that conferred them. Lockes second Treatise of Government fundamentally places sovereignty into the individuals hands. Locke, argued state of equality rather than war. Locke believed that in order for human beings to protect their property as well as themselves, they must join together and enter into a social contract, developing an executive power with authority. When the governing bodies begin to protect themselves instead of their people, Locke states that the people must resist and revolt, otherwise known as the â€Å"right of rebellion† where individuals should resist AND even attempt to replace the government. . 382 Revolution is no stranger to the united states. American revolution is how our country.

Effectiveness Of Non Medical Nurse Prescribing Primary Care

Effectiveness Of Non Medical Nurse Prescribing Primary Care Nurse-led clinics have been increasing for some time and Marsden (1992) identified the benefits of using specialist nurses to compliment services already offered by doctors. Read (1999) defined nurse-led care as being the interface between nursing and medicine. Miles (2003) cited ten individual authors as saying that research shows that nurses are capable of carrying out procedures usually in the domain of doctors, often resulting in greater patient satisfaction. Patient satisfaction is an important quality indicator. Yellen (2002) felt that the measurement of patient satisfaction with nursing care was particularly important as it provided a good measure of overall satisfaction with services. Ford (1997) agreed with this principle but concentrated more on the competitive edge and financial survival being reflected in patient satisfaction. Cohen (1994) advocated the use of satisfaction questionnaires, but both Avis (1997) and Westbrook (1993) doubted their efficacy, questioning the validity of questionnaires and the way in which they are measured. Westbrook (1993) felt that questionnaires may be limiting and poorly evaluated, giving rise to a poor reputation for satisfaction questionnaires. Duffin (2002) commented that questionnaires with tick boxes appear to have limited use and may include leading questions where there is no scope for the patient to enlarge upon their answers. Both Robson (1993) and Wiles (1996) warned that the results of surveys can sometimes paint a falsely positive picture and may be difficult to translate into a course of action. However, Backhouse (2000) says that the power of a successful nurse-led user satisfaction survey lies in the immediacy and relevance of the results. This may have enormous potential to transform practice, especially if the staff are able to remain positive about any possible negative feedback. Backhouse (2000) commented that nurses may tend to take praise for granted, as a regular stream of cards and thanks is often the only feedback they receive. This may produce the belief that the service is satisfactory, but it has been found that although there is a great deal of satisfaction, there is also some dissatisfaction, particularly with respect to information (McColl (1996), Backhouse (2000), Byrne (2000), Duffin (2002)). As a Business Manager in General Practice in an affluent rural environment, the author has found that there are increasing frustrations and limitations with time and resources where a competent healthcare professional could manage a patients care more than adequately during one appointment. Additionally, continuity of care and health care management in a more patient centred, balanced way could benefit the patient. Discussion around the management of their medicines and general health education could aid to the patient taking responsibility for their own health care management. The Welsh Assembly Government (WAG) (WAG 2001, WAG 2005) has prioritised patient access to primary care services for the last few years which has impacted on patient expectation around the need for an urgent appointment. This has caused pressure on appointment systems, and subsequently changes have been made to deal with the demand. One way in which the practice would like to cope with these demands is by enabling the Senior Practice Nurse to give more holistic care, making the consultation seamless for the patient, thus reducing the need for additional appointments, having already consulted with an appropriate healthcare professional (WAG 2001, WAG 2005). This practice nurse is currently undertaking the Independent Nurse Prescribing (non-medical). When qualified, this will tie in with the nurse-led diabetes clinic and Minor Illness clinics for which she is qualified. The natural progression would be for her to prescribe appropriate medicine or dressings in relation to the competencies she has accumulated following evidence based practice in these disciplines. A nurse may spend a considerable amount of time dealing with the assessment and management of a patient, then waiting outside a GPs door for a prescription to be signed. This situation is far from ideal, and with the enhancement of the prescribing qualification, this could be done in a more appropriate way. This literature review looks at aspects of nurse prescribing in primary care, and how this can lead to patient satisfaction, autonomy and job satisfaction for nurse prescribers. Literature Search Strategy (Method: 10% c350 words) 582 LoBiondo-Wood (2002) describes a literature search as an efficient retrieval of scholarly literature related to the topic of interest, while Cormack (2000) describes a literature search as a review of previously written literature on a related topic in order to provide the researcher and the reader with knowledge of the field being researched. Research literature can originate from many sources. The volume of literature would be unmanageable if careful selection was not carried out (Cormack 2000, LoBiondo 2002). Polit (2004) recommends using electronic databases to locate relevant research information and points out the limitations of manual and internet sources as being time consuming and inconvenient, internet searching possibly not providing required results and bibliographic information. Polit (2004) likens locating all relevant information on the chosen subject to being like detective work. Primary research only was sought. CINAHL Plus (Cumulative Index of Nursing and Allied Health Literature) with Full Text and MEDLINE were used to search for key words non-medical AND nurse prescib AND primary care with published dates between January 2004 to present, resulting in 209 hits. These were restricted to research, years 2004-2010 and English-only articles in order to reduce the number of articles to 29. Playle (2000) suggests that the title of a research article is extremely important and should cover focus as well as identifying the research approach used (McCaughan, 1999 Stevens et al, 1993). In the authors case, an informative abstract facilitates the choice of research article. The abstract or introduction, as Bailey (1991) suggests it should prepare the stage for the problem to be investigated, as well as being brief. As suggested by Playle (2000) a well written abstract identifies the main points of the study, although the main weakness can be the word restriction as suggested by Burns and Grove (2001). It should represent an accurate picture (Reid, 1993) of the study with concise methodology, sample subject, reported findings and conclusion. This would enable any reader to base a decision to read the article (Reid, 1993). The rationale for choosing the critique guidelines from Benton Cormack (2000) is based on the convenience and manageability of a well structured process that enables to author to appraise with ease. A literature review is an important element of a research question. Rees (2003 p. 17) indicates that a thorough review of the literature is essential to provide the theoretical and conceptual context for the study. Parahoo (1997) supports this stating a literature search provides the identification and locating up to date material, relevant to the topic under review. It involves the scanning along with critical reading of the literature chosen to assess usefulness to the question under discussion. The authors knowledge and prior reading of literature directed at change management in primary care dictated the final choice of research articles to Richards, L.A; Richards, A; Gilead, L; Stessman, J; blab la bla and Raz, I (1999) title of an article International Journal of Dermatology 38, 623-627 (appendix 1). Those chosen for review were three qualitiative and one quantitative research articles relating to the question under evaluation. AUTHORS All eleven authors have either the appropriate professional qualifications or academic qualifications, for example MD or PhDs. A further research on the authors names and using databases CINAHL and Medline xx to present showed that between them they have published xxx articles in various medical journals with different topics. Most have no bearing on the subject of maggots and wounds blab la bla, while most of them have some bearingà ¢Ã¢â€š ¬Ã‚ ¦. The review (50% c1750 words) 2168 THE REVIEW (PAULAs) LITERATURE REVIEW A good literature review draws on a wide range of sources (McCaughan, 1999) and will identify the need for research. Nevertheless, A poor literature does not invalidate the findings but a good one does enhance the status of the research (Stevens et al, 1993:135). HYPOTHESIS A hypothesis is not included and an explanation could be that the aim of this study is to provide new information by utilising a descriptive research method. Burns and Grove (2001) suggested that if there is very little or no research being conducted on a particular question, then researchers state objectives or questions and there is an objectiveà ¢Ã¢â€š ¬Ã‚ ¦. OPERATIONAL DEFINITIONS Quantitative research should have all terms explained or defined. Stevens et al (1993) refer to common error by researchers in the assumption that readers are knowledgeable about the jargon and terminologies employed. METHODOLOGY The research approach is not acknowledged within the article. Howedver, it can be assumed that the approach is quantitative, in that it involves manipulation of the independent variable.. On the other hand, to provide the strongest evidence with a greater degree of à ¢Ã¢â€š ¬Ã‚ ¦.. Also included are certain qualitative components such as à ¢Ã¢â€š ¬Ã‚ ¦.. that would indicated possible combination of the two approaches, qualitative and quantitative. Using this combination in approach to research may not appear to be very scientific, however Docherty (2000) suggests that this method may produce a more meaningful and richer data. Even so, there is strength and weakness to both approaches and neither have been stated within this study. On the other handà ¢Ã¢â€š ¬Ã‚ ¦ but backed up with à ¢Ã¢â€š ¬Ã‚ ¦. And the author agreed with this type of approach as it enables a reader to scrutinise the data, without having to be familiar with research methodology, data statistics or the terminology. SUBJECTS The subjects are identified as 43xx in five depts. Of xx hospital à ¢Ã¢â€š ¬Ã‚ ¦. Nevertheless, many potential or suitable candidates for this type of research may be unwilling to participate (burns Grove, 2001 and Reid Boore, 1987) due to the xxxx. SAMPLE SELECTION The approach to the sample selection is not clearly stated and a good research study should explain the sample selection method as suggested by Baxter (2001b). Howeverà ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦ On the other hand, all the subjects are typically,à ¢Ã¢â€š ¬Ã‚ ¦. DATA COLLECTION Data collection procedures areà ¢Ã¢â€š ¬Ã‚ ¦.. not acknowledgedà ¢Ã¢â€š ¬Ã‚ ¦.. The validity and reliability are undefined within this study and McCaughan (1999) suggests that if the researcher has not mentioned testing for reliability and validity then it is unlikely that it has been done. ETHICAL CONSIDERATIONS Xxxxx ethical committee à ¢Ã¢â€š ¬Ã‚ ¦.. In the authors opinion, ethical consideration should have been an important part of this articleà ¢Ã¢â€š ¬Ã‚ ¦.. Nonetheless Appendix 3 shows/à ¢Ã¢â€š ¬Ã‚ ¦.. As suggested by Matthews Venables (1998) every published research report should include a description on how the informed consent is given. On the other hand, lack of acknowledgement of anonymity, confidentiality as well as the description of informed consent does not necessarily mean they have not been considered (Firby, 1995 McCaughan, 1999), merely that the researchers assumed that the results and method were more interesting to the reader. RESULTS The results are presented as xxxxx and backed up by xxx, which showed that xxx. However, quantitative data is limited wtug xxxx. In spite of this, there is sufficient detail that would enable a reader without any research experience to look at the results and understand what they signify and to judge with confidence the findings. DATA ANALYSIS The data analysis is appropriate to the type of data collected that is percentages and for the type of read that xxx was aiming for. In some ways the method employed is simple and easy to replicate. However, thereà ¢Ã¢â€š ¬Ã‚ ¦ Clarke (1999c) suggests that the data analysis relies heacily on the researchers skill and judgement to see that it is accurately exeuted, also not reported are values such as test values df and p. In addition, poor quality analysis will render the data anecdotal and unfocused, yet the analysis is focused, credible and to improve upon this, the author would suggest the inclusion of statistical tables. DISCUSSION The discussion is not really balanced, as it only mentions and draws upon xxxx However, what is discussed is very concise and knowledgeable. There is also no acknowledgement of the limitations or weakness of this particular stify and there is only one reference to disadvantages, THAT IS à ¢Ã¢â€š ¬Ã‚ ¦.. (Teresas) LITERATURE REVIEW The aim of the literature review was to find out what the nurses role is in primary care, in relation to providing xxxxx. To assist in the critiquing process, quantitative and qualitative papers were reviewed using the Benton and Cormack (2000) framework. Although the author finds this framework comprehensive and simplistic, it is noted Rees (2003) states qualitative and quantitative research are extremely different, and same method of critiquing cannot be used. This opinion is not upheld by Benton and Cormack (2000) as they promote the use of one framework for both. Within the articles reviewed the evident themes that emerged are xxx and xxxx. In order to guide the reader to continue reading a paper, the abstract should set the scene for the rest of the report. Playle (2000) states an abstract that is soundly written will list the main points of a study. It is noted three out of the four articles reviewed have concise detailed abstracts. Although, that by xxx (2006) lacked depth, understanding and did note cite up to date government papers to support the topic of xxxx. Burns and Grove (2001) highlight that a potential weakness noted wihin Gibbs et al (2004b) paper was the difficulty the reader encountered at determining whether the paper was quantitative or qualitative. Parahoo (1997) concedes this should have been obtained within the abstract, as this should briefly summarise the method, sampling and main findings within a study. Within the abstracts of the articles reviewed, the researchers have clearly portrayed and accurate image of all study methodologies, reported findings, sample subjects and conclusions. EDUCATION Gibbs et al (2004a) initial quantitative research paper tested one hundred and forty-one general practitioners and sixty-six practice nurse opinions relating to xxxx. Results favourably showed that ninety-seven percent of practice nurses raised xxxx but the article concluded xxxx within primary care and mainly relied upon xxxx. Leading on from this study, Gibbs et al (2004b) carried out a quantitative study involving eight general practices and one thousand five hundred and forty-nine kxdffdsdf. The article reports on xxxx. This quantitative paper involved structured interviews where questions were asked in a planned format. A structured interview involves set questions with no deviation from these (Parahoo 1997). A limitation of the study was the elevated drop-out rate but positively forty percent achieved a five percent or more weight loss at twelve months. It highlights whether the researcher has performed the study in a logical, systematic method, having paid attention to pointers that may influence the accuracy of the results (Rees 2003). Although Burns and Grove (2001) argue that a rigorous study should have exact measurement tools, a representative sample and a tightly controlled design. Audit was conducted in all practices prior to the study, where measurement tools such as weighing scales, height measure and large blood pressure cuffs were assessed. The provided consistency of the tools used at each centre along with evidence of their validity. Validity refers to whether an instrument measures what it stated to be measuring whilst reliability relies upon individuals using the tools and reporting accurate measurments obtained (Carter and Porter 2000). It was noted those practices participating in this study were self-selected, already having an interest in obesity management, thus possibly weakening representations. It was encouraging that a cross-section of those involved included large practices, rural, urban, single handed and those fro low deprivation areas. This appeared to provide a representative population with no evidence of bias selection. The xxxx project was ethically approved by xxxx. In contrast Moore et al (2003) in a cluster randomised control studyxxxxxxxx Cluster randomised trual means the sampling frame are geographically spread or the individual elements of the population are not know (Rees 2003). The advantage of this process is achievement of an accessible sample from an almost impossible total population (Rees 2003). Donnan (2000) states experimental research is the gold standard way of representing in a rigorous style that a treatment or intervention is effective. It concludes it si an essential tool for qualitative evaluation of a studys worth. Greenhalgh (2006) draws attention to the fact that publication of an article does not mean the evidence is robust. In conclusion as found in xxxx. Rees (2003) states bias is anything that distorts or affects a study, potentially altering or influencing the accuracy of the findings. Results noted that xxxx. They conclude more in=depth training of health professionals is needed xxxx. This would involve further implementation of training progrmmes and additional research. Ethical approval was granted by the xxxx ethics committee. The research paper by XX (2007) mixes quantitative and qualitative approaches and is known as triangulation,. Docherty (2000) suggests use of triangulation provides richer, more meaningful data. Holloway and Wheeler (2002) support this method stating it to be a way of obtaining rigour in qualitative research. Rees (2003 p. 235) lists this as being the use of more than one method of data collection within the same study in an attempt to produce more accurate information and understanding. This was a cross-sectional study with questionnaires being completed by forty General Practitioners and forty-seven practice nurses. A limitation to this study was no indication was made of the total number of initial questionnaires sent out in comparison to the response rate. A cross-sectional study is a survey that gazes at a situation at one point in time (Rees 2003). The qualitative results by xx (2005) were not shown within the report and rigour was disputed on reading the research paper as a full conclusion of the findings could not be made. It is realised word restriction could be the main reason for the results being omitted, but unfortunately it leaves the reading having to guess what they might have concluded. Ethical approval was supported by xxxx. In comparison with Gibbs et al (2004b) article the outcomes indicated mirror one another, with both papers coming to the conclusion that opportunties for xxxxxx in primary care are often missed or inadequate time given to education and support. Although the report by xx(2-3) shows xxxx, it was indicated this was in accordance with increasing responsibilities in implementation of chronic disease management. It is highlighted in the report that caution regarding results needs to take place. Also this article, although mainly quantitative, has a small sample size. Parahoo (1997) states quantitative research usually involves large numbers in probability samples. The importance of large numbers aims to lessen the chance of bias and correctly achieve statistical procedures (Rees 2003). A pilot study was not carried out prior to this research. Piloting of a questionnaire increases research validity and reliability as it highlights any anticipated problems accessing data, and ensures the method used to gather data works (Parahoo 1997). Research should be instigated because the researcher wants to extend knowledge base and understanding through rigorous collection of information, answering a question objectively and with accuracy (Rees 2003). SUPPORT Soanso (2009) article is a qualitative study and deals with support and perceptions of the patient who is obese. This is a primary study that reports research findings first hand (Greenhalgh 2006). Rees (2003) states to have involvement in qualitative research and understand a topic, individuals first have to see it through the eyes of those who experience it. This method aims to summarise perceptions, experiences, behaviour or interpretations. This process included a qualitative study with semi-structured interviews drawing on grounded theory methodology. Grounded theory aims to produce a concept or explanation that is grounded in the results and arises inductively by researchers understanding and analysis (Rees 2003). Polit et al (2001) strongly supports interviews stating they by far outweigh questionnaires. The response rate is higher, reaching a wider population than questionnaires, are less likely to mislead those reading the questions and provide wealthier data. Rees (2003) ag rees with the above adding, those involved can experience the belief of being in control and positively feeling more valued. It is noted there are disadvantages such as high cost, participants providing socially acceptable answers, affect of interviewer status and difficultly in expressing feelings (Rees 2003). Five general practices from differing socioeconomic backgrounds in Sheffield were involved with interviews conducted at their homes. This provided a varied population adding rigour to the study, and it could be generally assumed an individual would feel more comfortable being interviewed within their own surroundings. Although, it can be argued that interviewers have less power to control the interview within this environment as there is no assurance that the interviewee will maintain a safe place with no interruption, disturbance or being overheard (Pontin Webb 1995, Webb Pontin 1996). Kdfsdfsfhskdfhsd. Ethical approval was sought prior to this study from xxx Ethics Committee. Application to clinical practice (30% c 1050 words) 1086 APPLICATION TO PRACTICE At present within the authors practice setting issues of xxxx are raised xxxx. Since April 2006 the General Medical Service Contract (National Health Service 2006) awarded points for the xxxx. This critical review of the literature has aimed to answer the question: xxxxxxxxxxxxxxxxxxxxxxxxx? It is well documented that xxxx. Research that has been carried out in an ethical manner and is of robust design can benefit all involved and improve practice (Royal College of Nursing 2004). The document Best Research for Best Health (Department of Health 2006a) states research provides the support and evidence to tackle increasing challenges that disease and ill health have placed on society. This document supports a pilot study within primary care in England to improve evidence based practice of care by facilitating the conduct of clinical trial and other well designed studies. It would hardly be an exaggeration to say, pending successful results in 2014, the use of this structure within primary care in Wales could potentially benefit application of much needed research findings into practice. Findings of this review showed the counterweight project by Gibbs et al (2004a, 2004b) provided the best evidence of implementation within practice, showing xxxx. The Cochrane Library for Sytematic Reviews (2004) supports the Counterweight Project (2004b) stating The Counterweight Programme is an evidence-based weight managmentxxxx Brown Psarou (2007) in their literature review also supported this project stating it was rigorously conducted and soundly funded. Presentation of these research findings were undertaking xxxx. Banning (2005) suggests the management of obesity should focus on xxxx. The National Institue for Clinical Excellence (2001) states that primary care nurses are ideally placed to manage and assess obese individuals. This comprehensive package addresses issues and management of à ¢Ã¢â€š ¬Ã‚ ¦.. The material is simplistic with the alforithm providing an easy guide for the primary care nurse to follow, The à ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦ pathway opportunistically at routine appointments or reviews. To implement this in the clinical setting, xxxx. Successful implementation of this pathway into the practice setting would require change management issues to be addressed. Implementation of change following research can be a difficult process. Resistance, resentment and jealousy can all impede implementation of the change process (Cormack 2000). To overcome resistance to change the key factor is leadership, along with effective communication and a sound understanding of what motivates people (LaMonica 1994). Those involved in the change process must be kept informed and involved at each stage of change. Individuals like equilibrium and are keen to be involved once they know the process will not cause problems or a change of workload (Broome 1998). (Paulas) CONCLUSION A conclusion was included within the abstract, xxxx As suggested by McCaughan (1999) and Playle (2000), there is a restriction placed on researchers and authors by publications to condense from a much larger and more detailed research report. It can be assumed that this is the case with this research article. However, as suggested by Baxter (2001c) that in qualitative research to aid the flow and understandings, discussion and conclusion are kept together under one heading. In the authors opinion, the conclusion should have à ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦ RECOMMENDATIONS Stevens et al (1993) suggests the realistic researcher would draw conclusion from the data presented and then make further recommendations on what other research is required. However, there is no heading of recommendation or any indication that one was included. Alternatively, suggestions for further research studies and in the authors opinion threr should have been a recommendation for future randomised control trial. There is a possibility as suggested by Playle (2000) that the actual research report is more detailed with recommendations, but this may have been lost when condensed for publication. Teresas conclusion In conclusion, this literature review has shown xxxx. To achieve this, implementation of findings along with ongoing research is necessary to sustain the evolving needs of xxxx. It should be noted that a limited number of research articles were used for this review, providing partial evidence. Thus, it is suggested more concrete evidence is needed requiring a further search and review of the literature on xxxx. It would hardly be an exaggeration to say that this review has highlighted the need for further research on the topic of xxxx relating to support and education. It can be said this would potentially emphasise additional studies, which in turn could be applied to practice improving nurse education and support to the obese patient. APPLICATION TO CLINICAL PRACTICE AUTHORS CONCLUSIONS The article on à ¢Ã¢â€š ¬Ã‚ ¦. Appeared to be a concise, informative and innovative piece of research on first perusal. However, what appeared at first glance to be justà ¢Ã¢â€š ¬Ã‚ ¦.. turned out to be more complicated upon closer iinvestigation and mmmmmm. The reader begins to questionà ¢Ã¢â€š ¬Ã‚ ¦ It has a focus and direction, which is to assess the efficacy of maggot therapy and a very concise and informative methodology, which would enable anyone to reproduce a similar type of research. The data collection procedures are not clearly identified, although the simple representation allows it to be easily followed and replicated. This is further confounded by the entwined discussion and conclusion and as suggested by Baxter (2001c) this often occurs with qualitative research. Nevertheless, the reader must balance the evidence presented and sometimes more than one type of evidence (Roberts, 1999) is needed to determine if the interventions is practicable or efficient, as well as ethical and morally sound (Freak, 1995). Another point is the ethical considerations à ¢Ã¢â€š ¬Ã‚ ¦. Ethical significance à ¢Ã¢â€š ¬Ã‚ ¦. An assumption is the researcher focus on the results or alternative the method, as being more interesting or important (Firby, 1995) to the reader. As suggested by various authors including Polit Hungler (1991) all research has limitation and can be imperfect and if this research article has been condensed from a much larger research report, then this critique has been conducted on a published condensed research article and not the actual research report. Therefore, what imperfections or liitations that are identified within this critique, is the ability of the researchers to actually condense their work and the readers have to assume that the researchers have honestly presented their fndings (Firby, 1995). For all the points highlighted like ethical, operational definitions, qualitative/quantitative approach, this is a very good informative research article that allows anyone to replicate the study. AUTHORS RECOMMENDATION The author would like to recommend thatà ¢Ã¢â€š ¬Ã‚ ¦ Furthermore, it à ¢Ã¢â€š ¬Ã‚ ¦. However, as reported by XX, the main disadvantage is,,,, nevertheless, A readonable recommendation in the authors opinion would beà ¢Ã¢â€š ¬Ã‚ ¦, In addition, if there isà ¢Ã¢â€š ¬Ã‚ ¦ INTEGRATING RESEARCH INTO PRACTICE Sdfhsdkfhshdfhdfh to advocate and support the patient. References Avis, M. Bond, M. Arthur, A. (1997). Questioning patient satisfaction: an empirical investigation in two outpatient clinics. Social Science Medicine. 44,1:85-92 Backhouse, S. Brown, Y. (2000). Using a patient satisfaction survey to close the theory-practice gap. Nursing Standard. 14,38:32-35 Byrne, G. Richardson, J. Patel, A. (2000). Patient satisfaction with emergency nurse practitioners in AE. Journal of Clinical Nursing. 9,1:83-93 Cohen, L. Delaney, P. Boston, P. (1994). Listening to the customer: implementing a patient satisfaction measurement system. Gastroenterology Nursing. 17,3:110-115 Cormack, D. (editor) (2000). The Research Process in Nursing. (4th ed). Blackwell Science Ltd. Oxford. Duffin, C. (2002). If youre happy and you know it. Nursing Standard. 16,32:12-13 Ford, R. Bach, S. Fottler, M. (1997). Methods of measuring patient satisfaction in health care organizations. Health Care Management Review. 22,2:74-79 LoBiondo-Wood, G. Haber, J. (2002). Nursing Research, Methods, Critical Appraisal and Utilization. Mosby. Missouri. Marsden, E. (1992). Outpatient nurses must adapt to survive. British Journal of Nursing. 1(7) 356-357 McColl, E. Thomas, L. Bond, S. (1996). A study to determine patient satisfaction with nursing care. Nursing Standard. 10,52:34-38 Miles, K. Penny, N. Power, R. Mercey, D. (2003). Comparing doctor and nurse-led care in a sexual health clinic: patient satisfaction questionnaire. Journal of Advanced Nursing.42 (1), 64-72 Polit, D. Beck, C. Hungler, B. (2004). Essentials of Nursing Research, Methods, Appraisal a

A world of work Essay -- essays research papers

A WORLD OF WORK Outsourcing means that companies hand work they used to perform in-house to outside firms. ADVANTAGES: v  Ã‚  Ã‚  Ã‚  Ã‚  bring down costs à ¨ lift profits and boost growth v  Ã‚  Ã‚  Ã‚  Ã‚  specialisation Due to the advance in technology products have become more complex which made it difficult for one company to do all the work itself. In order to manage the complexity of these products the astute idea of outsourcing represents an ideal solution (e.g. car industry) DISADVANTAGES: v  Ã‚  Ã‚  Ã‚  Ã‚  drain of jobs, v  Ã‚  Ã‚  Ã‚  Ã‚  higher organisational costs à ¨ overview, Some years ago this phenomenon used to be hailed as a wonder of the new economy. Nowadays the opinion is less exuberant. Same forces of globalisation are blamed for relentless export of jobs from rich to poorer countries (depressing proof for the declining competitiveness in engineering skills) GLOBALISATION A network between businesses all over the world is established in order to make use of the strengths of different technologies and cultures. NEGATIVE ASPECTS: v  Ã‚  Ã‚  Ã‚  Ã‚  fierce competition, v  Ã‚  Ã‚  Ã‚  Ã‚  anxiety among people, v  Ã‚  Ã‚  Ã‚  Ã‚  possibilities of expansion for smaller companies are restricted (monopolies) The movement of work abroad agitates worriers in the West and is a cause of concern among the public. Global business work is farmed out to other companie...

Preventing the export of conflict diamonds in the Democratic Republic o

Preventing the export of conflict diamonds in the Democratic Republic of the Congo The Democratic Republic of Congo (DRC) has large reserves of cobalt, gold, gems, copper, timber, and uranium. However, the most valuable resource that the DRC possess is its large reserve of diamonds. Diamonds essentially serve as a pillar to the DRC’s struggling economy. Plagued by civil unrest, the DRC is desperately trying to stabilize its economy. Their efforts have been met with stiff resistance due to the ongoing civil war and illegal diamond trade. Not only is the DRC losing potential revenue from the illegal mining of diamonds, but also these diamonds are being used to finance the rebel armies. In response, the U.N. has drafted several resolutions and imposed sanctions in order to try and curtail the illegal trade. The DRC has also agreed to follow the Kimberley Process in hopes of preventing the export of illegal diamonds. However, these efforts are not enough to stop the trafficking of diamonds. Several steps must be taken to strengthen the Kimberley Process and change government policies within the DRC in order to stabilize the economy and end the civil war. History of conflict in the Congo The DRC’s current unstable government can be attributed mainly to its turbulent history. Since the late 1800’s the Congo region has experienced relatively few periods of peace and economic stability. Colonization severely hindered the future development of the Congo region. In the late 1870’s, King Leopold II of Belgium colonized the Congo territory. Treaties were signed with several tribal rulers in the territory, giving the King Leopold sovereignty in their areas. In 1885, the territory formally became the Congo Free State, he... ...r 22, 2002. Dietrich, Christian. Hard currency: the criminalized diamond economy of the Democratic Republic of the Congo and its neighbours. Ottawa: Partnership Africa Canada, c2002. Muller, Emma. Diamonds Smuggling Through Congo Republic Makes Mockery of Kimberley Process. Polishedprices.com, July 10, 2003. Tamm, Ingrid J. Diamonds in peace and war: severing the conflict-diamond connection. Cambridge, Mass: World Peace Foundation, 2002. U.N. document. Report of the Panel of Experts on the Illegal Exploitations of Natural Resources and Other Forms of Wealth in the Democratic Republic of Congo. www.globalpolicy.org William Wallis. Comment and Analysis: Kimberley Process: Africa's conflict diamonds: is the UN-backed certification scheme failing to bring transparency to the trade?" Financial Times October 29, 2003. www.kimberleyprocess.com

Lebanese Americans

The present paper is designed to show the adaptation of immigrants in the United States. We will include Alison Lambert, who is the representative of the Lebanese nation, was born in Lebanon and moved to the United States country for permanent residence two years ago. The principal issue to clarify in this essay will be whether it was difficult for Mrs. Lambert to assimilate with US culture and people, what differences she has found between two cultures and how different cultural norms influence her living in the new for her country on the daily basis.Immigrants in AmericaA lot of people from different countries come to the United States in search for their good future. There exists a myth that living in the United States is like a paradise, but it is not always so. The presidents of the United States together with other senators promote legislation to confer some kind of guest worker. Many people think that all those bills should not be accepted, because they are immoral. When they invite people from other countries to the United States they show them that they fit only for obsequious jobs that the Americans do not want to do. They think that they are too good for it. When foreigners start working in the United States at first they get miserable payment for the work they do.There is no expectation that you will rise up the economic and social ladder. There are a lot of bills all over the country which regulate rights of the guest worker. There are points when the foreigner can be expelled from the work and deported back to his country where he will continue his life in poverty. The bottom line in all of them is almost the same. It says that the Americans are not equal in their rights with other people who came from other countries to earn money. The plot is hidden but still it exists.America is a country that invites immigrants who arrived there legally and who comply with their laws and Constitution, who understand and can freely speak their language. Such pe ople begin their career with low-paid jobs. But such people have a chance to rise into a middle class and realize their dream. Such countries as Germany and France showed their folly of a guest worker economy. Immigrants do low-paid jobs. But now there are a lot of people in these countries who don’t absorb. People do not agree with the social welfare system. Let’s find out more about the adaptation of the people from Arabic countries in the United States by telling a story about one of the immigrants from Lebanon, Mrs. Lambert.Mrs. Lambert considers family and close people to be the most important in her life.The principal difference in the family values between Lebanese and American culture is that when one is young, one never looks into the future considering oneself outside family. Family appears to be the core of everything they plan to accomplish in life. American society is more independent in relation to family as a notion. Lebanese people share everything they have with their families, and they grow surrounded by their family members. Their cousins, sisters, brothers, with whom they grow, often appear to be their best friends.Each of them knows that he or she is the most important person in his or her life, and she was used to grow in such surrounding. What she has noticed in the United States of America and what is absolutely absent in the Lebanese families, and in Lebanon in particular, is the disease which she would call ‘family’ disease. This is the disease which is very popular among American children. In her society family is something which will never let her and her countrymen down. She was very much assisted by her family members when she has first entered the United States. Now she is not only in constant touch with all her relatives, but all members of her family help each other on the daily basis to the maximal extent.Mrs. Lambert is a teacher; she feels at present that her cultural difference does not prevent he r from effective working with the students and effectively performing in her daily life. Her first and probably, the biggest difficulty was the language. She had basic knowledge of the language, but it was not enough to teach students; and in order to acquire good position she had to learn it very fast. On the other hand, the accent is still very visible when she speaks and some students ask her about her origin. She was lucky not to see any discrimination in relation to her Lebanese identity on the side of her students. However, there are many Lebanese immigrants who also came to the United States to work and suffered from discrimination there.Most of native citizens are surprised on the fact of Lebanese very close family ties. When Mrs. Lambert tells the stories of her life, some of them cannot clearly understand the idea of family being the core of their lives, as well as that one can be so much connected with the family through all his or her life. Her assumption of the family n orms influences her behavior on the daily basis, and it is doubtless; it becomes even more vivid in the light of the norms according to which one lives.When people immigrate they face different difficulties and challenges. The principal challenge for Mrs. Lambert is the difference itself, the difference in cultural norms. She doesn’t think there are disadvantages in her culture. She thinks that every culture has its own advantages and disadvantages. Still, when one comes to another country he or she is a foreigner. The language is the biggest challenge between any two different cultural identities. Mrs. Lambert was faced this challenge and almost coped with it. Yet, she clearly understands that many other cultural challenges are ahead of her.Mrs. Lambert thinks that it is important to assimilate with the culture of the country one now is living in.She supposes that this assimilation is inevitable; however, the extent to which this assimilation should take place with every new comer should be reasonable. Mrs. Lambert’s family was afraid of her losing her identity on entering another country for the permanent residence; and it was probably one of her most important cultural challenges – to adjust to the new cultural surrounding without losing too much of her own cultural traditions. Assimilation with the cultural traditions of the other country often becomes the means of getting stable position and solid basis for human relations.When immigrants come to another country it is significant and highly important to have a source of strength and support there. It is necessary to have something which unite foreigners and help them feel a little bit be home.It may sound surprising, but yet family remains the principal source of support for her in the U.S. This is the peculiarity of her culture – not only is the family the stem of Lebanese identity, but it is also not influenced by the distance. She also gets a lot of support from the local Leb anese community. They have regular meetings during which they discuss urgent problems and issues, and try to find solutions beneficial for everyone. It is very often, that the members of the community ask for assistance in solving cultural problems, not only related to the language, but to the misunderstanding of the people they are surrounded by of their cultural preferences.Cultural identity at times becomes the matter of difficulty in getting assimilated to the new surrounding. Lebanese culture is not very well supported and popularized there, and it is often that Lebanese newcomers appear in cultural vacuum. Thus, this community and regular meetings become the means of supporting those who need this support. Very often people face personal misunderstanding with the native population, and they try to find the way out of the conflict.In the light of all above said, and taking into account the theories of cultural identity, it is possible to note the following. Cultural identity co nflicts are usually called intractable, and thus, they are not possible to be resolved through the traditional approaches. The frames of the individual identity are extremely influenced by the cultural identity and cultural surrounding. The differences in culture often become the ground for the cultural conflict, as the difference in cultural ideas and preferences may be taken by the other side as not simply an outrageous idea, but ridiculous and unreal understanding of the world.For the better cultural communication it may be suggested, that the attitudes towards other cultures should be more tolerate. The cultural ideas and beliefs expressed by the representatives of the other culture should not be taken as unreal or unacceptable. Differences in culture between people will always exist, and thus for the more effective communication it is important to understand and accept the significance of the traditions, which are valued by the other culture, as well as try to better explain th e traditions into which the newcomer would wish to assimilate. However, and what is more important, it is not allowed to break the cultural identity of the person; the difference in cultural views does not mean they are wrong.ConclusionThe issue of cultural identity was always urgent, and with the growing opportunities for migration, this issue will not soon lose the necessity of being discussed. However, it is important to understand one thing in relation to cultural conflicts: the differences between cultures should not and won’t be erased; they should be treated with tolerance. In conclusion It is important to say that it is up to everyone to decide whether to lead a life of immigrant or not. There are a lot of possibilities to have a nice life in one’s own country where one will be respected. Nobody will look at him or her as if he or she is an alien. One’s country is one’s home one must be proud of it. Everyone must do everything possible to make one ’s own country be respected. Escaping from problems at home and going abroad in search for good life and a great number of possibilities to realize oneself is not a way out.Works citedCarrithers, M. Why humans have cultures. Oxford: Oxford University Press. 1992 LeBaron, Michelle. Bridging cultural Conflicts: New Approaches for a Changing World. San Francisco: Jossey-Bass Publishers. 2003 Mathews, G. Global culture/ Individual identity: Searching for home in the cultural supermarket. London: Routledge. 2000 Stone, Douglas F., Patton, Bruce, and Heen, Sheila. Difficult Conversations: How to Discuss What Matters Most New York: Penguin Press. 2000