The, Marx, Engels, And Freud s Views On Society And Inner...

Revolutionist throughout history worked to create radical and persuasive changes in society. They suggested historical transitions from the current way of thought to the next way of thought and attempted to overthrow the established societal norms. A revolutionist’s philosophy is often presented through discussion of their theory in literary works. For example, in the Communist Manifesto, Marx and Engels attempted to modify society according to their discussion of a critique of capitalism. Similarly, Freud attempted to alter the way our society viewed the human mind in his work, An Outline of Psychoanalysis. Together Marx, Engels, and Freud changed the way humans examined the relationship of our place in society but they presented the concepts differently through outward examinations of the society and the inner examinations of self. Freud attempted to examine how our society viewed the human mind by turning society’s attention inward and exploring the mind’s inn er secrets. One of the large discoveries Freud popularized in society was the concept of a conscious and unconscious part of the mind. He believed the unconscious part of the mind was the primary source of human behavior because it comprised unreachable thoughts. This concept was a radical way to understand the mind, and Freud was the first to use psychology instead of sciences, such as biology, to discover where the mind hid its secrets. He believed studying psychology would help humans determine their baseShow MoreRelatedOrganisational Theory230255 Words   |  922 Pagesand provides an advanced introduction to the heterogeneous study of organizations, including chapters on phenomenology, critical theory and psychoanalysis. Like all good textbooks, the book is accessible, well researched and readers are encouraged to view chapters as a starting point for getting to grips with the field of organization theory. Dr Martin Brigham, Lancaster University, UK McAuley et al. provide a hi ghly readable account of ideas, perspectives and practices of organization. By thoroughly

Adhd The Tears, The Troubles - 2306 Words

Conor Crowley 1/15/15 ADHD: The Tears, The Troubles, The Triumphs In Dedication and Apology to Mary Scimone, Trumbull High School, and all it’s Denizens By Conor Francis Crowley ADHD is a very different beast, to be perfectly frank. You may have heard whispers and statements on how it leads to ‘hyperactivity’ and ‘impulsiveness,’ but it goes a little bit beyond an overzealous person. Sometimes, you say words you don’t exactly mean, words that come out of your mouth that you instantly wish to take back and erase. This innate fear is justified, as I have come to fear incarceration for saying the wrong thing. Now you may be well aware of the dos and don’ts of a human’s sentence memory, but for kids with Attention Deficit/Hyperactivity Disorder, the lines can be a bit more blurred. In fact, you could be arrested for â€Å"hate speech,† intentional or not; according to Doctor Barbara and Fletcher, it’s a good 22.5% chance that you could be arrested if you have ADHD. That scary†¦ but even then, there’s a chance. There’s a chance that you don’t even have to worry about it, provi ded you know what to say. There is a chance, and there always will, that you could rise above your disabilities and become something greater; something I strive to do, now that I saw the gravity of my decisions. And before I go onto this long discussion about ADHD, it’s tears, it’s troubles, and it’s triumphs, I’d like to state something. If your name is Mary Scimone, Tony Scimone or Megan Crowley, if you are aShow MoreRelatedKent Roberts Is One Of The Character In The Book By Jonathan1160 Words   |  5 Pages Kent Roberts is one of the character in the book by Jonathan Mooney, who was diagnosed with ADHD. ADHD stands for attention deficit hyperactivity disorder. It is a condition which causes symptoms such as inattentiveness, impulsivity and hyperactivity within individuals. Kent struggles with his ability to conform to the ques of society. As a result, Kent has trouble managing time, being organized, achieving and maintaining goals and keeping a job. Despite his short comings, Kent is extremely giftedRead MoreSensory Processing Disorder ( Spd )997 Words   |  4 PagesTears are streaming down a child’s face as they are throwing a tantrum because their food feels funny as they eat it, and the way their shirt feels is making them fidget. When tried to be comforted by touch it only makes matters worse. The events stated are all common symptoms of those with Sensory Processing Disorder (SPD), through looking at those symptoms a diagnosis can be formed, there are many types of SPD relaying different symptoms. Children with Sensory Processing Disorder can be diagnosedRead MoreMy Experience : My Personal Experience738 Words   |  3 Pagesacademic records, looking at me, or by speaking to me that I have a comorbid neurodevelopmental learning disability. When I was seven years old, I was diagnosed with ADHD without the Hyperactivity and a Sensory Processing Disorder. Essentially, I have considerable difficulty blocking out any and all audio-visual stimuli and trouble with organizing and processing the information I receive from the outside world. My circumstances affect every facet of my life, from academics to athletics and everythingRead MoreEssay On Mental Life994 Words   |  4 Pageswho would be frustrated coming home to a messy house every day after work. My mom was better at hiding her struggles, but I remember times when she would be shaking, and wiping away tears, trying to fool me and my little brother by insisting nothing was wrong. My brother got the worse of it. He was diagnosed with ADHD when I was in fifth grade. The wasn’t a surprise to any of us who had to live with him, but we thought that then we would find a way to fix him and move on with our lives. After fiveRead MoreStrong-Willed Child Book Report Essay example2650 Words   |  11 Pagesrecite to me when I was being â€Å"strong-willed†. Jokingly, I believe it is just a proper way of saying difficult; also known to my mother as stubborn, defiant and full of steam. One story in particular she described me as crying so angrily that my tears came shooting straight out. There may perhaps be some exaggeration there. Fast forward almost 25 years later and I gave birth to my very own little six pound ten ounce â€Å"nightmare†. My mother feels joy knowing I am getting what I gave. Isn’t thatRead MoreDifferent Types Of Special Needs Essay2282 Words   |  10 Pagesongoing uncooperative, defiant, and hostile behaviors toward authority figures that seriously impacts a child s daily functioning. Two of the most common disruptive behavior disorders are Attention-deficit hyperactivity disorder (ADHD) and Oppositional defiant disorder (ODD.) 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It remains important to be aware of what the body shows what it does and the surroundings in the classroom. Memorization is required while learning the new steps. This process can help with ADD and ADHD, as we ll as anyone who wants to improve their memory. Stress relief is the most important benefit of ballet. Ballet portrays as a great way to release stress because when being on stage or in the dance class, it is easy to forget about everything goingRead MoreAbnormal Psychology Terms9960 Words   |  40 Pagesimportant message about ones behavior reflects a biological cause implicated in borderline personality disorder is a child awakens suddenly to the sound of a bell, and heads for the bathroom. most likely the child is receiving a child diagnosed with ADHD displays comorbidity, and receives both stimulant medication and a form of behavior therapy. according to research, the comorbidity is most likely a child diagnosed with Aspergers disorder learns to make choices, and learns that rules are not necessarilyRead MoreDescriptive Information On Bipolar Disorder2423 Words   |  10 Pagesnormal people wouldn t take. Most of the time, people in manic states are unaware of the negative co nsequences of their actions. People having depressive episodes can tend to feel very sad or down, have trouble sleeping at night, feel like they can’t enjoy anything, feel worried or empty, have trouble concentrating, eat too much or too little, or even think about death and suicide. Depression produces a combination of physical and emotional symptoms that takes away a person’s ability to function nearly

Adolescence Essay Example For Students

Adolescence Essay AdolescenceAccording to the dictionary, the word Adolescence is the stage of youth; or maturity. And yet, if you really think about it, that definition merely touches the surface. Adolescence is that part of ones life that he or she will never forget because it plays a big role in the formation of who that person will become. It is quite normal for parents to think they know their children; REALLY know their children. In fact what they know, in most cases, is their childs external behavior. Anything, which doesnt fit into the parents idea of the childs character, is liable to be classified as an unexpected reaction or absurd behavior. To know a child however, one must not judge him by his defects, or his virtues. To do this could lead to the child being classified by the parents in such a way as to make it difficult for them ever to abandon this view. Knowledge of a persons external behavior is a rather superficial kind of knowledge. It could lead parents to think of their child in terms of what he does, rather than what he is. It is not clear what criteria parents follow when the want to classify or describe their child. Often they expect the child to fit into a scheme of adult values without realizing that the world of the adult and that of the child are quite distinct. Children have to be educated to be adults; it is not a matter of trying to turn them into adults when they are still children. And this is where the adolescence stage comes in. In addition to character, age is a relevant factor in the formation of a childs personality. One often hears the remark that a child is young for his age or vice versa. It could be that the only thing that has happened is that the child has taken on the characteristics of another age group. Parents should remember that, in a childs development, there is a whole series of successive stages from birth to maturity. A child in the process of growing up goes through a number of definite phases, each one having a particular physic structure that is reflected in characteristic behavior. Adolescence basically has two stages: Early adolescence (12-15), and the Young adult or Late adolescence (16-18). During the first stage, the child undergoes a series of physiological changes that are in conflict with the previous stage of stability. That is, the toddler stage wherein his/her parents are considered to be the childs best friends. This is when he reaches the height of his physical growth along with the formation of secondary sexual characteristics and the development, later on, of sexual maturity. This occurs earlier is some children than in others, particularly in the case of girls. As a result of emotional developments, feelings and emotions can take pride of place with the result that many children who were good at school begin to get bad results and go downhill in their schoolwork. The young person doesnt fully understand what is happening to him and sometimes acts like a child and at others like a grown up. Consequently he frequently shares his experiences in a gang and with friends of a similar age. The friendship frees the child from the insecurity which he/she feels towards older people, for the child senses that he/she is not what they want him/her to be and whats even worse, is not even what he/she wants to be. Similarly, the child needs in someway to oppose or test the family environment. Sometimes he encloses himself in a kind of dumbness from which it is very difficult to extract him and at other times, he is irritable without apparent cause. This is nothing more than a tendency to assert his personality. .u8de1c77856e3b6f9cd61f05e979d608d , .u8de1c77856e3b6f9cd61f05e979d608d .postImageUrl , .u8de1c77856e3b6f9cd61f05e979d608d .centered-text-area { min-height: 80px; position: relative; } .u8de1c77856e3b6f9cd61f05e979d608d , .u8de1c77856e3b6f9cd61f05e979d608d:hover , .u8de1c77856e3b6f9cd61f05e979d608d:visited , .u8de1c77856e3b6f9cd61f05e979d608d:active { border:0!important; } .u8de1c77856e3b6f9cd61f05e979d608d .clearfix:after { content: ""; display: table; clear: both; } .u8de1c77856e3b6f9cd61f05e979d608d { display: block; transition: background-color 250ms; webkit-transition: background-color 250ms; width: 100%; opacity: 1; transition: opacity 250ms; webkit-transition: opacity 250ms; background-color: #95A5A6; } .u8de1c77856e3b6f9cd61f05e979d608d:active , .u8de1c77856e3b6f9cd61f05e979d608d:hover { opacity: 1; transition: opacity 250ms; webkit-transition: opacity 250ms; background-color: #2C3E50; } .u8de1c77856e3b6f9cd61f05e979d608d .centered-text-area { width: 100%; position: relative ; } .u8de1c77856e3b6f9cd61f05e979d608d .ctaText { border-bottom: 0 solid #fff; color: #2980B9; font-size: 16px; font-weight: bold; margin: 0; padding: 0; text-decoration: underline; } .u8de1c77856e3b6f9cd61f05e979d608d .postTitle { color: #FFFFFF; font-size: 16px; font-weight: 600; margin: 0; padding: 0; width: 100%; } .u8de1c77856e3b6f9cd61f05e979d608d .ctaButton { background-color: #7F8C8D!important; color: #2980B9; border: none; border-radius: 3px; box-shadow: none; font-size: 14px; font-weight: bold; line-height: 26px; moz-border-radius: 3px; text-align: center; text-decoration: none; text-shadow: none; width: 80px; min-height: 80px; background: url(https://artscolumbia.org/wp-content/plugins/intelly-related-posts/assets/images/simple-arrow.png)no-repeat; position: absolute; right: 0; top: 0; } .u8de1c77856e3b6f9cd61f05e979d608d:hover .ctaButton { background-color: #34495E!important; } .u8de1c77856e3b6f9cd61f05e979d608d .centered-text { display: table; height: 80px; padding-left : 18px; top: 0; } .u8de1c77856e3b6f9cd61f05e979d608d .u8de1c77856e3b6f9cd61f05e979d608d-content { display: table-cell; margin: 0; padding: 0; padding-right: 108px; position: relative; vertical-align: middle; width: 100%; } .u8de1c77856e3b6f9cd61f05e979d608d:after { content: ""; display: block; clear: both; } READ: Love and Marriage EssayUnderstanding is the key to the process but it shouldnt be taken to extremes. Sometimes, decisions will have to be made in order to educate and to maintain the correct relationship with the child. He needs his parents even though he doesnt understand them and at times, even opposes them. The second stage is the continuation of the affirmation of the childs ego. The whole world has been a crisis and now has

SBAR Research free essay sample

Background: The Joint Commission International Patient Safety Goal 2 states that effective communication between health care workers needs to improve. The aim of this study was to determine the effect of SBAR (situation, background, assessment, recommendation) on the incidence of serious adverse events (SAE’s) in hospital wards. Method: In 16 hospital wards nurses were trained to use SBAR to communicate with physicians in cases of deteriorating patients. A pre (July 2010 and April 2011) and post (June 2011 and March 2012) intervention study was performed. Patient records were checked for SBAR items up to 48 h before a SAE. A questionnaire was used to measure nurse–physician communication and collaboration. Results: During 37,239 admissions 207 SAE’s occurred and were checked for SBAR items, 425 nurses were questioned. Post intervention all four SBAR elements were notated more frequently in patient records in case of a SAE (from 4% to 35%; p 0. We will write a custom essay sample on SBAR Research or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page 001), total score on the questionnaire increased in nurses (from 58 (range 31–97) to 64 (range 25–97); p 0. 001), the number of unplanned intensive care unit (ICU) admissions increased (from 13. 1/1000 to 14. 8/1000 admissions; relative risk ratio (RRR) = 50%; 95% CI 30–64; p = 0. 001) and unexpected deaths decreased (from 0. 99/1000 to 0. 34/1000 admissions; RRR = ? 227%; 95% CI ? 793 to ? 20; NNT 1656; p 0. 001). There was no difference in the number of cardiac arrest team calls. Conclusion: After introducing SBAR we found increased perception of effective communication and collaboration in nurses, an increase in unplanned ICU admissions and a decrease in unexpected deaths.  © 2013 Elsevier Ireland Ltd. All rights reserved. 1. Introduction The Joint Commission International Patient Safety Goal number 2 (Standard IPSG 2) states that effective communication among health care workers has to improve. According to the Institute of Medicine the six aims in the 21st-century health care system are: safe, effective, patient-centred, timely, ef? cient and equitable. 2 Many potential barriers have been reported in nurse–physician communication such as lack of structure, hierarchy, language, culture, sex and difference in communication style. 3–5 Nurses tend to be more detailed in their communications whereas physicians use more brief statements. 4 In the context of critical events, nurses and ? A Spanish translated version of the abstract of this article appears as Appendix in the ? nal online version at http://dx. doi. org/10. 1016/j. resuscitation. 2013. 03. 016. ? Corresponding author at: Antwerp University Hospital, Wilrijkstraat 10, 2650 Edegem, Belgium. E-mail addresses: koen. [emailprotected] ac. be, koen. de. [emailprotected] be (K. De Meester). 0300-9572/$ – see front matter  © 2013 Elsevier Ireland Ltd. All rights reserved. http://dx. doi. org/10. 1016/j. resuscitation. 2013. 03. 016 physicians often communicate over the phone which makes these communications error-prone. 6 Up to 65% of serious adverse events (SAEs) include communication as a contributing factor. 7 Root cause analysis of SAEs on wards reveals failure in three domains. First, no observations are made for a prolonged period and/or changes in vital signs are not detected. Second, despite the recording of vital signs, clinical deterioration is not recognized and/or no action is taken. Finally, when deterioration is recognized and assistance sought, medical attention is delayed. This delay in receiving medical attention can originate from sub-optimal nurse–physician communication or collaboration. 8 In answer to these three domains of failure, rapid response systems (RRSs) have been widely introduced although they are not supported by a high level of evidence. It remains uncertain which elements of RRSs contribute most to patient outcome but there is growing awareness that the effect depends on the different components such as the ability to detect and interpret deterioration, to communicate clearly and to start the correct response without delay. 10 By implementing a standard observation protocol incorporating the modi? ed early warning score (MEWS), better and accurate patient observation and K. De Meester et al. / Resuscitation 84 (2013) 1192–1196 interpretation of abnormal vital signs was achieved in our hospital. The components â€Å"detection† and â€Å"interpretation† were improved. It remained unclear whether in cases of patient deterioration the nurse–physician communication was clear and provided the best information to optimize collaboration so physicians could respond without delay. Dr. Michael Leonard, physicianleader at Kaizer Permanente in Denver introduced standardised communication with the SBAR (situation, background, assessment, and recommendation) structure to optimize effective communication. 12,13 By using the SBAR tool nurses could be empowered to formulate a recommendation to a physician. This is only possible after formal assessment of the patient and knowing the situation and the background of the patient. We hypothesized that if nurses are better prepared before calling a physician and by structuring the communication, physicians should be better informed and able to prioritise in their work, give the best orders and take the right actions. The aim of this study was to determine the effect of standard SBAR communication in deteriorating patients on the perception of effective communication and collaboration between nurses and physicians and on the incidence of SAEs in adult hospital wards. 2. Method 2. 1. Design, setting and participants We investigated SAEs and conducted a questionnaire for nurses pre and post the introduction of SBAR in the Antwerp University Hospital (AUH). AUH is the tertiary referral hospital of the University of Antwerp and has one campus of 573 beds. AUH provides all medical and surgical specialties but has no beds for chronic or psychiatric hospitalization. In the research period there were 244 beds on nine medical wards including a 10-bed cardiac care unit, 205 beds on seven surgical wards including eight beds for medium care and 45 beds on ? ve intensive care units (ICUs). Of the 16 medical and surgical wards nine have one nurse and seven have two nurses during the night shift. A mobile team of two nurses and one nursing aid support these nurses each night shift. The hospital has a physician-led cardiac arrest team 24 h a day, seven days a week. No additional rapid response team is available. The pre intervention period was 10 months between July 2010 and April 2011, and the post intervention period was 10 months between May 2011 and March 2012. To measure perception of effective nurse–physician communication and collaboration, nurses and physicians were asked to respond to the â€Å"Communication, Collaboration and Critical Thinking Quality Patient Outcomes Survey Tool† (CCCT Tool) questionnaire by Vazirani et al. pre and post intervention. 14 The participants for this questionnaire were all nurses involved in the direct care for patients on medical and surgical wards. The face validity of the Dutch translation of the CCCT Tool was veri? ed by a staff nurse, one director of nursing and two physicians. Consensus on wording was achieved. The translation was then back-translated into English for validation by an academic quali? ed expert. The hospital admission and discharge registration system and the hospital registration for emergency calls were used to detect cases of SAEs. This included all patients older than 16 years without do not attempt resuscitation (DNAR) order who stayed for at least one night on a medical or surgical nursing unit during the study period. Patients with a DNAR code were excluded from the study because the outcome indicator â€Å"unexpected death† was de? ned as â€Å"death without pre-existing DNAR code†. 15 The Ethics Committee of the hospital approved the study (EC Nr 11/43/316) registered in Belgium under number B300201112705. Informed consent for Patients was waived as no therapeutic intervention was scheduled 1193 or in? uenced by the trial. Nurses participating in the questionnaire signed for informed consent. 2. 2. Intervention The intervention was the second step in the introduction of the afferent limb of a RRS. 9 The afferent limb of a RRS has the following components: patient observation, measurement of vital signs, patient assessment, recognition of clinical deterioration, call criteria for triggering a response and a policy to communicate with the health care workers of the efferent limb of the RRS. The ? rst step was introduced on 1 November 2009 and consisted of the Introduction of a standardised nurse observation protocol including the MEWS and a coloured graphical observation chart. 11 The MEWS includes 6 vital signs: heart rate, respiratory rate, oxygen saturation, consciousness (AVPU = alert, voice, pain, and unresponsive), systolic blood pressure and temperature. 16 This second step focused on better communication, collaboration and critical thinking in cases of clinical emergencies on medical and surgical wards. Nurses were educated and instructed to use the SBAR tool for handover communication between nursing shifts and to use SBAR in cases of deteriorating patients when calling a physician. Physicians were not instructed because the aim of this study was to use SBAR only in the communication of nurses calling physicians. First, for each ward one or two reference nurses received a two-day course in SBAR by discussing the problem of communication-related errors and the need for standard communication in clinical emergencies, explaining the use of SBAR and training in using SBAR by roleplay. Second, the other nurses were educated and instructed by the reference nurse of their ward in a 2-h training session. Additionally, a 4-h lesson on early detection, the ABCDE algorithm (airway, breathing, circulation, disability, and exposure), critical thinking and SBAR communication for all nurses was part of the intervention. 17,18 Nurses were instructed to be better prepared before calling for help by taking every step in the early warning process: frequent patient observation and measuring six vital signs at the same time according to the standardised nurse observation protocol, calculation of MEWS, assessing the patient by using the ABCDE algorithm and notating their ?ndings in the patient record according the SBAR structure. No instruction was given about writing down and reading back the verbal orders given by physicians. 2. 3. Main outcome measures 2. 3. 1. The questionnaire The perception of effective communication was measured by the CCCT Tool. 13 Twelve questions were postulated for nurses about physicians. A 4-point Likert scale was used scoring each question in the same direction: â₠¬Å"strongly agree (4 points)†, â€Å"agree (3 points)†, â€Å"disagree (2 points)†, and â€Å"strongly disagree (1 point)†. Three dimensions were deducted: collaboration, communication between nurses and physicians and perception of communication. 2. 3. 2. Cases of a SAE Patient records with identi? ed SAEs were checked by an investigator for a period of 48 h before the SAE for SBAR items according to the SBAR form of the Kaiser Permanente Centre for Health Research (1) to investigate if nurses prepared their communication according to the SBAR protocol, (2) to analyze the type and frequency of vital signs noted in the patient record. SAE’s were de?ned as: unexpected deaths (=deaths without do not attempt resuscitation code), unplanned admission to an ICU and cardiac arrest team calls. 19,20 1194 K. De Meester et al. / Resuscitation 84 (2013) 1192–1196 Table 1 Demographics of â€Å"Communication, Collaboration and Critical Thinking Quality Patient Outcomes Survey Tool† questionnaire participants. Total Nurses Gender (male) Age in years Medical nursing unit Surgical nursing unit Experi ence in years Years in the nursing unit Number % Mean (range) % % Mean (range) Mean (range) Pre intervention period Post intervention period 425 10. 6 40. 0 (21–64) 42. 9 57. 1 15. 4 (0–44) 12. 0 (0–32) 245 9. 1 40. 5 (21–64) 46. 9 53. 1 15. 4 (0–44) 11. 3 (0–32) 180 12. 9 39. 51 (21–63) 37. 3* 62. 7* 15. 4 (0–37) 13. 2 (1–32) p-Values: independent samples t-test, Pearsons’ chi-square, Mann–Whitney U-test not signi? cant. * Pearsons’ chi-square = p 0. 05. 2. 4. Statistical analysis Descriptive analysis of the study population was performed comparing the characteristics of the pre and post intervention population. Independent sample t-test, Pearsons’ chi-square, Fishers’ exact test and Cronbachs alfa were performed. In cases of non-normally distributed continuous variables the non-parametric Mann–Whitney U-test was used. The relative risk ratio (RRR) and number needed to treat (NNT = ((1/ARR) ? 100)) were calculated. For data analysis we used SPSS ® , version 20. 0 (IBM, Chicago, IL, USA) and statistical signi? cance was set at p 0. 05. 21 2. 4. 1. The questionnaire The total score on the CCCT Tool ranges from 12 to 48. We transformed this to a 0–100 scale by using the formula: ((total score ? lowest possible score)/range of total score) ? 100 for clarity reasons. Mean values are reported. The three dimensions were: â€Å"collaboration† (questions 1, 2, 3 and 4), â€Å"overall perception of communication† (questions 5, 6, 7), â€Å"communication between physicians and nurses† (questions 8, 9, 10, 11 and 12). 2. 4. 2. Patient record analysis Wards were divided according to medical and surgical specialty. Length of stay (LOS) was coded in days. The variable SBAR was scored â€Å"1† if all 4 elements of SBAR were found in the patient record and all other possible combinations were scored â€Å"0† as not compliant with the SBAR protocol. 3. Results 3. 1. The questionnaire The questionnaire was completed by 425 nurses. Nurses’ response rate in the pre intervention period was 72% (n = 245) and 53% in the post intervention period (n = 180). For questionnaire participants there were no demographic differences between pre and post intervention group (Table 1). The mean age of the respondents was 40 years, they were mainly female (90%) of Belgian nationality (92%) and worked as a nurse for 15 years. Sixty percent of the nurses had a bachelor degree. Nurses’ total score on the CCCT Tool increased from 58 (range 31–97; Cronbach’s alpha = 0.883) in the pre intervention period to 64 (range 25–97; p 0. 001; Cronbach’s alpha = 0. 843) in the post intervention period. The subscales for nurse–physician communication and for collaboration changed in the same direction (Table 2). 3. 2. Patient record analysis The SBAR items were notated more frequently in patient records from mean 32% in the pre intervention period to 56% (p 0. 005) post intervention. Pre intervention only 4% of the SAE’s all 4 SBAR elements were notated in the patient records and in the post intervention period this increased to 35% (p 0.001). 3. 3. Patient outcome During the research periods with 210,074 inpatient days and 37,239 admissions there were 207 SAE’s of which 81 (4. 4/1000 admissions) in the pre intervention period and 126 (6. 7/1000 admissions) in the post intervention period. Of the patients with SAE’s 35% had a previous ICU episode during the same hospital stay. Compared to the pre intervention period patients with a SAE episode in the post intervention period were younger (from mean 68 to 63 years) and stayed shorter in the hospital (from mean 32 days to 46 days) (Table 3). Patients with SAE episodes were mainly male (54%) and were admitted to medical wards in 73%. In 88% of the SAE’s vital signs were found in the patient record up to 8 h prior to the event. The number of unplanned ICU-transfers increased from 51 (13. 1/1000 admissions) in the pre intervention period to 105 (14. 8/1000 admissions) in the post intervention period (RRR = 50%, 95% CI = 30–64; p = 0. 001). There was no signi? cant difference in Cardiac Arrest Team calls (Table 3). The number of unexpected deaths decreased from 16 (0. 99/1000 admissions) in the pre intervention period to 5 (0.34/1000 admissions) in the post intervention period (RRR = ? 227%, 95% CI = ? 793 to ? 20, NNT 1656; p 0. 001). Table 2 Results of the â€Å"Communication, Collaboration and Critical Thinking Quality Patient Outcomes Survey Tool† questionnaire. Pre intervention N = 245 Nurses Total score (48b ) Subscales Collaboration (16b ) Communication with physician (20b Overall perception of c ommunication (12b ) a b c Cronbach’s alpha for the whole population. Independent samples t-test. Scores corrected to a 0–100 scale. Post intervention N = 18 p 58. 6 (31–97) 63. 9 (25–97)

The Evil in God free essay sample

Carl Jung’s theory explains that archetypes are inherited ideas or modes of thoughts, which are derived from the experience of the person’s race and are present in the subconscious of the individual. It is an idealized and generic model for characters. There’s the hero that has experienced a severe childhood, but is able to work past it all and eventually becomes king. For an example, look at Simba in the Lion King and his journey. While the hero is usually brave and loved (at the end), the villain is described as a power hungry animal, who at the end is either redeemed or killed. For example, look at the ‘Wicked Witch of the West’ and her fall from power. A villain is defined as â€Å"The person or thing responsible for specified trouble, harm, or damage; also has great power and influence†. An archetypal villain wants power at any price, and will stop at nothing to get what he/she desires. We will write a custom essay sample on The Evil in God or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page This is true of many villains, especially one in particular: Adolf Hitler. Hitler had enough power and influences to convince an entire country to turn against an entire ethnic group. He stopped at nothing to achieve his goals, and when one plan didn’t work, he moved onto another one. He was ruthless, and went by his own moral code. He truly believed that what he was doing was the â€Å"right thing†. He is the epitome of an archetypal villain. Do you notice that girl helping up that young man? That’s me, Essowe Telou. I do community service every month at Ronald McDonald’s soup kitchen and am usually seen smiling. I am†¦ your archetypal villain. Granted I doesn’t possess â€Å"scaly green skin, a crooked wart-spotted nose and a slender black hat paired with a classic evil cackle†, but I do contain five characteristics, that is often over looked in villains, which make me your perfect nemesis. I am intelligent, and effective villains are intelligent. That doesn’t mean, per say, that I am intellectually gifted, though I am, but I often avoid making stupid mistakes. I make sure that I am always two steps ahead at all times. In addition to being intelligent, I am also determined. This is what separates the great villains from the â€Å"lesser baddies†. A truly formidable villain is possessed by an unstoppable drive to achieve their goal. Just as nothing could stop Sauron of Mordor from dominating the Middle Earth, nothing will stop me from going to college. Even my own physical and emotional health is only considered a minor setback. Under no circumstances will I ever cease. Furthermore, I am immoral. Of course, I have a sense of what’s wrong and right, but I â€Å"subscribe to my own moral code†. I know that I should stop when my body is aching and my eyes are rimmed with tears but in my eyes, it’s for the best. â€Å"No pain, no gain†. Above all, I am staggeringly powerful. My power lies within the resources that are at my disposal, which include, my teacher, school, and information that I have been given. The only difference between me and a villain: A villain usually fails at the end, but failure isn’t an option for me. I am Essowe Telou, and I am your archetypal villain. We have created a prototype for every character and we are unable to break them, because if we do than they would be unidentifiable in our eyes. The possibility that we might not be able to tell the hero from the villain is ludicrous. How could we not when we have given them set characteristics that they must follow to be considered a hero or a nemesis? In retrospective, I reiterate my opening statement on archetypes â€Å"The archetype is a symbolic formula which always begins to function when there are no conscious ideas present, or when conscious ideas are inhibited for internal or external reasons. † Works Cited The Lion King

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buy custom Passive Smoking essay About 90 % of all lung cancers are caused by tobacco use (Jemal, 2005). Lung cancer risk increases depending on the number of cigarettes that one has smoked and the duration of time when one has been smoking. Doctors tend to define this risk in the form of pack-years of an individuals smoking history. They do this by multiplying the number of packets of cigarettes that one smokes per day by the number of years when one has been smoking. Smoking pipe and cigar can also cause lung cancer, although in this case, the risk is not as high as in cigarette smoking. Tobacco smoke is known to contain about 4,000 chemical compounds, some of which have been proven to be carcinogenic or cancer-causing. The two primary carcinogenic chemicals found in tobacco smoke are polycyclic aromatic hydrocarbons and nitrosamines. When one ceases smoking, the risk of suffering from lung cancer decreases dramatically every yer because damaged cells tend to be replaced by the continually-growing normal lung cells. For former smoker, it takes 15 years for the risk of developing lung cancer to become similar to that of a person who has never smoked. Passive smoking can also cause lung cancer. Non-smokers can become passive smoking by inhaling tobacco smoke produced by smokers. This happens when these non-smokers share working or living quarters with smokers and has become an established risk factor for this type of cancer. According to The American Cancer Society, about 3,000 lung cancer deaths that are reported in the U.S every year are attributed to passive smoking. Lung cancer can also be caused by radon gas, asbestos fibers, familial predisposition, lung diseases and air pollution. When one is exposed to asbestos, asbestos fibers can persist in the lung tissue for a lifetime, especially among individuals who work iin settings where they are exposed to asbestos. Today, use of asbestos for acoustic and thermal insulation is banned or used in limited cases in many countries as a result of the danger of lung cancer that bring to people who work in the asbestos industry. Likewise, exposure to radon gas can increase the risk of getting lung cancer. As for familial predisposition, numerous studies have indicated that lung cancer is likely to occur more among both non-smoking and smoking relatives of people who have suffered from lung cancer compared to the general population. Lung cancer survivors have a higher risk of suffering from the disease for the second time compared to other people. Finally, air population also raises the likelihood of someone suffering from lung cancer according to an observation made by Pope (2002). Experts believe that the lung cancer risk posed by breathing polluted air is similar to the risk caused by passive smoking. Buy custom Passive Smoking essay

Corporate Strategy Essay Example | Topics and Well Written Essays - 250 words - 1

Corporate Strategy - Essay Example supplies from over 1071 factories in 56 countries Furthermore PVH has its headquarters in Manhattan, but has administrative offices in Milan, Trento and Hong Kong as well as operating distribution facilities at locations across the U.S. (PVH Annual Reports, 2008). In regards to the sourcing operations of the firm, according to the Corporate Social Responsibility report, PVH has implemented a ‘Global Human Rights and Social Responsibility Program’ which indicates that the standards for price, quality and logistics are kept on par with the human rights consideration (PVH CSR, 2008). What this means is that the firm self-identifies a global operator and all stakeholders are equally responsible to the firm’s code of conduct. Why PVH is a global firm is important because of the implications is has for the firms strategy. According to the 2008 financial reports more than 30% of the income derived before interest and tax comes from international sales which are up from 25% in 2007. It is the case that the retail sales of PVH is are diverse across the company’s product line, including Calvin Klein brand which has approximately 56% of its sales in international markets to Bass where about 1% of sales are in international markets (PVH,2008). Implicit in this is that different product lines have varying success and strategy in different markets. The question of which value chain activities the company performs in house and which are outsourced is evident from the firm’s financial reports. One specific example is the Calvin Klein brand; wherein the firm maintains a dedicated in-house marketing, advertising and design division. These divisions are responsible for maintaining and controlling the global marketing strategy of the brand and controlling the product development for most of their product licensees. The reasoning behind this strategy is owing to the fact that the firm wants to exert a certain level of control over the entire brand to ensure product and